IMCAS Alert is an online forum dedicated to physicians who are facing a complication case in practice. It allows physicians to enter the topic group related to their inquiry and post anonymously to receive advice from our community of experts on how to proceed.

Since its launch in 2017, IMCAS Alert has expanded to include a wide range of topic groups: Injectables & Threads / Lasers, EBD & Peelings / Clinical Dermatology / Genital Treatments / Plastic Surgery / plus a new group dedicated to Russian-speaking physicians.

Thanks to our knowledge-thirsty community and super-responsive coordinators, the Injectables & Threads group was able to reach (and pass) the 2000 member milestone in 2021! We asked our coordinators if they could share a few words about their thoughts & feelings on this amazing achievement.

1. How does IMCAS Alert function and how does it help physicians in their everyday practice?

Dr Feiner: It can be a very confronting and lonely experience when an unexpected perplexing or alarming clinical complication occurs. Frequently there are few resources available to assist a physician in the management of such situations.

Remarkably, IMCAS Alert functions online 24 hours a day, all year round.

Any IMCAS Academy member can submit a complication, inquiry, report or topic for discussion and if preferred this can be anonymous. All members can respond with collegiate assistance. IMCAS promptly alerts members to the presence of a new submission.

So, it is very reassuring to have the ready support of expert colleagues from around the world within very expedient time frame. In fact, collegiate responses are often available within minutes!

In this way, IMCAS Alert is an exceptional facility founded on an altruistic philosophy of mutual assistance and support.

2. What does reaching 2000+ members mean for you?

Dr Rappl: I’m really excited to be one of the first coordinators and initiators of this great group! In 4 years, we made it up to 2000 members on this important, industry-independent, international non-profit platform, to support colleagues when they have troubles.

The 2000-member milestone underlines the importance and quality of our project. I’m very proud of this project. The high number of members encourages us to proceed in our efforts to keep on improving this important tool of quality control.

I also want to thank all the coordinators, board members and all the colleagues and friends who are taking an active part in IMCAS Alert! Without them, it wouldn't have been possible to create such a tool.

Also many thanks to Benjamin Ascher, who is the mastermind behind this project and who brought this baby to life! Without him, we wouldn’t be here.

3. Were there certain types of inquiries or cases that were a personal favorite? Did you find yourself drawn more to one topic of inquiry than others?

Dr Feiner: I personally find all the submissions challenging. In common with all scientific disciplines our particular field is ever changing with novel innovations waiting to be shared and in time published. For example, colleagues have revealed novel approaches to the remediation of permanent fillers in our alert facility that can prove very helpful yet are awaiting official publication.

When one considers that a colleague somewhere in the world has submitted a perplexing case that is troubling to the degree that he/she is calling for assistance, one has to respect the anxiety that may associated with such a request. Ultimately, no physician is an island. We all may at some instance find ourselves in need of collegiate assistance. Furthermore, we all learn from each other which is ultimately very rewarding for all participants.

4. What would you like to continue seeing with IMCAS Alert? How do you imagine it in the future?

Dr Rappl: As we are constantly working on improving IMCAS Alert, and I think in the future it will become more and more important for all colleagues who are working in the aesthetic fields, a tool to help them bring quality and safety to their practice. In terms of safey, it will become a must to be part of such an important community. We‘re still in the beginning and I think there is no limit!

5. Do you have a case that you answered in 2020 that was particularly memorable or interesting? If so, could you describe it?

Dr Feiner: Of course, there are very many cases that are memorable, interesting and challenging. Perhaps the one that stands out for me is a case of chin filler injection that in all likelihood resulted in a vasculo-occlusive event.

It very much resembled a case that I personally had submitted some months before. I believe there were some lessons for all who kindly participated in responses. The midline chin region is considered a rather safe area and very few cases of filler related vascular complications have been reported in the literature.

So, the most important lesson was that no area is entirely safe from the possibility of vascular occlusion and that injectors must be mindful at all times to minimize risk in this regard. Discussions included the institution prior & post incident interrogation with ultrasound, the use of large size cannula instead of needles and of course the prompt institution of hyaluronidase to protect from necrotic sequalae.

Dr Rappl: There are lots of cases in 2020... I would like to mention the first case posted on IMCAS Alert on December 19, 2016. It was the successful start, so to say, of an incredible idea aimed to help and support colleagues when they have troubles.

The first case was about ischemia or hematoma! As we all know, especially for colleagues who are starting to work with injectables, it is important to get information quickly to initiate the right treatments. Back in 2016, it took some time to get the answers, but in 2020 we are able to present answers mostly within an hour, which underlines the quality of IMCAS Alert.

Bonus question! A hot topic of discussion right now on IMCAS Alert is about complications related to the Covid-19 vaccines in patients who have previously had filler treatments. What is your take on this issue? Were your views influenced at all by posts on IMCAS Alert?

Dr Feiner: Well, this is certainly an evolving concern and we are awaiting reports from colleagues around the world regarding any complications related to injectable fillers and COVID-19 vaccines.

We know from historical experience that influenza and other vaccinations, concurrent illnesses, dental, oropharyngeal and sinus infections can all contribute to the development of delayed immunologic reactions in the location where fillers have previously been injected.

IMCAS is encouraging reports and discussions via IMCAS alert and to date participating physicians are benefiting from the interchange of opinions in this regard. Given that generalized allergic reactions to vaccines are also possible, it may be challenging to differentiate these from more specific filler related delayed immunological reactions.