Objectives: Facial Gold Reinforcement: 28 Years of Experience in the Use of Gold Threads

Objectives:

To present clinical outcomes from over 11,000 gold thread interventions performed over 28 years.

To outline patient selection, technique, and optimal anatomical layer for lasting results.

To assess patient satisfaction and complication rates using the Patient Satisfaction Scale (PSS).

To review histological evidence of collagen stimulation, angiogenesis, and skin improvement.

To confirm the compatibility of gold threads with future aesthetic interventions.

Introduction: Gold threads gained popularity in aesthetic surgery in the early 1990s. Manufactured in Spain, they consist of a 5/0 thread made of 99.99% pure gold (0.1 mm in diameter) combined with a polyglycolic component. Since their introduction, ongoing debate has surrounded their effectiveness. This study focuses on evaluating their clinical value based on long-term experience.

Materials / method: Gold thread implantation was performed on 11,062 patients over 28 years in four Moscow clinics. This retrospective study analyzed pre- and post-procedure photo collages and patient satisfaction using the Patient Satisfaction Scale (PSS). A detailed evaluation was conducted on 492 facial cases from 1996 to 2024. Among them, 86% were women aged 30–60, 11% women aged 20–30, and 3% men aged 25–60.

Results: One year after implantation, the Patient Satisfaction Scale (PSS) indicated a 91% success rate with minimal complications. Satisfaction scores were 4.8 after one month, 4.7 after six months, and 4.6 after one year, confirming stable long-term outcomes.

Conclusion: Gold thread implantation reinforces connective tissue, enhances skin hydration and elasticity, and provides a long-term rejuvenating effect. It does not interfere with future surgical or non-surgical aesthetic interventions, making it a safe and compatible technique in facial rejuvenation.

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Objectives: The aim of the study is to evaluate the efficacy of a combination protocol with High-Intensity Focused Ultrasound (HIFU), Poly-D,L-lactic acid (PDLLA) and botulinum toxin A in mild to moderate neck skin aging. Neck skin aging, involves horizontal lines, prominent platysmal bands, sagging skin, fine lines, loss of jawline definition and is a challenging problem, as patients’ satisfaction rates are relatively low when a monotherapy is applied.

Introduction: Botulinum toxin A is the gold standard for platysmal bands and vertical bands of the neck. HIFU, through thermal damage, leads to collagen production, skin tightening and rejuvenation, targeting to deep dermis and SMAS. PDLLA is a biocompatible collagen biostimulator that promotes neocolagenesis, enhances elasticity, and promotes skin rejuvenation and gradual skin tightening.
In the present study, we examine the effectiveness of combining BTX-A with PDLLA and HIFU as a way to address stubborn signs of neck aging.

Materials / method: 89 patients (69 women, 20 men; mean age:53y) with moderate neck aging were enrolled in the study. All patients had undergone BΤΧ-Α in the past as monotherapy.
The protocol consisted of BTX-A administered on day 1 (average:41u in platysmal bands & 25u in jawline -Nefertiti lift).
HIFU was performed on day 14, 35 and 56 after BTX-A, targeting depths of 3 and 4,5 mm (mean shots: 350 per session).
PDLLA injected by cannula in average dose of 3ml per neck side, diluted in 10ml SWFI per vial, followed on day 28, 49 and 70 after BTX-A. Photographs were taken on day 1 & 2 months after the last PDLL.

Results: A significant reduction in vertical neck bands and neck skin texture was observed 15 days after the completion of treatments, with a patient satisfaction rate of 89% on month 4, way higher than botulinum toxin A monotherapy (55%).
Patients reported improvement in both dynamic and static wrinkles, skin elasticity and thickness, sagging, overall texture and firmness.
Nearly all patients reported improved skin tone, hydration, and jawline definition, with no severe side effects observed, apart from mild erythema and slight bruising after HIFU and PDLLA.

Conclusion: The combination of BTX-A, HIFU and PDLLA is a safe minimally invasive therapeutic approach with excellent results in treating neck skin aging.
The combined protocol targeted all structures of neck and lower face that contribute to skin aging. In addition, BTX-A seems to have a better performance and longer duration when applied as a part of an EBD and PDLLA potocol.

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Objectives: Melasma is a common melanin disorder in vietnamese women. Various approaches still show limitations. Polynucleotide, known as bio-regenerative injection could play the role in hypopigmenting properties.

Introduction: To compare the efficacy and safety of combination with oral tranexamic acid, topical cysteamin 7.5% and polynucleotide (PN) injection in the treatment of melasma

Materials / method: 60 female patients of facial melasma were divided in to 3 groups. Group A (20 patients) was only injected 20mg polynucleotide (PN) for 3 times every 2 months. Group B (20 patients) were described oral 500mg tranexamic acid per day, applied cysteamin 7.5% cream every day. Group C (20 patients) was asked to take the same oral pills, skincare routine and injected PN solution for 3 times within 6 months. We recorded digital potograghs, modified melasma area severity index (mMASI), redness, patients satisfaction and downtime for evaluating.

Results: All groups showed significant changes in modified melasma area and severity index (mMASI) score after using the treatment (P<0.05). However, group C showed the highest improvement (>75%) in mMASI as compared to group B (60%) and group A (30%) after 6 months. There was 4 patients (20%) in group B complained abour irritation due to topical cysteamin 7.5% meanwhile there was no report in group C. There is down time from 24-48h in injected group and lowest satisfaction in group A

Conclusion: Oral TXA, topical cysteamin 7.5% was effective in melasma treatment. However, the decreasing of irritation rate and increasing of brightening effect was mentioned with polynucleotide injection.

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Objectives: To assess the current application and perceptions of biostimulators among medical professionals and patients in China, providing data to guide clinical practice.

Introduction: Aging embodies humanity’s profound sorrow, while beauty remains an eternal pursuit. ISAPS data reports 34.9 million aesthetic procedures in 2023, with non-surgical treatments growing 5.5% faster than surgical ones. Biostimulators, stimulating extracellular matrix regeneration, are emerging as alternatives to collagen/hyaluronic acid fillers, yet lack extensive clinical data in China since the first biostimulator was approved in 2021. Injectable practitioners require deeper material insights to optimize safe, effective applications.

Materials / method: A cross-sectional study employing convenience sampling was conducted. Questionnaires were distributed to aesthetic medical professionals and patients with biostimulator experience. Physician and Patient surveys were collected offline between November 2024. Descriptive statistics were analyzed using SPSS 22.0, with absolute numbers and percentages (%) reported. The ranking questions were analyzed using the reverse scoring method.

Results: Biostimulators were widely applied for natural aesthetic outcomes (physicians: 84.0%; patients: 67.67%), particularly in facial treatments. Gender-specific preferences were observed, with males prioritizing contour definition and females favoring tightness and lifting. However, 40.0% of physicians expressed dissatisfaction with product longevity, while 39.2% desired enhanced efficacy. Additionally, 19.2%, 43.2%, and 14.4% of physicians reported dissatisfaction with pre-mixing protocols, storage stability, and post-injection massage techniques, respectively.

Conclusion: Biostimulators are increasingly utilized for their natural aesthetic outcomes, though safety remains the primary concern. Comprehensive preclinical data and reliable clinical evidence are critical for product selection. We advocate for collaborative efforts among manufacturers, frontline clinicians, and basic research professionals to develop detailed clinical guidelines and standardized training programs, thereby improving satisfaction among healthcare providers and patients alike.

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Objectives: Since the boom in fillers, cosmetologists have tried to solve many problems with their help: to restore volumes, to achieve lifting, to reduce wrinkles and much more. As a result, we came to the conclusion that many patients look "bloated", which is called overfill syndrome. But it is impossible to achieve lifting with the help of hyaluronic acid preparations. With their help, we restore the lost volumes. And for lifting into the lateral areas of the face, we use calcium hydroxyapatite.

Introduction: Mauricio De Matzo divided the face into lifting and volumetric parts. And this is anatomically justified. And in order to obtain aesthetic results while preserving individual facial features, it is necessary to inject drugs into the lifting zones that reduce excess skin, this is calcium hydroxyapatite. And in volumetric zones, use hyaluronic acid preparations.

Materials / method: I use calcium hydroxyapatite in two types, in dilution with physical solution and in pure form, as well as hyaluronic acid in one procedure in different areas of the face, and I will share detailed video injection techniques and the results of 10 years of using this technique.

Results: In the report, I will present a video demonstration of a hybrid rejuvenation technique with calcium hydroxyapatite and hyaluronic acid preparations in different areas of the face in one procedure. The preparation of calcium hydroxyapatite in dilution with saline solution to reduce excess skin, pure hydroxyapatite for camouflage of malar fat packages, and deep injections of hyaluronic acid with high g prime in the central areas of the face to restore insufficient volume.

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Objectives: The primary objective of this initiative is to introduce new minimally invasive procedures within the realms of authentic medicine and surgery

Introduction: The escalating demand for minimally invasive aesthetic procedures has catalyzed the advancement of innovative techniques that yield rejuvenating outcomes without necessitating extensive surgical interventions. This study presents a novel methodology for the transposition and fixation of tissues that avoids additional skin excision during Noninvasive forehead and facelift procedures. This technique employs endoscopic and US guidance to facilitate precise tissue dissection and manipulation

Materials / method: A prospective study was conducted involving 711 female patients and 47 male patients, aged 24 to 74 years, who underwent Minimally invasive forehead and facelift surgeries between January 2017 and March 2025. The procedures involved the transposition of forehead and facial tissues towards the temporal and occipital areas, executed without traditional skin excision. Temporal lines were employed for tissue fixation, thus eliminating the need for fixation devices such as screws or Endotines. Endoscopic and US visualization techniques were utilized to ensure precise tissue repositioning

Results: A total 758 patients underwent a Minimally-invasive forehead and facelift procedure, with no major complications reported. The evaluation of patient satisfaction was based on post-operative consultations, facial dimension measurements, and pre- and post-operative photographs for determining the level of satisfaction with the aesthetic outcomes.
The results demonstrated reduction in wrinkles, elevation of sagging tissues, and overall rejuvenation. 82% reported high levels of satisfaction and 15% of patients reported moderate improvement.

Conclusion: The transposition of tissues without the excision of excess skin, as well as the elimination of screws, Endotines, and other devices for tissue fixation under endoscopic and ultrasound guidance, represents a promising advancement in the field of Minimally-invasive facial rejuvenation. This technique facilitates the precise repositioning of tissues, yielding natural and youthful results while avoiding the scarring typically associated with conventional skin resection procedures. Furthermore, the reduced invasiveness and shorter recovery times associated with this approach

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Objectives: Diode and Nd: YAG lasers are used for hirsutism in Asian populations to achieve long-term hair reduction by targeting and damaging hair follicles. Diode lasers are effective for darker, thicker hair, while Nd: YAG lasers are suitable for various skin types, including darker skin tones, and penetrate deeper into the skin. The objective was to evaluate the efficacy and safety of the DIODE and long-pulse Nd: YAG laser on Asian Type IV-V skin.

Introduction: Facial hirsutism and hypertrichosis are common problems, and dermatology offers several methods for unwanted hair in many patients. The theory of selective photo thermolysis, a safe and effective method when operated by trained and experienced professionals, has revolutionised hair reduction. Before starting laser therapy, assessing the skin type, the fluence, the pulse duration, and the type of laser to be used is crucial for safety and outcome.

Materials / method: Seventy-five patients completed their treatment course with DIODE and long-pulsed Nd: YAG (1064 nm) with fluences between 16 J/cm2 and 20 J/cm2. The average hair density reduction was assessed using hair count on digital photographs at 1, 3, 6 and 9 months. Efficacy of hair reduction was graded according to a 4point visual scale from poor to excellent — poor < 25% reduction in hair from baseline; fair < 25–50% reduction in hair from baseline, good < 50–75% reduction in hair from baseline; and excellent > 75% reduction in hair from baseline.

Results: Six sittings of the Diode laser were done in all subjects within six months. At the third follow-up visit, the percentage of hair reduction was fair in 5.4% of patients, excellent in 73% of patients in group A and fair in 5.3%, excellent in 68.4% of patients in group A. In contrast, at the final follow-up visit, it was excellent in 81.1% of patients in group A and 50% in group B. P-value was significant (P 0.026). Erythema was observed to be the most common complication in both lasers, 32.4% and 26.3% of cases. The diode laser showed more efficacy and was more comfortable than the Nd: YAG las

Conclusion: For Asian skin with dark hair, the diode laser remains the preferred choice. However, it's important to note that the diode laser has a narrow margin of safety. Proper pre- and post-procedure cooling is crucial to minimise complications. Despite the diode laser's higher efficacy, it's worth considering that the side effects of the Nd: YAG laser are less in darker skin, making it a viable alternative.

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Objectives: This study evaluates the efficacy and safety of Autologous & Tissue-specific Exosomes using Autologous Micrografting Technology (AMT) in promoting hair regrowth in Androgenetic Alopecia.

Introduction: Hair loss resulting from androgenetic alopecia (AGA) benefits from advanced regenerative approaches that bridge medical and surgical modalities to optimize hair regrowth by stimulating follicular regeneration and enhancing scalp health. The autologous and tissue-specific exosomes obtained by AMT, has emerged as a promising strategy that leverages the body's intrinsic regenerative capacity.
AMT technology enables the precise obtaining of patient-specific progenitor cells, exosomes, growth factors and extracellular matrix components, facilitating targeted tissue-specific paracrine communication.

Materials / method: A systematic review was carried out following PRISMA guidelines, covering studies from 2019 to 2025 that evaluated the use of AMT for hair regrowth in AGA. Databases searched included PubMed, Scopus, and Embase, using keywords like “autologous micrografts,” “exosomes,” and “hair loss.” Studies involved male and female patients with early to moderate AGA. Treatments used scalp tissue processed through approved and registered medical devices to produce a biological suspension without enzymes or lab culture.

Results: AMT-derived exosomes showed strong efficacy in treating AGA, with 18–29% hair density gains and up to 24% thicker shafts in 6–12 months. Anagen/telogen ratios improved, and 77.8% of men, 81.2% of women reported visible results after one session. A 12.3 hairs/cm² increase was seen in females at 3 months. AMT was safe with mild erythema resolving quicly. No serious side effects were reported, and >90% of patients were satisfied. Contraindicated in late-stage AGA and inflamed scalps.

Conclusion: AMT containing tissue-specific and non manipulated exosomes represents a safe and an effective alternative for hair restoration in males (MPHL) and females (FPHL). AMT is a personalized approach using patient own regenerative potential to regulate the normal hair follicle function and improve hair density.

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Objectives: Objectives: 1. To define teledermatology and its role in modern dermatological care.


2. To explore how teledermatology can assist in diagnosing and managing alopecia areata.


3. To examine the advantages and limitations of teledermatology in alopecia areata treatment.


4. To discuss the technology and tools used in teledermatology for alopecia areata.

5. To identify best practices and future potential for teledermatology in hair loss disorders

Introduction: Introduction: Teledermatology has become an essential tool in dermatological care, particularly during and after the pandemic. With advancements in digital health, dermatologists can now manage various skin and hair disorders remotely. Alopecia areata, an autoimmune condition characterized by sudden hair loss, is one such condition that benefits from virtual consultation and follow-up through teledermatology.

Materials / method: Materials / method: Teledermatology utilizes synchronous (real-time video consultations) and asynchronous (store-and-forward) methods to evaluate skin and hair conditions. Technologies such as high-resolution images, teletrichoscopy (remote scalp examination), and specialized mobile apps play a key role in diagnosing and monitoring alopecia areata. These tools help dermatologists assess scalp conditions, identify hair loss patterns, and adjust treatments based on patient feedback and clinical images.

Results: Results: In cases of alopecia areata, teledermatology has proven effective in providing early diagnosis and timely interventions. Patients experience improved access to specialized care, reduced travel, and consistent follow-ups, all contributing to enhanced patient outcomes. Furthermore, patient satisfaction with teledermatology is high, with mConclusion: Teledermatology offers a promising, cost-effective solution for managing alopecia areata. While challenges remain, such as the need for better integration of tools and standardization of guidelines, the potential to improve patient care and

Conclusion: Conclusion: Teledermatology offers a promising, cost-effective solution for managing alopecia areata. While challenges remain, such as the need for better integration of tools and standardization of guidelines, the potential to improve patient care and expand access to dermatological expertise is undeniable. Future developments in telemedicine may further revolutionize how alopecia areata is diagnosed and treated.

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Objectives: The objective of this study is to explore the unique characteristics of Asian beauty ideals, which emphasize radiance, balance, and subtlety, and to demonstrate how aesthetic treatments such as Poly-L-lactic acid (PLLA-SCA) and hyaluronic acid (HA) skinboosters can enhance these attributes. This presentation aims to provide a holistic approach to addressing both facial harmony and skin quality, empowering Asian women to embrace their individuality and achieve self-acceptance.

Introduction: Asian beauty ideals emphasize harmony, balance, and radiance, valuing soft contours and flawless skin over dramatic transformations. The concept of "glass skin," popularized in Korean beauty, reflects the importance of radiant, hydrated skin as a symbol of vitality. Growing up in Hong Kong, I experienced the contrast between Western and Asian beauty standards, which shaped my appreciation for subtle, natural enhancements. Treatments like HA skinboosters and PLLA-SCA align with these ideals, offering a holistic approach to skin radiance and facial harmony while empowering self-confidence.

Materials / method: This study analyzed Asian beauty ideals, focusing on the cultural emphasis on harmony, radiance, and subtlety. Hyaluronic acid (HA) skinboosters were evaluated for improving hydration, texture, and achieving the "glass skin" effect. Poly-L-lactic acid (PLLA-SCA) was assessed for its ability to restore volume, stimulate collagen, and enhance facial harmony. A holistic approach combining HA skinboosters and PLLA-SCA was implemented, addressing both skin quality and facial contours. Case studies were used to illustrate how these treatments align with Asian aesthetic preferences.

Results: HA skinboosters improved skin hydration, elasticity, and texture, achieving the luminous "glass skin" effect. Patients reported smoother, radiant skin with reduced fine lines and improved confidence. PLLA-SCA restored volume in areas like the temples, cheeks, and jawline, creating balanced facial harmony with natural-looking results. The combination of HA skinboosters and PLLA-SCA provided a comprehensive solution, addressing both skin quality and contours. Patients expressed high satisfaction, appreciating the subtle enhancements that respected their natural features and cultural values.

Conclusion: Asian beauty ideals emphasize radiance, balance, and subtlety, reflecting cultural values of harmony and natural elegance. HA skinboosters and PLLA-SCA offer effective solutions for enhancing these attributes. HA skinboosters improve skin quality, achieving the "glass skin" effect, while PLLA-SCA restores facial harmony through subtle volume restoration. Combined, these treatments empower patients to embrace their individuality and achieve self-confidence, promoting a more inclusive and holistic understanding of beauty.

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是
请注明名称（个人，公司，学会等等）: Galderma

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Objectives: This lecture explores ultrasound as a transformative tool in aesthetic medicine, not only for safety but also for precision and facial analysis. Attendees will learn how real-time imaging enhances filler placement, prevents complications, and provides a new, science-backed approach to facial assessment, improving treatment outcomes.

Introduction: Ultrasound technology is reshaping aesthetic medicine by offering unparalleled visibility beneath the skin. This session introduces its role in enhancing safety, optimizing injection techniques, and redefining facial analysis to achieve personalized, natural results.

Materials / method: This lecture will cover the essentials of ultrasound in aesthetics, including device characteristics, vascular mapping, and guided filler injections. Simple case studies will demonstrate how ultrasound enhances safety, precision, and facial assessment, providing a practical approach for everyday clinical use.

Results: Ultrasound integration significantly reduces complications, enhances precision in aesthetic procedures, and allows for a more individualized treatment approach. Clinical findings show improved patient outcomes and a higher level of procedural confidence among practitioners.

Conclusion: Ultrasound is not just a safety tool but a revolution in aesthetic medicine. By incorporating this technology, practitioners gain an advanced, science-driven approach to injections and facial analysis, leading to safer, more predictable, and highly personalized treatments that elevate aesthetic practice standards.

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Objectives: 1. Understand the principles and characteristics of dual-molecular PDLLA biostimulators.
2. Learn a personalized injection technique using small and large PDLLA for full-face rejuvenation and lifting.
3. Apply targeted PDLLA injection mapping to address volume loss, skin laxity, and texture refinement.

Introduction: - This presentation proposes a structured, dual-molecular PDLLA injection protocol as a novel alternative to conventional fillers for full-face rejuvenation. By integrating small and large particle types across anatomical zones, the technique provides natural volumization, contour lifting, and skin refinement. With growing concern over filler-related complications, this method represents a forward-looking, safe, and reproducible injectable strategy in aesthetic medicine.

Materials / method: - Small-particle PDLLA was reconstituted with 5 cc normal saline and 1 cc Xylocaine (no adrenaline), injected into infraorbital and medial midface using fanning and bolus techniques in sub-dermal plane. Large-particle PDLLA was mixed with 7 cc normal saline and 1 cc Xylocaine, injected via fanning technique into temporal, zygomatic arch, preauricular, and jawline areas for volumization and lifting. Both used 25G cannula or 30G needle depending on area.

Results: - Visible facial lifting observed 1 month post-treatment with dual-molecular PDLLA. Brow elevation, jawline contour, and infraorbital hollowness improved. Skin showed enhanced firmness, refined texture, and reduced pore size. Rejuvenation effects were seen across treated areas. No major adverse events reported. Technique highlights the synergy of small and large PDLLA in layered facial biostimulation.

Conclusion: - This study supports the efficacy of dual-molecular PDLLA injection for full-face rejuvenation. Objective improvements were observed in brow elevation, jawline definition, pore size reduction, and skin texture at 1-month follow-up. No significant adverse events were reported. The protocol demonstrates a safe, anatomy-guided, and customizable approach with high patient satisfaction and minimal downtime.

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Objectives: simplify the management of androgenetic alopecia in aesthetic practice. Focus to 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 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.

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, microneedling, and LLLT 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 practice.

Conclusion: Managing AGA doesn't require complex algorithms, we just 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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Objectives: This study is dedicated to constructing a precise visual diagnosis system for the generalized "facial over-filling syndrome". Through the integration and analysis of multi-dimensional data, it aims to achieve the rapid identification and classification of different symptoms. Meanwhile, personalized aesthetic restoration plans will be formulated to improve the patients' facial morphology and functions, provide standardized diagnostic and treatment norms for the medical aesthetics industry, and promote the healthy and sustainable development of the industry.

Introduction: Facial filling techniques have gained wide popularity due to their effectiveness in improving facial contours. However, the "facial over-filling syndrome" caused by over-filling has become increasingly prominent. It manifests as facial swelling, stiff expressions, abnormal proportions of facial features, etc., which not only affect aesthetics but may also pose potential health risks. Due to the lack of unified diagnostic criteria and effective restoration plans, it has severely restricted the development of the medical aesthetics industry.

Materials / method: Clinical cases of patients of different ages, genders, and regions are collected. High-frequency ultrasound and multi-angle photography are used to obtain facial data. Based on the diagnostic results, personalized restoration plans combining non-surgical methods and surgical methods (such as removal of filling materials and thread lift repair) are adopted, and the effects are evaluated through long-term follow-up.

Results: The visual diagnosis system has been successfully constructed, with a diagnostic accuracy rate exceeding 90%. The personalized restoration plans have significantly improved the facial appearance of 90% of the patients, restored their functions well, and achieved a satisfaction rate of over 90%, with stable long-term effects.

Conclusion: The diagnostic and restoration system established in this study is scientific and effective, providing a reliable basis for clinical practice in medical aesthetics and helping to standardize industry operations. In the future, the research scope will be expanded, and the diagnosis and treatment system will be optimized to improve the quality of medical aesthetics services.

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