IMCAS

Ready-to-use liquid abobotulinumtoxinA: an overview of available Phase III clinical data for moderate-to-severe glabellar line treatment (unrestricted educational grant from Galderma)

Objectives: The objective of this presentation is to provide an overview of available clinical Phase III data for glabellar line (GL) treatment with abobotulinumtoxinA solution for injection (ABO solution), including data supporting the European Marketing Authorization Application that recently resulted in a positive opinion in a decentralized procedure allowing for national Marketing Authorization approvals in several European countries.

Introduction: ABO solution is the first ready-to-use liquid botulinum toxin type A formulation to be introduced in Europe. Compared with traditional powder formulations requiring reconstitution before use, ABO solution offers injectors a convenient ready-to-use formulation with reduced preparation time and improved precision and reproducibility in dose delivery.

Materials / method: Subjects aged 18-65 years with moderate-to-severe GLs at maximum frown participated in two Phase III studies (NCT02353871; NCT02493946). Data obtained up to 6 months after double-blind GL treatment (50U ABO solution or placebo [randomized 2:1]) were pooled. Additional open-label data over up to five treatment cycles with 50U ABO solution were collected (NCT02493946). Investigators assessed GL severity at maximum frown (ILA). Subjects assessed time to onset of effect, GL severity (SSA), satisfaction with GL appearance, and psychological well-being (FACE-Q). Adverse events were collected

Results: GL severity improved to “none or mild” in 88% (ILA) and 77% of subjects (SSA) at Month 1 after ABO solution injection, N=250 (p<0.0001 vs placebo, N=122). Improvement was maintained in 10% (ILA) and 15% (SSA) at Month 6 (p<0.001 vs placebo). A majority of subjects had an effect within 2-3 days. With repeated treatment cycles, ABO solution achieved consistent and predictable GL improvement, and consistently improved ratings for subjects’ satisfaction and psychological well-being. No new or unexpected adverse events were reported compared with the safety profile of the ABO powder formulation.

Conclusion: ABO solution effectively improved GL severity, with rapid onset of effect. GL improvement lasted up to 6 months after a single treatment with ABO solution. Improvements in GL severity, subjects’ ratings of satisfaction with GL appearance, and psychological well-being were maintained over repeated treatment cycles. ABO solution was well tolerated for treatment of GLs, and its safety profile was in line with that for the ABO powder formulation.

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 new hyaluronic acid dermal filler tested in the nasolabial folds – Comparative study (unrestricted educational grant from Symatese)

Objectives: The aim of the study was to evaluate the performance and safety of tested Product as well as its non-inferiority to a worldwide well-established HA dermal filler.

Introduction: An innovative hyaluronic acid (HA) filler was developed based on a new cross-linking process allowing the optimal combination of essential characteristics known the development of dermal fillers. As a result, the new dermal fillers are adapted to the tissue and anatomical specificities of each facial rejuvenation indication. Using this innovation, a new HA based filler was designed for the treatment of nasolabial folds and has been tested.

Materials / method: A prospective, randomized, double-blinded, comparative split-face clinical trial was carried out on 45 subjects presenting moderate-to-severe bilateral nasolabial folds (NLFs). The assessed parameters included improvement on Wrinkle Severity Rating Scale (WSRS), and Global Aesthetic Improvement Scale (GAIS) according to a blinded Evaluator and subjects. The wrinkle volume and depth were defined by a fringe projection system. Safety outcomes measured were injection site reactions and adverse device events.

Results: Non-inferiority between both fillers was established by the mean WSRS scores from day D14 to 9 months with a significant improvement at 3 and 6 months. All along this study, the tested Product allows to gain 3 months compared to the reference. Aesthetic improvement assessed by the blinded evaluator and subjects were also durably high. For the blinded evaluator, the comparison of the GAIS scores were significantly in favour of the tested Product at 3-month and 6-month. No statistical difference was noted on other observations.

Conclusion: GAIS responder rate of the tested Product evolved from 100% between 14-day and 3-month to 82% at 9-month. The quantification by fringe projection technique confirmed the previous efficacy results and the durability over 9 months. The treatments were safe and well tolerated with no significant difference in safety data between both fillers. The tested Product is at least equivalent to a well-established comparator for the correction of NLF in subjects. These results led to CE Mark approval of the device in 2021 and mark the promising start of a series of clinical results.

Disclosures

Did you receive any funding to support your research for this TOPIC?
Yes
Please specify entities (individual, company, society): Symatese

Were you provided with any honoraria, payment or other compensation for your work on this study?
Yes
Please specify entities (individual, company, society): Symatese

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: Symatese

Different & Yet the same: cosmetic procedures in SPT 1-3 vs SPT 4-6 patients in Toronto, Canada

Objectives: 1) Categorize the breadth of cosmetic procedures sought and performed on patients representing two main cohorts: lighter skin tones (SPT 1 - 3) and deeper skin tones (SPT 4 - 6) in Toronto Canada at a private dermatology office October 2020 - December 2021 inclusive.
2) Determine whether particular procedures are more popular in one cohort contrasted against another.
3) Determine whether there is a significant difference in the median and average age of patients seeking cosmetic procedures between the two cohorts.

Introduction: Toronto Canada is a metropolitan area of approximately 6 million people and the largest city in Canada. A highly diverse racial-ethnic city, ~ 50% of Torontonians are born outside of Canada (Statistics Canada). While there is recent data that documents the cosmetic desires of patients of varying demographics (Dermatol Surg. 2020; 46(12):1728-1732), this is questionnaire-based and American. The following 14-month retrospective review captures the urban Canadian racial-ethnic composite, cosmetic requests and procedures of patients seen in-clinic for cosmetic dermatology appointments.

Materials / method: The clinic electronic medical record EMR (Accuro) search function was used to derive the cohort of patients who attended the clinic for a cosmetic encounter from October 2020 - December 2021. The EMR results included patient demographics as well as photo identification (provincial health card). All patients ' scheduled appointments were cross referenced with EMR clinical encounter notes and invoices to verify the treatment received. SPT was again verified independently through in-clinic photography captured for each cosmetic patient.

Results: Patients served were predominantly female (97%). SPT IV - VI patients were over represented compared to the demographics of the city of Toronto, particularly patients of SPT V and VI. This cohort's top objectives were skincare recommendations, benign lesion removal (Dermatosis papulosis nigra), neuromodulator injections, volumizing filler and laser hair reduction. Treatments of the neck and midface sites were more commonly requested. In contrast, patients of SPT I - III most commonly sought out neuromodulation, scalp PRP, volumizing filler and IPL (intense pulsed light) and were older.

Conclusion: This 14-month retrospective review provides evidence that patients of two main cohorts, SPT 1 - 3 and SPT 4 - 6 have both shared and different cosmetic objectives. SPT 1 - 3 patients, comprise a range of ages and requested scalp PRP and IPL in addition to injectable treatments with neuromodulators and fillers. Patients of SPT 4 - 6 also sought neuromodulation and filler, but microneedling and laser hair reduction were more common requests. They are significantly younger than the SPT 1 -3 patients. The results debunk the myth that the SPT 4 - 6 cohort is disinterested in cosmetic procedures.

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

Technical evaluation and comparison of calcium hydroxylapatite (CaHA) containing dermal fillers (unrestricted educational grant from Merz Aesthetics)

Objectives: Four CaHA containing market products CaHA/CMC (Radiesse; Merz North America, Raleigh, NC), CaHA/CMC with Lidocaine, (Radiesse+; Merz North America, Raleigh, NC), CaHA/HA (HArmonyCa; Allergan Aesthetics, an AbbVie company, Irvine CA) and CaHA/PEG (Neauvia Stimulate; MatexLab SA, Lugano, CH) were analyzed regarding their rheological profile, extrusion force, gel carrier composition, and quality of the CaHA particles.

Introduction: Dermal filler products containing calcium hydroxylapatite (CaHA) microspheres are used to address signs of aging such as wrinkles and folds in the face. The increasing number of these products in the market warrants investigation into differences between them.

Materials / method: Above mentioned products were analyzed for appearance, solid content, rheological profile, extrusion force, and gel carrier composition. The CaHA particles were isolated from the products and characterized by microscopy regarding appearance.

Results: Rheological evaluation shows strong differences of the storage modulus G’ between products. The CaHA/CMC products have high G’ values around 1400 Pa*s [1] whereas CaHA/HA and CaHA/PEG G’ values are about 10% of this value.

CaHA/CMC has the lowest extrusion force of 19 N followed by CaHA/PEG (23 N), and CaHA/HA (25 N). The extrusion force profile of CaHA/PEG shows irregularities and fluctuations.

CaHA/CMC and CaHA/HA are comparable in CaHA content (~56 w/w%) whereas CaHA/PEG only contains 1% of CaHA.

Conclusion: The analyzed samples of CaHA/CMC, CaHA/CMC with Lidocaine, CaHA/HA, and CAHA/PEG show significant differences in rheology profile and extrusion force. CaHA/CMC products have the highest storage module G’ and the lowest extrusion force. The CaHA particles also differ significantly between the samples: microspheres in CaHA/CMC are smooth with a spherical character, CaHA/HA consists of microspheres with irregularities and broken parts of microspheres whereas CaHA/PEG contains small fragments of crystalline CaHA. CaHA/CMC, CaHA/HA and CaHA/PEG all contain CaHA, but are not comparable.

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 evaluation of topical creams on wrinkles and in-vitro evidence of structural and gene expression changes in the dermis (unrestricted educational grant from Laboratoires Filorga Paris)

Objectives: [A] Evaluate in-vivo the tolerance
and clinical efficacy in wrinkle dimensions of two cream formulations
(cream-gel and cream) on human subjects using topical application
twice a day for 56 days;
[B] Characterize underlying extracellular matrix (ECM) changes induced by the cream-gel product in an ex-vivo model;
[C] Investigate gene expression in hydration function induced by the cream-gel product in an in-vitro model.

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

In-field assessment of the perception of smoothness when dispensing different Filler formulations (unrestricted educational grant from Allergan Aesthetics)

Objectives: Report the results of a study to devise the factors influencing users' perception of smoothness related to dispensing different cross-linked hyaluronic acid (HA) filler formulations.

Introduction: Physicians need to be aware of dermal fillers' variable rheologic and physicochemical properties to select the most appropriate product for the target outcomes and achieve optimal patient results. Since a prior study showed some variation in the forces applied to dispense cross-linked HA filler formulations, biometric testing was conducted to assess and quantify users' perceptions of the "smoothness" of injection.

Materials / method: Five cross-linked HA laboratory formulations with different smoothness profiles, defined as AC, D, and B, were tested by 12 experienced professionals. Muscle effort data was collected from the key muscle groups involved in the dispensing. The force applied to the plunger was recorded using a force-sensing resistor and analyzed to determine if force deviations may impact smoothness perceptions. In addition, survey methods were used to obtain subject feedback regarding perceptions of smoothness, effort, flow control, etc. P values <.1 were considered significant for this preliminary study.

Results: Significantly more effort was required to dispense the formula H24 profile AC (H24AC) vs. the other formulations (P < .1). Consistently, users rated the perceived effort to dispense higher for the H24AC, followed by the VB20AC, VB20B, VB20B+, and V17D-. The plunger forces' deviation was the highest for the H24AC and the lowest for the V17D-. In the user's ratings, the V17D- received the highest rating for overall smoothness, followed by the VB20AC, VB20B, VB20B+, and H24AC. The standard deviation of the force applied to the plunger inversely correlated with product smoothness (R = -.96).

Conclusion: Objective and subjective measurements of muscle effort, plunger force, and product smoothness showed significant differences across the tested formulations. Notwithstanding, a strong correlation between plunger force deviation measures and the perceived smoothness was found, thus demonstrating users' perceptions of smoothness can be predicted. Early estimation of perceived smoothness may help product design meet physicians' expectations of injection experience and thereby optimize aesthetic outcomes, patient safety, and treatment 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 new Filler syringe with improved ergonomic performance to enhance end-user experience (unrestricted educational grant from Allergan Aesthetics)

Objectives: The syringe of a hyaluronic acid (HA) injectable dermal filler on the market and 2 pre-production syringe designs, which included a circular plunger cap design (CPD) and an elongated plunger cap design (EPD), were tested by practitioners in the laboratory and in the field to compare their ergonomic performance and identify opportunities for improvement.

Introduction: The specific rheological properties of dermal fillers can affect the ease of delivery. While new gel technologies are investigated, new syringe designs may improve professional injector comfort and patient experience.

Materials / method: The 3 syringe designs were tested in the laboratory with 3 HA fillers with varying viscosities. Twelve professional injectors performed the testing in the US Ergonomics lab using silicone head models. The testing methods included muscle effort measures, contact pressure analysis, dynamic posture analysis, and user surveys. In the field, 20 professional injectors tested with patients the 3 dermal fillers using the best performing of the new syringe designs. On-site observations, structured interview methods, and survey techniques were used to assess syringe performance.

Results: In the laboratory post-test survey, the EPD was determined to offer more comfort to the thumb, wrist, and forearm than the CPD and the standard design (STD) (P≤.09 vs. STD). Overall, the EPD performance received a better rating than CPD and STD, with improved plunger effort, ease of aspiration, and ability to gauge the dose (P≤.09 vs. STD). In the field post-test survey, the overall comfort ratings of the EPD were very favorable, with all ratings exceeding 8.6 on average. The overall rating for the syringe performance was 8.8/10 on average, with some features rating >9 scores.

Conclusion: The EPD was considered the most effective in user comfort, ease of use, error reduction, and other criteria essential for a successful product. The good results observed at the laboratory stage were confirmed by the field investigation with very positive performance ratings and feedback from the test participants. All subjects (100%) indicated that the new syringe is an improvement over the prior design and would not result in hand fatigue. The new syringe characteristics will favorably impact the user’s experience and promote increased product usage and better patients outcomes.

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

Study design of LONG RUN: a LONGitudinal evaluation and real-world evidence of uniquely purified incobotulinumtoxinA in treatment naïve participants (unrestricted educational grant from Merz Aesthetics)

Objectives: We describe the design of an open-label, prospective, observational study, aimed at capturing long-term, real-world evidence and clinically relevant data of INCO use in clinical practice.

Introduction: IncobotulinumtoxinA (INCO) is approved for the temporary improvement of moderate to severe upper facial lines (UFL), in the North American, Latin American, European, and Asia-Pacific regions. Though widely used since 2010, there are limited studies on long-term use of botulinum toxin A products in terms of patient satisfaction and changes in dose and patterns of administration over time. Here, we describe the design of an open-label, prospective, observational study, aimed at capturing long-term, real-world evidence and clinically relevant data of INCO use in clinical practice.

Materials / method: Participants between 18 to 65 years of age who have never received prior botulinum neurotoxin type A treatment and are seeking treatment with INCO for UFL will be enrolled at approximately 25 clinical sites in 12 countries. Participants will be treated with INCO according to standard of care for up to three years, and the following data will be collected: treatment, safety, effectiveness, self-perception of age, severity of UFLs, aesthetic improvement in appearance of UFL compared to baseline, participant satisfaction with treatment. Neutralizing antibodies will be assessed in blood samples.

Conclusion: The data collected in this clinical study will allow for a general assessment of the long term safety, efficacy, and patient satisfaction of continuous treatments with INCO administered as needed per physician and participant’s discretion for UFLs under real-world conditions. Data from this study will also allow insight into aesthetic uses of INCO in a global patient population, and exploration of the potential effects of neutralizing antibodies.

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

Subject satisfaction and duration of effect of on-label 50U abobotulinumtoxinA treatment of glabellar lines - results from three individual trials (unrestricted educational grant from Galderma)

Objectives: To evaluate efficacy, subject satisfaction and safety of treatment of glabellar lines (GLs) with the on-label 50 U dose of abobotulinumtoxinA (ABO) in three clinical trials.

Introduction: ABO is approved for use in GL treatment using a dose of 50 U. Here we present results from three recently published clinical trials, using on-label dosing, with a focus on ≥1-grade GL improvement and subject satisfaction, reflecting clinical outcomes of significance for the subjects.

Materials / method: Data from three trials were included: NCT03736928, double-blind, Phase 2; NCT03960957, double-blind, Phase 3; NCT03687736, open-label, Phase 4. In all three trials, subjects with moderate-to-severe GLs were treated with 50U ABO and followed for at least 6 months (9 months in the Phase 2 trial). Assessments included investigator- and subject-assessed GL severity, subject satisfaction, onset of effect using a subject diary, and adverse events.

Results: The trials included 80, 224, and 120 subjects in the ABO groups respectively, the majority achieving ≥1-grade improvement in GL severity. Subjects reported median onset of effect after 2 days in all three trials. In each trial, 53%, 46% and 37% of subjects maintained ≥1-grade improvement in investigator-assessed GL severity at Month 6, and at Month 9, 18% of subjects in the Phase 2 trial still had ≥1-grade improvement. The majority of subjects were satisfied and found results natural-looking up to Month 6 in all three trials. Treatment-related adverse events were non-serious and mostly mild.

Conclusion: ABO 50U for glabellar line treatment was consistently efficacious and well tolerated, with fast onset across all three trials. A ≥1-grade improvement and high rates of subject satisfaction were reported up to 6 to 9 months after injection.

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

Assessment of subject satisfaction after glabellar line treatment with escalating doses of abobotulinumtoxinA in a randomized, double-blind study (unrestricted educational grant from Galderma)

Objectives: To evaluate data on subject satisfaction with glabellar line (GL) treatment using abobotulinumtoxinA (ABO) doses up to 125 U versus placebo, evaluated as part of a Phase 2 dose-escalating study.

Introduction: ABO is approved for GL treatment using a dose of 50 U. Higher doses of up to 125 U were investigated in a Phase 2 study, with primary endpoint: ≥2-grade GL severity improvement and a GL severity score of 0 or 1 assessed concomitantly by the investigator and subject. Here we present data on subject satisfaction with GL treatment, evaluated as part of this study.

Materials / method: In this 9-month, double-blind study (NCT03736928), subjects received an ABO dose of 50U, 75U, 100U, or 125U, or placebo. Assessments included a subject satisfaction questionnaire, 3 FACE-Q scales (Psychological Function, Appraisal of Lines, and Perceived Age), GLSS at maximum frown, and safety. Time to return to baseline GL severity was assessed concurrently on both investigator and subject scales.

Results: Around 80 subjects were evaluated per group. Subject satisfaction was high after treatment, >90% were satisfied with their appearance and agreed that they looked natural and appeared refreshed at Month 1. Subjects’ well-being improved, and they were less bothered about their GLs and perceived themselves as younger up to Month 9. At Month 9, 18% (50U), 26% (75U), 35% (100U), 31% (125U) retained a ≥1-grade improvement (investigator GLSS). The median time to return to baseline GLSS scores was 226, 240, 252, and 256 days, respectively. Treatment was generally safe across all doses.

Conclusion: ABO was efficacious and well-tolerated across all doses from 50U to 125U, with ≥1-grade severity improvement maintained for up to 9 months. Subjects reported natural results and high rates of satisfaction, sustained to Month 9, as well as a wider positive impact on well-being and age assessment. Subject satisfaction is an aspect of clinical importance, which captures treatment effect over time.

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

Lower facial shape improvements after treatment with OnabotulinumtoxinA for masseter muscle prominence (unrestricted educational grant from Allergan Aesthetics)

Objectives: Evaluate objective measures of lower facial shaping improvements with onabotulinumtoxinA in masseter muscle prominence (MMP).

Introduction: MMP may cause a wide, square, or trapezoidal lower face shape, and a heavy jawline. Controlled clinical trial data are needed to confirm the safety and efficacy of botulinum toxin A as numerous publications have documented the unapproved use of botulinum toxin in the masseter for >20 years. Primary results of a randomized, double-blind, placebo-controlled, 6-month, phase 2b study demonstrated the safety and efficacy of 2 doses of onabotulinumtoxinA for MMP. Facial shaping improvements from this study, including lower facial volume, lower facial width, and mandibular facial angles, are reported

Materials / method: Adults with grade 4 (marked) or 5 (very marked) MMP on the 5-grade clinician Masseter Muscle Prominence Scale (MMPS) were randomized 1:1:1 to onabotulinumtoxinA 72 U, 48 U, or placebo; proportion with MMPS grade ≤3 (minimal to moderate) at day 90 was the primary endpoint. Also measured were changes from baseline to day 90 in facial volume based on 3D images (VECTRA M3; Canfield Scientific, Parsippany, NJ, USA) using the landmark area of interest (AOI) method, and in facial width and mandibular angle based on 2D image projections from 3D models oriented using prespecified facial landmarks.

Results: Among 145 participants evaluated, significantly greater ( P < 0.0001 ) proportions achieved MMPS grade ≤3 at day 90 in the onabotulinumtoxinA 72 U and 48 U groups compared with placebo (91.3% and 90.6% vs 21.7%, respectively). Significantly greater ( P < 0.0001) proportions achieved MMPS grade ≤3 at day 90 in the onabotulinumtoxinA 72 U and 48 U groups compared with placebo (91.3% and 90.6% vs 21.7%, respectively). Significantly greater ( P < 0.0001) changes in lower facial volume, lower facial width, and mandibular facial angle were achieved with onabotulinumtoxinA 72 U and 48 U compared wit

Conclusion: OnabotulinumtoxinA significantly reduced lower facial volume and width and increased mandibular facial angle, features that indicate improvements toward a more ovoid and less square or trapezoidal facial shape. Improvements were observed at both onabotulinumtoxinA doses. These findings, using objective imaging methods, were consistent with the results of the primary efficacy analysis.

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

Natural-Looking outcomes as well as self-perception of appearance and psychological well-being after treatment with OnabotulinumtoxinA for upper facial lines (unrestricted educational grant from Allergan Aesthetics)

Objectives: OnabotulinumtoxinA (onabotA) is indicated to treat upper facial lines (UFL), which are among the highest treatment priorities for aesthetically-concerned adults. However, some individuals may be concerned about unnatural-looking outcomes, and this could pose a barrier when considering treatment. In this post-hoc analysis of 2 studies on simultaneous treatment of UFL with onabotA, participant-reported outcomes, including satisfaction with natural look and psychological impact, were assessed among those who met the primary efficacy endpoint, including in a subset of millennials and men.

Introduction: There is a growing demand for non-surgical cosmetic dermatology procedures, including among young adults and men. The simultaneous treatment of multiple upper facial regions can be used in clinical practice with the goal of facial rejuvenation that is balanced and natural-looking. Two recent pivotal studies demonstrated the safety and efficacy of onabotA for the treatment of forehead lines (FHL) and glabellar lines (GL), with or without concurrent treatment of crow’s feet lines (CFL); this post-hoc analysis reports patient-reported outcomes from these studies.

Materials / method: The analysis included 633 neurotoxin-naïve adults with moderate to severe UFL who achieved investigator- and participant-assessed ≥2-grade improvement in the Facial Wrinkle Scale ratings of FHL severity at Day 30 (from moderate/severe to none/mild). Participants received onabotA (FHL: 20 U; GL: 20 U; ±24 U in CFL) in up to 3 treatment cycles. Facial Line Satisfaction Questionnaire (FLSQ) items 4 (natural look), 5 (treatment effect), 11 (met expectations), and Impact Domain (appearance and psychological impact) were used to assess PROs and stratified into millennials (born 1981-1997) and men.

Results: High levels of treatment satisfaction were noted at month 12; ≥75% of all participants were mostly/very satisfied with the treatment, and >90% reported that results met or exceeded their expectations. The majority of participants reported a positive impact on self-perceived appearance and psychological well-being. Importantly, 89.3% of all participants, 94.1% of millennials, and 80% of men reported being mostly/very satisfied with achieving natural-looking outcomes on Day 30; satisfaction with natural-looking outcomes remained >80% through 12 months for all analyzed groups.

Conclusion: Among participants achieving none or mild UFL severity after simultaneous treatment with onabotA, the majority reported high satisfaction with treatment overall, improved appearance and psychological well-being, and satisfaction with natural-looking outcomes of treatment. Similar outcomes were seen in millennial and men subgroups. These findings suggest that onabotA treatment is associated with self-perceived natural looking outcomes across gender and age at the doses studied here.

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

Protocol of biorevitalization with Sodium Hyaluronate 45mg/3Ml in association with amino acids, polyphenols, and antioxidants. (unrestricted educational grant from Skin Tech Pharma)

Objectives: The objective of the study is to evaluate the efficacy achieved in the improvement of patients with various degrees of skin photoaging, as well as to evaluate their degree of satisfaction during the international multicenter study with 51 patients involved.

Materials / method: Application of dermal implants for biorevitalization containing Hyaluronic Acid (HA) corrects the signs of skin aging and dermal atrophy by restoring hydration and normal skin physiology.

Results: Depending on the degree of skin photoaging and its condition, HA can provide satisfactory results both as a single treatment and/or as one of the stages of a 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

Efficacy study of novel monophasic dermal implant containing cross-linked hyaluronic acid associated with amino acids for treatment of the photoaging and its consequences. (unrestricted educational grant from Skin Tech Pharma)

Treatment of PEFS a poly-amino acidic solution: first results (unrestricted educational grant from Marllor Biomedical)

Objectives: PEFS affects mainly women and diet & sedentary lifestyle have primary roles. It causes disturbances to capillaries and venous and lymphatic return, and a difficult approach with the imperfections that causes disturbances in the psychosocial sphere of patients. The study performed testing a Medical Device used in mesotherapy on 36 voluntaries (F/M=35/1) showed good efficacy in short/medium term. Effectiveness was assessed both objectively (data on reduction of oedema and of skin nodules due to PEFS), and subjectively (clinician's and patient satisfaction), up to 12 weeks after the first visit.

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 severe case of lichen planopilaris mimicking a keratosis follicularis spinulosa decalvans

Objectives: 1. Emphasize the need for a clinical and histopathological correlation in order to make the correct diagnosis.
2. Highlight the important role of dermoscopy in the diagnosis of hair and keratinization disorders.

Introduction: Keratosis follicularis spinulosa decalvans (KFSD) is an X-linked xenodermatosis characterized by keratotic follicular papules, irreversible hair loss, and/or atrophic depression. While Lichen planopilaris (LPP) is a relatively uncommon cutaneous disorder characterized by a chronic lymphocytic inflammation that leads to the selective destruction of hair follicles. Besides classic LPP, there are two main clinical variants: frontal fibrosing alopecia and Graham-Little–Piccardi–Lasseur syndrome.

Materials / method: A 26-year-old female patient born from a non-consanguinous marriage, presented a rough keratotic papules on the body (mainly on the arms, buttocks) since childhood and loss of hair over the scalp and eyebrows 4 years ago. She was complaining about itchy skin, thick eyelashes, and a painful scalp. The dermatological examination revealed multiple, follicular, tiny, erythematous, keratotic papules over the arms, buttocks and the back suggesting a keratosis pilaris a well-defined erythematous alopecic plaque of 7*8cm, covering entire vertex of scalp with pustules

Results: Trichoscopy revealed perifollicular white scaling, erythema, pustules, absence of follicular opening in the scalp(a), tubular perifollicular white scales of the eyelashes(b), keratotic papules with keratin plug on the buttocks(e), arms. The skin biopsy confirmed the diagnosis of keratosis pilaris (f) while the biopsy specimen taken from the scalp showed orthohyperkeratosis, lichenoid infiltrate of lymphocytes in the dermis evoking a lichen planopilaris. We treated the patient with topical steroids on the scalp, with 200mg per day of doxycycline. Follow-up is still ongoing.

Conclusion: Patients with alopecia and keratotic papules should benefit from a detailed anamnesis specifying their family history, a complete dermatological and dermoscopy examination, skin and hair biopsies to differentiate between lichen plano pilaris and keratosis follicularis spinulosa decalvans.

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

Complications of skin lighteners in the southern population of Morocco

Objectives: To highlight the complications of the skin lightning habits in Moroccan women

Introduction: The use of Skin lightening cosmetics is a common habit in Morocco especially in phototype IV and V. The skin complications are closely related to the active ingredients (hydroquinone, mercury, kojic acid, retinol, steroids), the pigmentary enhancers or additives (alpha hydroxyl acid, lemon extract…), the long time duration (many months to years) and the area of application (more side effects if applied on large body surface area.

Materials / method: Within the National Initiative for Human Development, the Mohamed V Foundation for Solidarity organized a medical caravan on November 2019 in Laayoune (southern Morocco). 100 women benefited from dermatological consultations of whom 60 women confessed the use of skin bleaching products. Data include age of the patient, products use for bleaching habits, main duration of skin lightening products, number of products applied, the dermatological underlying condition if exist.

Results: The average age was 25 years, the average duration of skin lightening practice was 3 years, the products used were topical corticosteroids (100%), hydroquinone (60%), phytotherapy mask (chickpeas) (42%). The motivations for using these products were the search for beauty (31%), self-esteem (17%) and search for a husband (52%). These women obtained their products mainly from the markets but also from the Canary Islands. The main complications were: acne 75%, worsening of melasma 25%, combination of acne and melasma were found in 41.6%, tinea corporis 16%, stretch marks 25%

Conclusion: Despite the alert launched in 2010 by the Cosmetovigilence Center regarding the non-regulatory use of cosmetics containing mercury, hydroquinone and steroids, this practice is far from having disappeared, buying over-the-counter topical corticosteroids is worsening the situation in Morocco.

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

Deciphering dermal fillers behavior during facial expressions: a top-down approach to analyzing volumizer properties (unrestricted educational grant from Teoxane Laboratories)

Objectives: 1.Design mechanical experiments matching facial expressions
2.Evaluate mechanical properties of HA volumizers under dynamic conditions.
3.Highlight key features of potent volumizers: beyond the elastic modulus G’

Introduction: Hyaluronic acid soft-tissue fillers provide tissue projection to correct skin depressions caused by ageing. For this purpose, fillers are generally made of crosslinked HA gels with targeted mechanical properties and longevity for specific indications. To characterize their mechanical properties, oscillatory shear rheology remains the gold standard, with the shear elastic modulus G’ being the most communicated parameter. Yet, HA fillers undergo various forces and deformations (shear, compression) in vivo that cannot be captured with the sole G’ measured in quasi-static shear conditions. (cont.)

Materials / method: 4 commercialized volumizers (JUVVOL, RESLYFT, RHA4, and UD) were systematically analyzed. The shear elastic modulus, G’, as well as the range of dynamic stresses that can be endured by the gel, namely the Linear Viscoelastic Region (LVER), were measured by shear oscillatory rheology. An identical approach, but in compression (E’), was performed. Projection capacities were determined by following the gel resistance to progressive compression. Gel recovery capacities after a transient, but strong skin compression, were analyzed by Dynamic Mechanical Analysis.

Results: Despite their common classification as “Volumizers”, all tested hydrogels showed distinct mechanical performance. The key feature for a volumizer, the projection capacity, showed no correlation with the elastic modulus G’: the gel exhibiting the highest shear elastic modulus, G’, and compressive elastic resistance, E’, in quasi-static conditions (RESLYFT) also presented the poorest mechanical performance and recovery capacities in dynamic conditions. (cont.)

Conclusion: All volumizers do not equally behave in static or dynamic conditions and should be employed according to their specific mechanical characteristics. As a result, gel’s ability to withstand dynamic conditions (LVER) should be as much considered as the elastic modulus G’ (or E’). This would help closing the gap between preclinical characterizations and clinical outcomes with a more realistic picture of gel performance. (cont.)

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

Dynamic quadripolar radiofrequency: Pilot study of a new high-tech strategy for prevention and treatment of vulvar atrophy (unrestricted educational grant from Novaclinical)

Objectives: The aim of this study was to perform qualitative and semiquantitative evaluations of short-term changes in vulvar aesthetics to illustrate the efficacy of an accelerated DQRF vulvar rejuvenation program in women with mild to moderate vulvar atrophy.

Introduction: The well-being of the vulva and a woman’s quality of life are strongly correlated. Dynamic quadripolar radiofrequency (DQRF), one of the newest nonsurgical light- and energy-based vulvar rejuvenation technologies, has been demonstrated to be an effective option in aesthetic gynecology.

Materials / method: Twenty women with mild to moderate vulvar atrophy were prospectively screened and evaluated. Serial photographs documented the aesthetic impact of DQRF on the vulvar area over the 2-month study period. The overall aesthetic improvement was rated on a Global Aesthetic Improvement Scale modified to create a 10-point semiquantitative rating tool. Complications and side effects were recorded.

Results: All women successfully underwent 3 planned DQRF procedures spaced 7-10 days apart. Signs and symptoms of vulvar atrophy and the range of aesthetic judgments of the vulvar area were improved in most women after the first DQRF session, and improvements in vulvar aesthetics were persistently highly significant 1 month after the end of the DQRF rejuvenation program. No complications or side effects occurred.

Conclusion: Improvements in the signs and symptoms of vulvar atrophy by DQRF rejuvenation of the labia majora confirm the efficacy and safety of this technically simple outpatient procedure. In women with mild to moderate atrophy, a rapid rejuvenation program of closely spaced sessions achieved significant improvements.

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

Microneedle radiofrequency & HIFU combined treatment for skin tightening with focus dual (unrestricted educational grant from Eunsung Global Corp.)

Objectives: Both fractional radio frequency microneedle (FRM) as well as HIFU is a widely used device in facial rejuvenation but operator dependent. FRM is mostly used for rather superficial and medium deep tightening of the skin, HIFU predominantly for deeper structures like the SMAS system. A combination of both is expected to deliver better results with less downtime.

Introduction: Methods based on physics have increasingly been used in recent years for medical and also cosmetic purposes. Especially radiofrequency of various types as well as high intensity focused ultrasound (HIFU)
have been increasingly established.

Materials / method: We collected 12 patients with medium deep wrinkles and laxity, 9 female and 3 male volunteers age 46 -72 y, receiving 3 sessions of FRM+HIFU treatment, 4 weeks apart on cheeks, neck, perioral and temporal after 30 min of Emla numbing cream. The results were evaluated by 3 independent physicians using the B&A pictures of the cheek in each patient.

Results: All patients obtained good therapeutic responses with an improvement of 6 to 4 on a 10 point scale and with very little down time, which included some edema and redness for 24-48 hours that resolved completely without medication. Long-term follow-up for 1 year, showed no relapse and no adverse reactions such as scars and hyperpigmentation.

Conclusion: Wrinkles of the face due to ageing were treated successfully using FRM+ HIFU on cheeks, neck, perioral and temporal.

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 comparative test of pull-out strength performance of different insertion methods of poly(L-lactide-co-ε-caprolactone) barbed suspension threads

Objectives: The aim of the study is to propose a standardized method to measure the parameters of the holding, slippage, and pull-out forces of poly(L-lactide-co-ε-caprolactone) barbed suspension threads used for facial soft tissue repositioning. We compared the pull-out strength of different insertion patterns performed via 3 suspension threads with different lengths and needle gauges. The identification of the insertion technique-related variables influencing the pull-out strength and holding force may orientate the identification of the best technique and thread type for every single patient.

Introduction: There are only few studies investigating the pull-out tensions of suspension threads. Moreover, there is no standardized and mechanical method to measure the suspension threads’ gripping force on biological tissue that eliminates the variability introduced by users. Understanding the influence that technical variants have on the insertion performance may suggest the best option to achieve the optimal results. This study has two main objectives: validate a pull-out strength test methodology and perform a comparative pull-out strength performances of different insertion methods of the same threa

Materials / method: We created a device composed by an adjustable base frame and a reclining station installed on top. The station contains a linear motor and a mobile sliver. The linear motor can apply loads in the ramp of torque or time and activate the motion of the mobile sliver on which a digital dynamometer is fixed. We performed pull-out tests of 6 different insertion methods on fresh turkey breast meat with 3 double-needle thread types: 12 cm with needle diameter =0.85mm; 23 cm with needle diameter =1.28 mm; 23 cm with needle diameter =0.85 mm. In total 9 pull-out sets of 12 tests were performed.

Results: The threads’ pull-out strength from turkey breast meat was measured. Independently from the insertion technique, the collected data resulted extremely scattered within each test set. The main indications from the comparison of the average load of the pull-out tests measured within each insertion technique group are as follows: 1- the length of the barbed section does not influence the pull-out strength; 2- the insertion patterns that involve angles and direction modifications have higher pull-out strength; 3- the pull-out strength seems higher in threads with a needle with a lower diameter.

Conclusion: Several techniques are used for facial soft tissue suspension with poly(L-lactide-co-ε-caprolactone) barbed threads. The Jawline Reshaping Technique with J stick and the Lateral Reshaping Technique imply the creation of angles during the insertion of the thread thus improving soft tissues suspension because of the augmented grip force of barbed threads on surrounding tissue. Data also suggest that needle diameter influences the grip force: a thinner needle seems to increase it. This is probably due to the creation of a smaller tunnel by a thinner needle in the context of the soft tissue.

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

IncobotulinumtoxinA demonstrates safety and prolonged duration of effect in a dose-ranging study for glabellar lines: final study results

Objectives: To assess the duration of effect and safety of incobotulinumtoxinA (INCO) doses higher than the US Food and Drug Administration-approved 20 units (U) for glabellar frown lines (GFL).

Introduction: There is an increasing demand for a longer duration of effect from botulinum toxin A products. A 2-stage, phase 2, randomized, double-blind study was conducted to assess the duration of effect and safety of incobotulinumtoxinA (INCO) doses higher than the US Food and Drug Administration-approved 20 units (U) for glabellar frown lines (GFL). The stage 1 primary efficacy and safety results were reported previously. Here, we report the results of the final analysis (stage 1 and 2), including primary and secondary efficacy and safety endpoints.

Materials / method: A total of 241 subjects with moderate-to-severe GFL were randomized to receive a single treatment with either 20 U (N=61), 50 U (N=60), 75 U (N=61), or 100 U (N=59) INCO. The primary efficacy endpoint was duration of ≥ 1-point improvement from baseline assessed by investigator at maximum frown on the Facial Wrinkle Scale.

Results: The median duration of effect was 175 days for the 20 U group (95% confidence interval [CI] 142, 185), 185 days for the 50 U group (95% CI 182, 205),
210 days for the 75 U group (95% CI 182, 217), and 215 days for the 100 U group
(95% CI 183, 237). The incidence of treatment-related adverse events was low across all doses, and no treatment-related serious adverse events were reported.

Conclusion: INCO doses up to 100 U were well tolerated, consistent with the known safety profile of 20 U, and increasing dose resulted in prolonged duration of effect for GFL.

Disclosures

Did you receive any funding to support your research for this TOPIC?
Yes
Please specify entities (individual, company, society): Merz

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

Animal study indicates importance of distance between microspheres for neocollagenesis (unrestricted educational grant from Merz Aesthetics)

Objectives: 1. Understand how the dilution of Radiesse effects biostimulation for skin quality improvement
2. Understand the relation between spatial distance of microspheres and resulting neocollagenesis.

Introduction: Dilution of calcium hydroxylapatite (CaHA) is a common practice prior to injection. This dilution leads to a spreading of its microspheres in the skin. Dilutions vary between 1:1 to 1:10 with the most common being 1:1 and 1:2. Dilution and injection technique can have a significant impact on patient outcomes and vary between different indications. The understanding of which dilution leads to greater biostimulation in specific indications is key for best patient results and optimal skin quality improvement.

Materials / method: Six, ≥ 18-week-old, female, New Zealand White rabbits received injection on the back with CaHA (diluted/undiluted). At the end of the study period (14 days post injection), the animals were sacrificed. Formalin fixed skin tissue samples were processed and stained with Elastin Trichrome and IHC (Hsp47 for fibroblasts). An unbiased algorithm-based analysis approach was used: The Weighted Neighbor Ratio (ratio of distance to sounding spheres and the number of spheres) of Spherical Calcium Items were measured and correlated to surrounding amount of collagen and fibroblasts.

Results: In the early neocollagenesis stage a lower density of CaHA microspheres per area lead to more collagen production in a 50µm radius around an individual microsphere. This correlated to the number of fibroblasts present in the same area. More fibroblasts were present in areas with greater spatial distance between microspheres. These results indicate that early in biostimulation, fibroblasts invade areas with less microspheres and interact with those microspheres which results in neocollagenesis.

Conclusion: Correlation of greater distance between microspheres and higher collagen expression around microspheres was demonstrated in a rabbit model at the early neocollagenesis stage. Higher density of microspheres resulted in less biostimulation. This study demonstrates that in the early stage of biostimulation greater spatial distance between microspheres via dilution might be beneficial for skin quality improvement.

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

Increased hyaluronic acid concentration enhances the local tissue lifting capacity in an Ex Vivo human skin model (unrestricted educational grant from Merz Aesthetics)

Objectives: The current study aims to show the different behaviors of CPM-HA filler in terms of their local tissue lifting capacity within a human ex vivo tissue model.

Introduction: Dermal filler products using the Cohesive Polydensified Matrix (CPM®; Belotero®) technology are cross-linked hyaluronic acid (HA)-based gels which are injectable soft-tissue fillers indicated to address facial signs of ageing. Due to its molecular structure, HA has a high water-binding capacity that provides a non-permanent, but immediately visible effect of volume regain after treatment. The current study aims to show the different behaviors of CPM-HA filler in terms of their local tissue lifting capacity within a human ex vivo tissue model.

Materials / method: Human ex vivo skin was injected with CPM-HA20, -HA22.5 and -HA26 with a 30 G x 1/2” needle (95± 5µL/cm², n≥6). Each injection site was consecutively analyzed by two different methods:
Non-invasive 3D analysis: (LifeViz® Micro, Quantificare) was used to determine the z-height (vertical lift) of the tissue surface before and after each filler injection.
Histomorphology analysis: was done using the digitalized cryo-sections of each injection site. Software-assisted analysis was used to determine the vertical height (HF) of the filler bolus in relation to the dermis (HD).

Results: The topographical 3D analysis of the human ex vivo tissue shows an immediate local tissue lifting effect after filler application for each CPM-HA product tested. CPM-HA26, the filler with the highest HA concentration, demonstrated the greatest tissue lifting capacity compared to CPM-HA22.5 (*P<0.05) and CPM-HA20(***P<0.0005). Similar results were obtained during the histomorphological analysis in which the local tissue lifting capacity of CPM-HA26 is greater compared to CPM-HA20 (*P<0.05).

Conclusion: CPM-filler with a higher HA concentration provided a significantly greater local tissue lifting capacity, which is consistent with reported findings of clinical studies. These data further support the use of CPM-HA20 for smoothing of fine lines, while CPM-HA26 with its high HA concentration is designed to restore volume in deep wrinkles/depressions. In conclusion, the current study demonstrates that the local tissue lifting capacity of HA-filler can be addressed using a human ex vivo skin model and thus allowing for predictions for the lifting parameter in a clinical setting.

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

We return faces to victimes of the war - Project "Ukrainian Face"

Objectives: 120 patients will receive face treatment during 2022.
Why our project is so important?
The war effect on people’s personality. Face is the most visible part of any person, people look in to each other faces when they are communicating. Having visible deformities can lead to additional questions about the origin of them. The questions about changes of the face can act as triggers and constant reminders about causing adverse.

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

Infraorbital combined treatment for dark circle eyes: Q-switched laser, polydioxanone thread and hyaluronic acid filler

Objectives: The periorbital subunit is one of the first facial regions to show signs of aging. Treatment to correct different aspects of the periorbital aging process is commonly necessary. We present a case of a patient complaining of dark circle eyes. The association of non-ablative fractioned QSW laser (1064 nm), hyaluronic acid (HA) fillers, and polydioxanone (PDO) threads enabled the skin rejuvenation and lightening, as well as periorbital restructuring.

Introduction: The periorbital subunit signs of aging include skin darkening, volume depletion of the soft tissue, and bony resorption1,2. Ablative laser systems were the first resurfacing devices proven successful3. Non-ablative lasers bring good results with short downtime3. Soft tissue filler injection is an easy procedure to correct the infraorbital grooves, promoting immediate results1. Botulinum toxin is well indicated for dynamic orbital wrinkles but does not contribute to skin laxity, commonly present in this region. For this last indication, knotless PDO threads promote excellent results4.

Materials / method: A 55-year-old female complaining of dark circle eyes presented deep malar fat depletion and accentuated nasojugal and palpebromalar grooves, darkening, and laxity of infraorbital regions. The proposed sequence treatment was three sessions of fractioned QSW- laser 1064 nm, fluence 1.200 mJ, one month apart. Two HA fillers with different rheological properties were applied to the malar region and lid-cheek junction. Five knotless PDO threads were inserted per side in a hashtag arrangement (Fig.1).

Results: We call attention to the fact that combined treatment is mandatory to achieve good results because different procedures are necessary to correct all the periorbital aging processes1,2. Non-ablative fractioned QSW laser promotes skin brightening and improves skin texture3. HA filler is essential to recover the palpebromalar and tear trough depth3. Knotless PDO threads are biostimulating agents well indicated for skin laxity and wrinkles in dynamic regions, such as the periorbital area, where hydroxyapatite and poly-L-lactic are contra-indicated5.

Conclusion: The association of fractioned Q-switched laser, crosslinked hyaluronic acid fillers, and knotless polydioxanone thread promoted a significant clinical improvement, an excellent option for non-surgical rejuvenation of the infraorbital 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

Ultrasound follow-up of in vivo behavior of polydioxanone thread associated to crosslinked hyaluronic acid gel in the mandibular area

Objectives: We aim to report a case of in vivo long period ultrasound follow-up of a 53-year-old female submitted to barbed PDO threads and crosslinked hyaluronic acid gel applied in the same anatomic layer.

Introduction: Polydioxanone (PDO) is a synthetic polymer that induces neocollagenesis and is usually absorbed by hydrolyzation within six months1,2. In vitro studies hypothesized that the association between polydioxanone (PDO) threads and non-crosslinked hyaluronic acid (HA) gel might increase the rate of PDO degradation1. Still, its behavior when associated with cross-linked HA had not been described yet. Ultrasound has been widely used in cosmetic procedures3,4 and it can monitor HA gel behavior5.This is the first report about in vivo behavior of PDO thread associated with crosslinked HA gel through HRU.

Materials / method: A 53-year-old female healthy patient was submitted to two procedures at the exact moment. A total of 0.5 ml of a high G’, crosslinked HA gel (24 mg/ml with lidocaine) was injected through a 22G cannula in the subcutaneous layer in the mandibular line per side. Subsequently, a cannulated barbed PDO thread, 19 G, 100x160 mm, 0-0 USP, was inserted in the same anatomical layer. HRU images were obtained after the procedure and every two months until complete degradation of PDO threads. The ultrasound device used was a 22mHz - high frequency - linear transdutor.

Results: HRU in vivo evaluation showed the HA gel as oval anechoic imagens and the PDO thread as a linear hyperechoic image in the subcutaneous layer. Both materials were observed after two and four-month follow-ups. At six- months, only a few amounts of HA gel were present.

Conclusion: Despite the report of PDO early hydrolyzation when in contact with non-crosslinked HA, we did not see the same behavior in vivo US follow-up when associated with crosslinked HA.

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

Ultrasound follow-up of in vivo behavior of solid polydioxanone threads

Objectives: We aim to show the in vivo performance of solid polydioxanone (PDO) threads used as a filler material in the nasolabial and labio-mandibular folds through high resolution ultrasound

Introduction: Hyaluronic acid (HA) filling is one of the most frequent procedures in cosmetic dermatology. Beautification of lips and the perioral region has commonly been sought in the last years1. Different PDO threads were introduced as a good option for facial rejuvenation1. Solid PDO threads, also known as “solid fillers” can be an option to substitute or complement HA gel filler2, as they can improve laxity or promote lifting or filler effects3. High resolution ultrasound (HRU) have been used to evaluate the behavior of HA fillers4,5. Still, in vivo long period follow-up of PDO threads lack literature

Materials / method: 56-year-old female healthy patient was treated with solid cannulated PDO threads, 21G, 6-0, which were inserted along the nasolabial folds (one per side) and the labiomandibular folds (three per side), drawing a trident arrangement. HRU images were obtained after the procedure and for five months. The ultrasound device used for the analyses was a 22mHz - high frequency - linear transdutor.

Results: Three “solid fillers” were seen as a linear hyperechoic material in the subcutaneous layer. These PDO threads remained in the subcutaneous layer for five months in the nasolabial and labiomandibular folds (Fig 1).

Conclusion: Despite gradual degradation, the solid multiple stranded PDO threads remained in the subcutaneous layer for five months in the nasolabial and labiomandibular folds.

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

Safety and efficacy of combined non-ablative and ablative laser treatment of scars

Objectives: We aimed to evaluate the efficacy of fractional ablative Erbium:YAG laser combined with Near Infra Red light (NIR), intense pulsed light (IPL) and non-ablative Q-switched Nd:YAG laser for the treatment of hyper- and hypothropic postacne, postoperative and post traumatic scars.

Introduction: Scars, both hyper- and hypotrophic, have a significant effect on self-esteem and individual’s quality of life, especially when located on a non-covered parts of the body. Lasers and energy-based devices are commonly used for the treatment of scars. There are several publications showing results of combined protocols with ablative and non-ablative methods.

Materials / method: Study included 171 patients, 64 patients with hyperthropic scars (36 post-injury, 27 post-operative, 1 post-acne) and 107 patients with hypotrophic scars (44 post-acne, 33 stretch marks, 20 post-injury, 10 post-operative). Treatment protocol: 4 procedures with one month intervals. Each session included non-ablative fractional Q-switched 1064nm Nd:YAG laser, followed by IPL 450-600nm, NIR 780-1300nm and fractional ablative 2940nm Erb:YAG laser. Treatment efficacy was evaluated using the Patient Observer Scar Assessment Scale (POSAS), patients’ satisfaction was assessed with DLQI.

Results: The study showed clinical improvement in: color of the scar in 58% of patients, elasticity of the scar in 86% patients and position of the scar in 92% patient; which were relative to the healthy skin. The POSAS score was reduced in 92% of patients. The patients’ satisfaction level assessed with Likert scale: 51% of patients were satisfied with the treatment (marked 4 out of 5) and 35% very satisfied (5 out of 5). DLQI positive change in before and after questionnaire was present in 92% of patients.

Conclusion: This study presents good clinical outcomes in scar management with a high patient satisfaction rate and no significant adverse side effects. Our study reveals that improvement of scar appearance and scar quality was meaningful to the patient, with a significant impact on a patient's life quality.

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 hybrid filler: combining calcium hydroxylapatite and hyaluronic acid fillers for aesthetic indications

Objectives: The aim of this study is to investigate the safety of premixing CaHA and HA fillers before injection.

Introduction: Limited data are available describing the use of calcium hydroxylapatite (CaHA) and hyaluronic acid (HA) in combination.

Materials / method: The authors performed a retrospective chart review of patients injected with a premixed combination of CaHA and a cohesive polydensified matrix (CPM®) HA in the authors’ aesthetic practices. Patients records were evaluated for adverse events at 1-3 month, 5-7 month and >12-month posttreatment follow-up visits. The retrospective chart review identified 134 patients who had been treated with premixed CaHA: HA, most of whom were female (95%). Most patients were treated for multiple facial areas. Injections were subcutaneous and performed with 25G 38- or 50-mm cannulas.

Results: The authors identified a cohort of 134 patients who had been treated in their practices with premixed CaHA:CPM-HA over the period March 2018 to February 2020. Each patient was treated according to their individuals needs and aesthetic outcomes. Injections were performed with 25G 38- or 50-mm cannulas, using a fanning injection technique. 2 cases of slight overcorrection in a small area at 1-3 months were reported. No other AEs were reported.

Conclusion: The findings from this combined evaluation of the published literature and retrospective examination of case reports support the well-established individual safety profiles of CaHA and HA fillers and raised no concerns about the use of premixed CaHA and CPM-HA fillers for a range of facial indications.

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 case study of reducing facial asymmetry from facial nerve palsy

Objectives: Male /Before
FNGS Score: 12 | Grade3
FDI Score: 120
- physical :60
- social*wellbeing : 60

Male/ After
FNGS Score: 8 | Grade2
FDI Score: 145
- physical :65
- social*wellbeing : 80

Female / Before
FNGS Score: 12 | Grade3
FDI Score: 165
- physical :85
- social*wellbeing : 80

Female/ After
FNGS Score: 8 | Grade2
FDI Score: 190
- physical :85
- social*wellbeing : 95

Introduction: This study introduces a set of processes and
outcomes of using an acupuncture technique used
to treat cosmetically asymmetrical features in healthy
individuals, to treat residual symptoms of peripheral
facial nerve palsy. The treatment of peripheral facial
nerve palsy has been studied in a number of clinical
case studies. . This study aims to propose
a treatment strategy for the sequelae of peripheral
facial nerve palsy by treating two patients with residual
symptoms related to peripheral facial nerve palsy.

Materials / method: The patients attended the clinic twice a
week for three weeks and received DALA treatment.
The DALA treatment utilized Serin needles of 0.14mm
diameter and 30mm length, as well as needles of
0.16mm diameter and 30mm length. The treatment
lasted 15 minutes, and the electroacupuncture
was performed using the STRATEK STN-330 model.
Other medications or facial treatments were not
administered for three weeks. Using the MORPHEUS
3D scanner, this study measured changes in facial
asymmetry in the expressionless state and the /
ē/ pronunciation state before and after

Results: Both patients' FNGS grade was lowered (lower grade is betterthan higher grade), which indicates improvement. In the case of the male patient's measured FDI score, both the physical and social wellbeing scores were 60, and the physical score increased by five points afterthe DALA treatment. . In the case of the female patient's measured FDI score, the physical score (85) was not relatively low even before the DALA treatment, and there was no change in the score even after the
DALA treatment. But the Social*well being score appeared
to increase by 15 points from 80 to 95.

Conclusion: DALA was effective at improving the quality of life and social status of patients with sequelae of facial nerve palsy. Due to the small number of patients in this study, it is not possible to assume that DALA treatment will produce positive effects on the sequelae of facial nerve palsy. Nevertheless, based on the results of the two patients, it may be possible to formulate the hypothesis that DALA might have positive effects on the sequelae of facial nerve palsy. The following research will testify to this hypothesis.

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 comparative study of long pulsed Alexandrite laser versus pulsed dye laser in the treatment of rosacea

Objectives: To compare the effectiveness of long-pulsed alexandrite laser (LPAL) with that of pulsed dye laser (PDL) for rosacea.

Introduction: Rosacea is a common cutaneous condition characterized by erythema and vasodilation on the face. Because, rosacea is chronic and recurrent in its nature, its treatment is difficult and lifelong management with lifestyle modification is often required. Treatment methods vary depending on the severity and clinical subtypes. Facial flushing and telangiectasia is common symptom of rosacea, which respond well to laser devices targeting vascular structures. Evidence on the efficacy and safety of long-pulsed alexandrite laser for treatment of rosacea is limited.

Materials / method: This was a single-blind randomized controlled trial on patients who were clinically diagnosed with rosacea. Randomly assigned split face in each patient received four times monthly treatment of PDL or LPAL. At every visit, erythema index was measured by MarkVuTM and Mexameter® and digital photographs were evaluated by two independent dermatologists with physician's global assessment.

Results: 27 patients were enrolled and received four laser treatments. Erythema index significantly decreased on both treated sides (LPAL 366.5±101.0 vs. 295.8±90.2, p <0.001, PDL 369.0±124.3 vs. 302.7±92.1, p <0.001) one month after 4th treatment. Three months after the last treatment, the reduction of erythema index was maintained (LPAL 360.3±96.8 vs. 282.0±89.2, p <0.001, PDL 364.3±121.6 vs. 281.6±97.8, p <0.001). Physician-assessed global aesthetic improvement scale and patient satisfaction were comparable between LPAL and PDL sides and did not show significant difference.

Conclusion: This study showed that LPAL showed comparable effect to PDL for the decrease of erythema index in rosacea. Therefore, LPAL could be a promising alternative treatment option with good merits for rosacea.

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

Efficacy of a solution containing amino acids, copper and hyaluronic acid (unrestricted educational grant from Elastic Lab)

Objectives: The aim of this human study is to evaluate the efficacy of the product containing amino acids, copper, and hyaluronic acid on the improvement of skin aging.

Introduction: We have developed a composition that increases the expression of Elastin as well as Collagen and confirmed that the composition increased the expression of Elastin and Collagen in human skin fibroblasts. Based on this in vitro study, we further conducted clinical studies to observe changes in the composition causes on human skin condition with variable mechanical tests.

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

Skin quality boosters and their physicochemical properties

Objectives: Physicians choose their injectable products based on clinical experience, study results, and scientific data for physicochemical characterization.
For improving overall skin quality, there is an injectable hyaluronic acid hydrogel based product range, known as skin quality boosters (SQBs). The aim of this study is to investigate SQBs of different companies and manufacturing technologies and their physicochemical properties.

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

Hyperacute serum outperforms PRP as a regenerative factor

Objectives: 1. Differences between PRP and hypACT
2. Biological effects of PRP and hypACT
3. Possible clinical applications

Introduction: Blood products have recently become a widely used treatment in regenerative medicine. Particularly, PRP has become the therapeutic mostly used for this purpose, however, multiple studies have shown controversy about its benefits. In contrast, hyperacute serum (hypACT) is a cell and fibrin-free solution, obtained after pressing out fibrin clots, which maintains the highly regenerative capacities of PRP. In numerous studies it was shown that hypACT promotes the proliferation of various cell types, controls inflammation in vitro and has a more reliable effect than PRP.

Materials / method: PRP was prepared using two centrifugation steps in the presence of anticoagulants and hypACT was isolated from activated platelet-rich-fibrin. In order to produce a stable and standardized product that allows long-term storage, hypACT was freeze-dried. Viability of the stem cells and fibroblasts was determined by XTT assay and the progress of differentiation was tested via histological staining and monitoring of specific gene expression. Additionally, we performed scratch assay with endothelial cells and senescence assay with fibroblasts.

Results: We compared the biological activity of PRP and hypACT and we observed significant differences in growth factors content. HypACT increased metabolic activity of all tested cell types, supported adipogenic differentiation of stem cells, inhibited apoptosis and did not induce inflammation.

Conclusion: HypACT is a good alternative to PRP due to its better regenerative potential. Using hypACT is closer to physiological conditions and do not carry a risk of administrating overconcentrated doses of growth factors or cytokines to the injury site, as is the case with. Since hypACT can be formulated as a stable off-the-shelf product harvested from young healty volunteers, it can replace PRP use in cellular therapies, such as Cell-Assisted Lipotransfer (CAL) or combined application with hyaluronic acid (HA).

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

Tolerance of IPN hyaluronic acid gels in an Ex vivo human skin model (unrestricted educational grant from Laboratoires Vivacy)

Objectives: To investigate two different hyaluronic acid based gels (IPN-16 and IPN-26) immediate bio-integration by using tissular

Introduction: Dermis can be defined as a specialized conjunctive tissue. Indeed, collagen and elastin fibers density are very high, leading to a pretty compact extracellular matrix. In contrast, hypodermis is mostly made up of voluminous cells (adipocytes), separated from each other by fairly loose extra-cellular matrix. Therefore, products indicated for one or the other of these tissues must show adapted rheological properties in order to limit potential inflammatory foreign body reactions. This paper investigates immediate tissular responses after IPN-16 and IPN-26 injections.

Materials / method: Fragments of normal human skin are obtained from abdominoplasty surgery procedures. Skin samples are cut into several pieces and rinsed with phosphate buffer. Each skin fragment is placed in a porous insert, which is itself positioned on a culture well. Tissue samples are maintained in survival conditions. For each considered tissue layer (dermis and hypodermis), 9 hyaluronic acid gels injections have been performed per sample. After 3 days, Il-6, Il-8, caspase 3, caspase 7 have been dosed using different ELISA kits. In addition, histological visualizations of the gels have been performed.

Results: For the injections performed in the dermis, results show that IPN-16 is slightly better distributed and tolerated than IPN-26. Furthermore, it is interesting to note that both products seem to induce a weaker inflammatory response than PBS injections. Conversely, when injections are performed in the hypodermis, IPN-16 seems to migrate and aggregate at the dermis-hypodermis interface. IPN-26 is evenly distributed. Inflammatory response is also weaker with the 2 products than with PBS.

Conclusion: Whether in the dermis or the hypodermis, the inflammatory response induced by Stylage gels is minimal and even appears to be lower than that induced by PBS. The antioxidant properties of hyaluronic acid are hypothesized to explain this result. In addition, IPN-16 is indeed the best tolerated product in the dermis, while both products seem to be comparable in the hypodermis.

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

Efficiency of IPN hyaluronic acid gels in an Ex-vivo human skin model (unrestricted educational grant from Laboratoires Vivacy)

Objectives: To investigate dermal fillers IPN-16 and IPN-26 immediate mechanical and biological performances. Skin texture and type I pro-collagen synthesis will be analyzed.

Introduction: In aesthetic medicine, hyaluronic acid (HA) gels are used either to improve superficial tissues hydration and quality, and also to restore (or create) facial volumes. Hence, injections depths are drastically different between those two groups of indications (i.e dermis and hypodermis). Given the fact that biomechanics and histology of target tissues are also very different, it would make sense to assess products immediate efficacy when they are used in their predilection indication, but also if they are misused (i.e incorrect injections).

Materials / method: Fragments of normal human skin are obtained from abdominoplasty surgery procedures. Skin samples are cut into several pieces and rinsed with phosphate buffer. Each skin fragment is placed in a porous insert, which is itself positioned on a culture well. For each considered tissue layer, 9 HA gels injections have been performed per sample. After 3 days, two tests have been performed: 1) evaluation of the type 1 collagen synthesis (ELISA, Human Pro-Collagen I alpha 1). 2) Evaluation of skin micro-relief (LifeVizMicro)

Results: When IPN-16 is injected to the dermis, type 1 procollagen synthesis augments by 64% and the skin texture is improved by 33%. IPN-26 results shows 27% and 18% improvement, respectively. Hypodermis injections: when IPN-26 is injected in the hypodermis, type 1 procollagen synthesis augments by 59% and the skin texture is improved by 28%. IPN-16 results shows 39% and 16% improvement, respectively.

Conclusion: A good comprehension of the injected target tissues is mandatory to be able to define optimal injectable HA gels rheologies. If those parameters are not taken into account, clinical efficacy could be easily impaired. In addition, our results also demonstrates that the stronger HA gel rheology y is not always to most efficient.

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

Treatment of androgenetic alopecia (AGA) with sabal serrulata and biomimetic peptides delivered with microneedling (unrestricted educational grant from Toskanimed)

Objectives: The aim of the study is to assess the efficacy of microneedling in the treatment of AGA, by serial micropuncture, with commercial sterile cosmetic preparations.

Introduction: The aim of the study is to assess the efficacy of microneedling in the treatment of AGA, by serial micropuncture, with commercial sterile cosmetic preparations.

Results: At the 10th session, 70% of the patients treated presented an improvement in cumulative hair thickness (mm/cm2).

Conclusion: Transcutaneous administration by microneedling has shown good results for AGA

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 molecular weight hyaluronic acid (HMWHA) for the treatment and prevention of skin aging (unrestricted educational grant from Toskanimed)

Objectives: To demonstrate the effectiveness of high molecular weight hyaluronic acid (HMWHA) as treatment and prevention of skin aging, it was injected using 30G / 4 mm needles in 6 volunteers of both genders, every three weeks.

Introduction: We have a new generation of skin biorevitalizers with a high molecular weight (2.7-3.7∙10^6 Da) non-cross-linked hyaluronic acid similar to that of the skin. Its injection deep into the dermis stimulates collagen production, increases skin hydration, firmness and elasticity, improves the morphology and function of fibroblasts, and reinforces the epidermal barrier

Results: The results show improved firmness 15.2%, elasticity 66.1% and hydration 19.8%.

Conclusion: The dermal injection of HMWHA has proven to be effective and safe in the treatment and prevention of skin aging.

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

Comparative study of the efficacy of two commercially available transcutaneous biorevitalizers (unrestricted educational grant from Toskanimed)

Objectives: Two commercially available biorevitalizers with a very similar composition were compared, using different application techniques: a) intradermal injection into the superficial dermis; and b) a novel electroporation technique combined with microabrasion that act simultaneously.

Introduction: As people grow older, the skin gradually ages, particularly in the facial region. The different techniques and compounds are available that act upon the extracellular matrix, favoring its renewal and affording the nutrients required for regeneration of the skin.

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

Actinic reticuloid mimicking mycosis fungoides

Objectives: Skin conditions arising on sun-exposed areas and worsening after exposure to the entire spectrum of solar radiation are getting more common and they represent difficult diagnostic and therapeutic problems. It was confirmed that exposure to (UV) radiation (mostly UVA, UVB and visible light beyond 400 nm) may have an effect on numerous molecular processes that damage the skin, causing different skin changes and diseases. Thereby, we present a case of actinic reticuloid (AR) as a rare skin condition , facing an increase in its prevalence.

Introduction: AR is a rare dermatosis, defined as an eczematous hypersensitivity reaction to UV rays that can vary from mild eczematous cases to AR and the most severe cases may mimic cutaneous T-cell lymphoma. Diagnosis is based on clinical, histopathologic, and photobiologic features. The etiology and pathogenesis of the disease have not been fully established.It is suspected that the immune system overreacts to substances within the skin that are made ‘allergic’ by UV and visible light. An association with allergic and/or photoallergic contact dermatitis has been found.

Materials / method: 50 years old Moroccan farmer with a 10 years history of an itchy eruption first appeared on the scalp, neck, upper back, forearms, and legs. He reported a recent exacerbation of the disease due to medicinal plants consumption and during the spring-summer period.On physical examination, we observed in sun-exposed skin erythematous scaly, indurated, achromic and hyperpigmented plaques .Excoriations , lichenification, accentuation of natural folds and skin peeling on the face. The diagnosis of actinic reticuloid was made on the anamnesis, the clinical manifestation and pathology patterns .

Results: AR affects mostly elderly men,clinical manifestations are very reminiscent of atopic dermatitis,mycosis fungoides, Sezary's syndrome, and tardive cutaneous porphyria. The lesions are located mainly on sun-exposed areas but they can extend to covered areas and some patients may present with erythroderma.Skin biopsy reveals psoriasiform hyperplasia,and inflammatory infiltration (lymphocytic, eosinophilic, and rarely plasmacytic ).Some atypical lymphocytes may be seen within the epidermis. Hence, the diagnostic process is based on arguments in favor while excluding differential diagnosis.

Conclusion: Treatment is challenging, from topical tacrolimus,low-dose PUVA,narrow-band UVB, B-carotene, hydroxychloroquine to immunosuppressive agents.As the disease has a chronic course , it requires proper management and complete skin protection from ultraviolet light, requiring patients to change their lifestyle as to adopt a nocturnal pattern of living and avoid provoking factors such as contact allergens. AR should be considered in every patient who presents with persistent, unclear, erythematous skin changes on sun exposure areas.

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

Human stromal cell aggregates concentrate adipose tissue constitutive cell population by In vitro DNA quantification analysis (unrestricted educational grant from Tulip)

Objectives: Regenerative cell strategies rely on stromal cell implants to attain an observable clinical outcome. However, the effective cell dose to ensure a therapeutic response remains unknown. To achieve a higher cell does, Ramon Llull, MD et al hypothesized that reducing the volume occupied by mature adipocytes in lipoaspirate will concentrate the stromal vascular fraction present in the original tissue.

Materials / method: Human standardized lipoaspirate (n=6) was centrifuged (1200 g for 3 minutes) and the water phase was discarded. Mechanical disaggregation was achieved by shearing tissue through 2.4mm and 1.2mm luer-to-luer transfers. After a second centrifugation (800 g for 1 O minutes}, stromal cell aggregates were separated from the supernatant oil phase. Lipoaspirate percentage composition was determined by its constituent weights. Cell content was measured by total DNA quantification, and partial cell viability was determined by image cytometry...(cont.)

Results: Stromal cell aggregates reduced the standardized lipoaspirate mass to 28.6 + 4.2 percent. Accordingly, the cell density increased by 222.6 + 63.3 percent (from 9.9 + 1.4 million cells/g to 31.3 + 6.6 million cells/g; p < 0.05). Cell viability was unaffected in stromal cell aggregates (71.3 + 2.5 percent} compared to standardized lipoaspirate (72.2 + 2.3 percent}, and histologic analysis revealed high-density areas enriched with stromal cells (622.9 + 145.6 percent} and extracellular matrix (871.2 + 80.3 percent}.

Conclusion: Stromal cell aggregates represent a biological agent that triplicates the cell density versus unprocessed lipoaspirate, low on oil and water fluids, and enriched extracellular matrix components.

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

Long term results of facial lipoatrophy treated with polyacrylamide gel

Objectives: To assess the long term efficacy, subject patient satisfaction and safety of the polyacrylamide gel as filler for treat facial lipoatrophy.

Introduction: Facial lipoatrophy is a distressing complication presented in patients with human immunodeficiency virus (HIV) in antiretroviral therapy. Although new antiretrovirals are associated with less lipoatrophy, the prevalence is still high. This subcutaneous facial loss affects the quality of life, self esteem and treatment adherence.
Filling materials are widely used in plastic surgery to restore facial volumes. The polyacrylamide gel is a permanent non biodegradable filler that has been shown as an appropriate and safe treatment option for facial lipoatrophy in HIV patients.

Materials / method: We included fifteen patients with facial lipoatrophy treated with polyacrylamide gel in a Spanish public hospital between 2011 and 2021. All the patients suffered from lipoatrophy grade II-III due to the antiretroviral treatment and were in a stable clinical situation. We describe the patients demographics, fillers use history and side-effects.

Results: Patients were predominantly male with a medium age of 53 years. Only 3 of the patients had been injected previously with other fillers. The number of infiltrations required during the follow-up were between one and three. The main area injected was the cheek followed by mandible and temple. All the patients were satisfied with the improvement in their appearance. Delayed local infection appeared in 2 patients (13%), followed by a case of minor asymmetry. The two infections consisted of facial skin abscesses that were satisfactory treated by percutaneous drainage and antibiotic.

Conclusion: Polyacrylamide gel is a useful filler for the facial lipoatrophy treatment and allow improvement in quality of life of HIV-infected patients, not without complications. Further well designed controlled trials are needed to asses the security of permanent fillers for this stigmatizing condition.

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

Hyperchromia: a general approach

Objectives: This research aims at helping doctors have a general understanding of hyperchromia and its correct and effective treatment.

Introduction: Hyperchromia, popularly known as skin patches or stains, does not generally represent a beauty standard either for men or women, regardless of the several different patterns stablished by religion, beliefs, aesthetic reasons or vanity.

Materials / method: This research was carried out along 15 years of medical practice and studies on the subject.

Results: Several physiopathologic factors are associated with the appearance of hyperchromia, such as thyroid, UV light exposure, hormonal contraceptives,
trauma, post-inflammatory processes and genetics.
Skin lightening or skin uniformization treatments are common, and are associated to purity, beauty and innocence. General care is also important: using chemical and physical products for photoprotection, avoiding sun exposure between 11am and 3pm, and preventing starting factors such as photosensibilizing drugs.

Conclusion: Main depigmentation substances with their respective acting mechanisms (melanocyte destruction, preventing tyrosinase synthesis, skin depigmentation) and also peelings and lasers must be considered in the treatment choice. Common treatments are mesotherapy with tranexamic acid, use of oli ola pycnogel (oral), Laser Q- Switched Nd YAG and Intense pulsed light (IPL).

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

Rejuvenation of the upper third using a safe treatment with hyaluronic acid and a pneumatic platform

Objectives: The objective of this technique is to show, towards the use of a pneumatic platform, the action of this safe treatment with the combination of cross-linked hyaluronic acid and saline solution introduced by a unique 10 milliliters needle free syringe, in order to promote the rejuvenation of the upper third of face, combining parameters such as pressure and filling in the pre-frontal hair line, scalp hair, corrugator, vertical and eyebrown lines, temporal area and lower eyelid zone until the zygomatic arch, with the purpose of tightening, filling and lifting of the entire treated zone.

Introduction: The growing demand for facial rejuvenation procedures with low risk and minimal downtime has promoted the development of minimally invasive methods such as Pneumatic Technique Platform. The synergic action of HA and the platform demonstrates that the micro injuries and biological action provoke no excessive scarring during the healing process inducing neo-collagenases towards the stimulation of kinetic energy of the jet volumetric remodeling technology. This study has the intent to demonstrate the safety and efficacy of both techniques to promote the rejuvenation of the upper third of the face

Materials / method: 10 patients over 40 years old were treated with a formulation composed by 1ml of cross-linked hyaluronic acid and 9 mls of saline solution, applied on the upper third of the face in only one session. The pressure can very between 5 to 40% and the filling applied was 60 µmol to achieve the “end point”, which is a bump between 0.6 - 1 cm caused by the 1cm radial lateral dispersion. This exclusive technique has been developed by myself to safely treat the corrugator zone, filling the eyebrown, lower eyelid and temporal area and lifting the pre-hair line, vertical eyebrown lines and zygomatic arch

Results: In my personal protocol the SMAS and, indirectly some muscles and ligaments are treated, avoiding damages and important side effects on dangerous zones. Applying the concept of layered arrangement of the face, anatomy-based key anchoring points are used to reduce the signs of aging and restore the youthful appearance of the face, with tightening and lifting effects. Using the 3D evaluation 30 days after the procedure, it is possible to observe an extraordinary result that demonstrates the formation of ascendant vectors, a soft tissue retraction and lifting of upper face.

Conclusion: This non-surgical procedure is very interesting to provoke the lifting of the upper third of the face without downtime. Nonsurgical management of the occipitofrontalis, corrugator supercilii, procerus, depressor supercilii, orbicularis oculi, and temporalis muscles can correct dynamic and static rhytids and also allow for desired alterations such as lifting effects in the forehead and periorbital areas with forehead and brow elevation and resting brow position. It also re-establishes youthful convexity and proper hairline position. All the patients were very satisfied with the results.

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

Subcutaneous injections of nanofat adipose-derived stem cell grafting in facial rejuvenation (unrestricted educational grant from Tulip)

Objectives: In 2013, Dr. Tonnard et al introduced the nanofat grafting technique. This involved mechanical emulsification to disassociate adipose tissue while retaining the extracellular matrix (which includes nucleated cells and adipose-derived stem cells (ASC)), then injected using a 30-G needle into fine lines of the face. Dr. Sophie Menkes et al aim to assess whether the novel technique of subcutaneous nanofat injection using a 25-G cannula:
- Improves skin quality
- Yields a regenerative effect
- Achieves a lifting effect

Materials / method: 50 patients were enrolled between June 2018-December 2018 (mean age, 35-65). Microfat was obtained from all patients, then emulsified to obtain a nanofat suspension, which was injected subcutaneously into all parts of the face using 4 entry points.

Results: - Mean follow up time was 9 months
- All patients confirmed improvement in skin quality
- A lifting effect was observed
- Data confirmed cellviability was maintained and ASCs were not damaged
- Biopsies showed increased dermal cellularity, vascular density, elastin and collagen fiber density

Conclusion: Subcutaneous injection of nanofat appears to be an effective method for facial rejuvenation.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No
Please specify entities (individual, company, society): Tulip Medical

Were you provided with any honoraria, payment or other compensation for your work on this study?
No
Please specify entities (individual, company, society): Tulip Medical

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No
Please specify entities (individual, company, society): Tulip Medical

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: tulipTulip Medical

Superficial application of hyaluronic acid on tear trough - Six years follow up

Objectives: The purpose of this study was to evaluate the efficacy and safety of the superficial application technique with the use of a fluid monophasic polydensified hyaluronic acid, immediately after injection and over 6 years in the treatment of the tear trough deformities.

Introduction: With new advancements in cosmetic medicine, nonsurgical and minimally invasive procedures have become first-line treatment options for the periorbital rejuvenation, but there is no filler specifically designed for the periorbital area, due to its characteristics, this anatomical area is usually considered difficult to treat.

Materials / method: Subdermal application of fluid monophasic polydensified hyaluronic acid at 2014, 2017 and 2021 in the same patient (Woman, 35 years old, no comorbidities) at Faculdade de Medicina do ABC – Santo André – Brasil.

Results: The applicator physician rated the treatment as excelent. The patient got so satisfied with the result 6 years ago (2014), that she return to add more product in 2017 and 2021.
There were no reports of adverse effects during or after the applications.

Conclusion: This superficial subdermal technique has few adverse effects and yields good results, leading to a high degree of 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

Water uptake of hyaluronic acid fillers (unrestricted educational grant from Galderma)

Objectives: To compare the resistance to water uptake of three commercial crosslinked hyaluronic acid (HA) filler products.

Introduction: With little or no counter-pressure, it is possible for an HA filler to absorb water and increase in volume. Resistance to water uptake differs between products. This can be demonstrated by staining and sedimentation of crosslinked HA filler gel in water. Less water uptake will result in stronger staining of the crosslinked HA gel.

Materials / method: A solution of toluidine blue (TOL) was prepared by adding 200 µl of 1% TOL into 100 ml of water. To a 10 ml measuring glass, 0.2 g product was weighed in. About 5 ml of TOL solution was added. The product was thoroughly dispersed by shaking and allowed to sediment. The measuring glass was filled all the way up, whereafter dispersion and sedimentation was repeated to allow complete staining and water saturation.
The same procedure was applied to all three commercial crosslinked HA filler products, HA-REye, HA-JVol and HA-TRe2, with HA contents of 20, 15 and 15 mg/mL respectively.

Results: Water uptake for HA-REye was less than for HA-JVol and HA-TRe2 and the sedimented crosslinked gel displayed a stronger staining and more homogenous appearance.
Stronger staining reveals a higher concentration of crosslinked HA. The lower HA content of HA-JVol and HA-TRe2 compensates somewhat for their tendency to absorb water, but to the cost of less crosslinked gel in the product. Additionally, a part of the crosslinked HA in HA-TRe2 is replaced by adding soluble HA, effectively equivalent to lowering the HA content. Analogously, soluble HA does not sediment with the crosslinked stained gel.

Conclusion: HA-REye is more resistant to water uptake than the other gels, as shown by the stronger staining and the smaller volume after saturation. Some vendors aim to compensate a greater water uptake by lowering the HA content (e.g. as in HA-JVol) resulting in less crosslinked HA gel in the product, which could impact the clinical effect and/or longevity. Some vendors additionally replace a part of the HA gel with HA solution (e.g. as in HA-TRe2). The effect is equal to lowering the HA content further, since soluble HA leaves the injection site momentarily, and does not add to the final result.

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

Multispectral imaging and artificial neural network-based classification of skin lesions including melanoma and rare diseases

Objectives: The aim of the study is to develop a quick and reliable method to classify a wide range of skin lesions to assist dermatologists and family doctors with objective decisions. During this research, a multispectral method and a classifier of artificial neural networks were developed, which can provide additional information to the dermatologist in ambiguous situations (such as skin melanoma or rare diseases), as well as give the patient a sense of security that the diagnosis is made objectively.

Introduction: Skin lesions are a widespread disease that cause great burden suffering and have serious consequences for health and life quality for millions of people globally. Skin lesions are numerous, diverse and heterogeneous, often skin lesions may indicate on rare genetic diseases.The rarity of these conditions and the variability of their clinical manifestations render primary diagnostics difficult and often missed, leaving many patients without proper diagnosis and effective treatment.

Materials / method: The multispectral image sets were obtained by a previously developed portable multispectral imaging device. The multispectral device was equipped with narrow-band LEDs: 526nm (green), 663nm (red), and 964nm (infrared) to obtain diffuse reflectance images, and 405nm for the acquisition of filtered (515nm long-pass filter) skin AF images.

To find the best possible ANN architecture capable of performing skin lesions classification, the DARTS search algorithm was used. A five meta-layer neural network architecture was found and trained for 32 class discrimination.

Results: In the presented study spectral reflectance and autofluorescence clinical images of 32 skin lesion classes were collected and analyzed. Diagnostic thresholds for p' maps, p' most frequent values and autofluorescence intensity maps for 32 lesion classes were obtained and considered. Developed and trained ANN for classification of multispectral reflectance and autofluorescence clinical images, confusion matrices were obtained.

Conclusion: The use of multispectral image processing algorithms and deep learning for the fully automatic classification of multispectral and autofluorescence clinical images raises a well-grounded practical interest for dermatologists and technology developers. Our research is one of the first attempts to classify multispectral clinical images by using CNN. Within the presented research, we proposed to use spectrally resolved reflectance and autofluorescence images for CNN training and classification. Obtained first results demonstrate high potential for automated classification of wide classes of skin

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

Dynamic quadripolar radiofrequency and ultra-pulsed radioportation 12-month synergy in postmenopausal vulvovaginal atrophy (unrestricted educational grant from Novaclinical)

Objectives: Evaluating the impact on vulvovaginal atrophy symptoms, with vaginal dryness expected to benefit the most from the DQRFTM (Dynamic Quadripolar Radiofrequency) / UPRTM (Ultra-Pulsed Radioporation) synergy, is the goal of this interim study.

Materials / method: Study on 106 women(age,56.8±8.61 y/o)with vaginal atrophy and dryness.VVA trt:4 to 5 25-min sess. every 14-16 days(coupling gel w/hyaluronic acid);1 more maint. sess. after 6 months and a final visit(only assessment, no
trt)after 12 months.Operative temp in target tissues during the
procedure:42°C(range 40-43°C).Assessments(baseline and at the end of the trt cycle):vaginal dryness(primary efficacy parameter, 10-cm impromptu Visual Analogue Scale);dyspareunia,burning and itching(4-score impromptu Likert-
like scale)and photographic documentation at baseline at the end of the trt cycle.

Results: Vaginal dryness rapidly improved vs baseline (T0), with a highly significant reduction(−83.1%) at the end of the treatment cycle (T1) that steadily persisted after 6 and 12 months(T2 and T3; −79.2% and −64.9%,respectively).All other symptoms similarly improved vs baseline over the year of follow-up: dyspareunia −81.5% (T1) and−70.4% (T3); burning −87.0% (T1) and −65.2% (T3); itching −89.5% (T1) and −68.4%(T3).All treatments were well tolerated, with no troubling pain or other side effects during or after the procedures.

Conclusion: The study confirms,over a one-year follow-up, the previously demonstrated benefits of the DQRF in synergy with UPR as an innovative treatment option of vulvovaginal atrophy/genitourinary syndrome of the menopause symptoms. The novel UPR technology facilitates the deep penetration of active topical principles favourably acting on postmenopausal atrophic tissues. The DQRF/UPR concept aims to enhance the effects of the DQRF technology exploiting the synergy between the double biological effects-by the energy-based DQRF and the UPR active principle.

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

Subject satisfaction with twice-yearly treatment of glabellar lines with abobotulinumtoxinA in millennials (unrestricted educational grant from Galderma)

Objectives: To analyze and compare subject satisfaction with abobotulinumtoxinA twice-yearly treatment in the glabellar lines in different age groups, post-hoc.

Introduction: Millennials are increasingly becoming a larger part of the aesthetic market. However, expectations are high, particularly with their first aesthetic treatment, which data shows is likely to be botulinum toxins. They also represent a subset which may not be as open to frequent aesthetic treatments.

Materials / method: A post-hoc analysis compared subject satisfaction by age in a 12-month, open-label, multicenter study (NCT03687736) of two glabellar line injections of 50U abobotulinumtoxinA (at baseline and 6 months). Age groups were segmented by decade, from 20-61+ years old, with millennials defined as age 21-40. Subject satisfaction and subject-reported FACE-Q were evaluated 6 months after each treatment.

Results: While overall satisfaction rate was high across all age groups (≥86%), a higher proportion of millennials was highly satisfied (21-40: 75%; 50-60+: 49%). Millennials were happier with their glabellar lines at baseline, but all age groups reported large improvements 6 months after second treatment (mean Rasch score increase: 10.1-28.2). The youngest and oldest groups had larger improvements in psychological wellness (mean Rasch score increase 6 months after each treatment: 21-30: 4.1-8.9, >60: 8.6-15.7). At study end, 100% of millennials stated they would like to receive the treatment again.

Conclusion: While all age groups were satisfied with and experienced psychological benefits from treatment, millennials appeared to be particularly happy with two treatments a year of abobotulinumtoxinA.

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 evaluation of the safety and performance of a novel hyaluronic acid filler in correction of mid-face age-related volume deficit

Objectives: This clinical study evaluated performance and safety of a soft tissue filler
(HA filler cross-linked with BDDE, produced with XTR™ Technology) for facial volume restoration/augmentation of mid-face age-related volume deficit. Filler performance was assessed by the Global Aesthetic Improvement Scale (GAIS) at 1, 3, 6, 9 and 12 months after injection. Evolution of Face Volume Loss was assessed with a clinical scale (FVLS) and objective instrumental evaluation (3D LifeViz™ Mini, Quantificare). Other evaluations were skin quality parameters, patient and injector satisfaction and device safety.

Introduction: Hyaluronic acid (HA) soft-tissue fillers have been used for over 20 years to correct facial volume loss. The injectable HA fillers can add volume, thus reducing lines, wrinkles and folds and giving a smoother appearance to the skin. The filler used in this clinical study consists of cross-linked HA from non-animal origin (25 mg/mL), supplemented with 0.3% lidocaine hydrochloride which reduces the pain associated with injections. This high G’ filler is intended for facial tissue augmentation, facial volume restoration and shaping of face contours.

Materials / method: This was a prospective, non-comparative, single center study on 50 healthy women aged 40-60 and thus crossing three generations (Millennials, X Generation, and Baby Boomers) and with volume deficit on malar area. At visit 1 subjects received a first injection. At follow-up visits assessment of safety and performance was made. Each side of the face was treated with supraperiostal boluses in this sequence: zygomatic arch (2 boluses in line, ̴0.2-0.3 ml each), malar area (3 boluses, lateral SOOF, medial SOOF, deep malar fat pad, ̴0.3-0.4 ml each), deep pyriform fossa (1 bolus, ̴0.3-0.4 ml).

Results: Evaluations occurred at M1, M3, M6, M9 and M12. At M1 all subjects achieved an improvement in GAIS, as assessed by the investigator, with 22% very much improved, 54% much improved and 24% improved. Results were even better after touch-up and were maintained throughout the study, as also confirmed by improvement of FVLS. Measurements of skin quality showed a significant improvement of skin density, a significant increase of skin thickness and firmness. Finally, subjects’ and injector’s satisfaction were very good. Moreover, no adverse device effects and no device deficiency occurred.

Conclusion: Here we present results at 12 months. The novel HA filler injected in subjects with mild to moderate mid-face volume deficit induced a global aesthetic improvement on all subjects until 9 months and in 98% of subjects until 12 months after the first injection, as confirmed by both clinical and subjective evaluations. Objective instrumental measurements also highlighted a significant increase of cheekbone volume, skin density, thickness and firmness. This study confirmed the device safety, tolerability, and clinical performance.

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

Positive results of scalp seborrheic dermatitis treatment with hyaluronic acid mechanically stabilized hair formulation complexes: a case report.

Objectives: Seborrheic dermatitis (SD) is a chronic relapsing inflammatory skin disorder clinically characterized by scaling and poorly defined erythematous patches. The prevalence of adult seborrheic dermatitis is estimated at 5%1. This affection normally appears on seborrheic areas as an inflammatory response to Malassezia species. Hyaluronic acid mechanically stabilized hair formulation complexes (HHC) can be a different way of therapy to cure, prevent and manage SD. The objective is to report a two months follow up assessment of injection of HHC in an adult male person with SD on the scalp area.

Introduction: SD is a chronic, recurring inflammatory skin disorder that manifests as erythematous macules or plaques with varying levels of scaling associated with pruritus. On HHC the main ingredient is hyaluronic acid (HA), stabilized with a specific active ingredient’s formulation composed by amino acids, vitamins and minerals thanks to the patented CHAC technology the active components are released sequentially, thereby competition for the same receptors is eliminated. The combination of these activities can result into down regulation of the skin alteration in SD.

Materials / method: A 50 years old male with frequent recurrence of SD symptoms on the scalp area, not adequately controlled with topical treatments was selected for HHC procedure in our clinic. Besides pruritus, the affected area presented patches with pink-red erythema and large thickened scales. Three treatment sessions biweekly were suggested as protocol, a control session was done 2 weeks after last treatment. Three milliliters HHC were used per session. The injectable method was intradermal micropapula technique. No side effects were observed.

Results: The treatment was able to produce significant improvement of both pruritus and scaling, in a time-dependent manner already observable after first session. In addition, a progressive reduction on erythema with an improvement of scalp skin texture have been observed two weeks after the last treatment, the patient was very satisfied with the overall outcome.

Conclusion: This report demonstrates that injectable treatment with HHC is beneficial reducing inflammation and scaling. This outcome suggests that the HA together with the active ingredients present in the HHC formulation, may help to reduce the symptoms of SD on the scalp area. These data need to be corroborated, but suggest that HHC has a therapeutic and preventive benefit in the handling of SD. The celular mechanisms underlying the observed effect needs to be further investigated.

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 and tolerability of a retinol-containing neck cream (unrestricted educational grant from Skinceuticals)

Objectives: The goal of this testing campaign was to evaluate the efficacy and tolerability on the neck of a cream containing 0.2% retinol, tripeptide, and glaucine, and to gain insight as to the cutaneous mechanism of action through historical analysis of biopsy samples.

Introduction: Neck skin has an inherently different physiology than facial skin, with a thinner and more extensible dermal layer. Factors such as collagen loss, platysmal weakening, local subcutaneous fat accumulation, sun exposure, and gravitational force combined with the neck’s constant movement, contribute to age-related changes such as prominent wrinkles and horizontal banding that are deeper than on the face.

Materials / method: Two independent clinical studies were performed on the test product:
Study 1. A blinded clinical study was conducted over the course of 16 weeks on 50 subjects aged 40-60 who presented with mild-to-moderate sagging on neck, fine lines and wrinkles, including horizontal necklines, lack of firmness and elasticity on the neck, crepiness, rough skin, and uneven skin tone.
Study 2. An additional blinded trial was conducted over the course of 12 weeks on 11 subjects aged 55-75 who presented with mild-to-moderate signs of aging on the neck. (cont.)

Results: - In the larger trial, after 4 weeks of treatment, subjects showed statistically significant improvement in neck skin texture, firmness, elasticity, and skin tone evenness.
- By week 8, significant improvement in more prominent signs of neck aging such as horizontal lines, sagging and crepiness were observed. The degree of improvement continued to increase in magnitude through week 16.
- The cream was tolerated, and visible improvement was observed in the appearance of the neck skin. (cont.)

Conclusion: Taken together, the results of the described clinical studies illustrate the efficacy of a cream containing 0.2% retinol, tripeptide, and glaucine to improve signs of aging on the neck. The histological analysis suggests that the stimulation of dermal matrix proteins may play a role in the observed cosmetic benefits.

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

Outcomes after Nd:Yag laser treatment of vascular lesions

Objectives: Outcomes in Caucasian with II-III Fitzpatrick skin type treated for skin vascular lesions such as spider veins or angiomas

Introduction: Vascular skin lesions are harmless marks with multiple factors that determine their development. Studies shown that telangiectasia and spider veins tend to be more frequent in women than men, while angiomas are more frequently seen in children. This study aims to retrospect the treatment of such vascular lesions using Nd: YAG laser

Materials / method: In this study we used the same Nd:YAG laser for all treated patients, transparent echo gel for gliding and cooling, ice packs for cooling.
The Nd:YAG (Neodymium:Yttrium Aluminum Garnet) laser functions in the near infrared range at a wavelength of 1064nm. Because of the longer wavelength, depth of penetration can be up to 6mm, producing homogeneous coagulation. The laser is best known for its ability to slowly heat large volume of tissues with deep coagulation and minimal vaporization. The treatment session mainly lasted 30 minutes. The transparent gel is the usual gel used for echography and

Results: There were 85 laser treatments using spots of 3 mm, 5 mm and 7 mm. The 3 mm laser spot was mainly used for facial lesions, while the 5 mm and 7 mm laser spot were used for body and lower limbs lesions. The main localization of the vascular lesions were the limbs in patients with the mean age of 36 years (with a range between 10 and 54 years). Half of the patients didn’t have any additional risk factors for secondary reactions. The majority of patients, consisted of women, only needed one session of vascular treatment.
For the few angiomas treated with laser, there wasn’t need for any complemen

Conclusion: The fact that the average age range was between 30 and 40 years and the dominant patients were females suggests that active, working women are preoccupied by their quality of skin, and their looks. Speaking of nasal telangiectasia occurrence, rhinoplasty was a determinant risk factor. One particular case of a female patient with consistent blueish spider-veins who was taking oral anticoagulants needed to pause them one week before the vascular therapy in order to perform a safe 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

Case series of 12 patients with keloid scars treated with intralesional injections of 5-FU, betamethasone, hyaluronidase followed by fractional laser

Objectives: The aim of this study was to present the effectiveness of a combination treatment against keloids. We performed the therapy protocol in 12 people with keloids, that had not undergone any treatment before. The most common reasons of appearence have been: surgery, cesarean section, mole excision and tattoo. Our treatment involved as a first part intralesional injections of 5-FU, betamethasone, hyaluronidase followed by fractional laser.

Introduction: Keloids have high occurance rates especially post-operatively, after tattoos or cesarean section. The most popular treatment is still intralesional injection with triamcinolone. Nevertheless some cases seem to be even resistant or they reoccure shortly after the treatment. In our study we present 12 different cases with keloid scars which have been treated successfully.

Materials / method: 12 patients, 4 male and 8 female have been enrolled during the last 2 years. All showed pink to reddish, firm, benign, scar hypertrophic tissue. Mean appearence duration: 8 months. 70% of the patients complained about temporal pain/itching. Patients were treated with an average of 5 monthly sessions with intralesional injections of 1/3 5-FU, 1/3 betamethasone, 1/3 hyaluronidase, (max. amount 1,5 ml). We performed an average of 3 monthly sessions of fractional laser CO2, 10.600nm. Parameters used: pulse Energy 12mJ, Watt 20W, density 34%. Post procedure advice: daily use of a silicone gel.

Results: Evaluation of the results were performed at each appointment as well as 6 months after the whole procedure. They included clinical examination and measurement of the keloids as well as photodocumentation. Favorable results regarding the texture, the size as well as the general appearence of the scars appeared already after the intralesional injections. The initial complaints disappeared early enough. The fractional laser led additionaly to skin rejuvenation through collagen production. All patients were free of relapse still six months after the completion of the treatment protocol.

Conclusion: The combination of intralesional injections with the mixture of 5-FU, betamethasone, hyaluronidase followed by fractional laser succeeded to improve the appearence of keloid scars in all our patients. Morover, none of the cases showed relapse of the lesion in the follow-up appointments.

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

Face's harmony with "multilayer art"

Objectives: 1- Harmonize our patient’s face, improving and rejuvenating the appearance, maintain functionality and physiology in a natural way.
2– Inject minimal amount of product to be respectful of physical and rheological properties of
the tissues

Introduction: The study of anatomy is the foundation for a high-quality Aesthetic Medicine practice. But none of us can think that injecting the tissues of a corpse can be the
same of injecting our patients. The face, in its natural essence, should not be considered as a series of divided areas, because, on a daily basis, it is expressing
as a whole, it is a whole, a Unicum. Both on an individual point of view and on a functional-aesthetic point of view. Moreover, the quality of tissues is completely different in terms of hydration, thickness, tension and turgor. Looking from a different perspective, we

Materials / method: Materials and methods.
With the use of cross-linked CPM (Cohesive Polydensified Matrix) hyaluronic acid, we can
choose among a range of 4 different products, with specific characteristics and structure,
allowing to work on a patient’s face in its entirety, creating deep support architectures, sculpturing hypodermis and dermis and painting the epidermis. This is a technique called Multilayer Art, designed to obtain our pre-defined objectives.
In details, to harmonize and rejuvenate the face we are showing, the following products and
related amounts have been used:
HA-CPM 26 mg/ml: total 1

Results: Multilayer Art.
This technique can be considered a complex architectural procedure. The study of proportion and 3D, lights and shadows, perspectives and analysis of loadbearing structures, of movable coatings is the starting point in order to exploit the different consistency and ligamentous embrications to create a multilayer
approach with specific materials. Everything is structured, sculpted and painted at 360 degrees in order to obtain balance and harmony

Conclusion: The concept of Multilayer Art and the related technique, are an optimal approach, in clinical practice, for a global, balanced and harmonized rejuvenation of
the face. CPM Hyaluronic Acid, with the availability of different concentration-products, can be considered an ideal tool. The specific tool to execute such a
technique and to obtain the expected results, respecting physiology and functionality of face tissues

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

Comparison of eyebrow lifting techniques accompanying upper lid blepharoplasty in female patients

Objectives: To compare eyebrow lifting accompanying upper lid blepharoplasty using suspension through incision versus eyebrow arch lipofilling.

Introduction: Upper lid blepharoplasty is in top 5 most popular surgeries. Procedure is mostly performed for aesthetical purposes, although medical indications are also relevant for many patients to increase peripheral eye view. Although removing soft tissue excess is enough in most cases, eyebrow position should be evaluated prior to the surgery to avoid over excision, which can lead to upper lid retraction. The proper position for female eyebrow is 6-8 mm above orbital rim. Eyebrow’s descent leads to lateral periorbicular tissue heaviness, increases upper lid skin excess causing pseudoptosis.

Materials / method: A randomized, controlled, parallel-group clinical trial was conducted. The suspension was performed through 1.5-2 cm length orbicularis oculi muscle aperture fixing to frontal bone periosteum with 3-0 Vycril stitch. Lipofilling to lateral supraorbital area under the eyebrow through 1 mm hole blunt canula, 2 to 3 ml of prepared fat was grafted. For both patients groups we performed the same technique upper lid blepharoplasty. Clinical evaluation and satisfaction test was performed after six months post operation.

Results: 47 female patients were included to the study. 24 patients underwent upper blepharoplasty and brow suspension (the first group), 23 – upper blepharoplasty and eyebrow arch lipofilling. Groups were homogeneous according to the patient age and body mass index. After six months post-surgery the patients were recalled and clinically examined: 22 patients in the first group and 20 patients in the second group respectively. The eyebrows position was properly lifted for 19 patients in the first group and for 14 patients in the second group.

Conclusion: Both techniques can be used to correct mild to middle eyebrow ptosis. Eyebrow lift with fat grafting gives more shaped orbital arch appearance, but less predictable in comparison with brow suspension. In cases, when medial part of eyebrow is dramatically fallen down, endoscopic forehead lift is indicated to get proper aesthetic result.

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

Efficacy and tolerability of a pigment correction serum with a novel combination of retinoids and pigment control actives in asian women with melasma (unrestricted educational grant from Cantabria Labs)

Objectives: The aim of this study is to evaluate the efficacy and tolerability of a pigment correction serum in improving the clinical signs of melasma in Asian patients.
The formulation contains a novel combination of retinoids (RetinSphere Technology) and scientifically-demonstrated actives which act of all phases of melanogenesis: niacinamide, kojic acid, N-acetylglucosamine, peptides and Portulaca.

Introduction: The aim of this study is to evaluate the efficacy and tolerability of a pigment correction serum in improving the clinical signs of melasma in Asian patients.
The formulation contains a novel combination of retinoids (RetinSphere Technology) and scientifically-demonstrated actives which act of all phases of melanogenesis: niacinamide, kojic acid, N-acetylglucosamine, peptides and Portulaca.

Materials / method: The aim of this study is to evaluate the efficacy and tolerability of a pigment correction serum in improving the clinical signs of melasma in Asian patients.
The formulation contains a novel combination of retinoids (RetinSphere Technology) and scientifically-demonstrated actives which act of all phases of melanogenesis: niacinamide, kojic acid, N-acetylglucosamine, peptides and Portulaca.

Results: MASI score decreased significantly over the study period, reaching a reduction of 63% at 4th visit (p<0.001). Melanin index also decreased by 26% at 4th visit (p<0.001).
Regarding side effects, burning and tingling sensations were most prevalent but mild and transient during the first days of application. Acne, itching and xerosis also occurred while peeling and hyperpigmentation were rare. None of the patients discontinued treatment due to side effects.
Clinical photography showed improvement in skin pigmentation and reduction in skin wrinkles and pore size.

Conclusion: The pigment correction serum showed very good clinical results and good tolerability in the treatment of melasma in Asian females. Skin retinization is necessary to ensure good tolerability, so it is recommended that application be increased gradually if necessary. Correct patient education is also important in ensuring optimal treatment compliance and adherence.

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 and tolerance of a cosmetic regimen, after performing a microneedle preodecure in volunteers with skin aging (unrestricted educational grant from Cantabria Labs)

Objectives: To assess the tolerance and efficacy in skin regeneration and rejuvenation of SCA 40% and the serum with IFC-CAF and WGC, applied after microneedling session

Introduction: Previously published studies showed that the application of SCA 40% right after fractional laser treatment promotes the skin regeneration, increases antiaging efficacy and it is well tolerated.

Materials / method: A prospective, double-blind, aleatorized split-face and vehicle-controlled study in 20 aging patients was performed. Active/vehicle was applied immediately after microneedling treatment and BID for 7 days. The next 3 weeks they applied BID IFC-CAF and WGC serum/vehicle and mineral photoprotection. Evaluations consisted in: Clinical and photography (T0,T7,T28). Dermoscopy images and microcolumns density (T3,T7,T28 in 10 patients). Instrumental evaluation for wrinkle, oval definition; elasticity, firmness and hydration (T0,T28). Improvement perceived by investigator and patient (T28).

Results: We found a trend to better recovery of the dermoscopy microcolumns within the active side compare with the vehicle treated-side at T3d. Regarding side effects no differences were found between hemifaces. For antiaging evaluation it was shown a significant better improvement in facial oval definition on the active treated side vs the vehicle treated side. At the end of the study a mild improvement in wrinkles, elasticity and firmness was founded.

Conclusion: The regimen with SCA immediately post-procedure and serum with IFC-CAF and WGC for 3 weeks had excellent tolerance. 2.Skin regeneration (microcolumns density) was better in T3 on the active treated-side vs. vehicle (not statistically significant). Topical application of these growth factors increases and accelerates skin healing. 3.The definition of the facial oval improved significantly more on the active treated-side compared to vehicle (p <0.05). The regimen induces firmness of the skin 4. Moderate or intense global improvement was perceived in most cases.

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

Effects of a nutritional supplement with special collagen peptides applied in parallel to minimally invasive interventions (unrestricted educational grant from Elasten)

Objectives: Nowadays nutritional supplements are used more than ever to improve skin appearance. Studies have shown that oral collagen peptides can stimulate the synthesis of body own collagen fibres and hyaluronic acid in corial skin cells (fibroblasts) and thereby sustainably improve skin structure and appearance [1-4]. On the other hand, interventions are gaining increased popularity. Their effects on skin appearance are naturally considerable, but usually not very long-lasting. This pilot study demonstrates the synergistic effects of nutraceuticals and invasive methods.

Introduction: Nowadays nutritional supplements are used more than ever to improve skin appearance. Studies have shown that oral collagen peptides can stimulate the synthesis of body own collagen fibres and hyaluronic acid in corial skin cells (fibroblasts) and thereby sustainably improve skin structure and appearance [1-4]. On the other hand, interventions are gaining increased popularity. Their effects on skin appearance are naturally considerable, but usually not very long-lasting. In the present pilot study, potential synergistic effects of a combination of both measures were investigated. It was examine

Materials / method: Open, uncontrolled, monocentric application study, 12 subjects (f/m, 30-60 years old) with healthy skin received a nutritional supplement with the daily amount of 2.5 g collagen peptides, 666 mg acerola fruit extract, 80 mg vitamin C, 3 mg zinc, 2.3 mg vitamin E, and 50 μg biotin for 8 weeks (plus 4 weeks). Parallel the subjects underwent an aesthetic minimally invasive intervention (botulinum toxin therapy forehead area, not for the first time) 2 weeks after study onset. Benefits were evaluated by a specialist in aesthetic and plastic surgery (MD) and and subjective evaluation.

Results: At the end of the 8-week observation period, the medical evaluation as well as most subjects assessed the skin appearance as considerably better than before. However, on medical evaluation, improvement was usually detected outside the treated area. This may be related to the strong effect of the minimal invasive treatment. In the further course (T12), this observation might become relative.

Conclusion: Both the minimally invasive interventions and the intake of a nutritional supplement with collagen peptides are applied to improve skin appearance. The participants of the present application study knew the extend and sustainability of effects of former invasive interventions. Thus, it can be assumed that they were able to compare such effects with the results of a concomitant intake of the nutritional supplement. As a first result of this study, the 8-week application of the nutritional supplement can additionally improve skin appearance.

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

Comparative histomorphological evaluation of the injectable cohesive polydensified matrix-hyaluronic acid (CPM-HA26) and calcium hydroxylapatite (CaHA) combination (unrestricted educational grant from Merz Aesthetics)

Objectives: No single technology, filler, or neuromodulator can achieve all the results desired in treating the aging face. Cohesive Polydensified Matrix-Hyaluronic Acid (CPM-HA26) and Calcium Hydroxylapatite (CaHA) effectiveness and safety has been demonstrated in numerous studies. Combined interventions have widespread application in clinical practice, but results are infrequently reported at scientific meetings and in the medical literature, as the area is difficult to study. Expert consensus supports a combination approach using multiple modalities in specific sequence for treatment of the aging face

Introduction: Aging is a result of the interplay of changes occurring in all facial anatomical layers. To target these, multilayer, combined intervention is required to relax, volumize, resurface, and re-drape facial skin. Combined aesthetic interventions have widespread application in clinical practice, but results are infrequently reported at scientific meetings and in the medical literature, as the area is difficult to study. Expert consensus supports a combination approach using multiple modalities in specific sequence for the safe and effective treatment of the aging face.

Materials / method: In this open-label, prospective, pilot, randomized, comparative clinical study, eight healthy female volunteers, 35–45 years of age with BMI < 21, were randomly assigned to experimental groups with a 1:1 who had one intradermal CPM-HA26 injection into integumentary tissues of the periauricular area (subdermal injection) and followed (Group I) or simultaneous (Group II) subdermal CaHA injection into the same area. The study was comprised of three visits. The histomorphological evaluation based on the type I collagen, the type III collagen and the elastic fibers’ analysis using

Results: immunohistochemistry test (IHC) in terms of the compatibility of the combination of CPM-HA26 and CaHA was assessed at Stage 2 (M01) and at Stage 3 (M06) compared to the baseline data. Mild staining corresponded to marker expression of 2 points, moderate - 4 points, and high - 6 points.The results demonstrate the combined injections of CPM-HA26 and CaHA supply histomorphological improvement.

Conclusion: Histology and immunohistochemistry following the combined injection of CPM-HA26 and CaHA showed phased injection had a greater remodeling effect on skin compared to simultaneous injection. This is confirmed by intense elastic fiber formation (р<0.05), type I–III collagen accumulation in the dermis (р<0.05) with the preserved 1:1 ratio and intense angiogenesis (p<0.05) that provides sustained blood supply to the tissues. Simultaneous injection of CPM-HA26 and CaHA is safe with no histologic and immunohistologic signs of inflammation and disturbance of tissue trophicity.

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

The progressive techniques in aesthetic dermatology: the cycle of alternating protocols (unrestricted educational grant from Dermaqual)

Objectives: To determine the effects on cutaneous aging by using a protocol comprising of multiple treatment modalities that include Platelet Rich Plasma, Hyaluronic Acid based Mesotherapy, Chemical and Organic peeling solutions and home care containing nature-based cosmeceuticals.

Introduction: Antiaging treatments revolve around use of multiple modalities. We have attempted to observe effects of alternating treatment usage between Platelet Rich Plasma, Organic-based skin peels and appropriate home care program, to produce results. The cycle has been observed to offer multiple benefits. These include easily observed results, patient and doctor satisfaction, and a significantly reduced downtime due to use of organic and nature-based peels and cosmeceuticals.

Materials / method: An observational study was conducted on a group of 15 patients having multiple signs of photoaging. Photographic comparison was done at regular intervals and patient input was taken at every stage regarding observation of improved changes.
Study Design: Cycle of alternating treatments was performed.
Step 1: PRP combined with non-cross linke Hyaluronic Acid Step.
Step 2: Ante Age peel
Step 3: Patient given appropriate home care.

Results: Observed results after completion of 2 cycles of alternating treatments. Reduction in peri-occular and peri oral wrinkles can be seen. No post inf1ammatory hyperpigmentation. Radiance is improved.
Photographic record was maintained throughout the study process. Objective assessment was done with the following parameters: Reduction in fine lines, Improvement in skin Radiance and presence of any Post lnflammatory Hyperpigmentation

Conclusion: Alternating between treatment modalities and home care gives sufficient results. The clinical process is designed to target multiple stages in skin rejuvenation and cell cycle process. This ensures aging process is targeted at regular intervals with actives that have significant penetration and hence, results.
Treatment plan can be followed with relevant home care to ensure results are adequately maintained. This cycle has been observed to produce effective results with minimal downtime and inconvenience to the 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

Speakers	Lecture title	Abstract	Number
Dr Benjamin ASCHER	Ready-to-use liquid abobotulinumtoxinA: an overview of available Phase III clinical data for moderate-to-severe glabellar line treatment (unrestricted educational grant from Galderma)	View	113846
Dr Benjamin ASCHER	A new hyaluronic acid dermal filler tested in the nasolabial folds – Comparative study (unrestricted educational grant from Symatese)	View	114407
Dr Renee A BEACH	Different & Yet the same: cosmetic procedures in SPT 1-3 vs SPT 4-6 patients in Toronto, Canada	View	114939
Dr Cleiton Jose BELLE KUNZLER	Technical evaluation and comparison of calcium hydroxylapatite (CaHA) containing dermal fillers (unrestricted educational grant from Merz Aesthetics)	View	116599
Dr Vinay BHARDWAJ	Clinical evaluation of topical creams on wrinkles and in-vitro evidence of structural and gene expression changes in the dermis (unrestricted educational grant from Laboratoires Filorga Paris)	View	115176
Kevin COSTELLO	In-field assessment of the perception of smoothness when dispensing different Filler formulations (unrestricted educational grant from Allergan Aesthetics)	View	116698
Kevin COSTELLO	A new Filler syringe with improved ergonomic performance to enhance end-user experience (unrestricted educational grant from Allergan Aesthetics)	View	116699
Andy CURRY	Study design of LONG RUN: a LONGitudinal evaluation and real-world evidence of uniquely purified incobotulinumtoxinA in treatment naïve participants (unrestricted educational grant from Merz Aesthetics)	View	116597
Dr Steven H DAYAN	Subject satisfaction and duration of effect of on-label 50U abobotulinumtoxinA treatment of glabellar lines - results from three individual trials (unrestricted educational grant from Galderma)	View	114885
Dr Steven H DAYAN	Assessment of subject satisfaction after glabellar line treatment with escalating doses of abobotulinumtoxinA in a randomized, double-blind study (unrestricted educational grant from Galderma)	View	114887
Dr Steven H DAYAN	Lower facial shape improvements after treatment with OnabotulinumtoxinA for masseter muscle prominence (unrestricted educational grant from Allergan Aesthetics)	View	116696
Dr Steven H DAYAN	Natural-Looking outcomes as well as self-perception of appearance and psychological well-being after treatment with OnabotulinumtoxinA for upper facial lines (unrestricted educational grant from Allergan Aesthetics)	View	116700
Dr Philippe DEPREZ	Protocol of biorevitalization with Sodium Hyaluronate 45mg/3Ml in association with amino acids, polyphenols, and antioxidants. (unrestricted educational grant from Skin Tech Pharma)	View	116944
Dr Philippe DEPREZ	Efficacy study of novel monophasic dermal implant containing cross-linked hyaluronic acid associated with amino acids for treatment of the photoaging and its consequences. (unrestricted educational grant from Skin Tech Pharma)	View	116945
Dr Daniele DONNAMARIA	Treatment of PEFS a poly-amino acidic solution: first results (unrestricted educational grant from Marllor Biomedical)	View	114470
Dr Farah EL HADADI	A severe case of lichen planopilaris mimicking a keratosis follicularis spinulosa decalvans	View	113762
Dr Farah EL HADADI	Complications of skin lighteners in the southern population of Morocco	View	113777
Dr Jimmy FAIVRE	Deciphering dermal fillers behavior during facial expressions: a top-down approach to analyzing volumizer properties (unrestricted educational grant from Teoxane Laboratories)	View	116758
Dr Elena FASOLA	Dynamic quadripolar radiofrequency: Pilot study of a new high-tech strategy for prevention and treatment of vulvar atrophy (unrestricted educational grant from Novaclinical)	View	116946
Prof Klaus FRITZ	Microneedle radiofrequency & HIFU combined treatment for skin tightening with focus dual (unrestricted educational grant from Eunsung Global Corp.)	View	116702
Dr Salvatore Piero FUNDARO	A comparative test of pull-out strength performance of different insertion methods of poly(L-lactide-co-ε-caprolactone) barbed suspension threads	View	116606
Dr Michael H GOLD	IncobotulinumtoxinA demonstrates safety and prolonged duration of effect in a dose-ranging study for glabellar lines: final study results	View	116571
Thomas HENGL	Animal study indicates importance of distance between microspheres for neocollagenesis (unrestricted educational grant from Merz Aesthetics)	View	116570
Thomas HENGL	Increased hyaluronic acid concentration enhances the local tissue lifting capacity in an Ex Vivo human skin model (unrestricted educational grant from Merz Aesthetics)	View	116580
Dr Anastasiia IGNATYEVA	We return faces to victimes of the war - Project "Ukrainian Face"	View	116893
Dr Maria Claudia ISSA	Infraorbital combined treatment for dark circle eyes: Q-switched laser, polydioxanone thread and hyaluronic acid filler	View	116605
Dr Maria Claudia ISSA	Ultrasound follow-up of in vivo behavior of polydioxanone thread associated to crosslinked hyaluronic acid gel in the mandibular area	View	116644
Dr Maria Claudia ISSA	Ultrasound follow-up of in vivo behavior of solid polydioxanone threads	View	116651
Dr Marta JANOWSKA	Safety and efficacy of combined non-ablative and ablative laser treatment of scars	View	116650
Dr Jonathan KADOUCH	A hybrid filler: combining calcium hydroxylapatite and hyaluronic acid fillers for aesthetic indications	View	116604
Dr Dam Hui KIM	A case study of reducing facial asymmetry from facial nerve palsy	View	116439
Dr Jihee KIM	A comparative study of long pulsed Alexandrite laser versus pulsed dye laser in the treatment of rosacea	View	116632
Manseok Mark KIM	Efficacy of a solution containing amino acids, copper and hyaluronic acid (unrestricted educational grant from Elastic Lab)	View	115045
Dr Linda KLEINE BORGER	Skin quality boosters and their physicochemical properties	View	114996
Dr Olga KUTEN PELLA	Hyperacute serum outperforms PRP as a regenerative factor	View	116631
Charlotte LAMY	Tolerance of IPN hyaluronic acid gels in an Ex vivo human skin model (unrestricted educational grant from Laboratoires Vivacy)	View	116677
Charlotte LAMY	Efficiency of IPN hyaluronic acid gels in an Ex-vivo human skin model (unrestricted educational grant from Laboratoires Vivacy)	View	116678
Dr Noura LEBBAR	Treatment of androgenetic alopecia (AGA) with sabal serrulata and biomimetic peptides delivered with microneedling (unrestricted educational grant from Toskanimed)	View	116707
Dr Noura LEBBAR	High molecular weight hyaluronic acid (HMWHA) for the treatment and prevention of skin aging (unrestricted educational grant from Toskanimed)	View	116708
Dr Noura LEBBAR	Comparative study of the efficacy of two commercially available transcutaneous biorevitalizers (unrestricted educational grant from Toskanimed)	View	116709
Dr Mezni LINE	Actinic reticuloid mimicking mycosis fungoides	View	116645
Dr Ramon LLULL CERDA	Human stromal cell aggregates concentrate adipose tissue constitutive cell population by In vitro DNA quantification analysis (unrestricted educational grant from Tulip)	View	116711
Dr Silvia LOPEZ SANZ	Long term results of facial lipoatrophy treated with polyacrylamide gel	View	116485
Dr Paulo Roberto MACIEIRA	Hyperchromia: a general approach	View	114922
Dr Claudia MARCAL	Rejuvenation of the upper third using a safe treatment with hyaluronic acid and a pneumatic platform	View	113395
Dr Sophie MENKES	Subcutaneous injections of nanofat adipose-derived stem cell grafting in facial rejuvenation (unrestricted educational grant from Tulip)	View	116710
Dr Giuliana Angelucci MIRANDA	Superficial application of hyaluronic acid on tear trough - Six years follow up	View	114951
Ake OHRLUND	Water uptake of hyaluronic acid fillers (unrestricted educational grant from Galderma)	View	114878
Dr Emilija Vija PLORINA	Multispectral imaging and artificial neural network-based classification of skin lesions including melanoma and rare diseases	View	116641
Dr Vincenzo PRESTIA	Dynamic quadripolar radiofrequency and ultra-pulsed radioportation 12-month synergy in postmenopausal vulvovaginal atrophy (unrestricted educational grant from Novaclinical)	View	116947
Inna PRYGOVA	Subject satisfaction with twice-yearly treatment of glabellar lines with abobotulinumtoxinA in millennials (unrestricted educational grant from Galderma)	View	114945
Dr Giovanni SALTI	Clinical evaluation of the safety and performance of a novel hyaluronic acid filler in correction of mid-face age-related volume deficit	View	116616
Dr Gabriel SIQUIER DAMETO	Positive results of scalp seborrheic dermatitis treatment with hyaluronic acid mechanically stabilized hair formulation complexes: a case report.	View	116501
Dr Kelly SULLIVAN	Evaluation of the efficacy and tolerability of a retinol-containing neck cream (unrestricted educational grant from Skinceuticals)	View	116756
Dr Siramona TOMA	Outcomes after Nd:Yag laser treatment of vascular lesions	View	114954
Dr Amalia TSIATOURA	Case series of 12 patients with keloid scars treated with intralesional injections of 5-FU, betamethasone, hyaluronidase followed by fractional laser	View	116022
Dr Lucio TUNESI	Face's harmony with "multilayer art"	View	116526
Dr Karolis VARKALYS	Comparison of eyebrow lifting techniques accompanying upper lid blepharoplasty in female patients	View	115000
Maria VILLALBA ALVAREZ	Efficacy and tolerability of a pigment correction serum with a novel combination of retinoids and pigment control actives in asian women with melasma (unrestricted educational grant from Cantabria Labs)	View	115019
Dr Maria Alejandra VITALE VILLAREJO	Evaluation of the efficacy and tolerance of a cosmetic regimen, after performing a microneedle preodecure in volunteers with skin aging (unrestricted educational grant from Cantabria Labs)	View	115015
Dr Imke Christina WEHAGE	Effects of a nutritional supplement with special collagen peptides applied in parallel to minimally invasive interventions (unrestricted educational grant from Elasten)	View	115012
Prof Yana YUTSKOVSKAYA	Comparative histomorphological evaluation of the injectable cohesive polydensified matrix-hyaluronic acid (CPM-HA26) and calcium hydroxylapatite (CaHA) combination (unrestricted educational grant from Merz Aesthetics)	View	116601
Dr Saman Urooj ZEESHAN	The progressive techniques in aesthetic dermatology: the cycle of alternating protocols (unrestricted educational grant from Dermaqual)	View	116701

IMCAS World Congress 2022
Program

FOCUS ON E-POSTER

Recommended sessions

IMCAS World Congress 2022 Program

FOCUS ON E-POSTER

Recommended sessions

IMCAS World Congress 2022
Program