Download Rhytidectomy

DRA. ANGIE OBLITAS
OTOLARYNGOLOGY
Ear. Nose. Throat
Face Surgery
Antiaging Treatment
mi. Otorrino
MEDICINE
OF
CENTRO DL
REJUVENATION
1
STEM CELL THERAPY
Antiaging Therapy
Facial Aesthetic Proccedures
2
3
ANTI-AGING THERAPY
The United Statesand European population
is growing older and otolaryngologists will
need to be prepared to take care of the
elderly patient.
 During the 20th century the number of persons in the U.S.
under age 65 has tripled while the number of persons over
65 has increased eleven times!
 According to the 1994 U.S. Census, 1 in 8 Americans was
elderly. The Census Bureau’s middle projections estimate
that the elderly population will be more than double by the
year 2050 and that 1 in 5 Americans will be elderly. The
persons of 85 and over are the fastest growing group.
4
 Elderly patients are
estimated to have 3.5
times more medical
problems than those
under age 65. These
patients are also likely to
be on multiple
medications and have
an increased sensitivity
to side effects of those
medications
 Some of the common otolaryngology related
complaints are hearing loss, dysphagia, balance
disorders, nasal complaints, vocal disturbance,
head and neck cancers, and cosmetic problems.
5
 The age-related decline in auditory function is one
of the most common complaints in elderly patients.
This decline in function is from cellular aging as well
as multiple other factors including noise exposure,
toxin exposure, nutrition, metabolism, genetic
factors, smoking, and cardiovascular disease.
 Approximately 60% of people over age 65 have at
least a mild to moderate hearing loss. It has been
estimated that 30% have a hearing loss that
adversely affects their receptive communication
ability.
6
 Dysphagia or the difficult for swallowing is another
common problem in the geriatric population.
 But in this age group malignancy must also be
ruled out. The many causes of dysphagia include
stroke, neuromuscular disease, medications,
diverticular problemas.
 There is reduced facial muscle strength,
decreased masticatory strength, reduced tongue
control, and missing dentition/poor denture.
7
 Vestibular or Equilibrium problems (vertigo) are one of
the principal causes of balance disorders in this age
group.
 Other
factors
include
cerebrovascular
disease,
cerebellar
degeneration,
Parkinson’s
disease,
Huntington’s disease, vitamin B12 deficiency, dementia,
diabetic neuropathy, brain and spinal cord tumors,
postural hypotension, atherosclerosis, muculoskeletal
metabolic and cardiovascular disorders, medications,
and visual impairment.
8
 Common nasal complaints among geriatric patients are
nasal obstruction, secretion, nose bleeding and olfactory
dysfunction.
 Factors that can lead to increased nasal inflammation
include a decrease in immune function, mucociliary
dysfunction, allergies, dehydration, and thickened nasal
secretions.
 Atrophy of the nasal mucosa and Nasal tumors can
present with nasal obstruction, pain, epistaxis, or mucus
secretion.
9
 Geriatric patients are leading longer lives with a
much greater period of health and activity than
in past decades.
 Along with the growth of the elderly population
there is an explosive growth in cosmetic surgery.
This group of patients will increasingly demand
cosmetic procedures to provide a more youthful
appearance.
10
 Many changes occur in the face and neck with age. In the
skin, there is loss of tone, dynamic and static wrinkling,
pigmentary changes, and gravitational descent of the skin
and underlying soft tissues.
 Cosmetic procedures to address these changes include
chemical peels, laser skin, roller with stem cells, facial fillers,
Botox injection, rhytidectomy, elevation of eyebrows,
periorbital changes, blepharoplasty.
 Rinoplasty with management of the nose tip
¿?
Can the clock pointers be
delayed?
Can the natural process be
reverted?
Can we be YOUNGER?
How can you make the time stop?
11
12
What options do we have?
STEM
CELLS
13
Welcome to Vitacell Laboratory
Vitacell Laboratory is located in Lucern
Switzerland. They are pioneers in cellular
therapies, products elaborated with the best
quality and with the control of the European
Comunity.
First and only distrubutor in Puerto Vallarta
 FDA APPROVEDREGISTER # 16294010804
14
 At the beginning of the new millennium, there are
no limits for the quality of life, our mission is to timely
attack deficiencies and degenerative illnesses.
 We introduce Vitacell Laboratory from Switzerland
to all the persons that see the future of medicine in
the alternative cellular and natural treatments.
 The best results are visible for the patients as well as
for the doctors that successfully recommend and
apply this products.
15
 Vitacell Laboratory is a company
dedicated to the research of the Medical
and Biological Sciences and the
production of a high technology line that
includes the latest advances in Enzymecatalytic and Molecule-hormonal Therapy
as well as Cellular Therapies.
 In Switzerland and Europe
since 1965
 In Mexico since 2000
 By our medical group since
2010
16
 Vitacell Laboratory is conformed by
a group of Medical Doctors, Biologists
and Biochemists that began
professional activity in organizations
of great prestige in the '70s, and who
got together to start the Institute of
Biological Research.
 We have the products of this
laboratory being distributed in Mexico
since the last two years and now they
are finally arriving for the first time to
Puerto Vallarta.
All these scientists worked and
researched under a common
denominator in the Medicalbiological area: to study the
deterioration process of a cell,
a tissue, an organ and
approach it in order to
prevent it."
As these studies were
advancing the need to
produce elements to respond
to the signs of physical
deterioration was clear.
17
18
 These experiences and knowledge have
been reflected in a technological
innovation that represents an invaluable
medical resource and that will contribute
to the maintenance of health, in its
preventive phase; to the cure of illnesses,
in its healing phase; and to slow down
the ageing and prolong youth in the
regenerative phase.
19
 Under these
concepts, Vitacell
Laboratory develops
the latest in
Renewing and
Revitalizing
treatments that have
ended up being a
Swiss tradition of
world-wide prestige.
20
STEM CELLS
 Cellular therapy -- also called live cell therapy, cellular
suspensions, glandular therapy, fresh cell therapy,
embryonic cell therapy, and organotherapy -- refers to
various procedures in which processed tissue from
animal embryos, fetuses or organs, is injected .
 Products are obtained from specific organs or tissues
said to correspond with the unhealthy organs or tissues
of the recipient
21
 Proponents claim that the recipient's body automatically
transports the injected cells to the target organs, where they
supposedly strengthen them and regenerate their structure.
 HUMAN VS ANIMAL STEM CELLS ?
 The organs and glands used in cell treatment include brain,
pituitary, thyroid, adrenals, thymus, liver, kidney, pancreas,
spleen, heart, ovary, testis, and parotid.
22
 The first recorded attempt at
cellular therapy occurred in
1912 when German physicians
attempted to treat
hypothyroid children with
thyroid cells . Cellular therapy,
as practiced today, was
developed in the early 1930s
by Paul Niehans, MD (18821971), a Swiss physician who
became known as "the father
of cell therapy.
23
 It soon became popular with celebrities
as a means of rejuvenation. A 1990
article in In Health magazine described
Niehans as a "public relations genius"
and stated that the " Clinique La Prairie,
which he had founded in ClarensMontreaux, Switzerland, had attracted
65,000 patients . Its current (1999) oneweek "revitalization program" costs
about $10,000.
24
The cellular therapy
started on 1954.
Important people As the
Pope Pio XII, Charles de
Gaulle, Winston Churchil,
Dukes of Windsor,
Charles Chaplin, Prince
of Monaco, Tina Turner,
have used this therapy.
25
 Synergistic combination of Swiss origin that prevents premature
aging and corrects the signs of aging.
 Significant development of this treatment is the revitalization
and renewal.Complex injection bioestimulants powerfull
animal fetal tissue and amino acids that promote the
production again of your own human growth hormone (HCH),
which can reverse the damage caused by aging and improve
the general wellbeing
 Therefore V-Humacell is considered the as the “vaccine of
youth". We recommend treatments annual V-Humacell from
35 years of age, with no side effects and no medical
contraindications.
26
 The "youth hormone", promotes the production of testosterone
or estrogen, depending on the sex of the user.
 It also offers strong antioxidant protection and induces a state
of general wellbeing. The clinical experience that this research
has yielded support the combined use stem cells with other
medications, since this action demonstrates adjuvant and
boosting preventative efficacy.
 Has been clinically tested and shows no interaction with other
treatments or medications. Produces a complete regeneration
of body cells.
27
 Complex of Placenta and
Umbilical
cord
Are
recommended to strengthen,
regenerate and revitalize the
body, helping to better perform
their
functions,
including:
Significantly improve the quality
of the skin with collagen and
elastin
deficiency
Improve
aging Boosts the immune
system to be a rich source of
stem cells.
28
 The cells found in cord and placenta are
unspecialized cells which generate the
remaining blood cells, including platelets,
clotting, and white blood cells. Like bone
marrow damaged by decreasing the
likelihood of rejection. Important to use in
any condition that affects the blood cancers
like leukemia and certain helpful to treat
AIDS, anemia.
29
30
31
32
33
Procedimientos realizados en la
estética y rejuvenecimiento facial:
 Blefaroplastia
 Dermoabrasión con roller
 Rinoplastia
 Otoplastia
 Reseccion de bolsas de Bichat:
 Implante malar
 Mentoplastia
 Inyección de materiales como botox, rellenos faciales
como el ácido hialurónico, surgiderm y restylane.
Rhytidectomy
 Few early historical
details
 Early 20th century:
Germans/French
 Techniques guarded
 Pre-antibiotic era– low
profile
 1976: SMAS (superfical
musculo-aponeurotic
system) coined by Paul
Tessier and anatomic
relations described by
Mitz/Peyronie
35
36
Pathophsiology of the Aging
Face
 Facial aging characteristics
 Gravitational migration of tissues
 Skin
 Subcutaneous fat
 Superficial fascia
 Increasing prominence of NLFs
 Downward-drooping jowls
 Laxity of submental and anterior neck tissues
Pathophsiology of the Aging Face
 Vectors of tissue migration
 Cheek and lower face
 Platysma
 Produces jowls and laxity in
the submental and anterior
neck regions
 5 fat collections (Hoefflin,
1998)





Malar
Nasolabial
Jowl
Buccal
Submental
37
SMAS
Platysma
 Origin: clavicles and 1st
rib
 Insertion: blends with
the SMAS and lip
depressors
38
39
The Consultation
 History
 Find patient desires/motivations
 SAFE
 Self-image
 Anxiety
 Fear
 Expectations
 Don’t operate if you don’t feel positive
 Compliance
40
Clinical Evaluation
 History
 Relevant medical history
 DM, tobacco use, CVD, psychiatric problems,
steroid use, HTN, prior surgeries/scarring
 Salivary or serum cotinine levels
 Medicine use: ASA/NSAIDs, steroids, vitamin E, OTC
herbal supplements (gingko biloba)
41
Clinical Evaluation
42
43
Clinical Evaluation
 Less than ideal candidates
 Discuss expectations in
detail
 Need for other
procedures
 Ideal patient
 Elastic skin
 Distinct bony landmarks
 High cheek bones
 Strong jaw line
 Little SQ fat
 Good bone structure
 Hyoid position
Ideal Face Lift Candidate
1. Lax skin
2. High cheek bones
3. Strong jaw line
4. High hyoid position
and minimal fat
44
Clinical Evaluation
 Adjunctive
Techniques
 Stem Stells- Youth
Vaccine
 Botox
 Laser peel
 Dermabrasion
 Chemical peel
 Neck treatment
 Implants
 Blepharoplasty
 Brow/forehead lift
 Midface lift
 Rhinoplasty
45
46
47
48
49
Nasolabial Fold
50
Face lifting does not treat the skin
 Consider
 Skin resurfacing
 Debate as to timing of treatment w/ respect
to the face lift




peeling
Preconditioned skin with Vit A/glycolic acid 6-8wks
Nonsmokers
Antivirals
51
Rhytidectomy with Stem Cell resurfacing and
Humacell Vaccine
52
53
What options do we have?
STEM
CELLS
54
Dra. Angie Oblitas Alcazar
 OTORRINOLARINGOLOGIA Y CIRUGIA DE CABEZA
Y CUELLO
 Univ. Autónoma de Guadalajara. Centro Medico
Nacional de Occidente.
 Certificate by the Mexican Board of
Otolaryngology, Ear, Nose, Throat Surgery
 TELF. 226 20 888 - 322 1505671
 Hospital Amerimed Puerto Vallarta
 Clinica Santa Rosa. Bucerias.
 [email protected]