Objectives: present a new book on ecography and Ultrasounds in aesthetic medicine

Introduction: Ecography and Ultrasounds in facial aesthetics is a new very cool target of modrn aesthetic medicine.
many authors from all over the world, anatomists, radiologists, aesthetic doctors gave her best knowledge to build a very practical book on this topic.

Materials / method: all the different topics of US in aesthetic medicine from anatomy to help during injections to help in improving safe injections have been discussed. a lot of images let the doctors understand better the matter and some videon further explain and make clear how to use ultrasounds for diagnostics in aesthetic medicine.

Results: will be see by all attendees. the results of this book will be proved by readers. We all Authors are ready for a second edition updating a target that changes also with the experience of all authors.

Conclusion: me, Hugues Cartier and Peter Velthuis, cohordinators of this project really hope that we made with all coauhtors an undestandable book that all the collegues will get in their office, to read every moment have a doubt during their activity.

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: OEO florence the editorial house

Objectives: This review aims to provide an in-depth analysis of the use of botulinum toxin injections for body contouring in targeted muscle groups, including the trapezius, deltoid, lateral head of triceps, quadriceps, soleus, and gluteus maximus. The objectives include exploring the anatomical considerations, injection techniques, efficacy, safety profiles, and outcomes associated with botulinum toxin injections in these specific areas for body contouring purposes.

Introduction: Body contouring using botulinum toxin injections in muscles beyond traditional cosmetic areas has garnered interest for its potential in reshaping specific body regions. This review focuses on the trapezius, deltoid, lateral head of triceps, quadriceps, soleus, and gluteus maximus muscles, elucidating their anatomy and the implications of botulinum toxin injections in altering their appearance and contour.

Materials / method: A comprehensive search strategy was employed utilizing databases such as PubMed, MEDLINE, and pertinent scholarly articles. Keywords specific to botulinum toxin injections, body contouring, targeted muscle groups, and aesthetic procedures were utilized to identify relevant studies, clinical trials, case reports, and guidelines. The selected literature was analyzed to gather information on the anatomical considerations, injection techniques, dosing, efficacy, safety profiles, and reported outcomes associated with botulinum toxin injections in the trapezius, deltoid, lateral head of triceps, qua

Results: The review discusses the anatomical relevance of the trapezius, deltoid, lateral head of triceps, quadriceps, soleus, and gluteus maximus muscles in body contouring procedures. It elaborates on the mechanisms by which botulinum toxin injections affect these muscle groups, leading to alterations in their appearance and contour. Furthermore, it outlines the specific injection techniques, dosages, duration of effects, reported outcomes, and safety considerations associated with using botulinum toxin for body contouring in these muscles.

Conclusion: Botulinum toxin injections have shown potential in selectively altering the appearance of various muscle groups for body contouring purposes, including the trapezius, deltoid, lateral head of triceps, quadriceps, soleus, and gluteus maximus. However, further research is needed to establish standardized protocols, optimize dosing regimens, and assess long-term safety and efficacy in these specific areas. Precise anatomical knowledge, patient selection criteria, and tailored injection techniques are essential in achieving desirable outcomes while minimizing adverse effects. As this field continu

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

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?
Yes
Please specify entities (individual, company, society): trainer and partner of cutaneous, giving facial ultrasound courses

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

Objectives: - Make injection anatomy visible through facial ultrasound

- Identify the filler type, layer-location, size and quantity before dissolving approach

- Learn the principles of ultrasound guided infiltrations to treat filler related complications

Introduction: Ultrasound serves as an evidence-based imaging tool in managing fillers and their potential complications. It aids in identifying cosmetic fillers, their location, and size. Beyond the immediate impact of vascular adverse events, late complications like delayed onset nodules, malar edema, the "overfilled face syndrome" and unintentionally placed filler can significantly affect a patient's psychosocial well-being.

Materials / method: To demonstrate the integration of facial ultrasound into daily soft tissue filler treatments and how it can be instrumental in addressing complications such as delayed onset nodules, malar edema, overfilled face syndrome and redistributed filler.

Results: Ultrasound offers real-time insight into subcutaneous anatomy. Ultrasound-guided hyaluronidase injection ensures precision, requiring smaller amounts of hyaluronidase to address complications like nodules, malar edema, overfilled face syndrome and redistributed filler.

Conclusion: As aesthetic practitioners, prioritizing safety is paramount. Proper ultrasound image interpretation enhances our understanding of injection anatomy, providing a more reliable means to manage potential complications associated with soft tissue filler injections.

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

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

Objectives: Calcium hydroxylapatite is well-established as a biostimulatory agent for skin tightening and improving skin quality. While there are histologic studies detailing the tissue response to hyperdilute CaHA, objective imaging studies to characterize the effect of such treatment on the overlying skin are lacking. This study reports on observed changes in ultrasound appearance of the skin components following treatment with hyperdilute CaHA in the neck and correlation to clinical changes.

Introduction: Calcium hydroxylapatite (CaHA) is a well-established biostimulatory filler, previously shown to stimulate collagen and elastin production. While there are histologic studies detailing the tissue response to hyperdilute CaHA, objective ultrasound imaging studies to characterize the effect of such treatment on the overlying skin are lacking. Changes in dermal and subdermal echogenicity and thickness have been previously found to correlate with aging and solar elastosis. We report on changes in these components after biostimulatory treatment with hyperdilute CaHA.

Materials / method: A total of 4 patients were treated with 2 syringes of hyperdilute CaHA in the neck and submentum over 2 treatment sessions, spaced two months apart. Ultrasound imaging was done using an L4-20 MHz linear probe. Imaging timepoints include baseline as well as 2, 4, and 6 months. Change in thickness and echogenicity for the upper and lower dermis and subcutaneous fat was assessed, and effect of treatment on the subepidermal low-echogenic band (SLEB) monitored. These imaging assessments were carried out alongside clinical assessment of laxity, using the neck skin laxity improvement (NSL) scale.

Results: Ultrasound imaging of the treated area following injection with CaHA permitted measurement of upper and lower dermis thickness, echogenicity, and assessment of SLEB prominence over time after treatment. Ultrasound findings and their relationship with clinical findings (NSL scale) are discussed.

Conclusion: Hyperdilute CaHA is an important treatment option for managing skin laxity in the neck and submentum. These findings provide further mechanistic support for the positive clinical outcomes observed in real-world patients as well as the case series patients discussed herein.

Disclosures

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

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?
Yes
Please specify entities (individual, company, society): Merz research grant

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: Merz

Objectives: we believe toxin and ultrasound should more be interesting to use than fillers, why ?

Introduction: US is a non invasive procedure
US permit a static and dynamic view
It is the perfect tool for toxin injection

Materials / method: we need to assess the value of using US for toxin injection.
muscle visualization: location, volume, mobility, as US is a dynamic examination
ultrasound-guided procedure: in which cases might it be of interest?

Results: why use ultrasound for toxin injection?
which location ?
which device ?
can it save units of toxin?
singles cases to explain the interest of US

Conclusion: in just 7 minutes, how do you or don't you see that, in this indication, US is not just a trendy new toy?

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

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?
Yes
Please specify entities (individual, company, society): trainer and partner of cutaneous, giving facial ultrasound courses

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

Objectives: To understand the difficulties studing risk and protective factors (here pre-filler injection ultrasonography) in rare diseases as vascular occlusion after filler injections

Introduction: Vascular occlusions after filler injections are rare events. The incidene is estimated to range between 1:5000 to 1:6000. Pre-filler injection ultrasonography (US) is advocated to reduce this risk. So far there no good clinical data to support pre-filler injection ultrasonography to reduce adverse events as vascular occlusion. And due to the rarity of these reactions it is really difficult to obtain good evidence.

Materials / method: Rough literature search

Results: The best study design would be a registry of filler occlusions that allows a nested case-control study. This would require huge efforts. Furthermore - say when pre-filler injection US would be done on a regular base - how much risk could be reduced? Assuming US would reduce the number of vascular events from 1:5000 to 1:10000, so the absolute risk reduction would be 0.01%. The relative reduction For the present data, the relative risk reduction is 0.01÷ = 0.01, which is 1%. Thus, US would reduce the risk of a vascular event by 1%.

Conclusion: The discussion on the merit of US is comparable to the discussion on aspiration. Therefore, there is no harm in doing an US before filler injection but it is not clear if this really will reduce the risk of vascular events.

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

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