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Body Treatments

Aesthetic and Functional Gynecology

ginecologia2

The results of Aesthetic and Functional Gynecology can improve women's sexual life and  provide a younger or more pleasant appearance to the genitals. Aesthetic and Functional Gynecology, therefore, enhances the quality of life for women by restoring the functionality of the genital area through innovative techniques, addressing aesthetics, and repairing any damage caused by childbirth or menopause.
A service for Aesthetic and Functional Gynecology is available to promote women's intimate well-being throughout various stages of life.

The therapeutic goal is to restore the functions of the female genital organ, which can be altered by:
Aging: Associated with hormonal changes during menopause, leading to loss of hydration, elasticity, and trophism of the mucous membranes, resulting in difficulties during sexual intercourse, and in advanced cases, impossibility.
Congenital pathological conditions: Morphological abnormalities (shape, size, or symmetry) of the labia minora or majora, Mons pubis, or the vagina.
Acquired conditions: Such as lichen sclerosus or vaginal dryness following oncological therapies.
Traumatic events: Scarring from episiotomy or lacerations after vaginal childbirth.

The aesthetics and functionality of the vulvo-vaginal area are closely related: a disturbance in one area inevitably affects the other. Today, preventive measures and modern technology help improve tissue quality and/or change its appearance, granting women a state of psycho-sexual well-being that extends well beyond menopause, even into old age.

Intimate issues and solutions

Vulvo-vaginal atrophy: it manifests with a series of symptoms related to climacteric, menopause, and post-menopausal age. These symptoms include dryness, vulvo-vaginal itching, painful or impossible sexual intercourse (dyspareunia), urinary incontinence. Today, we use pharmaceutical products that can also be used by women at potential risk of breast cancer, formulations of injectable hyaluronic acid of the new generation specific for the vulva and vagina, Platelet-Rich Plasma (PRP), botulinum toxin, endovaginal lasers for the restoration of normal vaginal and vulvar secretion and lubrication.

Congenital and acquired dysmorphias: excessively developed small labia that can cause friction-related issues and discomfort or embarrassment when wearing certain clothing, or due to aging, which results in the loss of turgidity of the large labia, accentuation of the hypertrophy of the small labia and their hyperpigmentation, and adiposity of the mons pubis. These issues can be corrected with outpatient or surgical procedures that can also be performed under local anesthesia.

Lichen sclerosus atrophicus: they can benefit from treatments with Platelet-Rich Plasma (PRP) or customized laser treatments.

Therapeutic strategies that can be implemented include:

Vulvo-vaginal atrophy and mild urinary incontinence
Laser

Pain during sexual intercourse (Dispareunia)
Botulinum Toxin/Laser/Radiofrequency

Atrohpy and aging of the labia majora
Filler

Aging of the vulvar area and vaginal dryness
Biostimulation

Aging of the vulvar area and vaginal dryness
Lipofilling

Lichen sclerosus et atrophicus
PRP

Aging in the vulvar area
Carboxytherapy

Vaginal Dryness - Vaginal pH Changes
Targeted dermocosmetics

Laser Treatment for Tattoo Removal

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The Q-switched laser allows for the removal of most tattoos, essentially eliminating the risk of leaving scars. In our center, we use equipment designed to produce multiple wavelengths to remove most tattoo pigments, including blue, black, red, green, and more. Tattoos in blue, black, red, orange, and purple are removed more quickly than yellow and green, but consecutive sessions can lead to the complete destruction and erasure of the pigment.
The laser releases a high-intensity burst of energy in very short times to avoid causing damage to the skin, destroying most of the ink present. The absorption of this light energy by the pigment results in the destruction of the tattoo and the formation of micro-fragments of colored pigment, which are eliminated by the body. The impact of the light energy on the skin is similar to the snap of a rubber band.
On average, it takes about 5/6 treatments to remove a "professional" tattoo, while "amateur" tattoos may require 3/4 sessions, spaced about a month apart. The number of sessions depends on the quantity and type of ink used, as well as its depth in the skin.
The painful sensation during the treatment is moderate and generally well-tolerated. After the treatment, it's common to experience a burning sensation that can last for a few hours. The duration of the procedure is 5-10 minutes.

Following the treatment, it will be necessary to apply an antibacterial ointment dressing, which should be repeated for 3/4 days until complete healing. Typically, there is pinpoint bleeding, and a crust may appear, which usually disappears in 7-9 days and is accompanied by slight redness (erythema). Several variables affect the duration of erythema, including individual reactivity, the treated area and its size, skin color, the location, and the depth reached by the laser beam. Soothing creams can be applied to alleviate this discomfort. The treated area can be moistened, but it is strongly advised not to rub the area. The application of protective sunscreen is essential.

In addition to the immediate undesired local effects mentioned above, the following conditions can occur: changes in skin pigmentation (light or dark spots), small skin burns.

Treatment with the Q-Switch laser is contraindicated in individuals with a history of hypertrophic or keloid scars and in those taking photosensitizing medications.

Unfortunately, in some cases, the results of tattoo removal with laser technology may be only temporary. The success of tattoo removal with laser therapy depends on various factors such as tattoo color, pigmentation techniques used, location, chronological factors, etc. To date, international research and clinical evidence suggest that laser therapy is safe, but there is no guarantee that the treatment will completely eliminate the lesion or aesthetic concern being treated. Each case should be evaluated individually, and the final result may vary.  

Radio frequency

glutei

What is radio frequency?

It is a minimally invasive method for treating skin aging and sagging of the face and body, providing a more "youthful and refreshed" appearance without ablating the skin or using injections. Electromagnetic energy produced by specialized electromedical devices penetrates the dermis and reaches the superficial muscle layer. As it passes through the tissues, it encounters resistance, which is converted into thermal energy capable of inducing skin restructuring.

At the temperature achieved in the deep dermis, collagen denatures, and its molecules rearrange, becoming shorter and thicker. Additionally, there is an increase in protein synthesis in fibroblasts, resulting in collagen production and an increase in the number and thickness of elastic fibers. All of this occurs safely without causing thermal damage or tissue necrosis.

What are the main indications for radio frequency in aesthetic medicine?

The primary indication for radiofrequency treatment is addressing skin laxity on both the face and body. Radiofrequency enhances the appearance of aged skin and epidermal texture, resulting in firmer tissues and reduced skin laxity. The induced vasoactive processes also positively affect skin complexion. The ultimate outcome is increased dermal thickness and a lifting effect, leading to a more toned appearance of the face and body.
Radiofrequency is also recommended for the treatment of acne, serving as a supportive therapy to promote the healing processes of pustules and improve the appearance of scars, primarily due to the stimulation of fibroblasts through its thermal action.

How is radio frequency done?

The therapy involves moving a handpiece over the skin's surface. Various areas can be treated, including the face, neck, décolleté, arms, inner and outer thighs, buttocks, and abdomen.

The treatment is not painful; in fact, it often produces a pleasant sensation of warmth. Transient erythema (redness) may occur, and in exceptional cases, there may be first-degree burns, which are typically localized and quickly resolve, leaving the skin's surface entirely normal. Sun and UV lamp exposure is not recommended immediately after the treatment.

The therapeutic protocol varies depending on the equipment used. Initial effects on skin restructuring can be seen on the face after just a few sessions, and this improvement continues for about a year. In other areas, results may be achieved more slowly. After completing the treatment cycle, it's essential to plan maintenance sessions.

The outcome of the treatment cannot be predicted in advance because it depends on the patient's clinical response and individual starting conditions.

 

Mesotherapy

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Mesotherapy involves the administration of drugs, intradermally via injection, to the skin areas adjacent to tissues affected by diseases. Multiple injections are performed, each with a small volume of the drug. From the injection point, the drug slowly diffuses to nearby structures. The drugs used are the same as those in the official pharmacopoeia but in minimal doses, at concentrations that remain locally elevated for an extended period, providing intense and prolonged activity.

Even if the indication for mesotherapy use is not always specified in the technical data sheet, the drugs used in our clinic are safe and effective because they are recommended and validated by the Italian Society of Aesthetic Medicine and the Italian Society of Mesotherapy. This recommendation is based on many years of experience, supported by clinical observations and scientific publications.

What are the main indications for mesotherapy in aesthetic medicine?

The main indications for mesotherapy treatment are:

  • Various aesthetic issues related to chronic insufficiency of the peripheral veno-lymphatic microcirculation.
  • Panniculopathy edemato-fibro-sclerotica or PEFS (alteration of subcutaneous adipose tissue, commonly known as "cellulite").
  • Skin aging.

The drugs used are those indicated by the Official Pharmacopoeia for the condition being treated. In particular:

  • Mesoglycan: a mixture of glycosaminoglycans that play a role in maintaining and improving microcirculation function.
  • Lymdiaral: a homeopathic medicine consisting of active ingredients that act on microcirculation and has been shown, based on clinical studies conducted in a hospital outpatient setting, to be effective in improving microvascular tissue function.

Normally, mesotherapy takes about 15 minutes, with some variability in time depending on the number and extent of the areas to be treated. The perception of pain depends on individual sensitivity and the treatment areas, but generally, the discomfort is well tolerated.

What results can one expect from Mesotherapy?

The effectiveness of mesotherapy is linked to the action of the administered drugs and therefore depends on the accuracy of the diagnosis and the use of active ingredients targeted at the identified condition. In general, mesotherapy with drugs that act on the microcirculation of the limbs can reduce the symptoms and progression of PEFS (pannicolopatia edemato-fibro-sclerotica).

The extent of the clinical response and the duration of therapy depend on many factors, as is the case in medicine. These factors include the type and severity of the condition, its stage of progression, the presence of other medical conditions, age, individual reactivity, and lifestyle. Since most clinical conditions treated with mesotherapy have a chronic course, including "cellulite," the therapeutic cycle needs to be periodically repeated, and maintenance sessions should be performed during intervals.

Are there any contraindications to the treatment?

An absolute contraindication is a proven allergy to the drugs that should be used. Severe coagulation disorders may warrant caution. Many chronic systemic diseases require case-by-case evaluations of the appropriateness of treatment and should always be reported to the doctor. Another contraindication is the presence of ongoing infections.

Can there be any unwanted side effects?

The modest volume of drug injected into the dermis with each puncture causes a small swelling of the skin surface (wheal), which disappears within a few hours. As with any injectable treatment, mild and transient local reactions can occur, related to both the microtrauma produced by the needle and the effect of the drug:

  • Transient erythema (redness).
  • Mild bleeding, bruising, or small hematomas: these mostly occur in patients with coagulation disorders and those taking aspirin or oral anticoagulants.
  • Local infectious complications (very rare but possible).

Normally, these reactions are localized and spontaneously resolve within a few days; only in exceptional cases may specific pharmacological support be required.

As with any other pharmacological treatment, a possible side effect is allergic reactions, which can range from localized skin reactions that rapidly resolve to systemic manifestations. Allergic reactivity can also develop after an initial period of trouble-free therapy.

What should one do after the treatment?

With mesotherapy, a small amount of medication is deposited in the dermis, which then diffuses to adjacent tissues in the days following the treatment. Any vigorous local mechanical stress can accelerate the removal of the drug through the lymphatic and blood circulation. Therefore, it is not advisable to perform massages, pressure therapy, or ultrasound applications on the treated areas shortly after the treatment. Additionally, to prevent the development of post-inflammatory pigmentation, it is not recommended to expose the treated areas to the sun or UVA lamps until the skin signs from the treatment have disappeared.

Pulsed Light

polpacci

Intense pulsed light (IPL) is a procedure that utilizes a source of pulsed light energy, which, unlike lasers, is non-coherent, non-collimated, and covers a broad spectrum of wavelengths. Due to these attributes, even though it isn't precisely a laser, it finds extensive use in fields ranging from cutaneous vascular lesions to pigment disorders, even in the treatment of hirsutism and hypertrichosis.

The technology upon which it is founded allows the operator to select the appropriate wavelength and parameters tailored to the pigmented lesion being treated. This choice takes into account its depth and location, whether the lesion is composed of melanin or hemoglobin. The light energy is absorbed solely by the target being aimed at, raising its temperature to the point of causing fragmentation and subsequently eliminating the lesion.

By addressing the effects of cutaneous photoaging on the face, neck, décolletage, and back of hands, IPL technology enables rapid, effective, non-invasive photorejuvenation with minimal side effects. Pulsed light penetrates deeply into the structure of the skin's collagen, and thanks to its wide spectrum of wavelengths, it concurrently acts upon a broad range of conditions. This includes pigmented lesions, photoaging, rosacea, and flushing—a flexibility that is unmatched by conventional monochromatic lasers.

Main indications of pulsed light

  • Non-ablative cutaneous photorejuvenation to treat photoaging damage, promoting neocollagen deposition, enhancing texture, and reducing dilated follicular ostia.
  • Pigmentation disorders: hyperpigmentation, sunspots, etc.
  • Vascular lesions: rosacea, flushing, couperose, ruby angiomas, etc.
  • Progressively permanent hair removal.

Preparation for the Treatment

Assessment of the individual's phototype, lesion type, and its predominant component (vascular or pigmented), aided by a cutaneous check-up.
In the 4 weeks prior to the treatment and the 3 following weeks, it is imperative to avoid exposure to sunlight and/or UVA lamps. Additionally, for at least two months prior to the treatment, medications or substances that heighten skin sensitivity to light should not be taken.

The Treatment:

Light energy is emitted through a specialized handpiece in a series of electronically controlled pulses, tailored to the patient's skin characteristics and the type of lesion or condition being treated. This approach enables the light to selectively target the desired area, leaving the healthy or normally pigmented skin unchanged and undamaged.

During the initial visit, the doctor performs a test to identify the most suitable wavelength for the specific case. The duration of the treatment varies based on the dimensions of the targeted area and the type of intervention, generally spanning from 30 to 60 minutes. The number of sessions also varies according to the aesthetic concern being addressed—typically 4 to 6 sessions for photorejuvenation, and at least 5 sessions for significant hair density reduction.

The therapy isn't notably painful and therefore doesn't require anesthesia; the application of a cold gel alleviates the sensation of slight tingling, followed by warmth, which is felt briefly and recedes swiftly.

IPL therapy is contraindicated in the following cases: pregnancy, suspicious skin lesions in the regions to be treated, impaired wound healing, the use of vitamin A or isotretinoin, and epilepsy.

Post-Treatment Period and Contraindications:

  • Treated hyperchromia may darken in the initial days post-session, lasting approximately 10-15 days.
  • Small crusts appear where vessels were treated (8-10 days).
  • Minor edema is present (lasting 24 hours) as well as moderate erythema (1-3 days).
  • Following the treatment, soothing creams will be applied. Sunscreen is essential before exposing the treated area to sunlight to prevent hyperpigmentation.

Intense Pulsed Light therapy is not advised in the following cases: pregnancy, suspicious skin lesions in the regions to be treated, impaired healing, consumption of vitamin A or isotretinoin, epilepsy.

IPL for Hair Removal

Pulsed light technology can be employed for hair removal. The light emitted from the device is selectively absorbed by the hair shaft, causing carbonization of the hair and its root. Epilation refers to a procedure that isn't permanent but yields long-lasting results; however, maintenance sessions are still required.

The outcome is deemed satisfactory if a hair thinning of 70-80% is achieved; the remaining 20-30% transforms into fine fuzz (vellus hair). Success rates vary depending on the phototype and treated areas. For instance, fair skin with dark hair responds more effectively, while certain regions such as the back of the hands or fingers might not respond at all.
IPL has no effect on white, red, and blonde hairs as its target is melanin; the more pigmented the hair, the more it will be affected. In individuals with even mild endocrine dysfunctions or those undergoing cortisone or hormonal treatments (e.g., contraceptive pills), treated hairs can regrow or new ones may appear. Consequently, while this treatment proves effective for most individuals, there's no prior guarantee of success.

Pre and Post Intense Pulsed Light Treatment Guidelines

The treatment is conducted over several weekly sessions (on average 6-8), followed by one or two maintenance sessions annually.
In the 4-6 weeks leading up to the treatment, waxing and/or tweezing should be avoided, and hair should not be bleached. However, shaving is permissible up to 3 days before the treatment.

In the 2 days prior to the session and in the days following it, the use of a loofah glove, at-home peeling with exfoliating creams, as well as the use of perfumes or alcohol-based tonics must be avoided. Throughout the month leading up to and during the treatment phases, sun exposure and tanning lamps must be avoided, and the application of self-tanning creams should be suspended. Saunas, steam baths, or exposure to any other sources of heat should also be refrained from during the entire treatment period.

After IPL therapy, the skin may become more or less intensely red, and this redness may persist for at least 1-5 days. Pinpoint areas of swelling and edema may also appear at the level of hair follicles. This simply the result of hair follicles being damaged due to the explosion of the hair within the follicle itself. This mechanism is the basis of permanent hair removal and indicates the successful outcome of the therapy.

After the treatment, it's important to use total sun protection. If you are undergoing antibiotic and/or anti-acne therapy or taking other medications, you should inform your doctor during the evaluation visit so that they can establish the correct start date for the treatment.

Contraindications and Side Effects

The treatment with Intense Pulsed Light (IPL) is not recommended in the following cases: pregnancy, suspected skin lesions in the areas that need to be treated, wound healing disorders, intake of vitamin A or isotretinoin, epilepsy.

Intense Pulsed Light (IPL) treatment can have some common side effects, including transient erythema (redness), tenderness, itching, swelling, and transient hyperpigmentation. There is also a possibility of hyperpigmentation or hypopigmentation occurring if the treated areas are not adequately protected from sunlight.

The quality of clinical outcomes from the treatment cannot be evaluated in advance, nor can precise guarantees be provided about the achievable results, as individual conditions are essential in determining the patient's clinical response.

Manual lymphatic drainage

massaggio

It is a series of maneuvers carried out manually, with a slight slow pressure, which allows to reduce the localized swelling on the upper and lower limbs or on face. It acts on the accumulation of water in the tissues, contrasting the edema due to a deficiency of the venous system to the lymphatic system.

Carboxytherapy

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Carbon dioxide in its gaseous state promotes vasodilation and restores proper blood flow, thereby stimulating fibroblast activity and supporting cellular regeneration. As a result, the skin improves its appearance in terms of firmness and elasticity.

University studies and clinical research have demonstrated that carbon dioxide administered subcutaneously or intradermally has a therapeutic effect through:

- An action on the microcirculation, which is beneficial in the treatment of "cellulite" as it addresses the vascular component that characterizes the microcirculatory physiopathology of edematofibrosclerotic panniculopathy, improving tissue perfusion.

- A lipolytic action, useful for treating regional adiposity, as it targets excess adipose tissue by inducing the breakdown of intradipocytic triglycerides.

- An effect on the skin, improving oxygenation and elasticity, leading to dermal rejuvenation.

For these reasons, carboxytherapy finds its applications in:

  • Plastic surgery
  • Aesthetic medicine
  • Dermatology
  • Phlebology
  • Anti-aging medicine

The applications of carboxytherapy in Aesthetic Medicine include the treatment of edematofibrosclerotic panniculopathy (EFSP - cellulite) and localized adiposity, skin rejuvenation (effect on skin laxity), and the treatment of dark circles and stretch marks.

Carboxytherapy is inadvisable in certain clinical conditions: severe respiratory, renal, hepatic, or cardiac insufficiency, severe anemia, severe arterial hypertension, tachyarrhythmias, previous cerebral stroke, thrombosis and thrombophlebitis, embolisms, and pregnancy.

This is an outpatient treatment performed through micro-injections, carried out in the areas affected by the aesthetic concern, using very fine needles inserted into a sterile disposable tube connected to a certified device. This computerized device provides a controlled, sterile, and customized delivery of CO2.

During the administration of the gas, a burning sensation is felt, which depends on the speed of the CO2 flow and individual sensitivity. After acting locally, carbon dioxide is eliminated physiologically through the lungs.

The side effects include transient bruising, fleeting local tenderness, at times a sensation of heaviness in the limb and mild subcutaneous crackling, while the occurrence of hematomas is less frequent.

The treatment is safe for the patient, as carbon dioxide is non-toxic, does not cause embolisms, and is compatible with the human body, which produces it constantly and eliminates it through the venous system via the lungs. The uses of this gas in surgery (laparoscopic procedures) and in diagnostics (colonoscopy) are well known in the medical field for their safety.

The treatment cycle involves 12-15 sessions on a weekly basis and can be repeated twice a year. The treatment duration averages around 20 minutes, and the return to normal activities is immediate.

Cryoadipolysis/Cryolipolysis

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Cryoadipolysis is the only non-invasive medical method that currently provides a certainty of results in reducing excess adipose tissue. Therefore, it can be a valid alternative for those patients who do not want to undergo liposuction (which still remains the primary indication for this aesthetic issue) or who have mild excess adiposity.

Cryolipolysis employs a state-of-the-art device based on a controlled cold application system. Through a suction mechanism, the excess adipose tissue fold is isolated between two plates and brought to a temperature of around minus 8 degrees Celsius for a period ranging from 20 to 45 minutes. Adipose tissue is particularly vulnerable to the effects of cold: adipose cells are irreversibly damaged and slowly reabsorbed through the lymphatic system, in a process that begins 15 days after the treatment and continues over the following 90 days.
As a result, the outcomes are not immediately visible, but gradually appear within a month to a month and a half. This gradual progression is accompanied by a good skin retraction, thereby avoiding the "hollowing" effect.

This method makes it possible to treat all areas commonly affected by excess adipose tissue, such as the abdomen, hips, trochanteric region, inner thighs and knees, back of the arms, and back.
Generally, a single session is sufficient, during which a maximum of two areas can be treated (for example, both hips). Sometimes, to optimize the result, a second treatment is performed after 90-120 days. There are certain medical conditions that constitute a contraindication to the treatment, which are identified during the medical consultation.
Side effects are extremely rare, mild, and generally tolerable. The most common ones include: redness in the treated area (lasting from a few minutes to a few hours), occasional bruises (related to the suction process), altered sensitivity in the treated area (which can last up to eight weeks), and pain in the treated area (lasting from 8 to 10 days).
The results of the treatment are permanent, provided there is no subsequent weight gain.

Treatment of Hyperhidrosis with Botulinum Toxin

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Sweating is a physiological phenomenon of our body regulated by the autonomic nervous system. When it occurs excessively in certain areas of the body, it is referred to as hyperhidrosis.

Hyperhidrosis can be primary or secondary: the primary form is the most common, and its cause is unknown, often triggered by emotional factors. The secondary form is associated with certain diseases or organ dysfunctions (such as obesity, infections, malignant neoplasms, thyroid disorders, diabetes mellitus, and other endocrine diseases) or neurological problems.

Hyperhidrosis most commonly affects the hands (palmar hyperhidrosis), but it can also occur in other areas of the body such as the armpits or feet. The degree of sweating can vary and can be severe, sometimes leading to dripping sweat. In some cases, the sweating can be particularly odorous, and this is referred to as bromhidrosis.

From a relational perspective, hyperhidrosis can be embarrassing and has a psychological impact, especially in severe cases. The condition typically begins in adolescence and tends to persist throughout life, negatively affecting social interactions.

Hyperhidrosis is often treated with topical antiperspirants containing aluminum chloride, but the results are not always satisfactory. Botulinum toxin, which has been used for this purpose for several years now, can reduce excessive sweating by inhibiting sweat glands. The treatment has no contraindications or side effects: the toxin is injected subcutaneously through micro-injections spaced about 1.5 cm apart on the palms of the hands, soles of the feet, or in the armpit area, sometimes using local anesthesia. The effect becomes apparent within two or three days and lasts for several months before gradually wearing off. On average, however, the inhibition of sweat glands persists for about 8 months; when the effect wears off, the treatment can be repeated.