title: Mécano-Stimulation™ of the skin improves sagging score and induces beneficial functional modification of the fibroblasts: clinical, biological, and histological evaluations.
abstract: BACKGROUND
  Loss of mechanical tension appears to be the major factor underlying decreased collagen synthesis in aged skin. Numerous in vitro studies have shown the impact of mechanical forces on fibroblasts through mechanotransduction, which consists of the conversion of mechanical signals to biochemical responses. Such responses are characterized by the modulation of gene expression coding not only for extracellular matrix components (collagens, elastin, etc.) but also for degradation enzymes (matrix metalloproteinases [MMPs]) and their inhibitors (tissue inhibitors of metalloproteinases [TIMPs]). A new device providing a mechanical stimulation of the cutaneous and subcutaneous tissue has been used in a simple, blinded, controlled, and randomized study.
  
  
  METHODS
  Thirty subjects (aged between 35 years and 50 years), with clinical signs of skin sagging, were randomly assigned to have a treatment on hemiface. After a total of 24 sessions with Mécano-Stimulation™, biopsies were performed on the treated side and control area for in vitro analysis (dosage of hyaluronic acid, elastin, type I collagen, MMP9; equivalent dermis retraction; GlaSbox(®); n=10) and electron microscopy (n=10). Furthermore, before and after the treatment, clinical evaluations and self-assessment questionnaire were done.
  
  
  RESULTS
  In vitro analysis showed increases in hyaluronic acid, elastin, type I collagen, and MMP9 content along with an improvement of the migratory capacity of the fibroblasts on the treated side. Electron microscopy evaluations showed a clear dermal remodeling in relation with the activation of fibroblast activity. A significant improvement of different clinical signs associated with skin aging and the satisfaction of the subjects were observed, correlated with an improvement of the sagging cheek.
  
  
  CONCLUSIONS
  Mécano-Stimulation is a noninvasive and safe technique delivered by flaps microbeats at various frequencies, which can significantly improve the skin trophicity. Results observed with objective measurements, ie, in vitro assessments and electron microscopy, confirm the firming and restructuring effect clinically observed.
authors: Research and Studies Center on the Integument (CERT), Department of Dermatology, Clinical Investigation Center (CIC 1431), Besançon University Hospital, Besançon, France ; INSERM UMR1098, FED4234 IBCT, University of Franche-Comté, Besançon, France.
authors: Philippe
authors: P
authors: Humbert
authors: Research and Studies Center on the Integument (CERT), Department of Dermatology, Clinical Investigation Center (CIC 1431), Besançon University Hospital, Besançon, France ; INSERM UMR1098, FED4234 IBCT, University of Franche-Comté, Besançon, France.
authors: Ferial
authors: F
authors: Fanian
authors: Research and Studies Center on the Integument (CERT), Department of Dermatology, Clinical Investigation Center (CIC 1431), Besançon University Hospital, Besançon, France ; INSERM UMR1098, FED4234 IBCT, University of Franche-Comté, Besançon, France.
authors: Thomas
authors: T
authors: Lihoreau
authors: Research and Studies Center on the Integument (CERT), Department of Dermatology, Clinical Investigation Center (CIC 1431), Besançon University Hospital, Besançon, France ; INSERM UMR1098, FED4234 IBCT, University of Franche-Comté, Besançon, France.
authors: Adeline
authors: A
authors: Jeudy
authors: Research and Studies Center on the Integument (CERT), Department of Dermatology, Clinical Investigation Center (CIC 1431), Besançon University Hospital, Besançon, France ; INSERM UMR1098, FED4234 IBCT, University of Franche-Comté, Besançon, France.
authors: Ahmed
authors: A
authors: Elkhyat
authors: SARL BIOEXIGENCE, Besançon, France.
authors: Sophie
authors: S
authors: Robin
authors: SARL BIOEXIGENCE, Besançon, France.
authors: Carol
authors: C
authors: Courderot-Masuyer
authors: SARL BIOEXIGENCE, Besançon, France.
authors: Hélène
authors: H
authors: Tauzin
authors: Research and Studies Center on the Integument (CERT), Department of Dermatology, Clinical Investigation Center (CIC 1431), Besançon University Hospital, Besançon, France ; INSERM UMR1098, FED4234 IBCT, University of Franche-Comté, Besançon, France ; Dermopharmacology and Cosmetology Unit, University of Paris Sud, France.
authors: Christine
authors: C
authors: Lafforgue
authors: University of Lyon 1, EA4169, Experimental, clinical and therapeutic aspects of the skin barrier function, INSERM US7 - CNRS UMS3453, Lyon, France.
authors: Marek
authors: M
authors: Haftek
mesh_terms: D000328:Adult; D024042:Collagen Type I / Q000096:biosynthesis; D003357:Cosmetic Techniques / Q000009:adverse effects / Q000295:instrumentation*; D004311:Double-Blind Method; D004549:Elastin / Q000096:biosynthesis; D005109:Extracellular Matrix / Q000378:metabolism; D005145:Face; D005260:Female; D005347:Fibroblasts / Q000378:metabolism*; D006801:Humans; D006820:Hyaluronic Acid / Q000096:biosynthesis; D008297:Male; D020780:Matrix Metalloproteinase 9; D008875:Middle Aged; D015595:Skin Aging
chemical_list: D024042:Collagen Type I; D006820:Hyaluronic Acid; D004549:Elastin; D020780:Matrix Metalloproteinase 9
keywords: fibroblast synthesis; mechanical stimulation; skin rejuvenation; skin sagging