high-pressure application was used (D), indicating sharper penetration markings of the superficial temporal fascia (E), which is also visible after lifting of the temporal fat body (F).
DISCUSSION
The jet-injecting device of our experiment delivers therapeutic material intra- and sub-dermally and acts as a micro-trauma generating device for achieving therapeutic changes in the skin. The micro-trauma caused by the forceful spread of the drug micro-droplets stimulates activity of the skin fibrocytes toward neo-collagenases.2
As an effective treatment modality, transcutaneous jet injections are applicable for dermal tightening, improvement of the agerelated skin atrophy,4,11 and adapted for remodeling of various scars (acne scars, hypertrophic scars, keloids).5,7
Cadaveric study of Seok et al12 confirmed dependency of the skin penetration on the amount of pressure applied with jet injection. Although the study was limited by inconsistency and lowered elasticity of the cadaveric tissue, the authors were able to demonstrate that viscosity of the injected materials additionally contributes to the penetration depth. Viscosity of the substances injected in our experiment was orginaly low (normal saline, 20% glucose) or was lowered (dermal filler, Restylane) through dilution in order to achieve an optimal skin penetration at any tested pressure level.
Due to the complexity of facial anatomy, precise studies of accessibility and penetration of various structures are necessary and must be documented.13 Facial skin tightening can be effectively acquired either by manipulation of the deep fascia or retinacula cutis or dermis layer.14 Fat bodies are primarily submandibular and can be aesthetically disturbing.15,16 These fat bodies, however, can also be easily reached using lipolytic substances. Scar therapy requires both superficial and deep applications (depending on the scar thickness). An exact characterization of the affected structures will optimize the quality of the application and treatment result.
The specific application format of Enerjet 2.0 enables several combined aesthetic treatment effects. Volumizations of the active aging process in layers of the dermal and subcutaneous fat with fat or various hyaluronic preparations can minimize or correct the deflation or thinning process.17,18 Also, facial skin smoothing can be supplemented with fractional laser or radiofrequency methods.13
Radial shock wave or tightening radio-frequency techniques can also be paired to enhance regenerative treatments.17,19,20 Deactivating facial expressions (botox) can additively complement tissue remodeling. The Enerjet procedure is a pearl in the mosaic of non-surgical facial rejuvenation, once facial anatomy is mastered.
We did not completely cover all possible structures in our study. However, the ongoing three-dimensional introduction of denser substances to patients with the Enerjet delivers comparable therapeutic results.
As an effective treatment modality, transcutaneous jet injections are applicable for dermal tightening, improvement of the agerelated skin atrophy,4,11 and adapted for remodeling of various scars (acne scars, hypertrophic scars, keloids).5,7
Cadaveric study of Seok et al12 confirmed dependency of the skin penetration on the amount of pressure applied with jet injection. Although the study was limited by inconsistency and lowered elasticity of the cadaveric tissue, the authors were able to demonstrate that viscosity of the injected materials additionally contributes to the penetration depth. Viscosity of the substances injected in our experiment was orginaly low (normal saline, 20% glucose) or was lowered (dermal filler, Restylane) through dilution in order to achieve an optimal skin penetration at any tested pressure level.
Due to the complexity of facial anatomy, precise studies of accessibility and penetration of various structures are necessary and must be documented.13 Facial skin tightening can be effectively acquired either by manipulation of the deep fascia or retinacula cutis or dermis layer.14 Fat bodies are primarily submandibular and can be aesthetically disturbing.15,16 These fat bodies, however, can also be easily reached using lipolytic substances. Scar therapy requires both superficial and deep applications (depending on the scar thickness). An exact characterization of the affected structures will optimize the quality of the application and treatment result.
The specific application format of Enerjet 2.0 enables several combined aesthetic treatment effects. Volumizations of the active aging process in layers of the dermal and subcutaneous fat with fat or various hyaluronic preparations can minimize or correct the deflation or thinning process.17,18 Also, facial skin smoothing can be supplemented with fractional laser or radiofrequency methods.13
Radial shock wave or tightening radio-frequency techniques can also be paired to enhance regenerative treatments.17,19,20 Deactivating facial expressions (botox) can additively complement tissue remodeling. The Enerjet procedure is a pearl in the mosaic of non-surgical facial rejuvenation, once facial anatomy is mastered.
We did not completely cover all possible structures in our study. However, the ongoing three-dimensional introduction of denser substances to patients with the Enerjet delivers comparable therapeutic results.
CONCLUSIONS
In a study with anatomical specimens, various cutaneous and
subcutaneous facial structures were treated with the Enerjet
system. Color-marked substances were introduced with different
volume and pressure parameters. The location of the possible
effect was finally sought by dissection, respectively, the so-called
hit rate was verified. Fascia and retinacular should be evaluated
for firming effects, subdermal and intradermal structures for
volumization, tightening, and scar therapy, and subcutaneous
fat structures for lipolytic effects should be shown. Further
