and of the style of life) of improvement. In selected patients the mini-invasive solution using surgical barbed or non-barbed threads can give good results but they should give a new good position of the skin reducing all processes of aging. These soft methods are indicated as the most diffuse and suitable treatments particularly for the non-advanced phases and for preventive indications with their mini-inva- siveness in multiple sessions and with almost no complications or scars.

2.Reduction of volume

(a)When there is no true skin excess but the aesthetic pathology is characterized by reduction of the skin structure with reduction or regression of the adipose and the connective tissues, surgery is not suitable and can only be of help in particular cases.

(b)The elective treatment is the use of substances to fill and thereby increasing the volume and to redraw the contours of the face. The principal fillers are found in the family of the hyaluronic acid that has the principal characteristic to be absorbable and practically without complications. Except for particular cases, it is best to avoid nonabsorbable fillers because of their complications. When necessary to use nonabsorbable fillers it is better to use solid prosthesis, such as solid silicone or Gore-Tex.

3.Skin aging

(a)In the case of patients without skin excess or reduction of the volume, but with underlying irregularity and degeneration of the cutaneous structure (the true cutaneous aging) it is necessary to adopt some protocol of noninvasive dermatologic cosmetic treatment that reduces the skin irregularities and improve the external aspect that favors a resumption of the microcirculation, of the oxygenation, and of the production of a physiological connective tissues [7–10].

When there is prolapse of the tissues, the angles of the mouth go down and, often, there may be formation of white saliva at the angles that interferes with the patient’s life of relationships. Aesthetic treatment allows the patient to reach the desire to maintain his own dignity and role in society.

28.4 T3 Bioresurfacing

Old age causes modifications, both physical and functional, of the organisms that, in the past, were considered as a sad and disheartening decadence of the bodily harmony and the human activities. From such feeling was born the instinctive impulse for the man to fight against the senile phenomenon.

In the case of patients with neither cutaneous excess nor reduction of the volumes, but have underlying cutaneous aging with irregularity and degeneration of the dermoepidermal structure, dermatologic cosmetic and noninvasive protocols of treatment are used to reduce these irregularities and improve the external aspect favoring improvement of the metabolism. The author has named such protocol “ T3 - Bioresurfacing,” meaning an attempt to rejuvenate the skin by stimulating the natural physiological regeneration with a triad of integrated treatments.

“Bioresurfacing” uses an integrated protocol by different methods to regulate the activity of the skin:

1.Endermologie – LPG®: Physical therapy finalized to vascularize and to drain the lymph

2.Young-Peel: This phase is used to regulate and to stimulate the skin

(a)Scrub-Peel: To regulate and to eliminate the horny layer of the skin

(b)Trans-Peel: To introduce substances and to stimulate the cellular activities

3.Photodynamic treatment: To bring energy and to activate the cellular functions

The integration of these methods has produced interesting results with limited complications and interruption of the working activity.

28.4.1 Endermologie LPG System®

LPG-System represents a true revolution in the field of physical therapy and aesthetics, both in the idea and in the practical application. It deals with patented equipment that uses air in the phases of aspiration and compression and a head with two rolls that allows traction on the tissues to perform some maneuvers and has physiotherapeutic applications. Such treatments allow the morphological and functional reconstitution of the connective and the adipose tissue [11–14].