Artigos Científicos

Botulinum toxin type A is widely used in aesthetic and therapeutic medicine and is considered safe. Nonetheless, rare adverse reactions can occur, even in patients with no previous allergic history. The authors report the case of a 50-year-old woman who developed a localized inflammatory reaction characterized by erythema, edema, vesicles, burning, and pruritus following injections in the upper face. A reactivity test with another formulation in the subcutaneous tissue of the arm produced an even more severe response, suggesting greater immune reactivity in subcutaneous tissue compared with muscle. Considering the known differences among commercial formulations, including accessory proteins and stabilizers, the test excluded the hypothesis of an allergy specific to a single brand. Standard therapies with corticosteroids and antibiotics failed to produce improvement, whereas ozone therapy led to significant recovery. This case emphasizes the importance of individualized follow-up and highlights the need for further studies to elucidate the immunopathological mechanisms underlying such rare hypersensitivity reactions.

Nonsurgical rhinoplasty with hyaluronic acid (HA) is minimally invasive but may result in severe vascular complications such as ischemia and necrosis. This case report describes a 30-year-old female patient who developed ischemia and early necrosis of the nasal tip after HA injection. Treatment was initiated approximately 72 hours after the injection, and management included multipoint hyaluronidase, massage and warm compresses, low-level red laser therapy, systemic antibiotic and corticosteroid administration, in addition to hyperbaric oxygen therapy and photodynamic therapy. Regression of ischemia was observed on the first day after treatment initiation, and complete re-epithelialization occurred within 26 days. Early diagnosis and multimodal management centered on hyaluronidase favored ischemia reversal and wound healing, minimizing sequelae.

Regeneration has emerged as a key concept in aesthetic medicine as the field evolves from predominantly volumetric correction toward biologically oriented strategies aimed at improving tissue quality, function, and long-term structural integrity. However, the widespread use of the term “regenerative” has often been used without biological precision, leading to conceptual overlap with repair, remodeling, and biostimulation. A critical evaluation of the biological basis and clinical evidence supporting regenerative claims is needed.

Collagen biostimulators, such as poly-L-lactic acid (PLLA) and calcium hydroxyapatite (CaHA), are widely used in facial esthetic treatments to improve skin quality, restore volume, and stimulate neocollagenesis.

Biocompatible polymers like polylactic acid (PLA) play a prominent role in biomedical applications due to their ability to stimulate collagen production via foreign body reactions (FBR). PLA is recognised for its synthesis from renewable, non-toxic sources and biodegradation into bioabsorbable lactic acid. This review explores the three main PLA isomers – poly-L-lactic acid (PLLA), poly-D-lactic acid (PDLA), and meso poly-D, L-lactic acid (PDLLA) – highlighting their distinct physicochemical properties, such as pH, charge, hydrophilicity, particle size, shape, and surface texture, which are crucial in initiating subclinical inflammation and activating fibroblasts for collagen production. Specifically, PLLA demonstrates superior collagen-stimulating potential with minimal inflammation, while PDLA and PDLLA exhibit variable inflammatory responses and collagen regeneration capacities. By evaluating structure-property-activity relationships (SPAR) among PLA variants, this review provides insights into optimising PLA-based biomaterials for enhanced collagen stimulation, guiding their application in regenerative medicine and aesthetic procedures.

Obesity remains a complex global health issue, necessitating multifaceted treatment approaches. Injectable pharmacotherapies have emerged as effective strategies to manage obesity by targeting metabolic pathways that regulate appetite, energy expenditure, and fat distribution. This review explores the mechanisms, clinical efficacy, and safety profiles of key injectable agents, including GLP-1 and GIP receptor agonists and lipolytic compounds. Additionally, it highlights the aesthetic challenges following significant weight loss, such as skin laxity, and discusses the role of biostimulators and non-invasive technologies in mitigating these effects. Despite the therapeutic promise of injectable agents, their widespread application is hindered by adverse effects, high costs, and accessibility issues. This paper underscores the need for integrative treatment models that combine pharmacological interventions with aesthetic and behavioral therapies to optimize patient outcomes. Future research should focus on refining personalized protocols and expanding the accessibility of these treatments to diverse populations.

Poly-L-lactic acid (PLLA) has become a popular treatment for body skin laxity, especially in female patients; however, research on its use in male patients remains limited, particularly in addressing changes in the gluteal region due to aging. This case report investigates the efficacy of PLLA in treating skin laxity in the gluteal area of three male patients aged 36, 41, and 50 years who were treated at the Antony Barbosa Institute between May 2023 and June 2024. The Male Gluteal Contour Method™: C-Tech Collagen Boost was employed using a C-shaped injection technique with an 18G × 70 mm cannula. Patients underwent four sessions of PLLA injections, reconstituted with bacteriostatic sterile water and lidocaine, at 4–6-week intervals. Improvements in the gluteal contour and skin laxity were noted in all patients, with increased collagen production contributing to enhanced muscle definition and firmness. Minimal side effects such as mild bruising, swelling, and tenderness were reported, and no nodules were observed. This study highlights the importance of tailored treatment plans that cater to the specific needs of middle-age and older men. The C-shaped injection technique allowed for an even distribution of the biostimulator while respecting male anatomy. PLLA is a promising nonsurgical solution for improving male gluteal contour and skin quality, although further research with larger groups is warranted to establish more definitive guidelines for its use in male gluteal augmentation.

The primary objective of this systematic review study was to investigate the effectiveness, durability, and adverse events of PLLA treatment for aesthetic indications. The search strategy was performed in MEDLINE (Ovid). The electronic literature search of five databases was performed, from the inception of the databases until the 12th of February 2024. This was to identify randomized clinical trials that assessed PLLA treatment in adult individuals exhibiting facial aging and/or facial lipoatrophy. Risk of bias was assessed using the Cochrane Risk-of-Bias Tool for Randomized Trials (RoB 2). Eleven RCTs out of 1467 identified citations were included. Four studies showed increased dermal thickness, significant improvement in facial lipoatrophy severity and aesthetic clinical scores, after PLLA treatment with its effects sustained for at least 25 months. Two studies demonstrated the superiority of PLLA over injectable human collagen. Also, three studies showed positive results favoring PLLA when compared with PH gel in lipoatrophy severity, transepidermal water loss, skin quality, elasticity, and patient satisfaction. All adverse events were mild-to-moderate in intensity, and the main ones worth noting were bruising, hematoma, tenderness, nodules, and edema. Five out of eleven studies were considered having high risk of bias. The evidence on the effectiveness and safety of PLLA for facial rejuvenation is of low quality; thus, the reported high effectiveness, safety, and long-lasting effects for this purpose should be further investigated.

Body Harmonization (BHA) is an innovative concept in aesthetics area based on a set of advanced injectable techniques that have shown promising results for body shaping. This is based on procedure combinations indicated to treat body aesthetic dysfunctions, such as localized fat, stretch marks, blemishes, flaccidity, buttocks remodeling, lean mass gain and muscle definition. This study aims to define the clinical concept of BHA, its applications and the main protocols used based on injectable pharmacotherapy. For this purpose, we performed a retrospective review of proven efficient injectable procedures with advanced results for the treatment of body aesthetic disorders, in addition to relying on data obtained from previous clinical experiences. Based on these data, we describe how different compounds can act for treatment of the main body aesthetic dysfunctions, such as lipolytic compounds and collagen biostimulators. In addition, the main application techniques and treatment protocols for each of these dysfunctions were defined. Minimally invasive injectable procedures offer an effective therapeutic option for patients who do not intend to undergo surgical interventions.

The aging process of the face is characterized by transformations in the skin bone and adipose tissue As the understanding of these changes has expanded so too has the range of available filler products in the market To maximize the effectiveness of hyaluronic acid it is crucial to have a comprehensive understanding of its rheological properties The numerous commercially available brands of hyaluronic acid differ in several aspects such as the purity of their raw materials methods of manufacturing concentration of hyaluronic acid presence and level of cross-linking and ability to provide volume and withstand degradation Aiming at the most assertive use of this product features as viscosity complex modulus G elastic modulus G tan d cross-linking concentration and swelling factor must be addressed correlating them with their expected clinical effects

Dietary and nutraceutical supplements based on hydrolyzed collagen are capable of modulating the biomechanical and functional properties of the skin tissue. Hydrolyzed collagen (CH) is a group of low molecular weight (3-6 KDa) peptides that can be obtained through the enzymatic hydrolysis of native collagen derived from animal (commonly bovine, porcine or marine) or vegetable sources. The stimulation of the synthesis of structural elements of the dermis has been proposed as one of the main factors associated with its promising biological effects however, its cellular and molecular mechanisms are still unknown in the literature. Thus, this literature review summarizes the most relevant clinical and experimental scientific studies on the composition, action mechanisms, absorption, bioavailability, effectiveness, toxicity and its therapeutic potential response on dermal aging.

Os bioestimuladores injetáveis são estratégias relevantes de volumização, contorno, suporte estrutural, e restauração da textura e qualidade cutânea. O ácido poli-L-lático (PLLA) é uma das tecnologias mais modernas disponíveis, sendo um produto biocompatível, reabsorvível e imunologicamente inerte. Exerce estímulo a neocolagênese através de uma resposta inflamatória localizada controlada. Dadas as características bioquímicas do PLLA, diferentes estudos descrevem sua eficácia, segurança e eventuais aplicabilidades técnicas. O objetivo do artigo é apresentar uma revisão de literatura sobre o PLLA em tratamentos estéticos, incluindo a composição química, mecanismo de ação, indicação, aplicação, durabilidade e seus potenciais efeitos adversos na harmonização facial e corporal.

Dietary supplementation containing Citrus sinensis extract is being widely used for weight loss due to its anti-adipogenic and antioxidant effects that regulate the metabolism of fatty acids. Bioactive compounds upregulate PPARα in the liver tissue, increasing oxidation of fatty acids and improving insulin sensitivity in addition to decreasing the expression of genes involved in the synthesis of fatty acids, such as LXRα and FAS. Studies on synephrine demonstrated their ability to stimulate the development of beige adipose tissue through greater expression of UCP1 and mtTFA, contributing to an increase in thermogenesis and mitochondrial biogenesis. However, despite its widespread use to reduce abdominal fat, few scientific studies have consensually proven the effectiveness of Moro orange extract for weight loss. This literature review summarizes the current information on the pharmacological and molecular mechanisms involved in the modulation of lipid metabolism by the bioactive compounds present in Moro orange extract.

O descarte de medicamentos por estabelecimentos de saúde, como farmácias e drogarias, em sua maioria, não se encontra embasado em um plano de gerenciamento de resíduos de serviços de saúde. Com isso, o descarte incorreto de resíduos de serviços de saúde por esses estabelecimentos torna-se uma realidade factível e cada vez mais comum de se observar. O presente estudo construído através da realização de uma revisão da literatura denota de um caráter teórico, explicativo e exploratório com abordagem qualitativa a respeito do tema proposto, além de apresentar soluções para os problemas apontados. O artigo aborda, como eixo central, a problemática do descarte incorreto de resíduos em estabelecimentos de saúde, além disso, explica as consequências que o descarte inadequado desses resíduos pode trazer a saúde humana e do meio ambiente, destaca o uso racional de medicamentos e a importância do farmacêutico clínico na estimulação dessa conduta, descreve políticas inovadoras adotadas em países Americanos e Europeus, discute a partir da classificação de cada resíduo de serviço de saúde como deve ser realizada sua destinação adequada, findado seu prazo de utilização, e menciona políticas adotadas por alguns estados brasileiros que apontam para um desenvolvimento sustentável e mitigador de impactos que estes resíduos podem trazer a saúde humana e do meio ambiente. O descarte incorreto de resíduos de estabelecimentos de saúde pode provocar alterações digestivas na saúde humana, como quadros de alteração gastrintestinal, insuficiência hepática e renal, episódios que afetam o sistema nervoso central como: agitação, ansiedade, depressão respiratória, coma. Muitos desses resíduos ao serem descartados de forma incorreta favorecem à resistência bacteriana, mutagênese e carcinogênese. Políticas como logística reversa e campanhas de destinação adequada de resíduos de medicamentos são algumas ações que têm obtido êxito na destinação correta dos resíduos de serviços de saúde no Brasil. O farmacêutico clínico por possuir uma gama de conhecimentos acerca de medicamentos e efeitos adversos tem se tornado um profissional cada vez requisitado nos estabelecimentos de saúde não apenas para garantir um gerenciamento adequado de resíduos de serviços de saúde, como também para estimular o uso racional de medicamentos por parte da população.