Wollina Uwe, Goldman Alberto, Berger Uwe, Abdel-Naser Mohammed Badawy
Department of Dermatology and Allergology, Hospital Dresden-Friedrichstadt, Dresden, Germany.
Dermatol Ther. 2008 Mar-Apr;21(2):118-30. doi: 10.1111/j.1529-8019.2008.00179.x.
The field of esthetic and cosmetic dermatology has gained remarkable interest all over the world. The major advantage of recent years is the high scientific levels of the most significant new developments in techniques and pharmacotherapy and other nonsurgical approaches. The present paper reviews selected fields of interest under this view. Sexual hormones are involved in the aging process of men and women. Skin function, in particular the epidermal barrier, is affected by a loss of endocrine activity. Hormone replacement therapy has only recently been introduced in treatment of aging males. This is an area of gender-medicine in dermatology with a strong well-aging attempt. Botulinum toxin therapy for hyperfunctional lines has become not only well-established but evidence-based medicine on its highest level. Recent advantages were gained in objective evaluation and monitoring the effect. Digital imaging techniques with various facets have been introduced to assess the achievements of treatment in the most objective way. This may become an example for other techniques as peeling, laser therapy, or radiofrequency in esthetic and cosmetic dermatology. Botulinum toxin has become a valuable tool for brow lifts. Details of the technique are discussed. Cellulite is a strongly female gender-related condition. During the past decades numerous treatments had been recommended but only recently a more critical scientific approach led to improvements in therapy of this common and disfiguring condition. Three major approaches are developed: (a) skin loosing with techniques such as subcision, (b) skin tightening with radiofrequency and other approaches, and (c) improving circulation in blood and lymphatic microvasculature using both physical treatments and pharmacotherapy. The last two chapters are devoted to body sculpturing by lipotransfer and lipolysis. Lipotransfer for facial or body sculpturing has a history of about 100 years. Nevertheless, recently the role of adult stem cells in adipose tissue has gained much interest. By optimizing the harvesting, storage, and transplantation of adipose tissue, remarkable long-standing results have been obtained. Here the present authors will focus on midface contouring, where lipotransfer competes with dermal fillers. Lipolysis is another effective tool in body sculpturing. The present authors will focus on recent advances in laser-assisted lipolysis for delicate body sculpturing in the submental region but also for gynecomastia abdominal region, flanks, and hips. In conclusion, esthetic and cosmetic dermatology has become a scientific-based subspeciality of dermatology with evidence-based treatments and a great variety of high-tech approaches to provide more effective, more selective, and safer therapeutic options.
美容与皮肤美容学领域在全球范围内引发了显著关注。近年来的主要优势在于技术、药物治疗及其他非手术方法方面最重要的新进展具备较高的科学水平。本文在此视角下回顾了一些热门领域。性激素参与了男性和女性的衰老过程。皮肤功能，尤其是表皮屏障，会因内分泌活动的丧失而受到影响。激素替代疗法直到最近才被引入到老年男性的治疗中。这是皮肤病学中性别医学的一个领域，有着强烈的抗衰尝试。用于治疗功能亢进性皱纹的肉毒毒素疗法不仅已得到广泛应用，而且已成为最高水平的循证医学。近期在客观评估和监测疗效方面取得了进展。已引入具有多个方面的数字成像技术，以最客观的方式评估治疗效果。这可能会成为美容与皮肤美容学中其他技术（如皮肤磨削术、激光治疗或射频治疗）的一个范例。肉毒毒素已成为提眉的一种有价值的工具。文中讨论了该技术的细节。脂肪团是一种与女性性别密切相关的病症。在过去几十年里，人们推荐了众多治疗方法，但直到最近，一种更为严谨的科学方法才使这种常见且有损美观的病症的治疗得到改善。已开发出三种主要方法：（a）采用诸如皮下分离术等技术来松解皮肤，（b）利用射频及其他方法收紧皮肤，以及（c）通过物理治疗和药物治疗来改善血液和淋巴微脉管系统的循环。最后两章专门论述了通过脂肪移植和脂肪分解进行身体塑形。用于面部或身体塑形的脂肪移植已有约100年的历史。然而，近来脂肪组织中成年干细胞的作用引发了广泛关注。通过优化脂肪组织的采集、储存和移植，已取得了显著的长期效果。在此，本文作者将重点关注中面部轮廓塑造，在这方面脂肪移植与真皮填充剂存在竞争。脂肪分解是身体塑形的另一种有效手段。本文作者将重点关注激光辅助脂肪分解在颏下区域精细身体塑形方面的最新进展，以及在男性乳房肥大、腹部、侧腹和臀部塑形方面的进展。总之，美容与皮肤美容学已成为皮肤病学中一门以科学为基础的亚专业，拥有循证治疗方法以及各种各样的高科技手段，以提供更有效、更具选择性且更安全的治疗选择。
