IMCAS

Management of complications in gluteal harmonization: Clinical experiences over 18 years

Objectives: To present a series of complications and their management in gluteal harmonization, including nodules, hematoma, seroma, migration, infection, and retractions, based on the author’s 18 years of clinical experience

Introduction: Gluteal harmonization, while effective in enhancing aesthetic appearance, can lead to various complications. This abstract details the author’s 18 years of clinical experience in identifying and managing these complications, providing insights into effective treatment strategies.

Materials / method: The author’s extensive experience involved managing complications such as:

1. Infection and Migration with Hydrogel:
Managed by complete removal of the product, often requiring additional sessions, with some cases progressing to seromas.
2. Palpable Migration with Hyaluronic Acid:
Treated by puncture and manual expression.
3. Solid Nodules with PMMA:
Addressed with aspiration using a special needle, combined with corticosteroid and 5-fluorouracil.
4. Hematomas and Seromas:
Handled with drainage, compression techniques, and intralesional medication.

Results: Photographic and video evidence before and after treatment, along with detailed management information, demonstrated the effectiveness of the strategies employed. The treatments showed significant success in resolving complications and improving patient outcomes.

Conclusion: This abstract provides a detailed account of the author’s clinical experiences over 18 years in managing complications from gluteal harmonization. Effective management of complications such as nodules, hematoma, seroma, migration, infection, and retractions is crucial for patient safety and satisfaction. The cases presented highlight the importance of tailored treatment approaches to address specific issues, ensuring optimal results and minimizing adverse effects.

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Next-generation aesthetics: Integrating HA fillers, skin boosters, and laser for superior outcomes

Objectives: To demonstrate the clinical efficacy of Smart Combination Therapy—integrating PEGylated HA fillers, non-crosslinked HA with CaHA, and laser treatment—in addressing facial rejuvenation and acne scar improvement. Through two distinct cases, this study highlights how a personalized, minimally invasive approach can optimize outcomes, enhance skin quality, and reduce product use while achieving natural, long-lasting aesthetic results

Introduction: As aesthetic medicine continues to evolve, the focus has shifted toward combining modalities to enhance both structure and skin quality. This presentation introduces Smart Combination Therapy, which integrates PEGylated HA fillers, non-crosslinked HA with CaHA, and laser treatment. Through two clinical cases, we explore how this strategic, minimally invasive approach can deliver natural, long-lasting results in facial rejuvenation and acne scar treatment.

Materials / method: Two patients were treated using Smart Combination Therapy. Case 1 involved facial rejuvenation using non-crosslinked HA with CaHA and PEGylated HA fillers in two phases—hydration and structural enhancement. Case 2 focused on acne scar treatment using PEGylated HA filler injection followed by fractional laser resurfacing. Techniques, product selection, and injection planes were customized based on individual facial anatomy and treatment goals.

Results: Case 1 showed visible improvement in midface volume, tear trough, and jawline definition with sustained results at 11 months. Case 2 demonstrated significant reduction in acne scar depth, improved skin texture, and hydration at both 1- and 6-month follow-ups. Both cases achieved natural-looking outcomes with minimal product use and downtime, supporting the effectiveness of a layered, combination approach in aesthetic treatment.

Conclusion: Smart Combination Therapy offers a strategic and efficient approach to facial rejuvenation and scar treatment. By integrating PEGylated HA fillers, non-crosslinked HA with CaHA, and laser technology, natural and long-lasting results can be achieved with less product and downtime. These cases highlight the importance of individualized treatment planning and modality synergy in modern aesthetic practice

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New developments in thread lifting in Japan

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 November and December 2023 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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Navigating the overload: When to choose skinboosters, hybrids, or collagen stimulators?

Objectives: To provide practitioners with a practical framework for selecting the most appropriate injectable treatments—such as skinboosters (e.g., HA, PDRN or collagen type I/iii), hybrids (e.g., HA with CaHA, CMC with PCL), HA fillers, or collagen stimulators (e.g., PLLA or CaHA)—based on patient-specific goals and clinical needs. This session emphasizes the importance of versatility, customization, and individuality. By understanding the unique mechanisms, indications, and outcomes of these ingredients, practitioners can confidently deliver tailored, safe, and effective aesthetic treatments.

Introduction: In aesthetic medicine, achieving optimal outcomes requires a systematic approach to patient care. With a wide range of injectables available—ranging from hyaluronic acid to collagen stimulators—practitioners must navigate complex decisions to address diverse patient needs. A structured framework can simplify this process by guiding clinicians through assessment, concern identification, product selection, and treatment planning. The PLAN approach (Profile, Locate, Apply, Navigate) offers an intuitive, step-by-step method to deliver safe, effective, and personalized aesthetic treatments.

Materials / method: The PLAN approach streamlines treatment selection: "P"Profile the patient by assessing age, skin quality, anatomy, and goals. "L"Locate the primary concern, such as skin texture, volume loss, or rejuvenation needs. "A"Apply the right product by matching concerns to solutions—HA/PDRN for hydration, hybrids for contouring, or collagen stimulators for structural improvement. "N"Navigate a tailored treatment plan to ensure safety, efficacy, and patient satisfaction. This step-by-step method optimizes outcomes in aesthetic practice.

Results: By applying this step-by-step framework, practitioners can effectively address diverse patient needs with precise treatment selection and planning. Skinboosters improve hydration and skin texture, hybrids provide volume and contouring with immediate correction, and collagen stimulators offer long-term structural rejuvenation. Tailored protocols ensure optimal safety, efficacy, and patient satisfaction, empowering aesthetic physicians to deliver personalized and innovative outcomes while navigating the wide array of injectable options with confidence.

Conclusion: The PLAN approach—Profile, Locate, Apply, Navigate—provides a structured framework for optimizing treatment outcomes in aesthetic practice. By thoroughly assessing patient needs, identifying primary concerns, matching the right products, and crafting tailored treatment plans, practitioners can achieve precise, effective, and personalized results. This method ensures safety, enhances patient satisfaction, and empowers clinicians to navigate the wide range of injectable options with confidence and consistency in achieving aesthetic goals.

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请注明名称（个人，公司，学会等等）: Galderma

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Open rhinoplasty with rib cartilage graft: A novel spring-shaped carving technique to prevent cartilage warping

Objectives: To advance and refine the use of rib cartilage in nasal
augmentation by developing a technique that minimizes
the risk of cartilage warping in both the short and long
term. This study aims to establish a more structurally
stable and reliable approach to rib cartilage grafting,
enhancing both aesthetic and functional outcomes in
open rhinoplasty.

Introduction: Cartilage warping remains a persistent challenge in open rhinoplasty,
often compromising both aesthetic results and structural integrity. While
various techniques have been proposed to mitigate this issue, a
consistently reliable solution has yet to be established.
This study presents a novel surgical approach developed by Dr. Teerasut
Wattanajindaporn to prevent warping of rib cartilage used for dorsal
augmentation. The technique has been clinically applied in surgical cases,
with both short- and long-term follow-ups demonstrating promising
stability and graft integration.

Materials / method: This study introduces a spring-shaped carving technique designed to
improve the stability of rib cartilage grafts in open rhinoplasty. The
technique involves using a scalpel to precisely sculpt rib cartilage into a
spring-like configuration, allowing for controlled flexibility and
curvature while minimizing the risk of postoperative warping. This
modification ensures that the cartilage adapts naturally to nasal
contours while maintaining its structural integrity.
The technique was applied in clinical cases with short- and long-term
follow-ups to assess its effectiveness.

Results: This study is based on clinical observations and
practical application rather than statistical analysis.
The findings suggest that the spring-shaped carving
technique enhances graft stability and reduces the
likelihood of cartilage warping in rib cartilage grafting
for open rhinoplasty.

Conclusion: This study highlights the benefits of the spring-shaped carving technique for rib cartilage grafting in open rhinoplasty. It enhances flexibility and stability while minimizing warping, ensuring natural conformation to the nasal dorsum. Despite being based on clinical observations, consistent outcomes suggest its reliability for long-term contour stability. Further research is needed to validate its efficacy, especially in complex and revision cases, contributing to the advancement of rhinoplasty techniques.

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Minimally invasive eyelid lift

Objectives: This presentation introduces a novel approach to upper eyelid rejuvenatio, the Minimally Invasive Eyelid Lift (MINEL), which involves tucking the upper eyelid skin rather than excising it.

Introduction: The trend towards minimally invasive procedures in aesthetic surgery has led to the development of techniques that prioritize tissue preservation. MINEL procedure involves upper eyelid rejuvenation by tucking in the excess skin.

Materials / method: We included patients with dermatochalasis and underwent MINEL procedure. The technique involved creating small incisions, tucking the excess skin inwards, and securing it with non absorbable sutures.

Results: Thirty patients underwent MINEL procedure, all reported positive functional and aesthetic outcomes. The technique effectively reduced redundant skin, preserved natural eyelid creases, and resulted in minimal to no scarring. The procedure duration was 20-45 min, with rapid recovery and return to activities. This technique offers significant advantages, including reduced downtime, a quicker procedure, and the preservation of natural eyelid anatomy, resulting in outcomes that are both effective, subtle, with no telltale sign of surgery.

Conclusion: MINEL offers a promising tissue-preserving alternative to traditional upper blepharoplasty, providing natural aesthetic outcomes with minimally scarring and faster recovery.

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Plasma radiofrequency-assisted microsuction for the treatment of Facial Overfilled Syndrome induced by diverse causes in Asian populations

Objectives: 1.Categorize the inducement of facial overfilled syndrome（FOS).
2.Introduce a new treatment method of FOS.
3.Evaluate the clinical outcomes and safety of the study device and surgical procedure.

Introduction: In Asia, facial overfilled syndrome (FOS) can arise from iatrogenic causes involving the excessive use of filling materials, as well as physiological causes such as adipose tissue hypertrophy type, age-related type, and lacuna type. This study aimed to demonstrate the safety and effectiveness of plasma radiofrequency-assisted microsuction (PRFAMS) for improving the appearance of FOS induced by various causes.

Materials / method: PRFAMS was performed on 84 anatomical regions of 37 female patients (including 12 with physiological causes, 6 with hyaluronic acid causes, and 19 with fat causes), aged between 20 and 50 years (mean, 35.9 years), who had FOS. Demographic and surgical data were collected retrospectively. Preoperative and postoperative photographs were taken, and satisfaction interviews were conducted at least six months after surgery.

Results: All patients underwent the operation successfully under local or intravenous anesthesia. Only four anatomic regions showed noticeable asymmetry post-surgery requiring a secondary operation. Additionally, five patients with longer edema periods demonstrated substantial improvement after more than five weeks. No cases of skin necrosis, thermal injury or other serious complications related to the study device or procedure were reported. Ultimately, all patients expressed satisfaction with their outcomes.

Conclusion: The PRFAMS technique is a safe and effective method for treating FOS induced by various causes,while minimizing complications and ensuring high patient satisfaction.

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The effective combination procedures for correcting complications of dermal filler injections and biostimulator injections

Objectives: Our clinical study objects to develop the protocol for treatment complication of Dermal fillers and Biostimulator as CaHA or PLLA, the complication prevention and identify appropriate candidates for Dermal fillers and Biostimulator injections based on patient-specific factors, such as age, skin condition, and desired aesthetic outcomes.

Introduction: Dermal fillers and Biostimulator as CaHA or PLLA are generally accepted and worldwide used in facial shaping and beautification nearly 2 decades as safe and well-tolerable aesthetic procedures ,but complications reaction still forms a prognostic problem, the summarized of complication are composed of immediate and early onset complication as bruising,erythema,bacterial infection, Herpes infection,dysesthesia, paresthesia,anesthesia,retinal artery occlusion,lump,vascular compromise and Retinal Artery Occlusion( the most severity),and also late or delayed onset complications.

Materials / method: 10 patients were enrolled voluntarily in our study. We separated the complications to 2 groups as Group A (5 patients) is Dermal filler complication and Group B (5 patients) is Biostimulator as CaHA or PLLA complications, the diagnosis was provided as early onset complication or late/delayed onset complications, the complications were categorized as infection/non infection and inflammations/non inflammations. Specific treatment were performed as Hyaluronidase in all cases of dermal filler, systemic antibiotic/antiviral were provided in case of infection.RF 3 Hz were provided in all cases

Results: All of 10 patients were satisfied and recovered. For dermal filler complication after hyaluronidase were injected, the lump/nodule were dissolved in all cases. All cases of bacterial infection (50%of cases), Clindamycin/Vancomycin were performed duration for 7 days, clinical were improved with in 7days.All cases with inflammation (50%of cases) were subsides after local triamcinolone injection. Increased vascularization, homogeneous skin color and decreased soft tissue fibrosis resulted from of Radiofrequency 3Hz with capacitive transmission head treatment in 28 days.

Conclusion: The effective combination procedures in our study could be the effectiveness way to be guideline for treatment the complications of dermal filler injection and biostimulator injection.

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Paradoxical effect: Increase in penile length secondary to restructuring of the dartos fascia by circumferential injection of hyaluronic acid

Objectives: Objectives

Evaluate effects of hyaluronic acid injection under Dartos fascia in patients with varying penile sizes. To assess changes in penile dimensions, including length, circumference, and diameter, along with patient satisfaction and follow-up of outcomes.

Introduction: Introduction

Penile dissatisfaction due to size can significantly impact self-esteem. Minimally invasive techniques like hyaluronic acid (HA) injections gained popularity for penile augmentation. HA injections show promise in improving girth and length, addressing issues like the small penis syndrome and Peyronie's disease.

Materials / method: Methodology:

Patients underwent penile augmentation with hyaluronic acid. Injections were administered under the Dartos fascia using predetermined volumes. The technique involved dermal filling using multiphasic, 100% cross-linked hyaluronic acid with a high G-prime, applied circumferentially under the Dartos fascia. This filler, produced with R2 technology, was administered at a ratio of 2.09 ml/cm, supplemented by 0.46 ml/cm of filler produced with IPN-Like Technology. Measurements of penile dimensions were recorded, along with any adverse events reported by patients, and changes in functio

Results: Results

The procedure utilizing hyaluronic acid injections for penile augmentation yielded highly satisfactory outcomes. Patient-reported data indicated significant contentment post-intervention.
Prior to the procedure, a patient presented with a flaccid penile length of 4.3 cm and diameter of 2,4 cm. There was a notable increase to 7.8 cm in length and 3.5 cm in diameter observed when the penis was flaccid. Importantly, no adverse events were observed, and the patient did not report any functional complaints.

Conclusion: Conclusion

Expanding understanding and practice of genital aesthetic procedures with hyaluronic acid injections is essential. By better studying efficacy, safety, and patient satisfaction, this technique emerges as a highly promising option. In conclusion, these procedures represent a valuable contribution to male sexual health and patient quality of life.

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请注明日期: Approved
和审阅情况: Patent on the method developed by me

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Injection strategy of the lateral temporal region and cranioauricular angle for upper facial contour

Objectives: Non-surgical facial contour and anti-aging are common aesthetic requests among Chinese patients. Treatment with soft-tissue filler is the preferred option as the procedures are less invasive with minimal downtime. Injection of the lateral temporal region and cranioauricular angle provides pleasing for both anti-aging and facial contour. In this presentation, treatment method and injection strategy of the lateral temproal and cranioauricular region are discussed.

Introduction: A semi-circled upper face outer rim and smooth calvarium-lateral temple-zygomatic arch transition meets not only the Chinese traditional physiognomy, but also our current aesthetic perspective. Fullness of the lateral-temporal region (within the hairline) is crucial in creating a semi-circled upper face outer rim contour. Furthermore, other than full and well contoured lateral temple, slightly protruded ears would also visually help concealing the zygomatic arch, as well as making the lower face look smaller in contrast.

Materials / method: The widest point of the lateral-temporal region (point W) should be vertical to the tragus, and horizontal to the mid-forehead line. First, inject on the supra-periosteum plane with a needle at the widest point of the lateral-temporal region to support the surrounding tissue. Then, inject around point W, to smooth the transition between the calvarium, lateral temple, and the zygomatic arch. More products can be place under the superficial temporal facia with a cannula if necessary. For optimal contouring results, more products can be injected to increase the cranioauricular angle.

Results: A round and full lateral temporal region would produce a well defined semi-circled upper face outer rim, and a concealed zygomatic arch . By increasing the cranioauricular angle and auricular show at frontal view, the protruded ears would further help reduce zygomatic arch prominence and lower face width in visual contrast. Addition session can be performed four to six weeks after if necessary.

Conclusion: With the proper indication, injection to the lateral temporal and cranioauricular region is a pratical method for both facial contour and anti-aging.

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Aesthetic lips via surgery

Objectives: -Anatomy of normal lip
-Charming lip
- deformity of lip which should correct by surgery
-Common aesthetic lip surgery: lip reduction, lip augmentation, upper lip lift, coner of mouth lifting
- Complications and how to deal with

Introduction: Aesthetic lip surgery, also known as cosmetic lip surgery, refers to a range of surgical procedures designed to enhance the appearance, shape, size, and proportion of the lips. Aesthetic lip surgery aims to address these concerns by improving lip contours, increasing volume, or correcting asymmetry to achieve a more balanced and youthful look. Common procedures include lip augmentation (using implants, fat grafts, or fillers), lip reduction (to reduce overly large lips), and lip lifts (to enhance the vermilion border and restore youthful proportions).

Materials / method: Oral presentation with vdo clip

Results: Participants will know about common lip problems that may be better achieve the cosmetic goal by surgery rather non surgical methods.

Conclusion: As with any cosmetic surgery, aesthetic lip surgery seeks to align the desired outcomes with the patient's unique facial features and preferences, ensuring a natural and harmonious enhancement with can not be achieved by non surgical ways.

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Benefits of combining multiple injection materials for anti-aging

Objectives: "This lecture aims to explore the clinical benefits of combining multiple injection materials in anti-aging treatments. Through participation in this lecture, attendees will be able to:
Understand the multiple aspects of facial aging and their impact on treatment approaches
Identify the characteristics and applications of different injection materials (polycaprolactone, poly-L-lactic acid, hyaluronic acid, and calcium hydroxylapatite)
Master strategies and techniques for combining multiple injection materials
Learn how to select optimal material combinations based on individual patient needs

Introduction: With aging, facial changes manifest in multiple aspects, including skeletal changes, ligament laxity, deep fat compartment alterations, temporal hollowing, and skin texture changes. These complex aging processes require comprehensive treatment approaches, as single injection materials often fail to achieve ideal results. This study explores the clinical benefits and personal experiences of combining multiple injection materials in anti-aging treatments.

Materials / method: The main injection materials used in this research include polycaprolactone, poly-L-lactic acid, hyaluronic acid, and calcium hydroxylapatite. Each material has distinct characteristics: the first two promote long-term collagen regeneration, suitable for point-to-point and space-to-space injections respectively; the third provides immediate hydration and volumizing effects, particularly suitable for sunken eye areas; the fourth helps improve skin texture.

Results: Clinical practice has revealed significant advantages of combining multiple injection materials: first, they provide comprehensive solutions for different aging phenomena; second, they combine immediate and long-term effects; third, they allow selection of the most suitable material combinations for different facial areas; fourth, they enable personalized treatment plans. For example, in the periorbital area, combinations of polydioxanone, collagen, hyaluronic acid with fibroblasts, and poly-L-lactic acid can be used; for facial contours, polycaprolactone can be used with firm hyaluronic acid

Conclusion: The conclusion indicates that combining multiple injection materials overcomes the limitations of single products, providing patients with more comprehensive, lasting, and natural anti-aging results. This integrated treatment approach not only improves patients' appearance but also enhances patient satisfaction and predictability of treatment outcomes.

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Mechanistic investigation of the combined use of botulinum toxin and photothermal therapy in androgenetic alopecia

Objectives: To assess the efficacy of a multimodal treatment regimen including botulinum toxin (BoNT), low-level laser therapy (LLLT), finasteride , and minoxidil in enhancing hair density and thickness in patients with androgenetic alopecia (AGA), compared to standard therapy.
The integration of novel modalities into traditional AGA treatments is gaining interest for improved therapeutic outcomes. This study introduces a combined protocol featuring BoNT and LLLT alongside standard pharmacologic treatments, evaluating its clinical potential through a controlled, split scalp trial.

Introduction: Androgenetic alopecia (AGA) is a prevalent condition with significant psychosocial impact. Standard therapies like finasteride and minoxidil show limited efficacy for some patients. Combining BoNT and LLLT with standard treatments may enhance outcomes. This study investigates the benefit of such a multimodal approach.

Materials / method: In this randomized, split scalp trial, participants received the combined therapy (BoNT, LLLT, finasteride, and minoxidil) on one side of the scalp and standard treatment (finasteride and minoxidil) on the other. Assessments included trichoscopic analysis of hair density and diameter at baseline and 12 weeks. Pain scores and adverse effects were also documented.

Results: Thirty-two patients completed the study. The combined therapy side showed significantly increased hair density (p<0.001) and greater hair thickness (p=0.02) compared to the standard treatment side. Mild pain was reported with BoNT injections, but no serious adverse events occurred.

Conclusion: Multimodal therapy combining BoNT, LLLT, finasteride, and minoxidil offers superior improvement in hair density and thickness in AGA patients compared to standard treatments. This strategy may represent a promising, more effective approach for AGA management, meriting further investigation.

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请注明名称（个人，公司，学会等等）: 1. Department of Plastic and Cosmetic Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai，200092, PR China. 2.Institute of Aesthetic Plastic Surgery and Medicine, School of Medicine, Tongji University, Shanghai, 200065, PR China

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这项工作的完成感谢以下机构的支持： Institute of Aesthetic Plastic Surgery and Medicine, School of Medicine, Tongji University, Shanghai, 200065, PR China

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