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Bucharest, Romania

Florescu I.P.,Bagdasar Arseni Emergency Hospital | Jianu S.A.,ProEstetica Medical Center | Chirita D.A.,Domina Sana Medical Center | Bold A.,University of Medicine and Pharmacy of Craiova
Romanian Journal of Morphology and Embryology | Year: 2013

Background and Aims: Nowadays patients want a long-lasting youthful appearance but through a less invasive approach. Our unique approach, "AdipoLASER reJuvenation (ALJ)", involves a variety of less invasive techniques based on simultaneous laser resurfacing, and lipolysis together with adipose tissue graft and redistribution. Recently, we added to this platelet-rich plasma therapy. We conducted a study aiming to emphasize the histopathological changes occurred following these procedures. Patients and Methods:Between 2011-2012, we included 50 patients that were preparing for abdominoplasty (tummy tuck) in which we applied ALJ procedures, in two comparative zones of inferior abdomen. Histological examination varied from 10 days to four months, according to the time of the abdominoplasty. Results: There was a notable histological difference between stimulated and non-stimulated fat graft regarding adipose cells structure and number, neocollagenesis, and dermal matrix remodeling. Conclusions: The low level laser therapy effect (LLLT) of the fractional CO2 laser combined with the effect of the growth factors derived from activated platelets (PRP) prolonged the life and improved the take of the facial fat graft, increase collagen formation and lead to a better remodeling of the dermal matrix. This unique surgical combination of all four approaches in our ALJ with additional PRP offers a real less invasive but strongly visible-yet atural result-as an alternative to the classic facelift. Source

Jianu D.M.,ProEstetica Medical Center | Filipescu M.,ProEstetica Medical Center | Jianu S.A.,ProEstetica Medical Center | Nita A.C.,ProEstetica Medical Center
Laser Therapy | Year: 2012

Background and aims: Patients now want a long-lasting youthful appearance but with a minimally-invasive approach. Our unique approach, "AdipoLASER reJuvenation (ALJ)", involves a variety of minimally-invasive laser- and lipolysis-based techniques, and the present study assessed the impact of this ALJ approach. Subjects and Methods: From 2008 - 2011, we prospectively enrolled 221 patients into the study. 71 of them, underwent the ALJ approach: 2 reductive techniques via microliposuction and laserassisted lipolysis (LAL); and 2 regenerative techniques via autologous fat graft and fractional CO2 laser resurfacing. The remaining 150 patients underwent only 1 or 2 of these techniques. Patients were monitored through 1 to 18 months, clinical photography was taken and histological assessments were performed. Results: ignificantly better and long-lasting results were obtained for the complete ALJ approach regarding all aspects of the face, mandible and neck compared with controls. The combination of the regenerative and the reductive approaches delivered on excellent balance, restoring a youthful, natural appearance to the face. Conclusions: The fractional CO 2 laser has both a photodestructive, or HLLT, effect and an LLLT component in the beam periphery. This LLLT effect possibly prolonged the life and improved the take of the fat grafts, with the well-documented HLLT effect inducing swift collagenesis and better remodeling of the dermal matrix. A natural look in depressed areas was thus restored with the combination of fat redistribution and the HLLT/LLLT effect. Microlipolysis and laser-assisted lipolysis (LAL) could at the same time remove those areas of redundant and prolapsed fat while countering skin laxity, and address both jowl formation and submental flaccidity. The unique combination of all four approaches in our "AdipoLASER reJuvenation" proved to be superior to any other lesser approach in both the long- and short term with very little patient downtime, but did not presentmuch more in terms of treatment time and cost to the patient. We believe that the ALJ approach offers a real minimally-invasive alternative to the classic surgical facelift. © 2012 JMLL, Tokyo, Japan. Source

Jianu D.M.,Carol Davila University of Medicine and Pharmacy | Jianu D.M.,ProEstetica Medical Center | Streinu-Cercel A.,Carol Davila University of Medicine and Pharmacy | Blidaru A.,Carol Davila University of Medicine and Pharmacy | And 9 more authors.
GERMS | Year: 2013

Introduction Recent articles have described an endogenous breast flora, particularly in the nipple ducts, with potential implications in the outcome of aesthetic breast surgery. To characterize the ecology of the breast, we designed a study to assess the microbial species identified on the breast skin and parenchyma in patients undergoing breast surgical interventions. Methods After obtaining informed consent and background data on concurrent diseases, previous contact with the hospital system and prior use of antibiotics, samples are collected preoperatively from three areas of the breast skin, bilaterally: the inframammary fold, the areola and the axilla, prior to decontamination. These samples will serve as positive controls and will aid in characterizing the normal breast skin flora. After preoperative decontamination, samples are again collected, to check for any residual bacterial flora and the nipple is sealed with Tegaderm (3M, USA) and betadine ointment, to reduce any putative bacterial load. Intraoperatively, samples are collected from: a) the incision line (dermal level): 1. superficially, 2. medium depth in the breast parenchyma, 3. deep parenchyma, and b) axillary parenchyma (where possible), together with a bioptic fragment. Postoperatively, a second nipple sample is collected. For secondary breast augmentation surgeries, capsular biopsy is also performed (where relevant), and the implants undergo sonication, to allow biofilm identification. In the laboratory, all samples are cultured on blood agar incubated with CO2, cystine lactose electrolyte deficient medium and Sabouraud gentamicin-chloramphenicol agar. For positive culture samples, the number of colonies and their morphologic characteristics are reported. Identification will be carried out with MALDI-TOF and VITEK (bioMérieux, France), yielding automated antibiotic sensitivity profiles. For all germs with sensitivity profiles differing from the wild-type strain, E-tests will be performed. Follow-up information on the postoperative evolution will be collected and analyzed for potential factors predictive of good evolution. Discussion This study will provide important information about the microflora of the breast skin, its sensitivity profile, and the degree of contamination of the nipple ducts and parenchyma, if any, addressing a scientific hypothesis insufficiently explored so far. © GERMS 2013. Source

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