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    <loc>https://www.grupochociai.com/blog/consulta-cirurgia-plastica-da-face-diagnostico</loc>
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    <loc>https://www.grupochociai.com/blog/angels-victorias-secret-depois-dos-40-gerenciamento-do-envelhecimento</loc>
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    <loc>https://www.grupochociai.com/blog/remodelamento-gluteo-firmeza-contorno-qualidade-da-pele</loc>
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      <image:title>Blog - Remodelamento glúteo: firmeza, contorno e qualidade da pele</image:title>
      <image:caption>Flacidez, perda de volume e ptose: qual é a diferença? Flacidez da pele: menor firmeza e maior frouxidão dos tecidos superficiais. Pode existir mesmo quando o volume está preservado. Perda de volume: redução do preenchimento da região, com possível mudança na projeção. A necessidade de volume deve ser avaliada separadamente da qualidade da pele. Ptose glútea: descida dos tecidos, observada na relação com a dobra inferior dos glúteos. O grau de queda pode limitar o alcance dos procedimentos de consultório. Essas alterações podem coexistir. O envelhecimento e as variações de peso estão associados a mudanças na sustentação e na posição dos tecidos. Quando há excesso importante de pele ou ptose acentuada, acrescentar volume não equivale a reposicionar as estruturas que cederam. [6] Como entender os graus de ptose glútea? A avaliação da ptose observa a posição dos tecidos em relação à dobra que separa o glúteo da parte posterior da coxa. Existem diferentes classificações na literatura, com critérios próprios. Por isso, uma graduação da queda não deve ser confundida com uma escala de firmeza da pele ou de intensidade da celulite. [6]</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/645704da036a2b79b1d80375/87daaa59-b2a9-43fa-9064-e2dcf2bdb625/fig3.jpg</image:loc>
      <image:title>Blog - Remodelamento glúteo: firmeza, contorno e qualidade da pele</image:title>
      <image:caption>Na prática, o desenho ajuda a reconhecer o que será examinado na consulta. Ele não permite definir o tratamento por autoavaliação. A extensão da queda, a qualidade da pele, o volume e a presença de excesso cutâneo precisam ser analisados em conjunto. Quanto maior a ptose, mais importante é discutir os limites dos procedimentos de consultório. Como os bioestimuladores de colágeno atuam? Bioestimuladores são substâncias injetáveis utilizadas para estimular a produção de componentes que dão estrutura aos tecidos. Entre as opções estudadas estão o ácido poli-L-láctico, conhecido como PLLA, e a hidroxiapatita de cálcio. [1,4] No caso do PLLA, as partículas desencadeiam uma resposta local que envolve células de defesa e fibroblastos, as células responsáveis pela produção de colágeno. Com o tempo, essa resposta pode contribuir para a estrutura do tecido. Trata-se de um processo biológico gradual, com intensidade variável entre as pessoas. [1] Produto, técnica e objetivo importam. Uma proposta voltada à qualidade da pele exige um planejamento diferente daquela que busca modificar o contorno. O que a ciência mostra sobre os benefícios? Um estudo publicado em 2023 na revista Dermatologic Surgery avaliou 20 mulheres com flacidez leve a moderada da pele dos glúteos e das coxas, associada a celulite de grau leve a moderado. Cada participante recebeu PLLA em uma área e água bacteriostática, sem princípio ativo, na outra, permitindo comparar as respostas na mesma pessoa. Foram feitas três sessões com intervalo de quatro semanas, e o seguimento durou 330 dias. Os pesquisadores observaram redução da profundidade das depressões, melhora do aspecto da pele e do grau de flacidez nos glúteos tratados. [1] Para as depressões laterais do quadril, conhecidas como hip dips, há descrições de técnica com ácido hialurônico de partículas grandes em pequenas séries de pacientes, com boa satisfação relatada. São relatos iniciais, que não permitem prometer a mesma resposta a todas as pessoas. [7] Esses achados apoiam possibilidades de tratamento em situações específicas. Como os estudos são pequenos, não permitem prometer a mesma resposta para todas as pessoas, grandes aumentos de volume ou equivalência a uma cirurgia. Também não tornam as características naturais do corpo, como os hip dips, alterações que precisem ser tratadas. Qual é o papel do ácido hialurônico? O ácido hialurônico utilizado como preenchedor é um gel formulado para acrescentar volume aos tecidos. Em situações selecionadas, pode contribuir para suavizar depressões de contorno e modificar a projeção da região. É uma proposta diferente do estímulo gradual de colágeno, embora os objetivos possam se complementar. [8] Quando se fala em “suporte estrutural” com preenchimento, a expressão se refere à contribuição do gel para o volume e o formato. Ela não significa reconstrução de ligamentos nem reprodução do reposicionamento obtido por uma cirurgia. Um estudo prospectivo brasileiro, publicado em 2025, acompanhou 30 mulheres por 12 meses após o uso de um preenchedor específico de ácido hialurônico. Foram observadas melhora estética e satisfação das participantes. A satisfação atingiu o pico de 90% aos 30 dias e chegou a 62% aos 12 meses, o que acompanha a degradação gradual do ácido hialurônico. [3] O estudo não teve grupo de comparação. Seus resultados ajudam a compreender o potencial do produto estudado, mas não permitem estimar bem complicações raras nem generalizar a resposta a todos os preenchedores. Cada produto tem indicações definidas em bula, e a região glútea nem sempre está incluída. Essa verificação precisa ser feita antes do tratamento. [3,10] E quando a principal queixa é a celulite? A celulite envolve a relação entre a pele, a gordura abaixo dela e faixas de tecido fibroso que conectam essas estruturas. Algumas dessas faixas tracionam a pele para dentro e participam da formação das depressões. Esse mecanismo tem apoio em estudos de imagem. Em uma pesquisa com 30 mulheres, uma área de glúteo com depressões de celulite foi comparada, na mesma pessoa, a uma área sem depressões por ressonância magnética. Septos fibrosos foram visualizados em 96,7% das áreas com depressões e eram mais espessos nelas. Isso ajuda a explicar por que tratar apenas o volume pode não resolver determinada irregularidade. [2] Por isso, a avaliação precisa distinguir o que é uma depressão localizada e o que é perda de firmeza mais difusa. Essa diferença muda a escolha do tratamento. Quando essa tração predomina, pode ser considerada a subcisão, procedimento que libera faixas fibrosas selecionadas. Quando há flacidez associada, o plano também pode contemplar o estímulo de colágeno. A subcisão foi avaliada em estudo observacional com 200 mulheres, e o estímulo de colágeno em outros estudos, mas a indicação precisa considerar o padrão de celulite e as características da pele. [1,4,5]</image:caption>
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    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/645704da036a2b79b1d80375/828887ac-a6bc-4b9b-9c25-c1cf2a662777/fig4.jpg</image:loc>
      <image:title>Blog - Remodelamento glúteo: firmeza, contorno e qualidade da pele</image:title>
      <image:caption>Quando combinar tratamentos? A associação pode ser considerada quando existem necessidades diferentes na mesma região. Cada recurso deve ter uma função definida no planejamento. Um estudo com 20 mulheres avaliou a combinação de ultrassom microfocado com visualização e hidroxiapatita de cálcio diluída, observando melhora da flacidez e da aparência da celulite em glúteos e coxas aos 90 dias. Entretanto, foi uma análise retrospectiva, sem grupo de comparação. Ela sugere benefício, mas não comprova que a combinação seja superior a cada tratamento isolado. [4] Os achados se referem aos recursos e às condições estudadas. Não podem ser automaticamente transferidos para qualquer aparelho, produto ou associação. Bioestimulador e ácido hialurônico também podem ser discutidos quando coexistem uma queixa de firmeza e uma necessidade de preenchimento. Cada recurso precisa ter uma finalidade definida. A presença de estudos sobre os tratamentos isolados não demonstra, por si só, que a combinação seja superior para todas as pessoas. Quando as mudanças aparecem? Quando o objetivo é estimular colágeno, a evolução acontece ao longo de semanas e meses. O tecido precisa de tempo para responder e se reorganizar. [1] No estudo com PLLA, as participantes foram acompanhadas por 330 dias. Isso reforça a importância de avaliar a evolução ao longo do tempo, sem julgar o tratamento apenas pela aparência logo após a aplicação. [1] Número de sessões, intervalos e necessidade de manutenção devem ser definidos conforme o produto, a indicação e a resposta observada. O planejamento inclui retornos para decidir se há benefício em continuar, ajustar ou encerrar as intervenções. Com o ácido hialurônico, a mudança de volume pode ser percebida mais cedo. Mesmo assim, o inchaço inicial interfere na aparência. A avaliação do resultado deve considerar a acomodação dos tecidos e o acompanhamento clínico. [3] Registro clínico: antes e depois</image:caption>
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      <image:title>Blog - Remodelamento glúteo: firmeza, contorno e qualidade da pele</image:title>
      <image:caption>Figura 4. Registro fornecido pela equipe, com autorização da paciente. Antes (à esquerda) e pós-procedimento imediato (à direita), conforme a identificação do material. Diferenças de iluminação e posicionamento limitam a comparação, e o aspecto imediato pode incluir inchaço. Um caso individual não permite prever a resposta de outras pessoas.</image:caption>
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    <loc>https://www.grupochociai.com/blog/dia-do-medico-historia-da-medicina-18-de-outubro</loc>
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      <image:loc>https://images.squarespace-cdn.com/content/v1/645704da036a2b79b1d80375/232e369a-0128-47f5-9637-8fb1af8592ba/medicina-egito-papiro.png</image:loc>
      <image:title>Blog - Dia do Médico: a história da medicina no mundo e por que celebramos em 18 de outubro</image:title>
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    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/645704da036a2b79b1d80375/7fc95544-7125-457b-b2a6-d7155f5d0164/medicina-grecia-asclepieion-cos.png</image:loc>
      <image:title>Blog - Dia do Médico: a história da medicina no mundo e por que celebramos em 18 de outubro</image:title>
      <image:caption>A medicina islâmica e medieval: preservar, testar e ensinar Enquanto a Europa atravessava a Idade Média, médicos do mundo islâmico traduziram, comentaram e corrigiram a herança grega. Avicena, no século XI, escreveu o Cânone da Medicina, que serviu de manual nas universidades europeias por séculos. Surgiram também os primeiros hospitais organizados, com enfermarias separadas e ensino à beira do leito. É um lembrete importante de que a medicina nunca foi obra de uma só cultura: é uma conversa entre civilizações. Renascimento e Revolução Científica: abrir o corpo para entender a vida Em 1543, Andreas Vesalius publicou De humani corporis fabrica, baseado em dissecações feitas por ele mesmo, e corrigiu séculos de erros herdados de Galeno. Em 1628, William Harvey demonstrou a circulação do sangue. Em 1796, Edward Jenner testou a primeira vacina, contra a varíola, abrindo caminho para a prevenção como estratégia de saúde pública. Pela primeira vez, a medicina passou a depender de experimento e demonstração, e não apenas de autoridade. Clique aqui e agende sua consulta Século XIX: anestesia, higiene e a teoria dos germes Se existe um século que mudou o que é operar, é o XIX. Em 1846, em Boston, a demonstração pública da anestesia com éter transformou a cirurgia: o paciente deixou de ser contido e passou a ser tratado, e o cirurgião ganhou tempo para trabalhar com precisão. Sem anestesia, nenhuma das cirurgias delicadas que fazemos hoje seria possível. Em 1847, o obstetra húngaro Ignaz Semmelweis mostrou, com estatística, que lavar as mãos reduzia drasticamente a mortalidade por febre puerperal. Foi ridicularizado pelos colegas. Poucas décadas depois, Louis Pasteur e Robert Koch estabeleceram a teoria dos germes, e Joseph Lister aplicou a antissepsia à cirurgia. Esta é uma das histórias que mais me marcam: um dado correto, apresentado cedo demais, e a resistência de uma classe inteira. Lembro disso sempre que a ciência contraria o que "sempre se fez".</image:caption>
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      <image:title>Blog - Dia do Médico: a história da medicina no mundo e por que celebramos em 18 de outubro</image:title>
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    <loc>https://www.grupochociai.com/blog/flacidez-corporal-lipoaspiracao-laser-radiofrequencia-retracao-pele</loc>
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    <loc>https://www.grupochociai.com/blog/cosme-e-damiao-medicos-historia</loc>
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    <lastmod>2026-10-23</lastmod>
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      <image:title>Blog - Cosme e Damião: os médicos gêmeos que viraram protetores das crianças no Brasil - Conquiste seu espaço</image:title>
      <image:caption>Relicário de São Cosme e São Damião no museu do Palácio de Diocleciano, em Split, na Croácia. Foto: Dra. Ana Carolina Chociai.</image:caption>
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    <loc>https://www.grupochociai.com/blog/ulisses-calipso-beleza-autentica-identidade</loc>
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    <loc>https://www.grupochociai.com/blog/ptose-palpebral-congenita-adulto-acompanhamento-e-revisao</loc>
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    <loc>https://www.grupochociai.com/blog/lobulo-bifido-reconstrucao-auricular</loc>
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      <image:title>Blog - Lóbulo Bífido e Reconstrução Auricular: Por Que Brincos Pesados e o Tempo Prejudicam a Orelha E Como Melhorar - Conquiste seu espaço</image:title>
      <image:caption>Seja o que for, o modo de contar sua história on-line faz toda a diferença.</image:caption>
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      <image:loc>https://images.squarespace-cdn.com/content/v1/645704da036a2b79b1d80375/48cd1b11-e127-48ec-b0c1-7c7c6ba24ffd/Reconstru%C3%A7%C3%A3o+de+l%C3%B3bulo+de+orelha.png</image:loc>
      <image:title>Blog - Lóbulo Bífido e Reconstrução Auricular: Por Que Brincos Pesados e o Tempo Prejudicam a Orelha E Como Melhorar - Conquiste seu espaço</image:title>
      <image:caption>Seja o que for, o modo de contar sua história on-line faz toda a diferença.</image:caption>
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      <image:title>Blog - Lip Lift: a cirurgia que encurta o lábio superior e devolve o sorriso jovem - Conquiste seu espaço</image:title>
      <image:caption>Além da melhora estética em repouso, essa paciente também teve grande melhora da sua mímica facial. Antes o lábio superior tampava todos os dentes durante a articulação das palavras e deixava um aspecto excessivamente pesado em razão de excesso de ácido hialurônico.</image:caption>
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      <image:title>Blog - Cirurgia endoscópica da face: o que é, vantagens, indicações e mitos e verdades - Conquiste seu espaço</image:title>
      <image:caption>Seja o que for, o modo de contar sua história on-line faz toda a diferença.</image:caption>
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