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IMCAS World Congress 2025
Program

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Surgical complications: Enter the debate and solve problems

Room: Amphi Havane - Level 3
Date: Thursday 30 January 2025 at 16:00 to 18:00
Format: FOCUS SESSION > lectures covering a major topic of the congress

Chairs

Dr Flore DELAUNAY

Plastic Surgeon

France

Dr Andre FERRAO VARGAS

Plastic Surgeon

Brazil

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
16:00	Dr Pavel PIMANCHEV	Simultaneous operations: How to get maximum results with minimal risks	View	139828
16:10	Dr Mariam TSIVTSIVADZE	Retrobulbar hemorrhage: Management and diagnostic insights through case report		145052
16:20	Prof Maurice Y NAHABEDIAN	Management of complications: Implant reconstruction	View	142807
16:30	Prof Foad NAHAI	Avoidance and management of sialocoele following facelift		142808
16:40	Dr Sebastian NISCHWITZ	Responsible aesthetics: Lessons learned from a facelift complication		142809
16:50	Dr Javier BEUT	Periorbital autograft & allograft complications: How to approach the problem - Medical or surgical	View	145255
17:00	Dr Elena MARTIN	Management of nipple areola necrosis complex with dimethyl sulfoxide	View	146295
17:10	Dr Tarek ZAHRA	Deep plane face lift with permanent filler removal ( how to deal with tissue loss and defects)	View	145152
17:20	Dr Fabian PEREZ RIVERA	Complications with fat graft: Laser, one more therapeutic option	View	145053
17:30	Dr Hasim Eray COPCU	Can regenerative applications (MSC, SVF, TOST, exosome, combined) replace "salvage surgeries"?	View	145345
17:40		Discussion and Q&A		145054

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Recommended sessions

Complications

Facelift (surgical)

Periorbital (non-surgical)

Skin aging

Liposculpture

Dr Pavel PIMANCHEV

Plastic Surgeon

Russia

Other author(s) :

Simultaneous operations: How to get maximum results with minimal risks

Objectives: Extensive and long operations are accompanied by great risks.
- Somatic condition (physical status);
- Anesthesia;
- The scope of surgical intervention;
- Duration of surgery;
- Blood loss;
- Hypovolemia;
- Hypothermia;
- Thrombosis and / or thrombo / fat embolism;
All these factors must be taken into account at all stages. From the selection of a candidate for surgery to postoperative administration.

Introduction: Modern plastic surgery is moving forward and with it, the demands and expectations of patients are growing. Patients strive to get the maximum result from one surgical intervention. They want to correct the shape and size of the mammary glands, want to get rid of excess subcutaneous fat, from the overhanging belly, want to add volume and shape to the buttocks, etc. Surgeons themselves are chasing after the demands of patients. “Mommy makeover” - this fashionable operation is already on everyone's lips. But, we must not forget that such extensive operations are accompanied by great risks.

Materials / method: Physical status: patients from the ASA I group, rarely ASA II should be taken for such operations;
Volume of surgical intervention:
-Liposuction no more than 6-8% of body weight;
- The area of surgery no more than 45%
Duration of surgery:
- an operation longer than 2 hours increases the risk of complications by 50%
- every subsequent 30 minutes increases the risk by 14%;
Blood loss:
- 20-40 ml of blood for every 1 liter of aspirate;
- if blood loss is less than 15% of the CBV, then crystalloids are sufficient, if more, colloids such as dextran, albumin or blood may be required.

Results: Such operations should be performed by a team of at least 3 doctors to reduce the time of surgery. We do it with a team of 4-5 doctors. We perform more than 100 simultaneous operations per year and, by following the safety principles described earlier, we do not have any serious complications.

Conclusion: Successful simultaneous operations give great joy and satisfaction to both the surgeon and the patient. But, it is extremely important to understand and take into account all the possible risks in these operations. It is necessary to prepare for such operations in advance and understand that the patient's introduction does not end in the early postoperative period. It is important to remember the main principle of the doctor, formulated by Hippocrates "Primum non nocere" (do not cause more harm to the patient with treatment than the disease itself)

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 Mariam TSIVTSIVADZE

Plastic Surgeon

Georgia

Other author(s) :

Retrobulbar hemorrhage: Management and diagnostic insights through case report

Objectives: To provide a detailed case reports on retrobulbar hemorrhage, focusing on the recognition, diagnosis, and management of this condition. This presentation will teach how to approach retrobulbar hemorrhage effectively, covering the latest treatment options available today. Understanding the condition and applying the most appropriate treatments for optimal patient 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

Prof Maurice Y NAHABEDIAN

Plastic Surgeon

United States

Other author(s) :

Management of complications: Implant reconstruction

Objectives: overview of common complications and management for implant based breast reconstruction

Introduction: Management of complications following implant reconstruction requires a thorough knowledge of anatomy, physiology of wound healing, and technical strategies.

Materials / method: To review the authors experience with implant malposition, capsular contracture, delayed wound healing, infection, implant flipping and seroma.

Results: Management of complications is dependent upon patient co-morbidities and timeliness of management. Infection and delayed healing are early complications whereas capsular contracture, rippling, and implant flipping are late complications. Case examples will be reviewed.

Conclusion: Successful management of complications requires preoperative counseling, early recognition, and prompt management.

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

Prof Foad NAHAI

Plastic Surgeon

United States

Other author(s) :

Avoidance and management of sialocoele following facelift

Objectives: Prevention and treatment of Sialocoele will be discussed

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 Sebastian NISCHWITZ

Plastic Surgeon

Austria

Other author(s) :

Responsible aesthetics: Lessons learned from a facelift complication

Objectives: A case report of a facelift surgery of a fellow plastic surgeon is presented. In this case several aspects have gone wrong. Emphasis will be put on the need to deal responsibly with aesthetic treatments and surgeries.

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 Javier BEUT

Cosmetic Surgeon

Spain

Other author(s) : JAVIER BEUT, MD , FERIAL FANIAN, MD PHD

Periorbital autograft & allograft complications: How to approach the problem - Medical or surgical

Objectives: 1. “To achieve safe and effective outcomes by focusing on prevention and a comprehensive understanding of anatomy.”
2. “To minimize complications through prevention and enhance results with a better understanding of anatomy.”

Introduction: Periocular infiltrations have become increasingly common nowadays. Various types of fillers, such as hyaluronic acid (HA), hydroxyapatite, and fat—more accurately termed fat grafts—are widely used. Aesthetic and vascular complications are also common and can sometimes be challenging to treat. The primary goal is prevention and a deeper understanding of the anatomy. Here, we present some examples

Materials / method: Ha and fat

Conclusion: The goal is to prioritize prevention and enhance outcomes through a better understanding of anatomy. Here, we present examples of techniques and results using these materials.

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 Elena MARTIN

Plastic Surgeon

Romania

Other author(s) :

Management of nipple areola necrosis complex with dimethyl sulfoxide

Objectives: 1. To evaluate the effectiveness of DMSO in treating nipple areola complex necrosis.
2. To assess the safety and tolerability of DMSO application in a clinical setting.
3. To determine the impact of DMSO treatment on healing time and aesthetic outcomes.
4. To document any adverse effects associated with DMSO use in nipple areola necrosis management.

Introduction: Nipple areola complex necrosis is a significant complication in breast surgery that can impact aesthetic outcomes and patient satisfaction. Dimethyl sulfoxide (DMSO) has been identified for its potential in enhancing tissue perfusion and promoting healing due to its pharmacological properties. This study investigates the efficacy and safety of DMSO in the management of nipple areola necrosis.

Materials / method: This retrospective study included 11 patients who experienced nipple areola complex necrosis following breast surgery between 2021 and 2024. DMSO was applied topically under controlled conditions, with patients monitored for healing progress, complication rates, and overall satisfaction.

Results: Preliminary findings indicate that all treated patients showed improved perfusion and faster healing rates compared to typical recovery timelines without DMSO. There were no significant adverse reactions reported, and patient satisfaction concerning aesthetic outcomes was generally high.

Conclusion: The use of DMSO appears to be a viable and safe option for managing nipple areola complex necrosis, promoting faster healing and improving cosmetic results. This treatment could be considered a beneficial adjunct to standard care practices in patients experiencing this complication. Further research with a larger sample size and a control group is recommended to substantiate these findings.

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 Tarek ZAHRA

Plastic Surgeon

Egypt

Other author(s) : Ahmed Ziena, Ahmed Zayed, Khaled Prince Moussa

Deep plane face lift with permanent filler removal ( how to deal with tissue loss and defects)

Objectives: permanent Dermal fillers provided an appealing option for facial rejuvenation, but inappropriate filler selection and injection techniques caused many complications that require surgical correction. most of the patients suffer from depressions , scarring following multiple failed attempts to remove the permanent fillers. This study examined the intraoperative skin, superficial muscular aponeurotic system (SMAS) and tissue abnormalities encountered during deep plane face lift with permanent filler removal and how to reconstruct it

Introduction: Dermal fillers provide an appealing option for facial rejuvenation, but inappropriate filler selection and injection techniques can cause complications requiring surgical correction. This study examined the intraoperative superficial muscular aponeurotic system (SMAS) and tissue abnormalities encountered during facelift after permanent filler removal.

Materials / method: This case series describes reconstructive techniques used in 148 women with SMAS defects following deep plane face lift with permanent filler extraction. Defects were repaired using temporalis fascia, and mastoid fascia, or combined platysma-SMAS grafts. Pre- and postoperative photographs were evaluated by two independent surgeons for midface volume analysis

Results: Preoperative complaints included facial contour asymmetry (100%), nodules/irregularities (70%), and disfiguring edema (35%). The mean follow-up was one year postoperatively. No lipofilling was required in this period. Patient satisfaction at one year was: extremely satisfied (70%), very satisfied (20%), satisfied (10%). Facial symmetry was rated as no asymmetry (80%), moderate asymmetry (10%), and mild asymmetry (10%). Standardized photo review found that 80% of surgeons were satisfied with pre- vs. one year postoperative results

Conclusion: This study shows promising aesthetic outcomes and high patient satisfaction at one year after simultaneous deep plane facelift and permanent filler removal with volume defect correction using various local tissue grafts. Larger studies with longer follow-ups are warranted to further assess these reconstructive techniques for significant SMAS defects resulting from improper permanent filler placement

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 Fabian PEREZ RIVERA

Plastic Surgeon

Argentina

Other author(s) :

Complications with fat graft: Laser, one more therapeutic option

Objectives: I show how I resolve the Tyndall Effect and overcorrections in the tear trough sulcus by using a diode laser.

Introduction: Fat grafts at facial level usually survive in a high percentage. Areas where the skin thickness is less (skin of the lower eyelid and palpebromalar groove thickness of 1.5 mm) are usually problematic areas due to this possibility of greater survival of grafted fatty tissue or in cases of overcorrection.

Materials / method: The case is shown of a complication of a fellow plastic surgeon with overcorrection of fat graft in the palpebromalar groove and orbital margin, and who asks me to give the patient a non-surgical option.

Results: The excess fat graft was melted under local anesthesia using a diode laser 980 nm in the office without leaving marks on the skin. Symmetry was achieved in both palpebromalar grooves.

Conclusion: I offer the melting of excess grafted fatty tissue using a diode laser as another therapeutic option.

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 Hasim Eray COPCU

Plastic Surgeon

Turkey

Other author(s) :

Can regenerative applications (MSC, SVF, TOST, exosome, combined) replace "salvage surgeries"?

Objectives: The most troublesome process in aesthetic surgery and applications is complication management. The main problem in complications arising from many reasons is hypoxia and necrosis in the application area due to lack of sufficient blood flow. In such cases, revision and salvage surgery is generally performed. But regenerative practices can replace slavage creeah. Existing complications can be treated with the regenerative instruments we have. A total of 21 necrosis treatments in a series of 1200 cases over the last 15 years will be presented in detail.Regenerative practices are lifesaving.

Introduction: The most important goal in aesthetic operations and interventions is to avoid complications while achieving the desired results. While failure to meet patient expectations and scars are important complications, partial or complete skin necrosis due to insufficient blood supply to the tissue are the most undesirable and difficult complications to manage. In these cases, the surgeon has very few options, and regenerative applications come first.

Materials / method: In this study, regenerative applications and their results in partial and complete skin necrosis encountered in a series of 1200 aesthetic applications in the last 15 years are presented and discussed in a total of 21 cases.Chronologically, the cases were first treated with PRP (platelet reach plasma), then SVF (stromal vascular fraction), then mechanically obtained stromal cells from fat tissue: TOST (Total stromal-cell transfer), supercharged MEST (Mechanical stromal-cell transfer), exosome and finally autologized exosome.

Results: In all cases, the management of existing complications with the regenerative approach was achieved without the need for any other surgical procedure. However, the latest, best, fastest results and the most scarless healing were achieved with autologized exosome, supercharged MEST, iMSC-derived exosome and TOST, respectively. The longest-lasting and slightly scarring healing was achieved with PRP.

Conclusion: Unlike all other branches, the complications of aesthetic surgery operations and interventions create great stress for the patient and the surgeon. Because the patient expects perfect and scarless results in these procedures. Therefore, the management of these complications is very difficult. However, regenerative applications are life-saving in this respect. In particular, the combination of the patient's own ECM-containing deparenchymal fat tissue with pluripotent iPSC-derived iMSC-derived exosome leads to excellent results and allows the desired result to be obtained in the shortest 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

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IMCAS World Congress 2025 Program

Surgical complications: Enter the debate and solve problems

Chairs

Lectures of the session

Recommended sessions

IMCAS World Congress 2025
Program