ABSTRACT Purpose To evaluate the effect of fractional carbon dioxide (CO2) laser treatment using lower power associated with pulse stacking within collagen fibers, using second harmonic generation microscopy and computerized image analysis. Methods Twenty male Wistar rats aging eight weeks were used. Each treatment area received a single-pass CO2 fractional laser with different parameters. The 20 animals were divided into two groups and euthanized after 30 and 60 days. Second harmonic generation images were obtained and program ImageJ was utilized to evaluate the collagen organization within all areas. Collagen anisotropy, entropy and optical density were quantified. Results Increased anisotropy over time was observed in all four areas, but only reached statistical significance (p = 0.0305) when the mildest parameters were used (area four). Entropy decreased over time in all areas, but without significance(p = 0.1779) in area four. Density showed an overtime increase only in area four, but no statistical significance was reached (p = 0.6534). Conclusions When combined, the results obtained in this study regarding anisotropy, entropy and density tend to demonstrate that it is possible to achieve collagen remodeling with the use of lower power levels associated with stacked pulses.

Abstract Purpose To evaluate whether silicone foam implants have a different evolution pattern compared to conventional texture implants. Methods Fifty-eight female patients underwent surgery. They were divided into two groups (silicone foam – Lifesil® – and microtexturized silicone – Lifesil®). The evolution was analyzed in postoperative consultations, with physical examination, photographic documentation and filling in a satisfaction questionnaire, in the postoperative period of one month, four months, one year and then annually, up to a maximum of 3 years of follow-up. Results There were no statistically significant differences in presence of rippling, stretch marks, breast ptosis, capsular contracture and quality of scars. There was a higher rate of patients who were very satisfied with the outcome 360 days after surgery in the group receiving silicone foam implants (p = 0.036). Conclusion In short time, silicone foam envelope implants proved to be as reliable as textured silicone envelope implants, making them an option for augmentation mammoplasty.

ABSTRACT Introduction: Prominence is the most common deformity of the ear, affecting about 5% of the population. Most reports on otoplasty describe subjective evaluations, and do not provide accurate postoperative assessment or a comparison between techniques. We propose the development and implementation of a specific protocol to evaluate results. Method: A prospective evaluation for a period of one year in patients who underwent bilateral otoplasty was performed, using a technique based on modeling of the cartilage with sutures, and helix-to-mastoid distance measurements at standardized points. Results: A total of 23 patients with an average age of 17.8 years underwent surgery. Reoperation was performed in 21.7% of the patients or 10.7% of the ears. Nearly 45% of the correction obtained at the upper point and 35% at the middle and lower points were lost in patients who did not undergo reoperation. Conclusions: The protocol was easily used and allowed objective evaluation of the preoperative deformity and surgical results. This technique produced results considered adequate and comparable to the literature. Introduction ear 5 population evaluations techniques Method sutures helixtomastoid helix mastoid Results 2 178 17 8 17. surgery 217 21 7 21.7 107 10 10.7 ears 45 35 reoperation Conclusions literature 1 21. 10. 4 3

RESUMO Introdução: A proeminência dos pavilhões auriculares é a forma mais comum de deformidade desta estrutura, afetando em torno de 5% da população. A maioria dos trabalhos acerca da cirurgia de otoplastia apresenta avaliações subjetivas, não permitindo apreciar acuradamente os resultados no pós-operatório, bem como dificultando a comparação entre técnicas. Propõe-se o desenvolvimento e aplicação de protocolo específico para avaliação dos resultados. Método: Avaliação prospectiva pelo período de um ano de pacientes submetidos à otoplastia bilateral utilizando técnica baseada em modelagem cartilaginosa com suturas, utilizando medidas da distância hélice-mastoide em pontos padronizados. Resultados: Foram operados 23 pacientes com idade média de 17,8 anos. A incidência de reoperação foi de 21,7% dos pacientes ou 10,7% das orelhas. Houve perda de cerca de 45% da correção obtida no ponto superior e 35% nos pontos médio e inferior nos pacientes não reoperados. Conclusões: O protocolo foi de fácil utilização e permitiu a avaliação objetiva tanto da deformidade no pré-operatório quanto dos resultados cirúrgicos. A técnica utilizada produziu resultados considerados adequados e comparáveis aos da literatura. Introdução estrutura 5 população subjetivas pósoperatório, pósoperatório pós operatório, operatório pós-operatório técnicas Propõese Propõe se Método suturas hélicemastoide hélice mastoide padronizados Resultados 2 178 17 8 17, anos 217 21 7 21,7 107 10 10,7 orelhas 45 35 reoperados Conclusões préoperatório pré cirúrgicos literatura 1 21, 10, 4 3

PURPOSE : To evaluate the effect of different energies and stacking in skin shrinkage. METHODS : Three decreasing settings of a fractional CO2 laser were applied to the abdomen of Twenty five Wistar rats divided into three groups. Group I (n=5) was histologically evaluated for microthermal zones dimensions. Groups II and III (n=10 each) were macroscopic evaluated with freeware ImageJ for area contraction immediately and after 30 and 60 days. RESULTS : No statistical significance was found within microthermal zone histological dimensions (Group I) in all settings studied. (Ablation depth: 76.90 to 97.18µm; Coagulation depth: 186.01 to 219.84 µm). In Group II, macroscopic evaluation showed that all settings cause significant immediate skin contraction. The highest setting cause significant more intense tightening effect initially, contracting skin area from 258.65 to 179.09 mm2. The same pattern was observed in Group III. At 30 and 60 days, the lowest setting significantly sustained contraction. CONCLUSION : Lower fractional CO2 laser energies associated to pulse stacking could cause consistent and long lasting tissue contraction in rats.