IMCAS

Local anesthetic minimally invasive liposuction (LAMS) with capistrano super-wet hypotonic tumescent technique: its’ safety and benefit

Objectives: 1. Know the feasibility of a hypotonic tumescent solution to perform microcannula liposuction with a suction syringe with a super-wet technique.
2. Learn that the LAMS technique is a safe and effective body contouring method based on the out-patient clinic.
3. Track the tolerance and side effects from Local Anesthetic Minimally Invasive Liposuction(LAMS)

Introduction: I have introduced the usefulness of this method at last year's IMCAS Paris meeting. The LAMS procedure consists of a local anesthetic hypotonic (half saline) tumescent without any sedation and micro-cannula manual 50cc syringe suction. The entire process was performed with an outpatient base and was able to return to normal daily life after the procedure. The new changed procedure provides safety and comfort for patients and enables more effective fat removal. This study compared the safety and effectiveness of the new method with classic LAMS.

Materials / method: This study was conducted on a two-year patient of the same surgeon from May 2017 to May 2019 in Korea. In addition to this basic LAMS, the new technique was to use only the Capistrano type micro-cannula, and started the process by doing the primary tumescent and then the secondary one just before suction using each syringe. A hypotonic tumescent consist of half saline and a lower concentration of sodium bicarbonate compared to Klein's tumescent solution. A total of 718 patients were enrolled with the classic LAMS (n=350), and the super-wet LAMS (n=368).

Results: The total tumescent(3,928 vs. 4,760 ml), lidocaine(1,340 vs. 1624mg) and lidocaine per weight(20.3 vs. 25.1mg.kg) were higher in the super-wet (p<0.001). The suction time per syringe (4.3 vs. 3.7 min) was shorter in the super-wet (p<0.001). The suctioned syringes (24.4 vs. 27.3) were more used in the super-wet (p<0.001). The multiple regression analysis showed that the suction time per syringe was significantly affected by weight, height, BMI, age, total tumescent, the super-wet, and the anatomical region being treated (p<0.001). There was no bleeding & IV replacement in the super-wet group.

Conclusion: Totally local Anesthetic Minimally Invasive Liposuction (LAMS) with Capistrano super-wet hypertonic tumescent technique is a safe and effective procedure for body contouring. It also shows that there is less risk of bleeding and relatively easy tunneling, allowing for more fat eliminated effectively.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

1064nm Nd:YAG laser assisted liposuction for the treatment of gynecomastia: a case series of 311 patients

Objectives: 311 male patients with gynecomastia of predominantly fatty tissue type participated in our study between the years 2011 – 2018.
Nd:YAG Laser assisted Liposuction constitutes a modern, safe and effective treatment for gynecomastia providing comparable results to those of traditional liposuction with the additional positive effect of skin tightening.

Introduction: Laser assisted liposuction is a modern, safe and almost non-invasive method to remove localized fat deposits from human body. A 1064 nm neodymium-doped yttrium aluminum laser was used to liquefy excess fat at male chest before its aspiration. In our study we evaluated the efficacy and safety of Nd:YAG Laser in the treatment of gynecomastia.

Materials / method: The diagnose was established by ultrasound imaging&clinical assessment. The procedure was performed under local anesthesia, injected with a cannula followed by laser lipolysis. The liquified fat was removed through aspiration as in traditional liposuction. The amount of anesthesia per session didn’t exceed 500ml of Klein solution. The avg energy delivered in the subcutaneous tissue was 1500Joules per side. Photo documentation&clinical examination were performed before the procedure & on 1, 6 & 12 month post-op. Patients were advised to wear a special pressure garment (vest) for 30 days post-op

Results: The evaluation of the results revealed favorable clinical outcomes according to both patients and physicians. The mean chest circumference was significantly reduced by approximately 3,2cm. The ultrasound scan revealed reduction of subcutaneous fat and increase of collagen-elastin proportion, giving the appearance of skin tightening due to laser-induced collagenesis. The complications mentioned such as pain, edema and ecchymosis were mild and subsided shortly after the procedure.

Conclusion: Nd:YAG Laser assisted Liposuction constitutes a safe and effective treatment for gynecomastia providing comparable results to those of traditional liposuction with the additional positive effect of skin tightening.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Labiaplasty for non-cosmetic gynecologists: how to be a hero

Objectives: This presentation aims to answer the following questions: (1) what are the indications of labiaplasty? (2) how to communicate with a labiaplasty patient? (3) how to set expectations and when to say "NO"? (4) what are the differences between v-wedge and linear resection? (5) how to choose the right procedure for the right patient for the right reasons? (6) who is at higher risk of complications? (7) how to deal with the clitoral hood? (8) what are the marking, cutting, suturing, and postoperative guidelines for a successful labiaplasty?

Introduction: Cosmetic surgery of the female genitalia is performed across several specialties including gynecology, dermatology, and plastic surgery. Labiaplasty is the fastest growing cosmetic female genital surgery procedure. It involves surgical modification of either the labia majora or minora, but most commonly, a reduction in the size of the labia minora.

The most commonly utilized surgical techniques for labiaplasty are v-wedge and linear resection of the labia minora. The goal often is to maintain the labial edge color and to correct a protrusion of the labia minora beyond the majora.

Conclusion: Using appropriate techniques, labiaplasty creates high patient satisfaction, with a low incidence of complications. However, the surgical skill required is often underestimated resulting in complications such as over-resection, asymmetry, and dehiscence.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Using eyelids fat compartments in facial rejuvenation and rhinoplasty

Objectives: Demonstrate the use of removable eyelid fat packs as a material for face and nose contouring

Introduction: Traditional methods of facial contouring are injectable fillers based on hyaluronic acid, as well as lipofilling. While performing blepharoplasty, the methodology of fat compartments transposition to correct the periorbital region is applied. In addition to the above, various combinations of cartilage-fascia grafts are used for contouring the nose. In my practice, I actively use removed excess fat compartments for contouring the face and nose.

Materials / method: Removal and preparation of transplants is performed during blepharoplasty in patients with excess eyelid fat compartments. Fat grafts are used for additional correction of the nasolacrimal sulcus and periorbital region alone or in addition to displaced lower eyelids herniated fat pads. Separately, fat grafts are used in contouring eyebrows, glabellar area, nasofrontal angle, lips “puppet wrinkles” and camouflage of the nasal dorsum.

Results: Contouring of the face and nose with the help of eyelid fat compartments in the combination with blepharoplasty was performed in 34 female patients aged from 25 to 62 years with the follow-up period of 8 to 12 months. In 28 cases (82%) there was a stable result of improving the contours of the corrected zones. Partial lysis was observed in 8 cases (23%), 6 of which were in smoking patients. No inflammatory complications and the formation of persistent infiltration and contour deformation of the “sausage” type were observed.

Conclusion: Possibilities of contouring the face and nose with the help of removed excess fat compartments are limited only by their not always large volume. However, when performing blepharoplasty, they can be considered a valuable material in the correction of any problem areas on the face, including rhinoplasty.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

New trends in aesthetic medicine: contouring - Threads vs fillers

Objectives: To demonstrate that using threads is safer than use of fillers for face contouring
To demonstrate the advantages of using threads over use of fillers in face contouring
To demonstrate that threads reduce over correction in contrast to fillers

Introduction: Contouring is considered a new trend in aesthetic medicine. Contouring requires a larger amount of fillers than in conventional filler injection as it is required to create a pronounced shape in various facial areas. That leads to higher vascular risks,impaired lymphatic drainage  and excess fibrosis. The way that fillers create the facial contours may lead to overcorrection and contour deformation over time. Also using fillers in contouring has higher economical demands than threads. Use of threads helps to reduce both physiological and economical limitations mentioned above.

Materials / method: Fillers Injection:
   Generally conducted using local anesthesia. The recovery period doesn’t take long, unless such complications as hаematoma or swelling take place.
Threads injection:
  Takes longer time to prepare as it requires injection anesthesia, where some form of swelling formation takes place. It requires a highly sterile handling , i.e. wearing sterile gloves, disinfecting the skin surface using Betadine, wrapping the surface of the target zone with sterile wipes and using one-time set of threads each time. The recovery period varies individually but generally takes up to 2 weeks.

Results:   As threads occupy considerably smaller area within tissues than fillers, their use demonstrate a number of advantages over fillers: more natural face shapes, greater tissue density, reduced migration and diffusion of the contours of the created volume, more defined,regular and stable resulting shapes (i.e.  cheekbones, chin, corner of the lower jaw)

Conclusion:    Being able to avoid such complications as vascular embolism makes threads a more favorable method for face contouring. By occupying smaller area within tissues, threads are reducing the risk of overcorrection. The long-term effects from using threads are more favorable than from fillers due to that threads leave the target tissue in a more healthy, elastic and not over-filled state. In a long run, this allows to perform better correction in tissues filled with threads than in tissues over-filled with fillers.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Combination of transmucous and transcutaneous treatment of periorbital region with Er:YAG laser

Objectives: This cases study aims to evaluate efficacy, safety and satisfaction of treatment of sagging skin, muscles and ligaments of the periorbital region using a new transmucous approach with erbium: YAG laser as an alternative to patients who do not wish to undergo the surgical procedure.

Introduction: The periocular region plays main role in the aging process, so it is important to maintain its volume and support properties.
Wrinkles and sagging around the eyes is a common complaint in the plastic surgery office, however patients today are seeking less invasive and less downtime therapies and are less inclined to undergo blepharoplasty surgery even with indication.The occidental upper eyelid has levator extensions inserting onto the skin surface to define a lid-fold that averages 6–8 mm above the lid margin, in the aging eyelid, the septum becomes attenuated and stretches.

Materials / method: 333 laser periorbital treatments were performed in 112 patients from October 2018 through May 2019. 32 men and 80 women were treated with 3 sessions per patient. We used a hybrid technique of transcutaneous and transmucous treatment using Erbium: YAG sub-ablative micro pulses that effectively “pump” the heat away from the surface deeper into the tissue with help of a retractor. Thirty days after the last treatment, patients were asked about their satisfaction with the procedure. Their photos were subjected to comparative measurements of the lid-fold distance above the lid margin.

Results: The average patients age was 49.4 years. The average interval between sessions was 32 days. Clinically all patients had eyebrow elevation, eyelid retraction with increased distance between lid-fold and lid margin. The results were documented by high definition photography. 93.75% of the patients rated their results as good or excellent, 6.25% rated as moderate improvement and none were dissatisfied. There was a case of eye irritation that resolved within 3 days with the use of lubricating eye drops. 35 patients who had previously undergone blepharoplasty, rated their results as excellent.

Conclusion: We conclude that the method that combines transmucous and transcutaneous laser treatment is highly effective for treatment of the periorbital region and offers an alternative to surgical treatment as well as maintaining long-term surgical outcome while minimizing the number of interventions required in the region.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Neck recontouring using a combination approach: an alternative to surgical rhytidectomy

Objectives: -Patients with submental fat, jowls formation, digastric muscle hypertrophy and platysma bands were selected
-Cryoliposculpt treatment for 1-3 sessions
-Filler for jawline reconstruction was used were appropriate

Introduction: Rejuvenation of the neck refers to a well-defined and appropriately balanced mandible and an acute cervicomental angle. Conventional surgical and non-surgical techniques have failed to provide satisfactory results to patients. An innovative approach using a novel Cryoliposculpt procedure with simultaneous active vacuum technology and short duration, high peak electric pulses is providing promising results.

Materials / method: Patients with submental fat were invited to take part in the study. Patients that had a previous rhytidectomy were excluded from the study. 50 patients that met the criteria had a treatment with the Cryoliposculpt procedure at 2-3 different sites. At 6 weeks intervals patients were invited to have a second and third treatment. At 6 weeks following the last treatment, patients were invited for photographs and punch biopsies. Filler was used were appropriate for jawline reconstruction following the treatment.

Results: The results have showed a neck recontouring following 1- 3 treatments. Histologic findings were in accordance with photos and patients satisfaction. Adverse effects included bruising and numbing of the area, which lasted few days following treatment.

Conclusion: Neck recontouring using the combined approach of the Cryoliposculpt procedure shows promising results for patients that want to avoid surgical platysma rhytidectomy.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Non-surgical rhinoplasty: the nose cross threads technique

Objectives: We present a completely new, effective and long lasting technique for nose reshaping using PDO (polydioxanone) threads: the nose cross threads technique.

Introduction: The nose is an anatomic-functional structure positioned at the centre of the face and therefore constitutes a fundamental element in the definition of a harmonious face. This explains why even today rhinoplasty represents one of the most requested interventions in the world. Even if surgical rhinoplasty remains the gold-standard to improve the aesthetic appearance of the nose shape, in some cases patients require a small nose touch-up with less invasive procedures.

Materials / method: Between March 2018 and September 2019, 80 patients were selected to be submitted to the nose cross threads technique. Four or five PDO threads size 19/100 L shape cannula with 6 directions barbed sutures have been used. Three entry points have been marked, the first 2 to 4 mm inferior to nasal tip, the other two were located in both paranasal line, 2 to 3 mm above ala nasi. From the nasal tip two or three threads have been inserted subcutaneously for slimming, reshaping the bridge and narrowing the tip of the nose, other two threads were inserted from paranasal line in a X shape, crossing eac

Results: In all cases a good improvement of nose shape has been achieved. The procedure has been well tolerated by all 80 patients. One of them presented a local inflammation in the early follow-up, resolved with steroid therapy for 3 days. No infections occurred. At late follow-up of 12 months the new nose shape was still present with great patients satisfaction.

Conclusion: This new technique for nose reshaping is safe and effective. The cross insertion of the threads, completely new and original, allows a longer lasting result in comparison with the other techniques for nose reshaping used so far.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Beauty concepts and facial proportions: a guide towards more beautiful aesthetic results

Objectives: Teach the new injectors about the history and the new concepts of beauty and the available injection points depending on these concepts to achieve a more natural and more beautiful results .

Introduction: Throughout history, humankind has been obsessed with beauty, and the fountain of youth. But the current powerful media influence idealizing the face and body appearance, has caused a massive global negative effect increasing dissatisfaction and doubts about ones looks and body shape, and has grown the demand to turn back the clock and stay young as long as possible, more than ever before. This brought up the topics of Aesthetic procedures, Anti-aging techniques and new plastic surgery techniques to the top head lines of the magazines, TV shows and scientific conferences.

Materials / method: Its a review of literature about the the beauty concepts and the modern injection plans and points based on it
set examples for facial measures (eye brows, cheeks, & lips )

Results: more natural more beautiful results, that is specific to each person's character and spirit.

Conclusion: Though beauty is subjective and there’s no defined rules or specific measures for it, yet as aesthetic physicians we can get the proper guidance to beautiful aesthetic results using the beauty concepts and facial profiles measures, as well as our proper knowledge of the anatomy and blend it with art, and only then you can get a harmonized, unique, natural beauty that reflects each individual spirit and character.
Always remind your patients who ask to be a replica of a certain star or celebrity, that beauty trends always expire, but beautiful faces remains timelessly beautiful.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Lips rejuvenation and volumization

Objectives: Aim of the lecture : Cover anatomy of perioral area , aging stages of lips and calcification of dental occlusion that has direct impact on lips relation and appearance .
In her lecture Dr.Olha will cover different techniques on lips augmentation and rejuvenation using combine therapies : dermal fillers , pdo threads, Botulinum toxin , chemical peels and medical micro-needling.
Lecture will cover difference between rejuvenation and volumasation of the lips

Lecture suitable for intermediate and advance practitioners.

Introduction: Popularity of lip fillers grows dramatically year by year . Although it is still remain one of the most common areas where complications occurs and even some relatively experience injectors have doubts and even fears about lip filler treatment.

Materials / method: Lecture will be delivered by Dr.Olha , power point with photo and video supported materials will be used .
In her lecture Dr.Olha will cover different techniques on lips augmentation and rejuvenation using combine materials such as : dermal fillers , pdo threads, Botulinum toxin , chemical peels and medical micro-needling.

Results: Photo of before and after Dr.Olha's clinical cases will be provided to support the lecture

Conclusion: Raise practitioners awareness about different techniques using HA fillers in lips volumisation and perioral rejuvenation: direct and indirect approaches using fillers with cannula and needles.
Complication prevention and management

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Patient satisfaction with absorbable anchoring facial threads

Objectives: -Are absorbable threads anchored to the temporalis fascia efficient as far as facial appearance and quality of life?
-What is the downtime of such procedure?
-Which area of the face is mostly affected by this technique ?

Introduction: The efficacy of thread lifting is still very controversial and different opinions are present in the literature about its efficacy in delivering effective long-term results with less complications, and greater patient satisfaction. Few reports studied the clinical results of anchored non-absorbable threads. The aim of this study is to evaluate patients’ satisfaction as far as facial appearance, quality of life, and adverse effects after undergoing facial thread lifting using the absorbable facial threads anchored on the superficial and deep temporal fascia.

Materials / method: The charts of patients for whom facial anchored thread lifting was performed using absorbable threads between February 2017 and September 2019 were studied. Demographic data including age and gender was collected. The filled Face-Q scales were also collected. Descriptive analysis was made for the adverse effects one week after the procedure. The mean value of adverse effects scales was compared one and two weeks after the procedure and also the mean values of facial appearance and quality of life scales were compared before, six months and twelve months after the procedure.

Results: All recruited subjects were females with a mean age of 43. There was a statistically significant decrease in the rate of adverse effects following the procedure between the first and second week.
The mean difference in patient’s perceived age before, six, and twelve months after the procedure was statistically significant.
The psychological distress significantly decreased and the psychological function improved 6 and 12 months after the procedure. The satisfaction with overall facial appearance increased significantly 6 months after with a mean of 20.08 and it was maintained 12 months after.

Conclusion: Face lifting using the polycaporolactone threads anchored on the temporalis fascia showed a significant improvement in the quality of life and facial appearance. The adverse effects are better tolerated by the patient 2 weeks after the procedure.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Italian ketogenic diet

Objectives: Obesity plays a relevant pathophysiological role in the development of health problems, arising as result of complex interaction of genetic, nutritional and metabolic factors. We conducted a dietary intervention case-control randomized trial, to compare the effectiveness on body composition of two nutri- tional protocols: a very-low-carbohydrate keto- genic diet (VLCKD), integrated by an aminoacid supplement with whey protein, and very low re- stricted-calorie diet (VLCD).

Introduction: The clinical study was conducted with a randomized case-con- trol in which twenty-five healthy subjects gave informed consent to participate in the interven- tional study and were evaluated for their health and nutritional status, by anthropometric, and body composition evaluation.

Materials / method: The results of this pilot study show that a diet low in carbohydrates, associated with a decreased caloric intake, is effective in weight loss. After VLCKD, versus VLCD, no significant differences in body lean of the trunk, body lean distribution (android and gynoid), total body lean were observed (p > 0.05). After VLCKD, no increasing of sarcopenia frequency, according ASSMI, was observed.

Results: Many studies have shown the effectiveness of the ketogenic diet on weight loss; even if not know how to work effectively, as some researchers believe that the weight loss is due to reduced calorie intake, satiety could also be induced by the effect of the proteins, rather than the low-carbohydrates.

Conclusion: Our pilot study showed that a VLCKD was highly effective in terms of body weight reduction without to induce lean body mass loss, preventing the risk of sarcopenia. Further clinical trials are needed on a larger pop- ulation and long-term body weight maintenance and risk factors management effects of VLCKD. There is no doubt, however, that a proper dietary approach would impact significantly on the re- duction of public expenditure costs, in view of prospective data on increasing the percentage of obese people in our nation.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Clinical experience of laser treatment of acne conglobate with concomitant oral isotretinoin

Objectives: Clinical evaluation of the efficacy and safety of a combination of laser methods and oral isotretinoin in the treatment of a patient with conglobate acne

Introduction: To refusal of laser and other cosmetic procedures on patients receiving or having recently received oral isotretinoin is a medical and legal standard and this contraindication is included in the official instructions of drags of 13-cis-retinoic acid. To date, there are a number of publications demonstrating the effectiveness and safety of this combination. However, probable medicolegal risks limit the use of this combination treatment in wide practice. The accumulation of positive experiences is important in the revision of the current protocol.

Materials / method: A clinical case of combined therapy of a patient with conglobate acne with concomitant oral isotretinoin. The decision to use laser treatment in combination with oral isotretinoin (16 mg per day) was made taking into account the presence of instability of inflammatory process and the pronounced scars with tendency hypertrophy on the face, which had significant negative impact on the psychological status of the patient. The course of laser treatment included 4 sessions with ND:YAP/KTP (1079/540 nm) laser, and 7 sessions of Er:YAG (2940 nm) with RecoSMA technology.
Documentation was based on photocontrol treatment outcome and the dynamics of value of Dermatology Life Quality Index (DLQI).

Results: During 1,5 year of treatment of the patient with severe widespread acne conglobate resistant course we have achieved stable remission of inflammation, expressed aesthetic result of scar correction and had a positive impact on the psychological status and social adaptation of the patient. No negative reactions have been observed. The result of treatment of this patient was compared with a similar clinical case of the patient with conglobate acne using isotretinoin monotherapy.

Conclusion: The combination of oral isotretinoin and laser methods in the treatment of severe acne is a topical and promising direction, the possible risk of which are probably lower than previously thought. Further study and accumulate of experience is needed to create treatment protocols with a high safety profile of this combination.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Lips architecture: age aspects of augmentation

Objectives: To make a clear-cut algorithms for lip augmentation, taking age specifics of lips shape.

Introduction: Lips zone is the first thing your interlocutor pays attention to. For a woman lips are the focus of her face. That's why it is so important to augment lips aesthetically taking into consideration not only proportions of a face, but also age specifics of lips. Architecture of lips should change for each age group.

To make your work look in the most aesthetic way, it is important to choose fillers of different density, since lips naturally have inhomogeneous structure.

Materials / method: In my work I determine age specifics of lips shape, materials of which density to use for aesthetic augmentation, and, based on the physiognomy data, define how optical features can influence complex perception of woman`s image. Besides, special attention is paid to augmentation of thin lips, the tactic applied to them and ways to prepare tissues for extensive augmentation.

Results: Graphics and videos with algorithms of lip augmentations with different density material based on age specifics of lips shape.

Conclusion: The issue of lips augmentation that brings out woman’s natural beauty and does not deprive her of individuality has become an important issue in modern society. Fashion for Insta Size lips have passed and modern augmentation strives for the most aesthetic result taking into consideration age specifics of the face.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Facial asymmetry and orhtodontics

Objectives: To learn the following:
What is facial asymmetry?
Its etiology & classification
Its prevalence
Diagnosis : Patient’s interview
Clinical Examination
Radiographic examination
Assessment of structures involved
2D Vs 3D ?
3D Evaluation of facial asymmetry using CBCT
Facial asymmetry in Orthodontic patients with different growth patterns.
Role of Orthodontics in treatment of facial asymmetry.

Introduction: With the recent advances in the 3D radiographic modalities, facial asymmetry could be evaluated with greater accuracy. The patient’s growth pattern influences the skeletal, dental, soft tissue components of the face, as well as the facial profile. Since, these components are contributing to facial asymmetry, assessment of facial asymmetry in patients with different vertical growth patterns is an essential part of diagnosis. The purpose of the present study was to use the cone-beam computed tomography in the evaluation of facial asymmetry in patients with different growth patterns.

Materials / method: Consents were taken from the participants before conducting the study.Cone-beam computed tomography (CT) scans were obtained in
30 adults (11men, 19 women) with different vertical growth pattern, and reconstructed into 3-dimensional (3D) models by using a 3D image software. Six parameters were used in the 3D assessment of facial asymmetry ; four linear measurements (in millimeters) and two angular measurements (in degrees) , and their right and left differences were calculated and analyzed.

Results: The right and left difference values derived from the study indicated a degree of facial asymmetry in all types of growers . The lateral ramal inclination was the most asymmetric value among the vertical growers , while for the horizontal growers , the highest asymmetry was found at the frontal ramal inclination. The normal growers showed the highest asymmetry at the ramus length.

Conclusion: A degree of facial asymmetry is detected regardless the type of growth.The lateral ramal inclination is a significant parameter in the assessment of facial asymmetry in all types of growers. Facial asymmetry has a tendency to increase according to the lower and lateral positioning of the landmarks in the face. There is a tendency towards left-side dominance.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability my supervisors Dr.Abbadi El Kadi and Dr Mohamed Nadim and all my family

A systematic review on the vascular complications following injection rhinoplasty with HA fillers

Objectives: Injection rhinoplasty or non-surgical nose reshaping is a popular procedure taking place world-wide. There has been tremendous demand in use of hyaluronic acid fillers for any cosmetic procedures because of its high biocompatibility, biodegradability, and non-immunogenicity. With the increase in number of patients opting for non-surgical rhinoplasty, more complications are documented.We intend to find precautionary measures to be undertaken while injecting a vascular area like nose and to understand the management of such complications to minimize loss.

Introduction: Nose is the aesthetic centre of the face and most of the patients turn up to aesthetic clinics these days to enhance their nose. Injection rhinoplasty has gained popularity because it is less expensive, it has potential for reversibility with no or minimal downtime. We intend to review the vascular complications associated with hyaluronic acid fillers.These complications range from skin necrosis due to pressure ischemia to blindness and cerebral stroke.

Materials / method: A thorough search of all the relevant research by using the key words that meets clearly defined inclusion and exclusion criteria are chosen. Search terms used are vascular complications, hyaluronic acid filler, blindness, skin necrosis, etc. A thorough search of The Pubmed, Medline, and Cochrane Library were made and relevant articles published up to September 2017 were analyzed based on specific inclusion criteria.

Results: A total of 36 studies have been included in the review.Injection rhinoplasty being mostly performed in Asian countries , complications are reported more from this part of the world (mostly in South Korea, Singapore and China).There are many studies from case reviews to case studies to find out the pattern of the complications like visual loss or skin necrosis to prevent it but, very few case studies provide an effective treatment algorithm that can be quickly and safely followed by the clinics in the case of accidental intravascular injection with impending blindness.

Conclusion: From the studies mentioned and from certain case reports and consensus done, we suggested some protocols to be followed to avoid adverse effects.The dangerous site commonly believed to be at greater risk for necrosis is glabella, but it can also occur at the nasolabial fold. some of the precautions to be followed to avoid such complications are: aspiration during injection, avoid using large volume of product, inject with precaution in areas where scar is present, use microcanualae which reduces the risk, use a temporary and biodegradable product in such areas of high vascularity.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Approach to laser treatment of colored skin patients

Objectives: The actual work aims at two major problems encountered with laser treatment of ethnic skin. The first one is how to avoid adverse effects, such as blistering, crusting, dyspigmentation and scarring, while improving the clinical outcome during laser treatments. The second one is how to prevent complications, especially post-inflammatory hyperpigmentation (PIH) after laser treatment.

Introduction: People of colored skin comprise the majority of the world population, and Asian subjects account for more than half of the total population of the Earth. Even so, the literature on the characteristics of colored skin and its treatment with lasers is limited.

Materials / method: Dark skin patients were treated with lasers for several problems, like hair reduction, hyperpigmented lesions (dark eye circles, melasma, lentigines, acanthosis nigricans, naevus of Ota), scar revision (acne, accident & post-surgical scars), stretch marks, skin lift and others. The laser treatments' results carried out show that trends are already developing in the laser treatment of dark skin patients with specific laser devices. The commonly met adverse reactions and complications are being skillfully avoided with the application of new generations of laser devices.

Results: The development of advanced laser technologies, the proper training of doctors, the appropriate application of treatment techniques, the growing experience of treating doctors and the use of individualized treatment protocols (wavelength, laser fluence & the number of passes) help prevent the undesirable post-treatment sequelae. Thorough pre-treatment patient preparation (informed consent) regarding the risks of cutaneous laser therapy remains an essential component in the treatment of dark skin patients in terms of results' expectations and complications' awareness.

Conclusion: In the future, more refined laser technologies will evolve to provide us with the ability to safely and effectively treat colored skin patients.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

IPL for the treatment of rosacea resistant to doxycycline and metronidazole gel

Objectives: Background Rosacea is a chronic disease that affects the skin aesthetic appearance. Doxycycline is the first line oral medication to treat rosacea, while metronidazole gel is the first line topical medication to treat rosacea.

Introduction: There are patients who are resistant to both treatments. We are going to present 3 rosacea Chinese patients who are resistant to the above said treatments but responded well to intense pulsed light treatment.

Materials / method: Methods 3 cases with oral doxycycline and metronidazole gel treated rosacea patients were referred by other doctors were studied. All 3 of them received 8 sessions of IPL treatment in a 4 weekly interval. Clinical photos were taken in every visits. Two individual blinded investigators were asked to assess and compare with the pretreatment photos.

Results: Results There were significant clinical improvement in the erythema, telangiectasia, number of papules and pustules. Patients were satisfied after the treatment.

Conclusion: Conclusion This study suggests IPL is effective in improving the erythema, telangiectasia, number of papules and pustules, despite the patients were resistant to oral doxycycline and metronidazole gel.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Correction of gluteal area with threads

Objectives: In modern social community our patients ask the aesthetical correction of their visual disadvantages not on the face only, but with increase of period of sexual activity on their body too. With increasing of the volume of gluteal area, they ask for increase of quality of skin and tightening of subcutaneous soft tissue. There are a lot of biomechanical, chemical and injection methods for better quality of skin, but only thread lifting is able in the same procedure to replace the exist volume and fixate it in the new position with increasing of quality of skin thanks their chemical composition.

Introduction: The acceptation of some anatomical rules and combination of lifting and bioregenerating threads guarantee for our patients good results with replace the volume and regenerating and tightening of skin and subcutaneous soft tissue without more invasive plastic surgery operation. Great bonuses of treatment for our patients are short rehabilitation period, absence of operation wounds and postoperation scars. Of course, the results of this mini-invasive procedure are in area of corrective dermatology and aesthetic surgery.

Materials / method: In this presentation we would like to present the method of aesthetical correction of gluteal area with threads. There are threads with barbs with both-side sharp needles. The chemical composition of thread is PCL and PLA, diameter of thread is 6/0, length 500 mm. We would like to show you some anatomical concepts for thread implantation in gluteal area. For these cases we realized the 4 dissections of female cadavers in Medical Faculty Department of Anatomy and Pathology of Comenius University in Bratislava. For results of this presentation were threated 10 female patients.

Results: We were threated 10 female patients with our presented method with combination of implantation of lifting threads with barbs and bioregenerating threads with barbs. The patients were photographed, the distance from gluteal fold till palpate indetected of spina iliatica posterior superrior were measured; the questionary of satisfied with result of procedure were filled. The 7 from 10 patients were full satisfied with result of thread implantation correction, 2 from 10 were satisfied with result of correction, 1 from 10 were not satisfied with result.

Conclusion: Good knowledge of anatomy helps to choice adequate of mini-invasive procedure and decrease of risks of procedure.
Good understanding of physical parameters of barbs and chemical composition of threads guarantee us to choice the best material for thread correction of gluteal area.
The combination of implantation of lifting and regenerating threads are universal method for replace of soft tissue, fixate them in the new position and tightening of subcutaneous soft tissue as universal physic-mechanical, chemical and mini-invasive method.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
Yes
Please specify date...: МПК A61F 9/007 RU confirmed for registration
and status : 8/10/2019

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Full-face aesthetic treatment involving several treatment modalities may improve facial aesthetic outcome

Objectives: To evaluate clinical outcome and perception of treatment with either abobotulinumtoxinA (ABO) or hyaluronic acid (HA) filler followed by repeated combined treatment with ABO, HA filler, and Skinboosters (SB) .

Introduction: Full-face aesthetic treatment involving several treatment modalities may improve facial aesthetic outcome.

Materials / method: The published literature till 2019 was reviewed.

Results: Repeated full-face combination treatment with ABO, HA filler, and SB was associated with considerably higher levels of aesthetic improvement and subject satisfaction than monotherapy with ABO or HA filler.

Conclusion: Repeated combination treatment achieved greater change in global facial aesthetic appearance than monotherapy. Aesthetic improvement and subject satisfaction was high and increased with each treatment.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Correlation between facial muscle movements and facial wrinkles

Objectives: This lecture is aimed to assist practitioners to understand the main cause of common facial wrinkles and their relationship with specific muscles. This helps them target the appropriate muscles when they administer neurotoxin to treat wrinkles or facial lines.

Introduction: The common wrinkles of the face are caused by increased contracture of the facial muscles. However, we can not always understand which wrinkle is exactly correlated with which muscle. As a result, injecting into the wrong muscle will not provide the best expected result. The deeper knowledge of correlation of facial muscles with the wrinkles will result in a more desirable outcome of treating these wrinkles. This also prevents unnecessary toxin injection into the muscles which are not causing the wrinkle.

Materials / method: In this lecture, I will go through the list of common facial wrinkles and their correlation with the specific muscles. I will also review the misconception about some specific wrinkles / facial lines. For each wrinkle/line I will introduce what neurotoxin treatment will provide the best result.

Results: We can expect to have a better treatment of wrinkles when the audience have this detailed knowledge.

Conclusion: The goal of this lecture is to give practitioners a better understanding of the correlation of facial muscle movements with specific wrinkles or facial lines in order to apply a better treatment with neurotoxins.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

SM lips - New injection technique for lip augmentation

Objectives: The objective of this presentation is to describe our SM Lips technique for lip augmentation to achieve balanced and natural lips look, with less product, less pain, lower risk for complication and very high patient satisfaction.

Introduction: Besides patient lip anatomy, lip augmentation technique is the major determinant for its outcome, especially if we want to achieve natural looking lips, that are in aesthetic harmony with the face. Most commonly lip augmentation is related to 1ml of hyaluronic acid filler per procedure, however different technique can significantly lower also product consumption, without compromising lips volume and shape. With SM Lips technique we can achieve balanced and natural lips look, with less product, less pain, lower risk for complication and very high patient satisfaction.

Materials / method: In the SM Lips injection technique, we first clinically examined patient’s lips to be able to select proper product according to the G' prime of hyaluronic acid filler. In some cases, we decided to use two different G' prime fillers for the same patient. After that we decanted hyaluronic acid filler into one or multiple 32-gauge fine micro syringes, preferably 0.3ml of filler per one 32-gauge syringe. The filler was then injected through multiple entry points on the vermilion border for the upper lip and the lower lip, with retrograde linear technique or lollipop technique.

Results: Between August 2019 and November 2019, 100 female patients underwent a nonsurgical lip augmentation procedure with hyaluronic acid fillers using this technique. Ninety-five patients (95%) reported that they were satisfied or extremely satisfied with their lip augmentation procedure. Amount of hyaluronic acid filler used per patient was between 0.25 ml up to 1.00 ml, in average 0.5 ml. No serious complications were observed.

Conclusion: The advantages of this technique are: 1) enhanced hyaluronic acid filler injection process, because of more accurate product delivery and placement, more balanced and symmetrical result, fast filler tissue integration, very natural lips appearance
2) reducing the risk of complications like erythema, bruising, oedema and arterial vascular occlusion 3) less amount of product needed for the required result (up to 50% less) 4) less injection pain, fast recovery time and higher levels of overall patient satisfaction

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

A prognostic tool for hypertrophic scar formation based on fundamental differences in systemic immunity

Objectives: In this talk it will be described how we can predict the formation of a hypertrophic scar out of wound healing by a patch test or a combination of two growth factors.

Introduction: Unpredictable hypertrophic scarring (HS) occurs after approximately 35% of all surgical procedures and causes significant physical and psychological complaints. Parallel to know the processes underlying HS formation, methods to determine whether an individual is predisposed to HS formation are required. Here we investigated whether differences in systemic immunity could be exploited to predict patients prone to HS after surgery.

Materials / method: A prospective cohort study was designed with normal scar (NS) and HS groups in which i) cytokine release by peripheral blood mononuclear cells (PBMC) and ii) the irritation threshold (IT) after an irritant (sodium lauryl sulphate) patch test were evaluated.

Results: The results of a univariate regression analysis of PBMC cytokine secretion show that low MCP-1, IL-8, IL-18 and IL-23 levels have a strong significant correlation with HS (p<0.010-0.004; AUC= 0.790-0.883). Notably, combinations of 2 cytokines (MCP-1 and IL-23; AUC: 0.921, Nagelkerke R2: 0.703) or 3 cytokines (TNF-a, MCP-1and IL-23; AUC: 0.942, Nagelkerke R2: 0.727) showed an improved AUC indicating better correlation with HS than single cytokine analysis. These combination models produce excellent prognostic results over a broad probability range (sensitivity: 93.8%, specificity 86.7%

Conclusion: Very fundamental immunological differences exist between individuals who develop HS and those who do not. More importantly, the suppressed PBMC cytokine secretion observed in HS individuals compared to NS individuals is the basis of an extremely predictive prognostic test for HT formation. The less invasive irritant skin patch test showed a very strong induction response in HS compared to NS individuals and provides a more accessible option for daily practice.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Outcome and safety of tear-trough filler injection using a cannula technique

Objectives: Understanding the techniques, materials, complications and outcome related to tear-trough dermal filler injection using a cannula.

Introduction: The Tear-Trough area is one of the most challenging for filler injection. Proper choice of the dermal filler, injection technique and injection device can avoid several side effects and complications.

Materials / method: This is a report on a series of 350 cases performed by 2 dermatologists over a 4-year period using 25 gauge / 38 mm cannulas. The last 100 cases were performed using fillers with lidocaine. For the Tear-Trough area we usually use cross linked hyaluronic acid fillers with low G prime.
The injection process was slow placing very small aliquots close to and above the inferior orbital margin. Gentle movement of the cannula was performed with no forceful pressure. Post injection pressure was applied with gauze at the cannula insertion point to avoid bruising. Video demonstration will be included.

Results: No bruising or significant swelling were noted using this technique. However, when using lidocaine impregnated fillers. Few patients complained of eyelid heaviness (9%) and blurred vision (3%) that lasted for a couple of hours. It was attributed to the effect of lidocaine on the periorbital muscles. One case complained of a migraine-like attack that resolved in 4 days without sequelae. The details will be discussed.

Conclusion: The use of a 25 gauge/ 38 mm cannula was shown to be safe and effective for filler treatment of the Tear-Trough area, and totally avoided bruising.
However, one needs to be aware of the effects of lidocaine impregnated fillers in this area to avoid undue anxiety for both the patient and physician.
limitations: This study is a retrospective case series and the number is not enough to confirm the safety regarding intravascular injection related complications.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

High power mid-infrared 1540nm Erbium: Glass fractional laser: facial rejuvenation by dermal coagulation

Objectives: To evaluate safety and efficacy of a high energy fractional 1540nm Erbium: Glass Laser for skin rejuvenation.

Introduction: Energy-based solutions for skin rejuvenation are abundant and continue to rise in demand. Current solutions either provide an effective but aggressive treatment with long downtime or a mild, dermal heating treatment with negligible downtime but less impressive results. Mid-infrared lasers however, provide an effective solution to skin rejuvenation with minimal downtime. Here we present the efficacy of a new high power 1540 erbium glass laser for skin rejuvenation, with almost no discomfort and no downtime.

Materials / method: 8 female patients with moderate to deep wrinkles (class II, Fitzpatrick Wrinkle Scale) were treated using a fractional 1540nm Er:Glass laser. Treatments were carried out on the entire face with a 49 pixels tip at 3000 mJ/pulse, 1 Hz and 1-2 passes. All patients underwent 4 treatment sessions with a 2-3-weeks interval and a follow-up visit at 3 to 4 weeks after the last treatment. Clinical evaluation was carried out by using GAIS scale comparing baseline and follow-up photographs by two independent dermatologists. Treatment settings were tested in an ex-vivo porcine model.

Results: All patients presented visible improvement in skin texture with an average GAIS score of 4.125. Patient satisfaction average score was 3.25. No major side effects were noted beside transient erythema and mild inconvenience at the day of the treatment. Porcine skin histology analysis presented explicit coagulation columns 500-750µm deep while keeping the epidermis intact.

Conclusion: Fractional Er:Glass laser was proven to be safe and effective treatment for facial rejuvenation. Since 1540nm wavelength is not absorbed by melanin, the treatment is considered safe for all skin types. No pain, down time or complication were correlated with treatments.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Clinical study of anti aging effect of sequential applications of biositmulating peeling device and booster injections

Objectives: The aim of the study was to evaluate, using 3D photosystem the effect of the sequential applications of biostimulating peeling device and booster injections in face rejuvenation

Introduction: The combination of the anti-aging molecules with different delivery systems is the most promising direction in the non-invasive aesthetic medicine.
Following this trend, innovative formula of active substances was created for a sequential treatment of aging combining a new peeling solution (a combination of AHA, anti-oxidants and new exclusive algae extract) with a skin booster injections (a solution of anti-oxidants, algae extract in native hyaluronic acid). The evaluation of anti-aging effect was made using 3D photosystem.

Materials / method: The study was conducted on 10 healthy volunteers (F, mean age 52).
The protocol consisted of 6 sequential treatments: one week peeling, next week booster and so on for 6 weeks.
The objective evaluation of the skin conditions (wrinkles, pores, skin uniformity and spots) using 3D photosystem was made before treatment (T=1) and 8 weeks later (T2).
A skincare software analyzes skin conditions (wrinkles, pore, skin uniformity and spots).

Results: The treatment protocol was found by patients not painful, pleasurable with no downtime. No side effects were reported during or after study conclusion.
All parameters (wrinkles, pores, spots, skin uniformity) improved 8 weeks after the protocol administration.

Conclusion: The results of the study confirm the effectiveness of the sequential approach without adding side effects

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Liposuction assisted deep plan face lift

Objectives: 1. Reduced time of skin undermining.
2. Improved mandibular line deformation.
3. Natural looking face.

Introduction: The most aggressive part of face lift surgery is skin layer undermining in the neck and lower face areas. Liposuction procedure helps with skin undressing and treats facial bulking.
During 2015-2019 period 175 patients were operated using personal face lift technique.

Materials / method: 1.Soft atraumatic liposuction through two symmetrical perforations in pre tragus areas to remove local excesses of adipose tissue in the parotid, melolabial and lower face areas.It develops skin mobilization in the neck, middle and lower face for further lifting.2.Extended face lift incision is performed. Face tissues are opened in different layers.3.SMAS lift and neck elevation is fixed in 3 key points with 3-0 Prolene anchoring sutures.4.Skin positioning without tension and face lift incision closure,Bichat fat pads are removed.5.Finally almost for all patients liposculpture is performed.

Results: Among 175 patients, who underwent mentioned above facelift technique, 163 (63%) were women and 12 (7%) male patients. Middle age was 48 years.
152 patients (responders) were evaluated clinically using standard post operative follow-up protocol and their images were reviewed by operated surgeon after one year post operation and later. The mean length of follow-up was 18 months (range 12-36 months). 128 (84%) patients were satisfied with the operation results (surgeon and patient agreement). 15 (10%) underwent additional correction procedures to improve face aesthetics.

Conclusion: • Neck and lower face liposuction reduces the time of skin undermining.
• Neck and lower face liposuction improves mandibular line deformation.
• Facelift performed in different tissue layers produces natural looking face.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Combination of low-power fractional CO₂ laser with Kligman's formula and topical methimazole 5% in the treatment of moderate to severe melasma

Objectives: The aim of this study was to compare the efficacy of combination therapy with Kligman's formula plus low-power fractional CO₂ laser versus topical methimazole plus low-power fractional CO₂ laser for treatment of moderate to severe melasma

Introduction: Melasma poses a great challenge, as its treatment modalities are unsatisfactory.

Materials / method: In this randomized, double-blind, split-face study, 48 female patients with melasma were enrolled and randomly allocated to treatment side of the face and applied a topical Kligman's formula or topical methimazole 5 % daily at night to each designated side of the face. They were treated with low-power fractional CO₂ laser every 3 weeks for six consecutive sessions and followed for 1 month after the last treatment session. Response to treatment was assessed using the Melanin Index (MI) score, modified Melasma Area and Severity Index (mMASI) score, and a subjective self-assessment and dermatolog

Results: There were substantial improvements in clinical evaluation after six treatments; however, this difference was not significant between two sides of the face. (p= 0.23). The differences between the mean MI and mMASI scores at baseline and at 1-month follow-up were compared between the two treatments and results were not statistically significant (p > 0.05). There were no significant adverse effects with either of the treatments.

Conclusion: This study concluded that combination of low-power fractional CO₂ laser with both Kligman's formula and topical methimazole 5 % is effective in the treatment of moderate to severe melasma.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Evaluation of the efficacy of drug delivery performed with ablative micropoints with Erbium Yag laser in androgenetic alopecia

Objectives: Evaluate the efficacy of drug delivery performed with ablative micropoints with Erbium-YAG laser in the treatment of male Androgenetic Alopecia(AGA)

Introduction: AGA is the most common type of hair loss in men. AGA manifests as a rarefaction of scalp hair with miniaturization of the follicles,sometimes seen as quiescent ones. There are no effective non-surgical treatments in the short term to improve the condition.Topical treatments used so far have a small ability to penetrate due to the barrier function of the skin. Recently, the use of lasers has been proposed to treat this condition. The Erbium Yag is laser technology able to activate quiescent follicles. Delivering drugs directly to dermis can increase the effectiveness of the treatment

Materials / method: Twelve male patients were selected for the study. Patients had their heads separated into two sides.Both sides were treated with fractional laser erbium robotic technology, but only one received drug delivery. The treatment was performed in 4 sessions at 15-day intervals. The results were evaluated by comparative photographs taken before and after the treatment period and the assessment of the patients’ opinion. The change in area with hair (hair zone) was evaluated with image analyzing software Image J

Results: Photographs and analyzing software Image J demonstrated treatment’s effectiveness in both sides; however, the side in which the substance was used showed superior results

Conclusion: Erbium Yag fractional laser is capable of activing quiescent foliculles. The drug delivery performed with ablative micropoints with Erbium Yag laser in AGA increased treatment’s effectiveness.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Solving the puzzle of High Definition Liposuction - A restrospective study of 368 cases

Objectives: 1. Review our experience and evaluate results of the high definition lipoplasty and fat grafting techniques.

2. Evaluate this techniques learning curve and share our experience.

Introduction: High definition lipoplasty represents an advanced and more artistic approach to conventional liposuction. The purpose of this study is to review our experience and evaluate results of the high definition lipoplasty and fat grafting techniques.

Materials / method: A retrospective chart review was performed for all patients who underwent ultrasound-assisted high definition lipoplasty alone or in combination with fat grafting at our clinic between January 2014 and May 2019. Only healthy men and women with a body mass index below 33 were included. Patient demographics, body morphological factors, type and timing of procedure, photographs taken before, during and after management and complications were collected and analysed.

Results: During the last 4 years, from January 2014 to May 2019, we performed 368 ultrasound-assisted high definition lipoplasty procedures, of whom 147 were men and 221 women with an average age of 47 years (range22-64). The mean body mass index was 28 kg/m2 (range, 21-33 kg/m2). One hundred and twenty-seven patients were active smokers. The first fifty procedures represented our “learning curve” and by keeping meticulous records and detailed descriptions of all stages of their recovery, we were able to minimize complications and provide more consistent and reproducible results. The mean follow-up

Conclusion: High definition liposculpture is a safe and reproducible form of advanced body contouring that utilises thorough liposuction and fat grafting to enhance muscular definition. However, it is a time-consuming procedure with a steep learning curve that is appropriate only for experienced surgeons.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Gut and skin microbiome: looking into the future of skin and anti-ageing treatments

Objectives: Objectives of our study are: 1. to present the available data about gut/skin microbiome imbalances and the development of common skin diseases and skin ageing 2. to present the potential revolutionary personalised skin and antiageing treatment options

Introduction: The microbiome is a vast collection of bacteria, viruses, fungi, and protozoa colonizing the gut, the skin and the mucosa. In the era of ‘’personalised medicine’’ or ‘’precision medicine’’, increased number of studies are focusing on the interaction between microbiota and the development of various cutaneous conditions, such as psoriasis or eczema. Moreover, data suggest that gut and skin microbiome play a significant role in the ageing process.

Results: Patients with psoriasis tend to have less diversity in their gut microbiome , while patients with eczema tend to have have significantly higher levels of S. Aureus on their skin compared to healthy controls. In rosacea there is a higher incidence of small intestinal bacterial overgrowth.
The loss of gut microbiome diversity plays also a key role in the ageing process.
Probiotics and prebiotics act similarly by restoring/maintaining the homeostasis of microbiome. Moreover, diet can play a role in changing the microbiome. Finally, nutricosmetics are becoming increasingly popular.

Conclusion: Microbiome can potentially serve in the future as the base for personalised skin approach for antiageing and beauty. We are in front of an exciting era that microbiome analysis could become a reality in personalized medicine , but further research is required.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Laser with optical micro-fiber, microfocalized ultrasound with vision system and guided subcision for global non-surgical buttock remodeling

Objectives: We evaluate the results of laser with optical micro-fibre technique combined with microfocalized ultrasound with vision system and guided subcision for global non-surgical buttock remodeling.

Materials / method: We report our experience after more than 5000 areas treated with laser with optical micro-fiber for the treatment of skin laxity of the face, neck and the body where 200 o 300 micron fiber is used for the face and the neck while instead a 300, 400 or 600 micron fiber is used for the body. The fiber is easily inserted, without incisions under the skin directly in the superficial hypo-derma. Immediately after a microfocalized ultrasound with vision system session is performed which allows in a single session to lift the muscles and the skin. After that, a session of guided subcision is performed: the new procedure represents the only FDA-cleared minimally invasive and clinically proven treatment to improve the cellulite blemishes for nearly four years in only one session.

Results: The areas of skin laxity of the buttocks, can benefits from the possibility that the Laser with optical micro-fiber has to retract the skin and remodel the derma, activate the collagen production, stimulate the neo-angiogenesis. The microfocalized ultrasound with vision system helps to obtain the maximum result possible working more deeply in the middle and deep hypo-derma up to the muscular fascia. The guided subcision procedure complete the full buttocks remodeling with a mini-invasive treatment of the cellulite blemishes.

Conclusion: The combination of laser with optical micro-fiber and microfocalized ultrasound with vision system is the the best non-surgical treatment for the areas of muscular and skin laxity of the face and the neck, but also of the body as the buttocks. The guided subcision procedure combines a proven approach with an innovative technology to treat the primary structural cause of cellulite blemishes in posterior thighs and buttocks.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Hours	Speakers	Lecture title	Abstract	Number
08:54	Dr Min Young CHO	Local anesthetic minimally invasive liposuction (LAMS) with capistrano super-wet hypotonic tumescent technique: its’ safety and benefit	View	100138
09:06	Dr Konstantina MAMALI	1064nm Nd:YAG laser assisted liposuction for the treatment of gynecomastia: a case series of 311 patients	View	99582
09:18	Dr Wael Ahmad AUWAD	Labiaplasty for non-cosmetic gynecologists: how to be a hero	View	99997
09:30	Dr Ilia ALMAZOV	Using eyelids fat compartments in facial rejuvenation and rhinoplasty	View	99713
09:42	Dr Elena BELISHEVA	New trends in aesthetic medicine: contouring - Threads vs fillers	View	98913
09:54	Dr Ana Carolina CHOCIAI	Combination of transmucous and transcutaneous treatment of periorbital region with Er:YAG laser	View	98813
10:06	Dr Eleana FERRARI	Neck recontouring using a combination approach: an alternative to surgical rhytidectomy	View	96621
10:18	Dr Ahmed HABIBA	Non-surgical rhinoplasty: the nose cross threads technique	View	98515
10:30	Dr Nadine HAMADA	Beauty concepts and facial proportions: a guide towards more beautiful aesthetic results	View	96678
10:42	Dr Olha VORODUKHINA	Lips rejuvenation and volumization	View	98277
10:54	Dr Georges Kamal ZIADE	Patient satisfaction with absorbable anchoring facial threads	View	98534
11:06	Dr Marco MARCHETTI	Italian ketogenic diet	View	95306
11:18	Dr Natalia KALASHNIKOVA	Clinical experience of laser treatment of acne conglobate with concomitant oral isotretinoin	View	99051
11:30	Dr Yana TOKAR	Lips architecture: age aspects of augmentation	View	98982
11:42	Dr Rim FATHALLA	Facial asymmetry and orhtodontics	View	97733
11:54	Dr Reema DAS MALLIK	A systematic review on the vascular complications following injection rhinoplasty with HA fillers	View	99089
12:06	Prof Pretidev RAMDAWON	Approach to laser treatment of colored skin patients	View	99201
12:18	Dr Lisa Kwin Wah CHAN	IPL for the treatment of rosacea resistant to doxycycline and metronidazole gel	View	99274
12:30	Dr Oscar JANSSEN	Live demonstration - Cutaneous echography device		100830
13:00		LUNCH BREAK		99064
14:00	Dr Natalia MARKOVA	Correction of gluteal area with threads	View	100236
14:12	Dr Shereen AHMED	Full-face aesthetic treatment involving several treatment modalities may improve facial aesthetic outcome	View	99266
14:24	Dr Mohsen TALANI	Correlation between facial muscle movements and facial wrinkles	View	99261
14:36	Dr Silvia SAMARIN	SM lips - New injection technique for lip augmentation	View	99499
14:48	Dr Frank NIESSEN	A prognostic tool for hypertrophic scar formation based on fundamental differences in systemic immunity	View	99503
15:00	Prof Hussein GHANEM	Outcome and safety of tear-trough filler injection using a cannula technique	View	99507
15:12	Dr Pablo NARANJO GARCIA	High power mid-infrared 1540nm Erbium: Glass fractional laser: facial rejuvenation by dermal coagulation	View	99626
15:24	Dr Irina POLEVA	Clinical study of anti aging effect of sequential applications of biositmulating peeling device and booster injections	View	100016
15:36	Dr Saulius VIKSRAITIS	Liposuction assisted deep plan face lift	View	100159
15:48	Dr Mohamad GOLDUST	Combination of low-power fractional CO₂ laser with Kligman's formula and topical methimazole 5% in the treatment of moderate to severe melasma	View	100164
16:00	Dr Patricia FABRINI DE ARAUJO	Evaluation of the efficacy of drug delivery performed with ablative micropoints with Erbium Yag laser in androgenetic alopecia	View	100137
16:12	Dr Athanasios ATHANASIOU	Solving the puzzle of High Definition Liposuction - A restrospective study of 368 cases	View	100171
16:24	Dr Maria Angeliki GKINI	Gut and skin microbiome: looking into the future of skin and anti-ageing treatments	View	100311
16:36	Dr Roberto DELLAVANZATO	Laser with optical micro-fiber, microfocalized ultrasound with vision system and guided subcision for global non-surgical buttock remodeling	View	100502

IMCAS World Congress 2020
Program

FOCUS ON S113 TO S120

Open Stage talks

Lectures of the session

Recommended sessions

IMCAS World Congress 2020 Program

FOCUS ON S113 TO S120

Open Stage talks

Lectures of the session

Recommended sessions

IMCAS World Congress 2020
Program