IMCAS

Personalized PRP and Class 4 Er:YAG Laser Therapy for Androgenetic Alopecia: A Case Study with Optimized Trichoscopy-Guided Treatment Protocols

Objectives: This presentation provides a structured, trichoscopy-guided approach to diagnosing and treating androgenetic alopecia (AGA). A case study is presented in which platelet-rich plasma (PRP) therapy was progressively optimized over 18 months, combined with Class 4 Er:YAG laser therapy for enhanced follicular stimulation. The stepwise refinement of PRP concentration and volume will be detailed, offering a personalized strategy for hair loss management.

Introduction: Hair loss is a major concern for millions worldwide, yet effective non-surgical solutions remain challenging. Many patients discontinue treatment due to suboptimal results or lack of clear guidance. While PRP therapy is widely used, its efficacy is highly dependent on concentration, volume, and application protocols. This case study highlights how a systematic, personalized PRP protocol—combined with the latest Class 4 Er:YAG laser technology—can optimize patient outcomes.

Materials / method: A 44-year-old female patient with persistent AGA was treated with a progressively refined PRP protocol and Er:YAG laser therapy:
1. Trichoscopy-based diagnosis, including AI-assisted follicular density mapping.
2. PRP optimization over four phases in 18 months, adjusting concentration (target: 1,000,000 platelets/µL) and volume (5 mL plasma).
3. Class 4 Er:YAG laser therapy (2940 nm, long-pulse mode) applied at key treatment milestones for enhanced follicular activation and vascular stimulation.
Patient progress was monitored using standardized clinical photography.

Results: Results:
• Significant improvement in hair density confirmed by standardized clinical photography.
• Patient-reported hair quality improvement, leading to discontinuation of cosmetic camouflage (hairpiece use).
• No adverse effects or complications, confirming the safety and tolerability of the combined treatment approach.

Conclusion: This case study demonstrates the critical importance of optimizing PRP concentration and volume in achieving consistent and effective results in AGA treatment. The combination of personalized PRP protocols with Class 4 Er:YAG laser therapy presents a novel, non-invasive strategy for enhanced follicular regeneration. Further clinical studies are needed to establish standardized guidelines for this promising multimodal approach.

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Por favor indique a entidade (pessoa ou empresa): Arthrex (Trainer), Fotona (Clinical Lecturer)

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Diversifying Intimate Area Treatments ~Changes and Current Status of Pubic Hair Removal and Female Genital plastic surgery at Our Clinic~

Objectives: The objective of this study is to analyze trends in the number of procedures and patient demographics related to pubic hair removal and Female genital plastic surgery, in order to clarify changes in demand for these treatments. Additionally, the study aims to evaluate the impact of the widespread adoption of pubic hair removal on Female genital plastic surgery and to identify trends in labia minora reduction choices.

Introduction: Intimate area treatments are gaining global attention, and in Japan, procedures such as pubic hair removal are becoming increasingly diverse and widespread. In this report, we present the history and current status of pubic hair removal and female genital plastic surgery at our clinic.

Materials / method: We investigated the number of patients who underwent pubic hair removal and female genital plastic surgery at our clinic between 2007 and 2024. In addition, we conducted a questionnaire survey (from May to November 2024) targeting 187 first-time patients seeking labia minora reduction, the most common type of female genital plastic surgery. The survey included questions about age, chief complaints, presence or absence of pubic hair removal, and home care practices such as the use of special soaps or creams.

Results: Pubic hair removal patients increased from 751 in 2007 to 5,179 in 2024, 7 times increase. Female genital plastic surgery patients grew from 35 to 302, 8.6 times increase. In 2007, 5.7% of patients were in their teens to 30s, with 94.2% in their 40s to 70s. By 2024, 66.7% were in their teens to 30s, and 33.3% in their 40s to 70s. For labia minora reduction, ages ranged from 18 to 64, avg 32.2. Reasons for surgery: discomfort (51.3%), pigmentation (37.9%), and asymmetry (28.3%). 58.2% had pubic hair removal, and 22.2% said it led to interest in labiaplasty. 35.2% used home care.

Conclusion: We are seeing a clear increase in demand for pubic hair removal and female genital plastic surgery, especially among younger patients. With the influence of social media and the increasing availability of commercial products and services, public interest in intimate area treatments appears to be expanding. Understanding patients’ backgrounds and motivations is crucial as these procedures continue to gain popularity and evolve as medical practices.

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The Role of Clostridium butyricum in Keloid Pathogenesis: Mechanisms Involving Macrophage-to-Myofibroblast Transition via the TGF-β/Smad-CXCL10 Axis

Objectives: 1、Understand the pathogenic role of Clostridium butyricum in keloid formation through microbial identification and functional validation.
2、Identify macrophage-to-myofibroblast transition (MMT) as a key cellular mechanism driving fibrosis in keloid tissues using single-cell transcriptomic analysis.
3、Evaluate the molecular pathways by which C. butyricum activates the TGF-β/Smad-CXCL10 axis to induce MMT and fibrosis, supported by multi-omics and animal model data.

Introduction: Keloids are fibroproliferative disorders characterized by excessive collagen deposition, often associated with unresolved inflammation and immune dysregulation. While microbial infections are implicated in dermatological conditions (e.g., acne, psoriasis), their role in keloid pathogenesis remains unexplored. We hypothesized that specific pathogens, particularly Clostridium butyricum, may drive keloid formation via microenvironmental alterations and macrophage phenotypic transitions.

Materials / method: Microbial Identification: C. butyricum was detected in keloid tissues via 16S rRNA sequencing, metaproteomics, and SEM.
Single-Cell Analysis: Public RNA-seq datasets were analyzed to map macrophage subpopulations and MMT markers.
Functional Validation: C. butyricum was co-cultured with THP-1 macrophages to quantify fibrosis markers and CXCL10; animal models validated in vivo effects.
Mechanistic Studies: TGF-β/Smad-CXCL10 pathway activation was investigated using RNA sequencing and pathway enrichment (KEGG/Reactome).

Results: Pathogen Presence: C. butyricum was enriched in keloid tissues (16S rRNA, SEM) and promoted fibroblast activity.
MMT Evidence: Single-cell analysis revealed elevated MMT-associated macrophage subsets in keloids vs. normal scars.
Fibrosis Induction: C. butyricum upregulated fibrosis markers and induced MMT via CXCL10 (p<0.005).
Mechanistic Pathway: TGF-β/Smad activation by C. butyricum drove CXCL10 overexpression, confirmed by RNA-seq and pathway enrichment (FDR<0.05).

Conclusion: This study establishes C. butyricum as a novel pathogenic driver of keloid formation, linking microbial infection to macrophage-to-myofibroblast transition and fibrosis via the TGF-β/Smad-CXCL10 axis. These findings highlight potential therapeutic targets for keloid management.

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New Developments in Thread Lifting in Japan: Effective Techniques Combining Thread Lifting and Fat-Suction Injection

Objectives: Facial aging typically involves both volume loss and expansion, leading to sagging and a bloated lower face. While thread lifting is commonly used to address this, its effects are often short-lived. To enhance and prolong results, the combination of thread lifting and a novel “fat-suction injection” technique is gaining popularity. This study aims to evaluate the clinical efficacy of this approach, known as the Suction Lift, in treating facial sagging.

Introduction: Between 2020 and 2023, the demand for aesthetic procedures in Japan tripled, particularly for minimally invasive treatments with minimal downtime. Facial contouring is now the second most popular procedure after blepharoplasty, and among these, the combination of thread lifting with liposuction—known as the “Suction Lift”—has gained significant attention. We developed a new liposuction technique called the “fat-suction injection,” which uses fine cannulas to minimize downtime. This method has since been widely adopted by many aesthetic surgeons in Japan.

Materials / method: Ten cases of Suction Lift procedures performed between June and August 2024 were analyzed. Preoperative and six-month postoperative facial contours and volume changes were compared using 3D Vectra imaging. Overlay analysis was conducted to evaluate the precise differences in volume and contour.

Results: Compared to thread lifting alone, combining thread lifting with liposuction improved lifting effects and resulted in more sustained contour changes over time.

Conclusion: The addition of liposuction to thread lifting enhances the tissue contraction and re-adhesion effects typically achieved with thread lifts. Moreover, the volume reduction from liposuction—which may otherwise increase the risk of sagging—can be compensated by the lifting effect of threads, creating a synergistic outcome. This approach may be especially effective for patients with moderate to severe sagging who seek stronger and longer-lasting results. Additionally, we will present 3D imaging analysis of volume changes following thread lift alone.

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Safety and Efficacy Analysis of Plant-Based Exosome Treatments for Androgenetic Alopecia

Objectives: This study aims to share the results of 1,500 exosome treatments administered to hair transplant and non-transplant individuals over one year. Exosomes play a crucial role in cell-to-cell components in regenerative medicine. Their application in scalp treatments has demonstrated promising results. This presentation highlights the importance of exosomes in improving treatment outcomes for androgenetic alopecia with overall patient satisfaction

Introduction: Plant-derived exosomes are emerging as a safe and effective cell-free therapy for scalp regeneration. In this study, we selected the HRLV exosome formulation due to its RSCE (Root Stem Cell Extract) content, which is rich in miRNA-122-5p. This specific miRNA has been shown to counteract the effects of DHT on hair follicles by reducing inflammation and promoting follicular cell survival, making HRLV a promising option for androgenetic alopecia management.

Materials / method: A total of 1,500 exosome treatments were conducted from September 2023 to March 2025 with Exocobio HRLV (RSCE) product in Doku Clinic. The study assessed the efficacy and short-term safety of these treatments, focusing on both patients who
underwent hair transplantation and those who did not. Clinical outcomes were monitored through regular follow-ups and evaluations of hair growth, scalp health, and patient satisfaction with 3 month 6 months 1 year before after pictures.

Results: Results from this extensive study will be discussed in detail, emphasizing the differences in treatment outcomes between individuals who received hair transplants and those who did not. Key metrics will include the rates of hair growth, scalp health improvement, and any reported adverse effects. Visual aids, including images, will be used to illustrate the results, and a thorough analysis of the proportionate outcomes will be elaborated upon during the presentation.

Conclusion: The findings from this study will provide valuable insights into the safety and effectiveness of plant-based rose stem cell exosome treatments for androgenetic alopecia. This research has the potential to enhance current treatment protocols and improve patient outcomes in the field of hair restoration.

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Por favor indique a entidade (pessoa ou empresa): Speaker for Exocobio

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Managing Androgenetic Alopecia in Aesthetic Practice: Practical, Evidence-Based Treatment Strategies

Objectives: This session aims to simplify the management of androgenetic alopecia in aesthetic practice. learn to identify common patterns of hair loss, choose safe and effective treatments including low-dose Finasteride, combine therapies like PRP and microneedling, structure 3–6 month treatment plans, and improve patient communication to boost adherence and satisfaction.

Introduction: Androgenetic alopecia (AGA) is one of the most common aesthetic concerns, yet many clinics still struggle with fragmented approaches and inconsistent results. This session focuses on simplifying AGA management by combining medical, injectable, and device-based therapies into clear, practical protocols. With the right structure and patient communication, aesthetic practitioners can deliver results that build trust and long-term treatment success.

Materials / method: This presentation is based on clinical experience and current evidence in the treatment of androgenetic alopecia. Protocols include the use of topical and oral medications (e.g., Minoxidil, Finasteride 0.5 mg), adjunctive treatments such as PRP, microneedling, and low-level laser therapy. Treatment plans are structured over 3–6 months with tailored combinations based on patient type, severity, and goals.

Results: Structured, multi-modal treatment plans for AGA showed improved patient satisfaction and visible hair density gains within 3–6 months. Combining oral agents with PRP and microneedling led to better outcomes than monotherapy. Patient adherence improved significantly when expectations were managed early and progress was tracked visually. These protocols proved effective across both male and female AGA patients in real-world aesthetic practice.

Conclusion: Managing AGA doesn't require complex algorithm. AGA management need a structured, consistent approach. By combining evidence-based treatments with supportive therapies and strong patient communication, aesthetic practitioners can achieve better clinical results and higher long-term satisfaction.

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Porsthetic hair injection a novel treatment for androgenetic alopecia in females- a retrospective case series analysis

Objectives: A retrospective analysis of the efficacy and safety of new generation of prosthetic hair implants as a treatment for androgenetic alopecia in 25 woman.

Introduction: Androgenetic alopecia is one of the most common conditions and is a stressful experience for both sexes, but substantially more distressing for women. Women with androgenetic alopecia possess a more negative body image and a pattern of less adaptive functioning. Although this is a verry common condition we still lack a non surgical effective treatment and surgical restoration remains the only reliable method to restore hair in women with sever alopecia. Therefore there is a need for an additional non-surgical treatment option to to restore hair.

Materials / method: 25 patients (ages 41-68) underwent prosthetic hair injection between 2020-2024. Patients underwent a test procedure in which 48 hairs were implanted to make sure there is no adverse reaction and 6-10 weeks later patients underwent full treatment (768-1152 hairs). Patients underwent between 1-3 treatment sessions with prosthetic hair fibers (by Hairstetics LTD)which are made of two biocompatible materials: nitinol and nylon and are preloaded on sterile disposable cartridges 12 hair fibers on each. Side effects and patient satisfaction rate were monotored 6-18 months post procedure.

Results: All patients that were chosen to undergo this treatment had good clinical improvement and over 80% mentioned that it improved their self confidence and body image. Side effects were mostly mild and included focal erythema and papular lesions (in 5 patients overall). No patients needed an extraction of the implants.

Conclusion: The new generation of prosthetic hair implants is a safe and effective procedure mainly for woman with stable and severe androgenetic alopecia- since there is a need for a reliable minimally invasive procedure .It can serve as an additional tool for patients which are looking for an office procedure rather a surgical one. Patient selection is crucial for positive outcome. More studies are needed to establish the long term outcome.

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Tailored Filler Strategies Based on Rheological Properties: A Scientific Approach to Facial Aesthetics

Objectives: This study aims to establish a clinically applicable strategy for selecting hyaluronic acid (HA) fillers based on rheological properties—specifically, gel firmness (G’), flexibility (xStrain), and cohesivity. The goal is to enhance safety, predictability, and aesthetic outcomes by tailoring filler selection and injection techniques according to facial anatomy and movement dynamics.

Introduction: Facial aging is a multilayered process involving volume loss, ligament laxity, and changes in skin elasticity. HA fillers have become essential in aesthetic medicine, but product selection often lacks scientific grounding. Understanding rheological behavior provides an objective framework to select appropriate fillers for specific anatomical needs—balancing support, mobility, and natural integration.

Materials / method: We analyzed the rheological characteristics (G’, xStrain, cohesivity) of commonly used HA fillers using data from published literature and in vitro measurements. A region-specific treatment algorithm was developed using a layer-by-layer anatomical model. Clinical case reviews and visual assessments were conducted to evaluate volume retention, mobility adaptation, and patient satisfaction post-treatment.

Results: High G’ fillers demonstrated superior lifting capacity and volume retention in structurally deficient areas such as the midface and chin. High xStrain fillers provided natural animation and improved integration in dynamic zones like lips and nasolabial folds. The layer-specific approach minimized complications such as lumpiness, migration, and unnatural appearance, enhancing overall treatment satisfaction.

Conclusion: Filler rheology plays a critical role in achieving safe and natural aesthetic results. Scientific understanding of viscoelastic properties and their clinical implications enables practitioners to deliver customized, anatomy-driven treatments. A rheology-based filler strategy supports both function and form—leading to reproducible outcomes and higher patient satisfaction in facial rejuvenation.

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Synergistic Effects of Fractional Picosecond Laser (FPL) and Rose Stem Cell-Derived Exosomes (RSCEs) in Acne Scar Treatment: A Split-Face Pilot Study

Objectives: To evaluate the clinical efficacy and safety of combining RSCEs with FPL in reducing atrophic acne scars by assessing post-treatment recovery, scar severity reduction, and adverse effects.

Introduction: Fractional Picosecond Laser (FPL) has been shown to be effective in treating atrophic acne scars. However, there is a need for improved post-treatment recovery and enhanced overall efficacy. Stem cell-derived exosomes have demonstrated potential as a cell-free therapy for tissue regeneration and recovery. Recently, interest has grown in plant-based exosomes, such as Rose Stem Cell-Derived Exosomes (RSCEs), which offer similar regenerative benefits. This study investigates the synergistic effects of FPL and RSCEs in treating atrophic acne scars.

Materials / method: A prospective, double-blind, randomized split-face pilot study on atrophic acne scars involved a single FPL session with dual fluences, RSCE application on one side, and a control gel on the other. Patients used a topical exosome moisturizer for 21 days, with assessments at 1 and 3 months post-treatment, including photography, IGA ratings, biometric analyses, and recovery monitoring.

Results: The RSCE-treated side showed significantly greater reductions in acne scar severity scores compared to the control side. RSCE-treated areas exhibited milder erythema, shorter recovery times, and reduced post-treatment pain. No severe adverse effects were observed. At follow-up visits, the RSCE-treated sides displayed improved skin texture, enhanced scar appearance, and fewer residual scars compared to the control.

Conclusion: The combination of FPL and RSCEs is a safe and effective approach for treating atrophic acne scars, promoting faster recovery and superior scar improvement compared to standard treatments. As a plant-based exosome therapy, RSCEs hold great potential for broader applications in aesthetic and regenerative dermatology.

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A power of combination: Hair transplantation and Autologous Micrografting

Objectives: Bring more clinical evidence to support autologous micrografting technique (AMT) in the use with hair transplant (HT) surgery to enhance graft survival, improve wound healing in donor area and stop the progression of androgenetic alopecia in the non-transplanted area.

Introduction: One of the primary limitations of hair transplantation is the extended recovery period, frequently accompanied by post-procedural telogen effluvium. Surgical stress can disrupt the normal hair cycle of non-transplanted follicles, prematurely shortening the anagen phase and resulting in transient shedding. The healing of both donor and recipient sites may require up to two months, potentially impacting patient satisfaction and overall outcomes. Another concern is the variable survival rate of transplanted grafts, influenced by surgical technique, graft handling, and patient-specific factors.

Materials / method: We propose AMT, used in AGA, as an adjunctive treatment in HT surgery. This procedure involves mechanical disaggregation of skin biopsies from the occipital region, creating a cell suspension with regenerative biocomponents. Also, grafts obtained during FUE can be utilized to prepare the AMT suspension. It delivers cytokines for wound healing, ECM components supporting follicle integrity and cells with regenerative potential. When injected into recipient and donor areas immediately before the implantation phase can foster optimal conditions for graft survival and enhance postsurgical recovery

Results: The 1500 clinical cases and work over 10 years have shown that there is a reduction of the percentage of transplanted hair shedding after surgery. Additionally, the donor area heals much faster without scarring and necrosis preserving that area in case of future treatments. AMT shows good improvement over the non-transplanted miniaturized hairs.

Conclusion: In summary, AMT has demonstrated to accelerate tissue repair in donor area and to reduce post-transplant effluvium, improve graft survival in the recipient area and prevent AGA progression in the non-transplanted follicles. This method represents a promising biological approach to optimizing clinical outcomes in hair restoration surgery.

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EFFECTIVENESS OF AUTOLOGOUS CELLULAR MICROGRAFT KIT IN HAIR RESTORATION FOR ANDROGENETIC ALOPECIA: A NOVEL CASE SERIES

Objectives: To evaluate the clinical efficacy of autologous cellular micrograft (ACM) therapy in patients with androgenetic alopecia (AGA), focusing on improvements in hair thickness and density after treatment.

Introduction: AGA is a chronic condition affecting up to 80% of men, marked by follicle miniaturization. Traditional therapies often lack consistent results. ACM therapy, derived from HF-MSCs, offers a regenerative approach. This study explores ACM’s clinical use in AGA, aiming to provide evidence of its efficacy and safety.

Materials / method: Two male AGA patients (ages 36 and 38) received ACM therapy. Three 2-mm scalp biopsies were processed with microlyzer blades (600 μm and 150 μm) to create a cell suspension, which was injected into hormone-sensitive scalp areas. Hair thickness and density were evaluated at 2-month follow-up.

Results: Both patients showed visible increases in hair density and thickness after 2 months. No side effects were reported. Patient satisfaction was high, supporting ACM as a promising, minimally invasive treatment for both early and advanced stages of AGA.

Conclusion: ACM therapy offers a novel, well-tolerated solution for AGA by reactivating follicular stem and progenitor cells. Early results are encouraging, but larger studies are needed to confirm long-term benefits and broader clinical applicability.

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Horas	Palestrantes	Título da apresentação	Resumo	Número
09:10	Dr Barry DEKEYSER	Personalized PRP and Class 4 Er:YAG Laser Therapy for Androgenetic Alopecia: A Case Study with Optimized Trichoscopy-Guided Treatment Protocols	Visualizar	148928
09:22	Dr Ayano OKUDA	Diversifying Intimate Area Treatments ~Changes and Current Status of Pubic Hair Removal and Female Genital plastic surgery at Our Clinic~	Visualizar	148937
09:34	Dr Xinwen KUANG	The Role of Clostridium butyricum in Keloid Pathogenesis: Mechanisms Involving Macrophage-to-Myofibroblast Transition via the TGF-β/Smad-CXCL10 Axis	Visualizar	149064
09:46	Dr Shunsuke NAGURA	New Developments in Thread Lifting in Japan: Effective Techniques Combining Thread Lifting and Fat-Suction Injection	Visualizar	149477
09:58	Dr Mehmet CIMEN	Safety and Efficacy Analysis of Plant-Based Exosome Treatments for Androgenetic Alopecia	Visualizar	149126
10:10	Dr Christopher Toshihiro WIRYA	Managing Androgenetic Alopecia in Aesthetic Practice: Practical, Evidence-Based Treatment Strategies	Visualizar	149472
10:22	Dr Lehavit AKERMAN	Porsthetic hair injection a novel treatment for androgenetic alopecia in females- a retrospective case series analysis	Visualizar	149473
10:34	Dr Kyung Tae BAE	Tailored Filler Strategies Based on Rheological Properties: A Scientific Approach to Facial Aesthetics	Visualizar	149474
10:46	Dr Suparuj LUEANGARUN	Synergistic Effects of Fractional Picosecond Laser (FPL) and Rose Stem Cell-Derived Exosomes (RSCEs) in Acne Scar Treatment: A Split-Face Pilot Study	Visualizar	149475
10:58	Dr Ratchathorn PANCHAPRATEEP	A power of combination: Hair transplantation and Autologous Micrografting	Visualizar	149478
11:10	Dr Panji RESPATI	EFFECTIVENESS OF AUTOLOGOUS CELLULAR MICROGRAFT KIT IN HAIR RESTORATION FOR ANDROGENETIC ALOPECIA: A NOVEL CASE SERIES	Visualizar	149479

IMCAS Asia 2025
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IMCAS Asia 2025 Programa

Non-sponsored scientific lectures

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IMCAS Asia 2025
Programa