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IMCAS World Congress 2020
Program

FOCUS ON S145

Contributed talks - Lasers & EBD

Room: Room Passy - level 1
Date: Friday 31 January 2020 at 08:00 to 09:00
Format: CONTRIBUTED TALKS > session made up of abstract submissions that were carefully reviewed and selected by the Scientific Board

Chairs

Dr Serge DAHAN

Dermatologist

France

Dr Ines VERNER

Dermatologist

Israel

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
08:00	Dr Ana Carolina ROCHA	Complete resolution of vascular occlusion after filler with ozone, Nd:YAG and intraoral erbium lasers	View	100284
08:08	Dr Krzysztof KACZYNSKI	Effectiveness and safety of dual protocol with HIFU technology: study results on the Polish population	View	97799
08:16	Dr Naglaa AGAMIA	Ablative fractional laser-assisted drug delivery of onabotulinum toxin versus onabotulinum toxin injection in hyperhidrosis	View	98020
08:24	Dr Lehavit AKERMAN	A combination of non-ablative fractional Q-switched and quasi-long pulse YAG for facial erythema and wrinkles	View	98239
08:32	Dr Tatiana BYKOVSKAYA	Laser-assisted delivery of growth factors: increasing the efficacy and minimizing the risks	View	96255
08:40	Dr Eman MEKKAWY	Combined treatment of post-acne scar	View	97673
08:48	Dr Tin Hau Sky WONG	Melasma updates and treatments in Asia skins	View	98389
08:56		Q&A		100398

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Lasers

Combined treatments

Lower face & submental (non-surgical)

Energy-based devices (EBD)

Drug delivery

Dr Ana Carolina ROCHA

Dermatologist

Brazil

Other author(s) : Marcelo Caselli

Complete resolution of vascular occlusion after filler with ozone, Nd:YAG and intraoral erbium lasers

Objectives: To offer effective laser alternatives of treatment for vascular occlusion after cosmetic fillers

Introduction: Vascular occlusion after cosmetic fillers has been increasing in incidence lately. However, guidelines fail to offer alternatives to patients in extreme pain, allergy to and/or with other contraindications for hyaluronidase treatment. We hereby present a case report of vascular occlusion after use of hyaluronic acid (Volbella, Allergan - IR) in right supralabial area.

Materials / method: Patient's complaint was “purse string” wrinkles, and hyaluronic acid was performed intradermally. Ecchimosis emerged, but no pain was reported then. Next day, the patient returned with "pain and red lesions" on upper lip. Diagnose was vascular occlusion, with mottled ecchymosis, blanching and a bright red patch on top of the right upper lip. 400 units of hyaluronidase were injected with cannula in the affected area, until most of the signs subsided. The patient complained thoroughly of pain and the procedure had to be suppressed. Although under Aspirin and Tadalaphil, pain persisted.

Results: After rejecting hyaluronidase (day 4), we treated the area with intraoral erbium laser followed by low dose ND:YAG (both Solon platform), while medication were kept. The patient underwent 10 ml ozone therapy (day 5), then rejected any new injectable. Pain remitted the following day, with great skin improvement, although a red patch persisted. The case had its complete resolution without any scarring 20 to 30 days after procedure.

Conclusion: Patients with a great deal of pain will reject painful interventions such as hyaluronidase, even followed by anesthetics. Guidelines for fillers complications need to consider alternative reperfusion techniques to reduce the skin suffering for these patients who cannot deal well with pain or face allergy to hyaluronidase. We present a case of successfully treated vascular occlusion with ozone and lasers.

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 Krzysztof KACZYNSKI

Poland

Other author(s) :

Effectiveness and safety of dual protocol with HIFU technology: study results on the Polish population

Objectives: The objective of the study was to evaluate effectiveness and safety of the dual treatment protocol of HIFU equipped with pen cartridge.

Introduction: There is a growing interest of patients in the field of minimally invasive procedures, with visible immediately after the procedure permanent effects and lack of healing period. HIFU technology meets these expectations. The use of pen-like cartridge may improve patients' comfort during the treatment.

Materials / method: Between May and September, a group of 9 patients with an average age of 52 years underwent two HIFU treatments at 4-week intervals. Study plan: 2 HIFU procedures every 4 weeks. Effectiveness measurement: Wrinkles and Volume improvement in WSRS & Merz scales; Skin sagging & skin tension improvement in VAS scale; Improvement in GAIS scale Safety measurements: Healing evaluation, adverse reaction evaluation.

Results: One month after the second procedure, a 69% reduction on the WSRS scale was obtained for the upper 1/3 face and a 73% improvement on the Merz scale for 2/3 of the lower face. Patients observed a 1.78-fold increase in skin tone (from 4.5 to 8 on a 10-point VAS scale) resulting in a 46% reduction in tissue sagging (reduction from 6.22 to 3.77 in VAS scale). Immediately after the second procedure, patients rated treatment effects at 4 in the GAIS scale and healing at a maximum level of 3.

Conclusion: In summary, clinical experience confirm the safety of HIFU technology in dual protocol. Before starting treatment, particular attention should be paid to the proper qualification of patients.

Disclosures

Did you receive any funding to support your research for this TOPIC?
Yes
Please specify entities (individual, company, society): Nova Group (partial funding of cartridges being used during study)

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 is presented thanks to the support of: Nova Group Poland (registration fee and accommodation)

Dr Naglaa AGAMIA

Dermatologist

Egypt

Other author(s) : Attia A, Soby N , Agamia N , Abdelraouf A .

Ablative fractional laser-assisted drug delivery of onabotulinum toxin versus onabotulinum toxin injection in hyperhidrosis

Objectives: Objectives: The aim of this study is to evaluate the efficacy and safety of injections of onabotulinum toxin A versus drug delivery of onabotulinum toxin A using fractional ablative laser for hyperhidrosis in a randomized intrapatient comparative study by clinical assessment using Iodine starch test and hyperhidrosis disease severity scale.

Introduction: Background: Hyperhidrosis is a disorder of excessive sweating due to over-stimulation of cholinergic receptors on eccrine glands. This pathologic disorder is characterized by sweating beyond what the body uses for homeostatic temperature regulation.(1) Eccrine glands are concentrated in areas such as the axillae, palms, soles, and face, so these are the areas most commonly affected by hyperhidrosis.(2)
There are two types of hyperhidrosis, primary and secondary and the management and treatment can be quite different. Primary disease will typically present earlier in life with more localized sy

Materials / method: This study was carried out on thirty adult patients, of both sexes presenting with idiopathic palmar hyperhidrosis with a median age of 27 years recruited from the outpatient clinic of the dermatology department of Alexandria University Hospital. Each patient was subjected to full history taking with exclusion of any previous hyperhidrosis treatment, Anticholinergic medication Neurological diseases, Systemic disease, Pregnancy. Then patients were be randomly classified into three equal groups of 10 patients each, randomly picked by closed envelope method labelled as group A,B and C.
The right

Results: There were statistical significant differences between the three studied groups regarding change of HDSS and iodine starch test after treatment and at the end of the follow up in the right hand (P<0.001).
There were no statistical significant differences between the three studied groups regarding change of HDSS and iodine starch test after treatment and at the end of the follow up in the left hand (P=0.668).
There were statistical significant differences between the right and left hand in group A regarding change of HDSS and iodine starch test after treatment (P=0.002) and at the end of the fo

Conclusion: Laser Assisted Drug Delivery using botulinum toxin is effective and safe line of treatment in hyperhidrosis with minimal side effect and complication comparing to injection.
Laser Assisted Drug Delivery using botulinum toxin A 75 units in the left hand were equivalent to onabotulinum toxin A 50 units injection in the right hand.

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 Lehavit AKERMAN

Dermatologist

Israel

Other author(s) : Dr. Assi Levi

A combination of non-ablative fractional Q-switched and quasi-long pulse YAG for facial erythema and wrinkles

Objectives: To assess improvement of both tone and texture using a high power, single wavelength fractional non-ablative 1,064-nm laser with with 2 different pulse durations; targeting both epidermis and dermis with a novel focused depth controlled technology.

Introduction: As patients are seeking for non-invasive procedures, these continue to rise in popularity. The market is flooded with new devices- for wide range of indications addressing both epidermis and dermis. Usually few devices are needed to target different depths and chromophores and to achieve desired result.

Materials / method: 20 patients with sun damage and reduced skin quality underwent 4- 6 treatments on the face and neck. Patients were treated with 2 different modes: Quasi Long Pulse (QPL) 1064nm immediately followed by high power fractional Q-switched 1,064-nm laser. The platform is a stand-alone system comprised of 4 distinct modes of operation-two were used in the study. The second applicator which was used operates with high repetition rate, large spot size allowing high coverage rate, where a variable depth control technology allowed targeting epidermis or dermis. Both treatment modes are non-ablative with

Results: 82% of patients had shown significant improvement in both dermal and epidermal indications, including: tone (erythema and pigmentation), wrinkles, pores etc'. Side effects were minimal and included mild and transient erythema and petechia.

Conclusion: The stand-alone fractional non-ablative QS & QLP 1,064-nm laser and it's focused depth controlled technology is clinically safe and effective in addressing epidermis and dermis resulting in clinical multilayer improvement of skin tone and texture. Since the treatment is non-ablative it serves as an optional tool for patients wishing for treatment without downtime.

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 Tatiana BYKOVSKAYA

Dermatologist

Russia

Other author(s) :

Laser-assisted delivery of growth factors: increasing the efficacy and minimizing the risks

Objectives: To learn the impact of laser assisted delivery of growth factors after full field and fractional ablative laser resurfacing. To evaluate the effect of the application on patients downtime and their satisfaction with the results.

Introduction: The key trends now include a decrease in aggressiveness of the procedures and mitigation the severity of rehabilitation while maintaining and increasing the efficacy and minimizing the risks of unwanted tissue response. Combining full field with fractional ablative represents the ultimate tool to change the surface of the skin and yet to work with the whole depth enabling to plan the procedure on request and according to indications. While growth factors control the inflammation and accelerate the healing of tissues.

Materials / method: Ten patients were treated consistently with combination of full field and fractional ablative Er-Yag laser, then the serum with growth factors was applied. All patients were given 4 more vials of serum to apply at home in 24-hour time range. All patients received one treatment only. Objective evaluation consisted of high resolution photography before the procedure and after 2 months and GAIS scale. As a subjective assessment, all the patients filled the questionnaire.

Results: Compared to baseline all patients showed significant improvement in skin quality, the visible reduction in pigmentation, rhytides, singes of photo aging, more youthful and refreshed look. No short or long-term side effects were reported. All were very satisfied with the procedure and the results.

Conclusion: Combining full field and fractional ablation with topical application of growth factor serum is safe, can reduce the procedure downtime, decrease the risk of post inflammatory hyperpigmentation and pattering. Also, such combination shows superior results to mono modality laser resurfacing

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 Eman MEKKAWY

Dermatologist

Egypt

Other author(s) :

Combined treatment of post-acne scar

Objectives: In some cases, a doctor or dermatologist may suggest a chemical peel or microdermabrasion to help improve the appearance of post acne scar. These milder treatments can be done right in the office. For serious scarring from previous bouts with acne, several types of treatment can help.

There are numerous treatments: chemical peels, dermabrasion/microdermabrasion, laser treatment, punch techniques, needling, plasmage, threads.

The above concepts and facts will be discussed in a short oral presentation.

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 Tin Hau Sky WONG

Hong Kong SAR China

Other author(s) :

Melasma updates and treatments in Asia skins

Objectives: Asian melasma is one of the important and common problem in oriental skins. With the advancement in the understanding of the parthenogenesis of melasma and various new technologies including picosecond lasers, pulsed needle radio-frequency and functional and integrative medicine, melasma is now much better managed in a pathogenesis-based and clinical-pattern-based approaches. In this presentation, we will discuss the importance of diagnosis and categorization of different types of melasma, and then treat the respective melanoma in the above approaches.

Introduction: Asian melasma is one of the important and common problem in oriental skins. It affects up to 40% of the population and post significant cosmetic and psycho-social disadvantage to the patient. With the advancement in the understanding of the pathogeneisis of melasma and various new technologies including picosecond lasers, pulsed needle radio-frequency and functional and integrative medicine, melasma is now much better managed in pathogenesis-based and clinical-pattern-based approaches.

Materials / method: Patients are diagnosed with melasma and categorized in respective subtypes. Then they are treated with primary treatment followed by specific regime including picosecond laser (of gentle toning, high power focusing destruction and fractional focusing lens), vascular laser, fractional semi-ablative laser, pulsed needle radio-frequency, application of functional and integrative medicine. All patients are treated with pathogenesis-based and clinical-pattern-based approaches and treatment effect is assessed by high resolution single lens reflection camera with computerized program for comparison.

Results: All patients after accurate diagnosis and respective innovative protocol-based treatments in pathogenesis-based and clinical-pattern-based approaches had satisfactory therapeutic outcomes.

Conclusion: Asian melasma with accurate diagnosis and categorization underwent justified pathogenesis-based and clinical-pattern-based treatments results in better clinical outcome.

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 2020 Program

FOCUS ON S145

Contributed talks - Lasers & EBD

Chairs

Lectures of the session

Recommended sessions

IMCAS World Congress 2020
Program