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IMCAS World Congress 2023
Program

FOCUS ON S222

Contributing lectures - Combined treatments for face

Room: Room 252 - Level 2
Date: Saturday 28 January 2023 at 17:00 to 18:00
Format: CONTRIBUTED TALKS > session made up of abstract submissions that were carefully reviewed and selected by the Scientific Board

Chairs

Dr Robert CHMIELEWSKI

Plastic Surgeon

Poland

Dr Diala HAYKAL

France

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
17:00		Introduction		124144
17:02	Dr Noury ADEL	Lip boosting (skin boosters & PDO smooth threads): therapeutic approach for lip rejuvenation	View	121726
17:12	Dr Armeela JAVAID	How to approach your patient when offering combination treatment	View	122067
17:22	Dr Maria ANGELO KHATTAR	Combination of threads with EBD for the ultimate non-surgical facelift	View	121729
17:32	Dr Emmanouil DIMONITSAS	Triple lift: three-layer non-invasive facelift based on three treatments	View	122191
17:42	Dr Madhuri BANNIGOL	“Magic with needles”: a new synergy of PRF and fractional MNRF for facial rejuvenation and scars in Indian scenario	View	121727
17:52		Q&A		124257

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Recommended sessions

Combined treatments

Facelift (non-surgical)

Fillers: HA (hyaluronic acid)

Energy-based devices (EBD)

Threads

Introduction

Dr Noury ADEL

Facial Plastic Surgeon

Egypt

Other author(s) :

Lip boosting (skin boosters & PDO smooth threads): therapeutic approach for lip rejuvenation

Objectives: Introducing a new therapeutic concept for lip rejuvenation without volumization by the combined used of skin boosters ( non cross linked hyaluronic acid ) & PDO smooth threads where both aids in collagen production.

Introduction: Hyaluronic acid (HA) is a natural component of the human body which plays an important role in skin viscoelasticity, therefore HA based fillers & skin boosters are widely used for purpose of volumization & maintaining skin elasticity through stimulation of collagen synthesis. Moreover PDO smooth threads have shown to be able to trigger an inflammatory response upon insertion into the body, the results of this process is fibroblast activation and collagen production.

Materials / method: Ten female patients were included in the study who suffered from dry lips with fissures and cracks. All patients were injected with a non-cross linked hyaluronic acid using cannula followed by placement of PDO smooth threads at the vermillion border. Digital pictures were taken before the injection and immediately after the injection for assessment of the clinical results.

Results: Marked improvement in the lip texture and elasticity were observed at 2 weeks after the injection which remained stable up to nine months after treatment. Moreover there was a marked decrease in the depth of the fissures and cracks in the lips.

Conclusion: Non cross linked hyaluronic acid injection into the lips along with smooth threads may offer a great improvement for dry lips with loose tissue and decreased elasticity. This can be further improved by encouraging the patient to follow a strict protocol for maintaining the hydration along with incorporating other injectables (PRP)

Disclosures

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

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

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

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

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

Dr Armeela JAVAID

Dermatologist

Pakistan

Other author(s) :

How to approach your patient when offering combination treatment

Objectives: 1.To satisfy our patient's demands ,one has to keep into consideration, their idea of self-image & their actual aesthetic needs.
2.We have a lot of responsibility to come up with the best approach. When combination treatments are to be offered, one has to map out the complete plan keeping in mind their budget and life style.
3.Combination therapy challenges physician to have a detailed understanding of patient's needs at cellular level to anatomic reversal of age related changes in each layer of face & neck.Your treatment plan will affect the over all aesthetic outcome & patient satisfaction.

Introduction: We had 2 groups of females, 15 in each group that had different treatment needs. Group A with more photo-damaged skin was offered peels, ablative lasers, non ablative laser and skin boosters later followed by subtle fillers and toxins. Group B with more sagging & bony changes were first given skin structural support by EBD as Hifu & RF, followed by threads, that was later followed by high G' fillers with bony placement and toxins. The different treatment approach gave a great patient satisfaction.

Materials / method: Females within age 30-55 years were included with Photo-damage and skin sagging. Group A included those with texture changes, pore visibiltiy, rhytides & pigmentary changes. Group B had faces with ageing signs and assessed as upper, mid and lower 1/3rd for wrinkles score and appearance of jowls. Group A with less sagging & more photodamage were offered peels, cosmaceutical ,microneedling , and ablative/non ablative lasers with less fillers and toxins. For Group B with more heavier faces and sagging, Hifu &RF was offered followed by Threads and High G' fillers.

Results: group A & B both had high aesthetic outcome and satisfaction level. There were no major side effects of combining various modalities. with Threads there were few complaints of pain at the treatment site , swelling and in 2 patients there was a palpable thread that settled in 2-3 weeks. HIfu ,RF and EBD were generally well tolerated. No untoward effect was seen with Fillers or toxins.

Conclusion: Combination therapy gives a great deal of synergy and an over all better aesthetic outcome to patient. There is not a single treatment modality that can address all aesthetic aspects for any one individual case. Educating patient before starting a treatment plan will gain confidence for your patient and enable the patient to stay with you for long term.

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 is presented thanks to the support of: Do not share the patient's picture

Dr Maria ANGELO KHATTAR

Dermatologist

United Arab Emirates

Other author(s) :

Combination of threads with EBD for the ultimate non-surgical facelift

Objectives: 1. To outline the best practices on the integrated treatment approach of biodegradable, biostimulating threads with lasers and Energy-Based Devices (EBDs) including intense pulsed light systems, fractional ablative, non-ablative and hybrid lasers, and radiofrequency microneedling.
2. To propose protocols with respect to appropriate time intervals between each procedure to allow for the shortest possible recovery time and the best possible outcomes.

Introduction: A multimodal approach to non-surgical facial rejuvenation often entails the combination of different minimally invasive techniques to achieve natural and harmonious results, whilst minimising the risk of complications. Within our established portfolio of non-surgical procedures are the bioresorbable suspension threads and a plethora of Lasers and EBD’s.
There is a paucity in the literature regarding safe practices with respect to the combination of threads with EBD’s. Many practitioners are apprehensive about this combination and believe that EBDs might destabilise the threads.

Materials / method: Patients who had undergone nonsurgical face lifting with bioresorbable, biostimulating threads, were subsequently treated with various lasers and EBDs including broadband light, fractional CO2 laser, hybrid lasers and a fractional radio-frequency micro needling system.
A 3D imaging system was used for the objective assessment of skin repositioning and skin quality in each case.

Results: All patients who received the combined treatment of bioresorbable, biostimulating threads and EBDs, were shown objectively to have positive results in terms of face lifting. All exhibited an improvement in skin texture and luminosity. Most importantly, the combined approach was not associated with any negative treatment emergent outcomes.

Conclusion: The lasers and EBDs potentiate both the lifting achieved with the biostimulating threads as well as the improvement is skin quality and luminosity.
The treatment of thread lift patients with EBDs is both safe and effective.

Disclosures

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

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

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

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

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

Dr Emmanouil DIMONITSAS

Plastic Surgeon

Greece

Other author(s) :

Triple lift: three-layer non-invasive facelift based on three treatments

Objectives: Triple lift is a combination of three treatments aimed at peeling, bio-stimulating and firming of the facial skin. With three different therapies (Jessner peel, Collagen booster and HiFu technology) we target at three different layers (dermis, subcutaneous, SMAS) in order to deep moisturize, reconstruct the mid-dermis of the skin as well as lift the SMAS of facial muscles.

Introduction: The combination of the three therapies include:
• Jessner Peel is a medium strength chemical peel that combines Salicylic acid (BHA), Lactic acid and Resorcinol that removes the top layer of epidermis and the upper portion of dermis.
• Horse collagen booster type I is injected in deep dermis and subcutaneous in order to stimulate fibroblasts to produce collagen type III with long-lasting results.
• HiFu is the latest in technology and is based on the action of focused ultrasound penetration at a depth of up to 4.5 mm into the skin, that is , at the same depth that an invasive facelift reaches.

Materials / method: 20 patients were enrolled in this face protocol in order to be assessed clinically and by photographic documentation after one month. The session of the triple combination is just monotherapy and it is repeated after 6 months.

Results: Obvious results were appeared after the 1st month with serious improvement in the texture of the skin, the lift of the cheeks and the jawline. The skin was significantly hydrated and tightened as well as fine lines were smoothened. The majority of the patients was satisfied with the result and was keen on repeating this protocol after 6 months.

Conclusion: Nowadays, the primary goal of aesthetic medicine is oriented in combined therapies in order to improve the dermis quality from the inside to outside and repair skin imperfections due to aging. The key success is attributed to the best possible treatment combination that responds to different layers 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

Dr Madhuri BANNIGOL

Facial Plastic Surgeon

India

Other author(s) : Dr.SHISHIRA.L , Dr.DHARANIPRIYA.A

“Magic with needles”: a new synergy of PRF and fractional MNRF for facial rejuvenation and scars in Indian scenario

Objectives: We found Microneedling with fractional Radio-frequency (MNRF) and PRF methods to be most effective on the skin. From our study subjects, we found combining Microneedling Fractional Radiofrequency and (Platelet-rich fibrin )PRF to be even more effective, and with PRF's Growth Factors and Microneedling controlled RF, we achieved lasting and effective results.
, with less downtime and better patient satisfaction.

Introduction: With aging, skin tends to get saggy, wrinkled, and fine lines and loses its texture and laxity. Some of the most common non-surgical facelift and rejuvenation treatments include Thread lift, Dermal fillers, Chemical peels, laser resurfacing, PRP, and Micro-needling, which are the most effective treatments. Recently, fractional (RF) has revolutionized the field of skin rejuvenation that uses fine needles to create tiny punctures in the skin which stimulates collagen and elastin to reduce aging signs. With the additional benefits of PRF, we are increasing the standards of anti-aging treatment.

Materials / method: An Observational study of 30 subjects has been considered. Each subject has been treated with micro-needling, fractional radiofrequency (MNRF), and PRF. All subjects have received three treatment sessions with a minimal interval of 3-4 weeks. Standard, The post-operative protocol was followed.

Results: All the subjects have shown significant improvement in combination with PRF. Immediate operative skin redness had significantly decreased, with almost no trace of the procedure being done. Improvement in terms of Aging signs like sagging skin, fine lines and wrinkles, and loss of volume were achieved faster. We have also observed an Improvement in skin texture and pigment reduction. We noticed a glow of 14 days over the skin. Acne Scars patients showed evident results along with PRF.

Conclusion: The demand of minimally invasive treatment techniques is increasing with low downtime, increased efficacy for skin rejuvenation. MNRF is recently developed as a minimally invasive method. Combined with PRF, using growth factors as a treatment method for aging skin is emerging as a more effective and imminent treatment in the future.
With the additional benefits of PRF, we are increasing the standards of anti-aging treatment. PRF has its benefits individually, but with the combination of fractional RF , there is a shortening of the therapy time, which aids in healing.

Disclosures

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

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

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

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

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

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IMCAS World Congress 2023 Program

FOCUS ON S222

Contributing lectures - Combined treatments for face

Chairs

Lectures of the session

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IMCAS World Congress 2023
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