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IMCAS World Congress 2019
Program

FOCUS ON S335, S336

Video paper - Contributed talks: surgery

Room: Courtyard (Exhibition Hall - Level 2)
Date: Saturday 2 February 2019 at 16:00 to 18:30
Format: OPEN STAGE TALK > oral presentations taking place on a dedicated stage within the exhibition area and which are video-recorded by our professional AV team

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
16:00	Dr Gennadiy PATLAZHAN	Reduction mammoplasty plus implants	View	81099
16:15	Dr Andre FERRAO VARGAS	Systematization of lateral canthopexy to improve periorbital contour in blepharoplasties	View	69987
16:30	Dr Renata MIGLIARDI	Direct brow lift: a simple and precise method to lift and shape the eyebrows	View	81847
16:45	Dr Min Young CHO	Role of hypotonic tumescent and microcannulas for reoperation of liposuction and local anesthetic minimally invasive liposuction (LAMS)	View	81947
17:00	Dr Hector Cesar DURAN VEGA	Mini/fast breast augmentation technique	View	81515
17:15	Dr Hemin Oathman SHERIFF	Nasal osteotomy and the treatment approaches	View	82481
17:30	Dr Frank LIN	Orbicularis turnover flap, a novel approach to enhance upper eyelid volume in male blepharoplasty	View	82757
17:45	Dr Tiago FERNANDES	Circunferential lipoabdominoplasty	View	82771
18:00	Dr Guray YESILADALI	Gluteal augmentation with intramuscular implants	View	83035
18:15	Dr Francisco IBERICO NOGUEIRA	Facial rejuvenation - New surgical techniques	View	83319

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Recommended sessions

Facelift (surgical)

Periorbital (blepharoplasty - surgical)

Buttocks (surgical)

Breast implant

Breast augmentation

Dr Gennadiy PATLAZHAN

Plastic Surgeon

Ukraine

Other author(s) : Olga Shkolnaya, Igor Torubarov.

Reduction mammoplasty plus implants

Objectives: Breasts reduction plus implant is one of the unmet problems of modern AM . Despite a remarkable progress in operative techniques for the breast enhancement correction of mammary glands cosmetic defections, a uniform approach in breast reduction with implants is still lacking.

Introduction: Women's breasts are one of the most attractive parts of the body of the beautiful half of humanity. It is natural that nowadays there is a growing demand for various procedures improving the shape of the breast. One of the challenges in plastic surgery is adequate correction of hypertrophic mastoptosis.
Due to the fact that for all types of mastopexy, in combination with reduction or without it, there is a short-term fullness of the upper pole, the combination of two types of surgical operations: breast reduction in combination with simultaneous implants setting has been discussed for a long time. However, many authors believe that this operation causes more complications than two separate operations.

Materials / method: Our experience includes 217 cases of reduction mastopexy combined with breast endoprosthesis replacement within the period from 2013 to 2017. All patients, for whom such operation was planned, necessarily passed a complex of all preoperative examinations. Additional methods of examination were applied: blood test for prolactin and immunogram.
Depending on the indications, we performed mastopexy by the type of periareolar or vertical or by the type of inverted "T".
Asymmetry was corrected with the help of glandular tissue reduction through the use of the upper pedicle, and the reduction was carried out from the lower and lateral poles, as well as from the base of the mammary glands. The maximum reduction made 230 grams. Implants were set under the muscle and under the fascia, mainly, high profile implants were used, textured and coated with micropolyurethane ones.

Results: The questionnaire "Breast-q" was used to assess the technique effectiveness. It was evaluated from 1 to 4 by the scale (satisfaction with the results) in the period of 1, 3, 6 and 12 months after surgery. 165 patients (75%) rated the result as excellent, 31 – as good (15%), 18 – as satisfactory (9.5%) and 3 (1.5%) - as unsatisfactory. Postoperative complications included seroma – in 9 (5%) patients, breast asymmetry was observed in 5 (2%) patients, marginal skin necrosis – in 4 (2%), and formation of pathological scars – in 3 (1.5%) patients. All patients who had such complications as seroma and marginal skin necrosis had a history of smoking experience for more than 5 years. Breast asymmetry was corrected in 9 - 12 months after surgery with the help of lipofilling or resection of non-contracted skin. There were no systemic complications or fatal cases.

Conclusion: The use of the above-described method of reduction mastopexy combined with implants setting replacement of the mammary glands allows obtaining a more stable aesthetic effect of the upper pole fullness and prevents the recurrence of ptosis with fewer surgical interventions without increasing the number of complications with the correct pre-, intra- and postoperative introduction.

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

Dr Andre FERRAO VARGAS

Plastic Surgeon

Brazil

Other author(s) :

Systematization of lateral canthopexy to improve periorbital contour in blepharoplasties

Objectives: To show the benefits of the association of blepharoplasty and lateral canthopexy in improving the periorbital contour and palpebromalar region.

Introduction: Introduction: The eye region is the first to show signs of aging on the face. Blepharoplasty surgery offers excellent results in the rejuvenation of the eye region. The technique of blepharoplasty surgery suffered important modifications. Modern techniques were established to improve the contour of the entire periorbitopalpebra region, as well as to reduce surgical stigmas.

Materials / method: Methods: Patients with moderate to severe flaccidity of the lower eyelid and marked transition of the eyelid-malar transition were submitted to an associated procedure of Blepharoplasty and lateral canthopexy. The canthopexy was performed by detachment of the orbicularis muscle from the lower eyelid to the inferior orbital rim and its repositioning with fixation in the superior orbital ridge. Canthopexy aimed repositioning of tissues periorbital and malar regions.

Results: Results: The use of the cantopexy procedure associated with Blepharoplasty prevents surgical stigmas such as the scleral show and the round eye and allows the treatment of the contour of the periorbitopalpebral region. The delicate and precise detachment of the orbicularis muscle from the lower eyelid to the inferior orbital border and its repositioning with fixation in the superior orbital rim makes canthopexy a simple and effective procedure in remodeling the contour of the lower eyelid and the palpebromalar junction.

Conclusion: Conclusion: the association of canthopexy in these models in the adequately selected group of patients offers gain in the aspect of the eyelid as well as in the aspect of the middle third of the face. Patients associate this procedure with a result superior to that of conventional blepharoplasty surgery, which guarantees high patient satisfaction with the final result of 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

Dr Renata MIGLIARDI

Oculoplastic Surgeon

Italy

Other author(s) :

Direct brow lift: a simple and precise method to lift and shape the eyebrows

Objectives: To evaluate the aesthetic outcome of the direct brow-lift technique and his potential adverse effects.

Introduction: The upper third of the face is integral to our perception of youth and beauty. While the eyelids anchor this facial cosmetic unit, the eyebrows and forehead are intrinsically linked to the upper eyelids, and their position and texture play an important role in creating pleasing eyes as well as conveying mood and youth. The most common browlifts are performed with endoscopic visualization. Yet, this technique requires special equipment and a prolonged learning curve.

Materials / method: We analyzes the outcome of 27 patients from September 2014 to April 2018. The indication was to elevate and reshape the lateral part of the brow associated to blepharoplasty. 25 brow lifts were bilateral and 2 were mono-lateral. All patients were evaluated clinically and by means of pre- and postoperative photographs. Patients completed questionnaires indicating scar quality and satisfaction with the results.

Results: The direct tecnique results in a significant browlift with secondary smoothing of the forehead topography. Aside from bruising and swelling, it results in minimal adverse effects. All pantients were very sutisfied, the pictures analisys showed a minimum elevation of 4 mm. No patients complained about the scar.

Conclusion: Browlifts are an important procedure in rejuvenating the upper third of the face and improving the overall facial aesthetic appearance. Direct brow lift requires accurate planning, preservation of subcutaneous volume and limited undermining so when these requirements are fulfilled this technique does not yield a visible scar and is the easiest, most precise, and most reliable procedure for brow shaping.

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

Dr Min Young CHO

Cosmetic Surgeon

South Korea

Other author(s) : Jung-Eun Kim MD. Ph.D, Bodri Son MD, Kyungnam Eoh MD, Gyu-1Hee Chae MD. Ph.D, Jae-Yong So MD. Ph.D, Ha-Jin Kim MD. Ph.D, Jae-Won Seo, MD, Sun-Ho Lee, MD Ph.D, Yun-Chan Park MD, Nam-Chul Kim, MD, Ph.D.

Role of hypotonic tumescent and microcannulas for reoperation of liposuction and local anesthetic minimally invasive liposuction (LAMS)

Objectives: 1. Know feasibility of hypotonic tumescent solution to perform microcannula liposuction with a suction syringe for re-contouring after liposuction or LAMS.
2. Learn that LAMS technique is a safe and effective body contouring method for reoperation of the same target region.
3. The tolerance for each patient and any side effects and complications are tracked and studied.

Introduction: Tumescent liposuction uses both the tumescent technique for local anesthesia and liposuction microcannulas having an inside diameter of 2 mm. A classic tumescent anesthetic solution may contain a 5- to 20-fold dilution of lidocaine (1%), epinephrine (1:100,000), and sodium bicarbonate (10 mEq per liter) in a physiologic saline solution. My institution has first developed and been performing local anesthetic minimally invasive liposuction (LAMS) since 2014 using a hypotonic tumescent consisting of half saline and a lower concentration of sodium bicarbonate compared to Klein tumescent solution.

Materials / method: LAMS consisted of minimized liposuction using a 1. 8 or 1. 6 mm cannula and infusion of 0.45% N/S hypotonic solution. The liposuction was conducted immediately after tumescent. Patients were discharged after the procedure without wearing a pressure garment. The research was conducted on patients who had received LAMS from November 2017 to April 2018. The patients were divided into three groups; the first group had no history of body contouring surgery (LAMS), the second group had previously received LAMS (re-LAMS), and the third group had previously performed liposuction (Liposuction).

Results: Total of 303 patients were enrolled with the LAMS (n=212), re-LAMS (n=59) and liposuction (n=32). The operation time (11-205 minutes) was the greatest statistically in the liposuction group (99.1 minutes), followed by the LAMS group (89.1 minutes) and the re-LAMS group (68.2 minutes, p<0.001). Whole body contouring was carried out successfully in one week with one or 2 days interval. There were no cases of failure to operate, whether in liposuction or in LAMS, prior to surgery. There were no complications or side effects that affected immediate return to daily life after the procedure.

Conclusion: Microcannula syringe manual liposuction with hypotonic tumescent is totally local anesthetized for more than three hours operation time. It also shows that there is less risk of bleeding and relatively easy tunneling, allowing for the use of the same target area of previous liposuction and LAMS as a body re-contouring 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

Dr Hector Cesar DURAN VEGA

Plastic Surgeon

Mexico

Other author(s) :

Mini/fast breast augmentation technique

Objectives: The objectives of this work are to communicate a new surgical breast augmentation technique, whom advantages are being reproducible, with a clear and easy marking, fast procedure time for both breasts (less than 30 minutes), and through a minimally invasive incision.

Introduction: Breast augmentation is one of the most popular procedures worldwide, and its frequency has been increasing in the last years. We describe a new technique for performing it,

Materials / method: We described two case series. The first one included 100 patients before realizing the minifast technique. In this group, we analyzed the problems in the preoperatory evaluation, implant selection, dead times, surgical procedure and safety. After identifying the issues, we proposed a solution to every problem and the minifast technique was establish. Then we compared the first 100 cases with the second 100 cases with the method. All patients were primary augmentation patients.

Results: We found after analyzing the two groups, significant differences in different variables. The main ones were the speed of the procedure, 30 minutes or less for both breast, and in incision size, being with the minifast method 2.5 cm, considering it as minimally invasive.

Conclusion: The minifast technique is a new technique, with the advantages of being short surgical time, (less than 30 minutes), short incision size (3-2.5 cm), can be performed submuscular or subglandular, and is safe, reproducible, with clear markings and harmonic breast implant selection according to each patient anatomy.

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

Dr Hemin Oathman SHERIFF

Plastic Surgeon

Iraq

Other author(s) : Hemin Sheriff , MRCS, MD, PhD

Nasal osteotomy and the treatment approaches

Objectives: The aim is to demonstrate different techniques of Dorsal Osteotomy, Medial Osteotomy, and Lateral Osteotomy in Rhinoplasty.

Introduction: The bony pyramid of the nose forms the upper one-third of the dorsal nasal framework. Osteotomy needs to be performed to narrow a wide nasal base, to close the open roof, or to realign the deviated nasal pyramid, in order to correct the bony problems and to achieve the better aesthetic skeletal base for the nasal soft tissue.

Materials / method: The different methods of the nasal osteotomy described and accompanied by 3 short videos to better demonstrate the techniques, and also the pre and post surgery pictures included to show the difference.

Results: Different lateral nasal osteotomy techniques gave the same satisfactory aesthetic results on the right and lift side of the same patient in the immediate and long-term postoperative assessments.

Conclusion: The different Osteotomy techniques can give the same optimal result as far as the techniques performed correctly for the selected 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

Dr Frank LIN

Plastic Surgeon

Australia

Other author(s) :

Orbicularis turnover flap, a novel approach to enhance upper eyelid volume in male blepharoplasty

Objectives: To present a novel modification of traditional blepharoplasty techniques for enhancement of upper eyelid volume in male patients.

Introduction: Upper blepharoplasty is a common procedure performed worldwide for rejuvenation of the ageing upper eyelid. We demonstrate a novel technique of the orbicularis oculi muscle turnover flap, a procedure yet to be described in the literature. This aims to improve age related upper eyelid hollowing at the time of upper blepharoplasty. It is suitable particularly in male patients in whom only subtle upper eyelid revolumization is required, or desired by patients; and can be used alone, or in conjunction with fat grafting.

Materials / method: The experience of a single surgeon was reviewed. A standard skin only upper eyelid blepharoplasty was performed, without muscle excision. The orbicularis oculi muscle is raised as a superiorly based, well vascularised, double breasted turnover flap. This provided additional bulk to augment the infrabrow region, which is prone to hollowing with aging. Complication rates and aesthetic outcomes were assessed.

Results: A total of 33 patients were included in the study between November 2016 and November 2018. All patients showed favourable aesthetic outcome with no major complications reported.

Conclusion: The orbicularis oculi turnover flap is a novel technique presented in the field of upper lid blepharoplasty. It can be performed quickly and easily, with minimal additional morbidity. The muscle provides a double layer of well vascularised tissue which improves the volume of the upper eyelid. It is particularly suitable for male patients who desire subtle results, or may not wish to undertake fat grafting.

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

Dr Tiago FERNANDES

Plastic Surgeon

Portugal

Other author(s) : Dr Tiago Baptista Fernandes

Circunferential lipoabdominoplasty

Objectives: The objective is to demonstrate the importance of defating the abdominal volume in an abdominoplasty

Introduction: Abdominoplasty is one of the most common surgeries for women after pregnancies, aged 35 and up. Normally no liposuction of the flap is done, except only a lipodefinition of the flanks.

We show how thorough liposuctioning the flap, can be a very safe procedure, but with some important tricks. Its performed together with a circunferencial liposuction, with or without lipolaser, with or without buttock fat augmentation, according to the case.

Materials / method: The author describes his technique with total lower trunk circunferencial liposuction and abdominoplasty on the same surgery, for patients with BMI ranging from 25 to 40

The subcarpa fat is removed selectively according to the case further increasing the definition of the abdomen.

SAFE Lipo technique is used with power assisted liposuction.

Buttock augmentation with fat, and external thigh liposuction are almost always performed at the same time

Back folds lipolaser was performed in some cases when excess flacidity was presente

Pre, intra and pos operatory details are shown in videos, in

Results: Several clinical cases are shown, from easy to difficult, in order to ilustrate the power of defating the flap and the importance of adressing the lower trunk circunferencially
Unsatisfactory results and complications are also presented and discussed

Conclusion: Very few patients have an indication for a normal abdominoplasty, without liposuction of the flap, and therefore its mandatory to master lipoabdominoplasty. Complication rate can be high if proper care is not taken.
Our series demonstrate how this advanced body contouring surgery can be done safely.

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

Dr Guray YESILADALI

Plastic Surgeon

Turkey

Other author(s) :

Gluteal augmentation with intramuscular implants

Objectives: 1. Explaining the potential and limitation of buttock implants
2. Describing a reproducible, safe and precise surgical technique to buttock augmentation
3. Sharing possible outcomes

Introduction: Buttock reshaping is one of the most popular surgeries in recent years and getting more attention continuously. Silicon buttock implant augmentation is one of the several methods that can be used to reshape posterior body. Since it has high complication rates on literature, a thorough anatomical knowledge and precise surgical technique is mandatory to stay safe and achieve acceptable results.

Materials / method: Intergluteal double incision is used to create a 7x8 cm pocket subfascially for the first phase of dissection. Then under direct visualization, using scissors and duck-bill retractor an intramuscular pocket is created considering desired implant dimensions. Either round or almond shaped implant is then placed intramuscularly and closure is performed.

Results: First choice in buttock augmention seem to be fat injection. It has its own limitations like the risk of fatal complications, unpredictability of fat graft survival rate and fat necrosis. For patient with a body mass index between 18-24, the amount of fat may not be sufficient to perform a fat transfer. For those patients, when performed properly, gluteal augmentation with intramuscular implants is an efficient and safe method.

Conclusion: Intramuscular implantation of silicon implants is a safe, efficient and consistent method for gluteal augmentation.

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

Dr Francisco IBERICO NOGUEIRA

Plastic Surgeon

Portugal

Other author(s) :

Facial rejuvenation - New surgical techniques

Objectives: This presentation is about the recent advances in surgical rejuvenation of neck and face.

Introduction: The autor begin the presentation with some considerations about the ageing process of face and neck, and next describe the personal protocol that he use in face lift and blefaroplasty and the association with non surgical procedures.
Finally present some clinical cases.

Materials / method: This presentation refers to the application of modern technology in more then 100 patients submitted to a facial rejuvenation combined with use of fillers and peelings.

Results: We present some cases of facial rejuvenation showing the improvement the we can obtain with the use of biological glues, with non aggressive face-lifts and association depending of the cases with fractionated co2 laser or chemical peelings

Conclusion: The association of surgical and non surgical procedures can provide very pleasant results in facial rejuvenation.

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

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IMCAS World Congress 2019 Program

FOCUS ON S335, S336

Video paper - Contributed talks: surgery

Lectures of the session

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IMCAS World Congress 2019
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