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IMCAS Filler Complications Survey

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Welcome to all aesthetic practitioners: thank you for your interest in this very first IMCAS Worldwide Survey on Cosmetic Fillers Complications. We are glad to count you as a part of that exciting study.

This survey has been written and conceived by the IMCAS Scientific Committee, with a very special thanks to:

Claudio DE LORENZI

Plastic Surgeon

Canada

Pierre NICOLAU

Plastic Surgeon

France

Michel ROUIF

Plastic Surgeon

France

THE PURPOSE of this confidential survey is to collect evidence based medicine data on the incidence of fillers complications. The participation is fully anonymous and opened to any practitionner dealing with fillers use in his / her practice. We're welcoming your answers and knowledge with gratitude for it will make this study more accurate.

THE OBJECTIVE of this survey is to measure the incidence and prevalence of complications arising from filler injections (ie vascular events, severe infections, granuloma and any others). This data has not been collected before in any reliable world way, and because of the increasing popularity of filler procedures, we have developed this questionnaire to collect important data that you can then use when counseling your patients.

TIME AND REWARD: the survey is designed to take less than 10 minutes of your time. Your time being valuable, you will be granted access to the extensive IMCAS Premium Media Access featuring more than recent 150 videotaped demonstrations. IMCAS is proud to offer you an unprecedented access to this valuable educational resource with 2 fully free months.

IMPORTANT - ANONYMITY AND CONFIDENTIALITY: though no confidential material or information is asked for during the survey fill in process, stay assured that this survey is strictly anonymous: answers will not be cross-referenced with names or emails, and all entries will be treated as pooled-data.

THE RESULTS will be presented during session 30 of IMCAS Annual Meeting 2012, "Fillers complications 2", on January 28th at the Palais des Congre`s, and published inside the IMCAS abstract booklet. Check out the full session content on the interactive program!

DEADLINE: Please note that the offer for IMCAS Media Premium stands for any participant who would have filled this survey before January 17th 2012.

Again, a warm thanks for your participation, and welcome to Paris!

The IMCAS Annual Meeting 2012 Scientific Committee

Part 1 - Demographic Data

Your email (optionnal)
(e-mails will not be cross-referenced with entries: all entries are CONFIDENTIAL and will only be treated as pooled data. Email can be useful to give if you wish to later participate to other IMCAS media experiences and sharing.)
1-1: Age
a) <30 years old b) 30-45 years c) 46-60 years d) >61 years
1-2: Years in Practice
a) <10 years b) 11-20 years c) 21-40 years d) >41 years
1-3: Your Specialty as recognized by your local or Federal medical licensing body
a) Dermatology b) Plastic Surgery c) Facial Plastic Surgery (ENT) d) Occuloplastic e) Family medicine f) Other If "Other", please specify:
1-4: Your country (where you primarily practice)

1-5: How many filler cases do you do per week?
a) NONE (I do not do this type of work) b) <5 c) 6-10 cases d) 11-20 cases e) 20-30 cases f) More than 30 cases per week
1-6: What type of filler(s) do you use?
a) Hyaluronic Acid b) Collagen c) Polylactic acids (NewFil®-Sculptra®...) d) Acrylic gels e) Alkylamides gels (Bio Alcamid®...) f) Polymethyl methacrylates microspheres ,PPMA ( Artefil®...) g) Acrylic hydrogene microcrystals (Dermalive®) h) Hydroxyapatite microspheres ( Radiesse®) i) Silicone oils j) Other If "Other", please specify:
1-7: What type of needle(s) do you use to inject?
a)Sharp needle b) Long blunt type canula c) Thin wall needle
1-7 bis: What is the gauge of your needle(s)?

1-8: Have you ever seen or treated a patient with problems or complications from facial filler treatments?
a) No b) Yes