IMCAS

Guidelines for injection techniques complete facial rejuvenation using the 3D vectoring lift

Objectives: • understanding aging process
• what are face fixed and mobile areas
• facial fat compartment
• what is 3D vectoring lift?

Introduction: The ageing process and tissue mobility The human face does not age uniformly. We can distinguish fixed areas and mobile areas,
Fixed areas of the face will mostly stay in position.
Mobile areas, In between the fixed areas of the face, we find mobile areas more
subject to gravity
Retaining Ligaments. The retaining ligaments of the mid-lateral face maintain the skin in its normal anatomic position, but they become less tight during the ageing process so they have to be strengthened to lift the face.
What is 3D Vector?: The changes in the face due to ageing can be denoted as the
“negative vector"

Materials / method: Using biostimulant dermal filler by vectoring techniques and strengths the retaining facial ligaments to achieve natural non-invasive facial lift without adding volume by minimal amount of products.
Two methods used:
- By cannulas
- By needles

Results: -Non-invasive natural soft tissue facial lifting without adding volume by minimal amount of products and the results lasts more than one year.
-Skin rejuvenation
-Scars treatment

Conclusion: -Providing non-invasive instant 3D face lifting without adding excess volume with skin rejuvenation using very simple injection technique with minimal amount of biostimulant dermal filler.
-Long lasting 3D lifting, lunch hour procedure, no down time needed & suits all genders, races and ages.
-Less in cost comparing with devices, threads and other old techniques

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Correction of age-related changes in the face with the combined usage of thread methods and calcium hydroxyapatite

Objectives: -Modificate of thread lifting procedure with using calcium hydroxyapatite.
-Getting natural and maximal appearance from combinative procedures
-Enhance dermal elasticity and stimulation neocollagenesis on aged skin
-Achieve long-lasting cosmetic and aesthetic effects

Introduction: Age-related facial dermal laxity is common problem of 35+ patients who visits cosmetologist and aesthetists. Main complains is losing turgor and elasticity of facial skin in nasolabial, jawl, prejawl and mandiblar line regions.

Materials / method: Combination of Thread Lifting Procedure and Calcium Hydroxyapatite

Results: -visual improvement of marionette lines
-dysappearance of sagged jawl
-stimulation of neocollagenesis
-long lasting lifting effect

Conclusion: The usage of calcium hydroxyapatite with dilution, at the first stage of correction,
followed by the use of helical absorbable threads from a copolymer of L-lactide
with e-caprolactone:
- Leading to a pronounced external effect of correcting drooping corners of the mouth
- This method also leads to improved quality and therapeutic skin lifting

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Topical agents in the treatment of melasma

Objectives: To aim is to discuss the efficacy and safety of current available topical agents in the treatment of Melasma

Introduction: Melasma is an acquired, highly prevalent, refractory pigmentary disorder caused by hypermelanosis of the skin. This condition is known to occur in all race/ethnic groups, most commonly affecting women with darker skin phototypes (III to VI). The classic topical lightening products such as hydroquinone or triple combination cream are mainstay treatment. However, treatment for Melasma remains challenging due to its chronicity and high recurrence rate. Recent studies have shown therapeutic efficacy on new topical formulations with varying efficacy.

Materials / method: This systemic review and meta-analysis assesses the efficacy and safety of topical agents for the treatment of Melasma.

Results: Forty-nine studies involving 2,319 participants, age range from 18-65 years (mean age 38.15) with skin phototypes II-VI from 12 different countries were included. A total of 75 treatment regimes, with topical hydroquinone, triple combination creams, hydroquinone-containing agents, tranexamic acid, azelaic acid, cysteamine, silymarin, kojic acid and zinc sulfate were included in the analysis. The overall analysis demonstrated no significant difference 5.5 (95% CI [-6.5; -4.5]) among treatment subgroups (p < 0.001).

Conclusion: Hydroquinone and hydroquinone-free topical agents shown similar efficacy. Hydroquinone-free topical agents should be encouraged for the treatment of Melasma, especially for patients on hydroquinone drug holiday or hydroquinone sensitivity.

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Treatment of chondrodermatitis nodularis helicis with intralesional hyaluronic acid injection: case report

Objectives: The authors of this study report two cases of female patients with Chondrodermatitis nodularis helicis treated with Intralesional Hyaluronic Acid Injection for rapid relief of pain and healing of ulcerations.

Introduction: Chondrodermatitis nodularis helicis is a chronic condition that presents as a painful ear nodule and is commonly seen in older adults. Usually caused by trauma and treated with intralesional steroid injections. If the condition remains, a surgical procedure is warranted. The main goal of therapy is to reduce pain and improve clinical appearance.

Materials / method: Two women with painful nodules located in the right anti-helix and left helix were treated with intralesional injections of 0.3 and 0.5 ml of high G prime Hyaluronic Acid.

Results: Both evolved with complete improvement of pain after 2 weeks and no recurrence of lesions was observed 15 months after treatment.

Conclusion: The injected Hyaluronic Acid protected the ear cartilage, reducing local compression. Hydration improved tissue elasticity, exerting an anti-inflammatory effect and accelerating local healing. The early improvement of pain, the low rates of recurrence and adverse effects, improve the quality of life of patients, reduce the cost of treatment and make injectable Hyaluronic Acid effective, fast and low-cost therapy.

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Plant exosome based regeneration: BioburnTM smart messengers for body contouring

Objectives: Exosomes are nano-sized biovesicles formed witht the fusion of multivesicular bodies and the plasma membrane. It has been proven to contain cell-specific cargos of proteins, lipids, and genetic materials, and they may be selectively picked up by surrounding or distant cells far from their release, reprogramming recipient cells to respond to their bioactive contents. In this study, for the first time, Pinapple (Ananas comosus) derived exosomes were used in order to decrease the number of fat follicules and support weight loss.

Introduction: Exosomes are the main components of the cellular communication. So far, it has been established that various cell types secrete exosomes that vary in their cellular content. Even though medicinal uses of plants is nothing new, plant exosomes are freshly discovered area that needs further investigations and research. As always, there is an unprecedented interest in the use of medicinal plant.

Materials / method: Pinapple-derived exosome (PDE) isolation, exosome characterization, Stem cell isolation from fat, adipogenic differantiation, cell viability with MTS, oil red staining, protein expression analysis with ELISA, gene expression analysis with RT-PCR

Results: After 2 weeks 3 times PDE treatment number of fat droplets inside of the cell decreased, LPL protein expression was decreased and PPAR gamma expression was increased. Also LPL gene expression was decreased, PPAR gamma, adiponectin, alpha p2, leptin, gene expression was increased.

Conclusion: As a result, pineapple derived exosomes are highly potential to use for weight lose and reduce adipose tissue. According to scientific results, PDEs have been used as a cosmetic product for slimming and reduces cellulite.

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Exosomes and hybrosomes in regenerative medicine

Objectives: Liposomes are clinically approved delivery nanovesicles used to transfer various factors. To acquire targeting capabilities, Liposomes require surface modifications with specific cell-surface markers. However, not all cells have their own specific surface markers. Therefore, it is challenging to develop target-specific Lip with targeting. To overcome these shortages, exosomes are being investigated for use as nanovesicles, due to their natural smart targeting capabilities. In this study, we have produced hybrid Exo-Lip hybrosomes to make the best nanovesicles in regenerative medicine.

Introduction: Cell to cell communication is compulsory in order to sustain tissue homeostasis and integrity of the organisms but most communication mechanisms between cells requires a coordination of the receptors and the signaling molecules. Recently, nano vesicle mediated cell communication become prominence because of the ability to shuttle different molecules from producing cells to the target cells via exosomes. In this study, we produced hybrid Exosome-Liposome hybrid nanovesicles to preserve the advantages of both complementary systems while eliminating their limitations in regenerative medicine

Materials / method: The effect of plant derived exosomes and hybrosomes on regenerative capacity and wound healing was checked using cell proliferation assay, in vitro wound healling scratch assay, matrigel tube formation assay for angiogenesis, growth factor array analysis. And also more detailed molecular profiling conducted with gene expression analysis by RT PCR and protein expression analysis by immunoblotting. Lastlly, in vivo experiment was done with 5 different rat groups with a incised wound treated with plant exosomes and hybrosomes.

Results: According to the results, plant exosomes and hybrosomes increased cell proliferation, migration and angiogenesis, have anti-inflammatory effect, increased essential growth factor, and gene expression levels of HDF, HUVEC and HACAT cells in vitro. Moreover, plant exosome-containing hydrogel formulations improved wound healing and histopathological rates in vivo. This research indicates a brand-new scope for wound healing therapeutics using hybrosomes and plant exosomes.

Conclusion: This research indicates a brand-new scope for wound healing therapeutics using hybrosomes and plant exosomes.

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Light and Bright protocol: a real alternative to ablative procedures

Objectives: The object of this case report is to show how a combined protocol for chrono and photo aging treatment by two different light sources could be an effective alternative to ablative treatments.

Introduction: Skin aging depends on various intrinsic (chronological) and extrinsic (ambiental) factors: chrono and photoaging changes include wrinkles, abnormal pigmentation, skin laxity, and telangiectasia.
Non ablative treatments are actually preferred to treat skin aging.

Materials / method: Three patients presenting chrono and photoaging lesions of the face were treated with two sessions (with a month of delay) of combined sources (Selective Waveband Technology - SWT 555nm and Frax 1550nm). The results were evaluated during a follow up visit after a month from the last treatment.

Results: This is an adjournment of my personal experience with this photofractional treatment: after a month from the last treatment all patients reported amazing results on skin quality, lightening and hyperpigmentations, without serious adverse effects or longer downtime.

Conclusion: Light and Bright protocol, a combined procedure for chrono and photo aging using two different light sources (Selective Waveband Technology - SWT 555nm and Frax 1550nm) could be an effective alternative to ablative treatments, resulting in remarkable results on global skin quality after just two sessions.

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Perfluorodecalin-infused silicone patch in picosecond laser-assisted tattoo removal: clinical and histopathologic finding

Objectives: This study aims to observe clinical and histopathologic changes using the PFD-infused silicone patch with picosecond laser.

Introduction: Laser tattoo removal needs to be treated 10 times or more for a long period of time. Perﬂuorodecalin (PFD)-infused silicone patch has previously been shown to reduce epidermal whitening produced in association with laser-assisted tattoo removal. This optical clearing agent with picosecond laser would result in more rapid and safe clearance of tattoos than conventional techniques.

Materials / method: Two patients with tattoo underwent skin biopsy followed by laser tattoo removal. The target site was divided into two areas, each of which received different protocols: one was picosecond laser with PFD-infused silicone patch, the other was picosecond laser alone. After one treatment, two patients underwent biopsy of two different treatment sites.

Results: Histopathologic evaluation showed that the PFD-infused silicone patch using the picosecond treatment site had the less remaining intradermal pigmentation than the other half. Clinically, the same results were obtained.

Conclusion: Our report compares skin biopsy findings before and after laser treatment and clinical results for tattoo removal. Although the number of cases is small, our preliminary findings suggest that the PFD-infused silicone patch using the picosecond treatment is favorable for tattoo removal.

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The experience of 2030 cases of thread lift combined with liposuction

Objectives: Ex. for lecture title "The experience of 591 cases of thread lift combined with liposuction"

1: Examine the effect of thread lift combined with liposuction and buccal fat pad reduction surgery (BFPR)
2: Consider liposuction and BFPR as effective to improve the sustainability of thread lift
3: Report the change of facial volume, using pre and post surgical 3D images

Introduction: Basically, the morphological effects of aging in face line is atrophy and swelling. As the skin grows weaker, it is no longer able to support the tissues beneath it, meaning that gravity pulls it downwards, which can be a factor of sagging face. In order to address problems caused by facial skin laxity, the thread lift procedure is one of the standard method.
Thread lift while it is possible for early social recovery and minimal down time is in limited in its therapeutic effects.
We are examining the effect of thread lift combined with liposuction and buccal fat pad reduction surgery (BFPR).

Materials / method: We are examining the change of facial volume based on pre- and post surgical 3D images of 10 patients with thread lift combined approach during January to December 2020.

Results: Liposuction and BFPR were effective in improving the effect of thread lift and produce long-lasting results.

Conclusion: By combining thread lifts with liposuction and BFPR, patients can achieve the better effect of contracture and re-adhension than a thread lift. Furthermore, thread lift procedure can cover the risk of sagging by liposuction or BFPR. It can be a choice for patients who want a long-lasting effect. We will report the change of facial volume, using pre and post 3D images.

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Evaluation of the clinical efficacy and adverse effects of long pulsed Nd:YAG laser in the treatment of seborrheic keratosis

Objectives: Evaluation of the clinical efficacy and adverse effects of long pulsed Nd:YAG laser in the treatment of SKs.
The patients cosmetic satisfaction and pain tolerability of the procedure.

Introduction: Seborrheic keratosis (SK) is one of the most common benign epidermal tumors that affect both sexes equally. Patients with SKs frequently desire treatment because of some associated itching and for cosmetic purposes. SKs have been treated with several techniques including cryosurgery, curettage, electrocautery. Several types of ablative and non-ablative lasers are currently available for treatment of SKs.

Materials / method: patients were treated by long pulsed Nd-yag laser at one side with 12 mm spot size, 1.5ms pulse duration and 60 J/cm² fluence, in partially 3 overlapping pulses, session monthly up to 3sessions. The other side was placebo treated by topical emollient daily for 1 month.

Results: patients evaluated clinically and by dermatoscope, (78.6%) of patients in laser side showed complete response, (21.4%) partial response. No response at placebo side.
No permanent side effects were detected.

Conclusion: long-pulsed Nd: YAG laser may represent an effective, well tolerated therapeutic modality for seborrheic keratoses.

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Skin rejuvenation effects of a combined Triple-wavelength laser (755nm, 810nm and 1064nm) for hair removal

Objectives: Objective: This study aims to investigate the efficacy of the triple-wavelength laser(755nm, 810nm, and 1064nm) for skin rejuvenation.

Introduction: Long-pulsed 1,064nm ND-YAG laser is well known for its deep penetration and rejuvenation effect. Also, 800-nm diode laser irradiation is known to induce collagen synthesis. Physicians in Korea discussed the rejuvenation effects of the three simultaneous wavelengths from one applicator (755nm, 810nm, and 1064nm) designed for the best hair removal.

Materials / method: Twenty patients (mean age 50.9 years) who visited a local dermatologic clinic in Korea without underlying inflammatory facial skin diseases were included. All patients received five successive treatments at two-week intervals. The outcome was determined by histopathology, objective skin assessment, and a patient satisfaction survey.

Results: Histopathologic evaluation with hematoxylin & eosin staining showed proliferation of dermal collagen fibers. Victoria blue staining showed an increased number of thick elastic bundles in the dermal-epidermal junction. The patient satisfaction survey showed that 92% perceived a moderate to excellent improvement (>50%) in their condition. No adverse reactions were reported.

Conclusion: Our preliminary findings suggest that the integrated triple-wavelength laser for hair removal is also a good candidate for skin rejuvenation.

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Hyaluronidase is not always the best option

Objectives: We want to understand what is the trigger of different adverse events in which hyaluronic acid is implicated. For this reason, we analyse what events are generated and propose different protocols to treat these. All protocols proposed are based in scientific fact.

Introduction: Hyaluronic acid (HA) is a common filler used in aesthetic medicine. When we infiltrate HA, we are exposed to different adverse events.
Mainly, we can observe early events as acute inflammation, infection, or occlusive event, this last could be trigger necrosis events. On the other hand, lates events could be nodules, granulomas, or biofilms infections. We need understand behaviour of HA to treat these events.
Although, the use of hyaluronidase in occlusive events is effective and safety, the use of this enzyme to resolve late adverse events is not clear.

Materials / method: We had studied more than 20,000 treatments with hyaluronic acids.
Early events had been acute inflammation and infections:
- Accute inflammation had been treated with steroids until resolution.
- Infections were treated with antibiotic.
- Occlusive events had been treated with hyaluronidase. Aspirin sublingual, and Sildenafil or Aspirin via oral in the next 5 days after occlusive event. We added therapy with antibiotics.
We treated late nodules or granulomas with antibiotics. Moreover, we add to the treatment steroids until resolution.

Results: We observe that early treatment with hyaluronidase in occlusive events is the key to avoid ischemic events and posterior necrosis. We had seen that way more efficient to infiltrated hyaluronidase is subcutaneously.
Late adverse events as nodules or granulomas were not treated with hyaluronidase because different studies analyse the role of hyaluronic acid in pro or anti-inflammatory response.
On the other hand, Hyaluronidase infiltration disperse antigens from manufacturing of HA or bacteria from biofilm and we would be the situation worse.
We resolve late events with steroids and antibiotic

Conclusion: We propose treat always vascular events with hyaluronidase and late inflammatory events with steroids or/and antibiotics. We will treat with antibiotic only when patient with late reaction to hyaluronic acid has an obvious bacterial infection in sites of injection or in other part.

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Botulinum toxin in management of vaginismus

Objectives: Learning application of botulinum toxin in management of primary vaginismus

Introduction: Vaginismus is highly under reported condition affecting from 7 to 15% of women. In this presentation we discuss dosing regimen and technical methods of application

Materials / method: Botulinum toxin used injecting the pubovaginals muscle to treat pateints suffering from primary vaginismus

Results: There is success rate reported two weeks post injection up to 95%. The complications can be avoided with right technique of application

Conclusion: Botulinum toxin is safe and effective tool in management of primary vaginismus if applied with the right technique

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Pelvic augmentation for ideal waist hip ratio (Hourglass body) for female attractiveness: a short-term preliminary report

Objectives: A Novel Procedure, Pelvic Augmentation for Ideal Waist Hip Ratio

Introduction: Waist Hip Ratio (WHR) and Body Mass Index (BMI) was thought to be the main factor of female attractiveness. 0.6 to 0.7 of WHR has been reported as an ideal female attractiveness. Surgical procedures including liposuction and chemical agents altering appetite and absorption of calories are introduced to get better body contouring. However, an attempt at ideal WHR was insufficient. Because, up to this study, there were no genuine skeletal approaches to achieve the fundamental pelvic bone alteration for the achievement of ideal WHR.

Materials / method: A volumetric CT scanning was performed on pelvic bones, and accurate size and dimension were measured. Using a minimally invasive plate augmentation technique, which is minimizing soft tissue injury and scars, a metal plate was inserted through the iliac crest and the incision size was varied to the implant size. We had patients with a metal plate and patients with a metal plate and silicone implants.

Results: We could obtain ideal WHR by increasing the pelvic width as much as the patients desired and good cosmetic results. The neurovascular complication was not reported

Conclusion: Pelvic osteoplasty with a metal plate and silicon idealizing waist-hip ratio is promising.

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Bio-Enhancers for the ageing neck - New kid on the block

Objectives: Bio-enhancers are injectable thermally stabilised high mol wt hyaluronic acid based skin remodelling treatment.
Their role in neck rejuvenation is quite promising since they are not just anti ageing products that help with ageing symptoms but are a regenerating tool that treats the source of ageing by stimulating collagen and elastin production ,activation of keratinocytes and preservation and increase in the viability of adipocytes.
Unlike fillers and injectable skin boosters bioenhancers provide 3D Bio remodelling of the tissue without volumization.

Introduction: A common complaint of patients presenting for facial cosmetic evaluation is the appearance of aging in the neck .
Specific structural changes that occur with age involve the skin, subcutaneous tissue, platysma and the deep fat compartments.
A plethora of treatment options are currently available, however with limited patient satisfaction.

Materials / method: Material used : Stabilized hybrid cooperative complexes of high and low molecular weight Hyaluronic Acid (HA) gel in a 2ml refilled syringe
Method: The neck was injected according to the Bio Aesthetic Point(BAP) Neck Technique with 2.0 mL , 2 treatments 1 month apart.

Injection technique

Marking the 10 BAP on the neck.
Pinch skin at the injection point and inject 0.2 ml per bolus at the superficial subcutaneous layer transversely across the skin.

Results: A significant improvement in terms of tissue bio-remodelling , improved appearance , reduced skin laxity and increased elasticity and consistency of superficial soft tissues in the treated cases was noted at the end of 6 weeks only to improve over the next 2 months.
Minor side effects such as erythema / edema /were transient and completely resolved.
No major side effects were observed.

Conclusion: In aesthetics there is an increasing interest in treating the neck with non surgical modalities.
Bio-enhancers represent an intriguing new paradigm for skin restoration with very promising results.
With its high HA concentration these favour a multilevel dynamic tissue remodelling improving the neck skin laxity with minimal to no downtime.

Combination therapies with Bio enhancers can be a game changer in the field of neck rejuvenation and need to be explored further.

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Prevention and treatment of medical rhinoplasty complications including blindness

Objectives: The aim of this presentation is to identify different patterns of nasal ischemia at an early stage; to describe rare complications such as fistulas; to classify different kinds of complications (ischemic, embolic, iatrogenic, infectious); to discuss predictable and unpredictable causes; to explain an effective protocol to avoid fatal evolution.
What can we do when complications arise?

Introduction: Nowadays, non-surgical nose job is one of the most popular procedures among medical injectors. Unfortunately, not all injectors have sufficient knowledge to be able to identify ischemic issues and other rare complications.

Conclusion: The idea is to spark a debate and share an effective protocol in order to avoid the evolution of the ischemic condition while reducing the risk of tragic outcomes such as blindness.

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The importance of anchor points in a Fast Face Lift

Objectives: Evaluate the efficacy and the durability of a nylon threads fast face lift using different anchor points. Our aim is to maintain as long as possible the traction on the SMAS or on different fascia providing a long lasting permanence of the suspending knot.

Introduction: Since many years we assist to a “repopularization” of minimal invasiveness procedure with shorter incisions and limited skin elevation, The answer offered by the insertion of PDO and similar absorbable threads has shown enormous limits in exerting an effective and stable traction. Almost all modern rhytidectomy techniques use suture suspension of deep tissues to fixed points along the face. These anchor points provide the lifted tissue an anchor on which to suspend and thus prevent relaxation of the tissue.

Materials / method: Through a 1,5 to 3 cm incision and a small undermining we operate a traction directly on sagging SMAS using a single nylon thread. The whole procedure request 20 min and is performed under local anesthesia. We evaluate how the selection of the anchoring points together with the precise direction of the thread definitely influence the quality and the durability of the result.

Results: We treated 91 patients evaluating different results relative to different anchor points. We observed a significant difference related to different area of anchoring

Conclusion: In selected patients this technique of face mini-lift is an efficient approach as a minimal invasive procedure. It permits, with one surgical time, to obtain satisfactory results with a soft natural appearance, respecting the natural tension lines of the facial tissues. We understand how the selection of anchoring points results decisive in term of duration and effectiveness.

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Este trabalho não recebeu nenhum patrocínio direto ou indireto. O mesmo está sob a própria responsabilidade do seu autor.

Botulinum toxin type A injections for sculpting the lower third of face: a case report

Objectives: Before the advent of Botox injections, surgery was the only option for the reduction of bigonial width of the face. Botox injections are safe and optimally efficacious. This case highlights the beneficial effects of Botox in sculpting the lower third of the face with quick results to the maximum patient satisfaction.

Introduction: The demand for aesthetic procedure is on the rise. Chiseled jaw line, high cheekbones and carved out hallows are the modern day beauty quotients. The gorgeous faces of fashion models staring from the advertisement neon boards and larger than life movie screen make all of us wanting to be like them. If these can be achieved by minimally invasive injections rather than surgery will be icing on cake. Botulinum toxin-A (Botox) is regularly used for reduction of the bulk and volume of the parotid gland and masseteric muscle, thereby narrowing the width of the lower face.1,2,3

Materials / method: Onabotulinumtoxin A( BOTOX) is used for procedure .Lyophilized vial of BOTOX was reconstituted with 2.5 ml of sterile, preservative-free 0.9% Sodium Chloride Injection. It was drawn up into 1ml syringe. The solution was injected using 30G needle attached with 1 cc syringe. Three point injection techniques was used to inject masseter muscle. The patient is then asked to clinch the teeth to be able to palpate the masseter muscle. 10 units of botox were injected in each point. The parotid gland is identified and 40 units of botox is injected into the gland

Results: 15 days after 140 units of botox injection the pictures showed significant reduction in both parotid gland as well as the masseter muscle. Patient was very satisfied with the results and has agreed to do regular maintenance follow up injections. No short term or long term complication occurred in this patient.

Conclusion: Botulinum toxin-A is a highly efficacious and cost effective, nonsurgical option for reducing the width and shape of the lower face and jawline. The procedure is simple done in office settings and takes barely 15 minutes. Botulinum toxin-A reduces the volume of the masseter muscle without affecting its motor function. Similarly it can also be effectively used to reduce the bulk of an enlarged parotid gland without affecting saliva production.

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Este trabalho não recebeu nenhum patrocínio direto ou indireto. O mesmo está sob a própria responsabilidade do seu autor.

Eletromagnetic field: actions beyond muscle hypertrophy

Objectives: Eletromagnetic Field is an advanced and intensive muscle stimulator which uses HI-EMT (High Intensity Electromagnetic Muscle Trainer) technology. Its focused electromagnetic field passes through all layers of skin and fat, directly stimulating the muscle through continuous and intense contractions . Muscle contraction acts beyond hypertrophy, stimulating the release of hormones responsible for optimizing the patient's metabolism

Introduction: Biological functions begin to decline from the age of 30 . Thus, with age, there is a decrease in muscle and bone mass , besides an increase in the percentage of fat and decrease in hormones such as estrogen, progesterone, leptin and insulin

Materials / method: Aerobic exercise prevents the decline in muscle strength and insulin resistance.
Electromagnetic field devices propose supra-optimal contractions in order to cause an even greater increase in muscle strength.
But, in fact, its action goes beyond.
The exercises are, according to the literature, considered safe and effective in reducing toxins resulting from inflammatory processes, food or stress. Electromagnetic field devices send signals to the brain, which begins to release hormones (insulin, estradiol , testosterone and leptin)

Results: Some hormones, such as insulin, enter fat cells and decrease fat drops.
Electromagnetic field devices, by causing a supra-optimal contraction, are a new way to increase the hormones testosterone and estradiol, which decrease over the years.
Leptin, in turn, is responsible for the increase in satiety, which also contributes to a decrease in abdominal circumference, responsible over the years for an increase in cardiovascular disease.

Conclusion: Thus, the benefits of the electromagnetic field go beyond increasing muscle mass and decreasing abdominal visceral fat, and should be even more used to provide beauty and health to patients.

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Hyperbaric oxygen therapy in aesthetic surgery

Objectives: We wonder whereas hyperbaric oxygenation is efficient to treat aesthetic surgery complications.

Introduction: The hyperbaric oxygen therapy has been used in medicine long time ago. Mainly, diabetic foot ulcer and infections has been treated with this method. Nowadays, Hyperbaric oxygenation open news approaches to treat different pathologies and complications.
Hyperbaric oxygenation increase oxygen dilution into blood plasma until 20% through increase pressure with 100% oxygen. Tissues oxygenation stimulate cellular regeneration, wound healing and anti-inflammatory processes.
We show as Hyperbaric oxygenation could help us to treat adverse effects generate by aesthetic surgery as necrosis.

Materials / method: Infraorbital necrosis with loss of tissue after blepharoplasty were treated with Hyperbaric Oxygen.
We divided treatment in several phases:
- 1st-5th session: 1.5-2 ATA during 30-60 minutes
- 6th-15th session: 2 ATA during 60 minutes
- 16th-20th session: 2,8-3 ATA during 60 minutes
- 20th-30th session: 3 ATA during 60 minutes
Necrotic tissue was removed during process to promote regeneration processes.

Results: Patient tolerated treatment and not adverse effects were detected.
Inflammatory processes were decreased between 1st -15th session. Tissue regeneration processes were increased when pressure were upper than 2.8ATA.
All tissue were regenerated in 30 session.
Although, antibiotic treatment were removed, we did not observe infection symptoms.

Conclusion: We propose hyperbaric oxygen therapy to treat aesthetic surgery complications. We use an protocol based in pressures upper than 2.5 ATA. This therapy promote wound healing an avoid infections.
In addition, we recommended hyperbaric oxygenation to accelerate aesthetic surgery recovery and improve results.

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Periorbital rejuvenation using chemical blepharoplasty with combination of deep phenol peel and botulinum toxin injections

Objectives: 1. Chemical blepharoplasty (with phenol-croton oil-TCA chemical peel ) can restore a youthful appearance to the periorbital region.
2. How to do it?
3. Tip & Tricks?
4. Treating complications

Introduction: Deep cheek wrinkles caused purely by sun damage are one of the best indications for a phenol peel.
Expression wrinkles in addition to are also an excellent indication, on condition that movement is blocked by botulinum toxin approximately 8 days before the peel. Without this highly effective synergetic combination, kinetic wrinkles will of course disappear during the first few weeks after the phenol peel, but will come back afterwards, much to the annoyance of patients.

Materials / method: The author shares his experience using different techniques and methods for nonsurgical periorbital rejuvenation and how it fits into the daily aesthetic practice.

Results: Clinical results will be shown during presentation.

Conclusion: Use of phenol-croton oil-TCA chemical peel combined with botulinum toxin in the periorbital region can be successfully performed with minimal to no complications. When these techniques are combined there is significant improvement in upper and lower lid laxity, hyperpigmentation, and reduction of fine rhytids. It is a cost effective treatment with long-lasting results.

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Por favor indique a entidade (pessoa ou empresa): Skin Tech Pharma Group

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Este trabalho não recebeu nenhum patrocínio direto ou indireto. O mesmo está sob a própria responsabilidade do seu autor.

Non-traditional treatment of Bruxism

Objectives: To evaluate the efficacy of botulinum toxin in the treatment of nocturnal bruxism in patients who have not responded to conservative treatments and keep up with medicinal development in order to provide up-to-date treatments for various medical complications.

Introduction: Nocturnal Bruxism (NB) is an abnormal maxillomandibular activity characterized by grinding & clenching of the teeth. Its an abnormal alignment of upper & lower teeth (malocclusion) may contribute to the problem, more often psychological factors cause NB, including anxiety, stress or tension & anger. NB also can be a complication of another disorder, such as Huntington's disease or Parkinson's disease, it can also can be an uncommon side effect of some psychiatric medications including antidepressants. It can lead to many complications such as jaw & neck pain, headache, and oral or facial pain.

Materials / method: NB can be diagnosed by checking patient's teeth, we'll notice the tip of the teeth are flattened or chipped, so first of all we have to reduce the factors that may worsen the case such as stress, anger, caffeine, nicotine and sleep disturbances. Then we start our therapeutic plan, doctors present different methods in treating such cases, traditional methods; such as splints (night guard) and some medications such as muscle relaxants, and there is a nontraditional method that works directly on the masseter & temporalis muscles and make it relax & weak enough to stop grinding & clenching.

Results: Botulinum toxin; is an exotoxin which inactivates muscles or glands, its been used recently in the treatment of cosmetic and non cosmetic conditions such as, tremors, hemifacial spasm, temporomandibular joint dysfunction, masticatory myalgia, qsialorrhea, hyperhydrosis and migraine. So as a result all studies show that botulinum toxin injections can reduce the frequency of bruxism episodes and decrease pain levels with a remarkable increase in effectiveness and safety.

Conclusion: Despite the paucity of works on the topic, botulinum toxin seems to be the best management option for minimizing symptoms and reducing the intensity of muscle contractions.

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Chin augmentation with soft tissue fillers

Objectives: 1) DIAGNOSE DIFFERENT TYPES OF CHIN MICROGENIA TROUGH A STEPWISE ANALYSIS APPROACH;
2) SUGGEST A SIMPLE METHOD TO ESTABLISH A MORE ACCURATE TREATMENT PLAN FOR CHIN PROJECTION OR ELONGATION, WHILE CONSIDERING DIFFERENT ANATOMICAL CHARACTERISTICS OF BOTH SEXES.

Introduction: FACIAL HARMONY IS STRONGLY INFLUENCED BY THE SIZE AND SHAPE OF THE CHIN. WHEN MILD OR MODERATE, CHIN DEFICIENCY CAN BE MINIMALLY INVASIVELY CORRECTED USING TEMPORARY INJECTABLE SOFT TISSUE FILLERS.

Materials / method: POWER POINT PRESENTATION THAT CAN BE SUBMITTED UPON REQUEST. 47 SLIDES .

Results: AT THE ENDE OF THE PRESENTATION THE AUDIENCE WILL BE ABLE TO DIAGNOSE ALL TYPES OF MICROGENIA AND TO INJECT THE CHIN (PROJECTION OR ELONGATION) CONSIDERING SEXUAL DIMORPHISM.

Conclusion: -THE DIAGNOSIS OF CHIN DYSMORPHOLOGIES IS NOT EASY WHEN THE INJECTOR DOES NOT KNOW SOME RULES;
- WITHOUT AN ACCURATE DIAGNOSIS, WE TEND TO INJECT ONLY WHAT WE SEE, INTUITIVELY;
-INJECTING THE CHIN WITHOUT CONSIDERING ANATOMICAL DIFFERENCES BETWEEN MEN AND WOMEN MAY RESULT IN UNWANTED FEMINIZATION OR MASCULINIZATION.

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1+1=3? Does combining microfocused ultrasound and radiofrequency yield extra benefit or causing more harm?

Objectives: 1. Comparing the pros and cons by combining two modalities
2. Tailor best timing interval for combining RF and HIFU in the treatment

Introduction: Over the last decade, non-invasive techniques have greatly increased in popularity due to their effectiveness in improving skin laxity, while minimising recovery time, risk of adverse effects and cost. Among variety of non-invasive methods, HIFU and RF treatments are the preferred choice. Although the use of RF and HIFU as individual modalities for the treatment of skin laxity has proven to be effective, there are lack of clinical study exploring the combination of these two modalities in one. We explore the safety, efficacy and result optimisation in combining these two methods.

Materials / method: 1. 1/3 of the total number of the patients complete one session of HIFU (~800 shots +/- 50 shots, up to Submental)
2. 1/3 of the total number of the patients complete two sessions of RF (40-45mins) with the interval of 3 months between treatments. – CONTROL GROUP B
3. Another half of the total number of the patients need to complete one session of HIFU (~800 shots +/- 50 shots, up to Submental) and 1 session of RF (40-45mins) – INVESTIGATED GROUP
RF to be done 3 months after HIFU.
4. Patients will be evaluated 6 months after their first treatment

Results: 1. Improvement and Satisfaction Score from patient for HIFU alone ~5-6
2. Improvement and Satisfaction Score from patient for RF alone ~5
3. Improvement and Satisfaction Score from patient for Investigated group ~7-8
4. Average Pain Score for HIFU ~6-7
5. Average pain Score for RF ~3-4

Conclusion: 1. Combining HIFU and RF in the same setting does not yield extra benefit, and might increase risk of adverse effect.
2. Combination of HIFU and RF achieve better result after 6 months, compare with single modality.
3. Combination of HIFU and RF achieving better result longevity.

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Por favor indique a entidade (pessoa ou empresa): Vanguard Aesthetic Singapore

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Este trabalho foi realizado com o patrocínio de: Vanguard Aesthetic Singapore

The role of soft tissue fillers in secondary rhinoplasty with over-resection

Objectives: Understand possible indications for non-surgical secondary rhinoplasty; learn the proper technique of using fillers and prevention of possible complications during nose reshaping

Introduction: Correction of the over-resected noses with soft tissue fillers is an exciting procedure that is considered an alternative to traditional rhinoplasty procedures in some cases ranging from minimal to severe nasal shape and breathing problems.

Materials / method: No matter how experienced a surgeon may be, there will be some cases requiring a secondary rhinoplasty. For many of them, I choose non-surgical methods for several reasons. First, I visit an average of 25 revision patients weekly, most of them have over-resected noses and are candidates for rib grafts. While they all expect me to solve their problem, I cannot perform that many revision surgeries and prefer non-surgical methods unless they do not work.

Results: Second, most of the patients are applying because they already had a poorly performed low-cost primary rhinoplasty by an inexperienced surgeon. Therefore, they cannot afford a secondary rhinoplasty at all. Third, some patients do not have the time or energy to undergo a secondary rhinoplasty. They prefer to have the least time for rest and to go back to their normal life as soon as possible. Fourth, some patients are not compliant with the aesthetic consequences of the donor sites for grafting.

Conclusion: In my personal experience, fillers could even be used to correct extensive secondary defects, such as inverted V deformity and saddle nose. Many patients are excited by observing the new shape of their noses in just fifteen minutes. Some cases had improvement in function other than form. I will describe my novel techniques to treat extreme cases of secondary rhinoplasty with the use of fillers. Besides perfect anatomy knowledge and ample experience with filler injections, there are pearls to avoid complications.

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Treatment of facial angiofibromas with electrocautery - A case report

Objectives: The authors of this study report a case of a 25 years old female patient with tuberous sclerosis, presenting multiple angiofibromas on face treated with shaving excision in the first step and coagulation in the last step with successful results. The therapeutic options for treatment are very limited so report a simple and efective treatment are very satisfactory as alternative treatment.

Introduction: Tuberous sclerosis (TS) is a neurocutaneous genodermatosis characterized by the formation of hamartomas in multiple organs.
The skin is involved in around 90% of the cases, with very cutaneous signs associated in this disease. Several treatments have been proposed like shaving excision, co2 laser, criosurgery. The present case study aims to report a case of surgical treatment using shaving excision and coagulation in the last step as a optional in treatments when there is skin involvement.

Materials / method: AAB, 25 years old, female, brown, student sought care for injuries to her face. Patient diagnosed with tuberous sclerosis started with facial papular lesions when he was 12 years old. The patient presented only the cutaneous findings of this disease. Physical examination revealed erythematous papules on the chin, forehead and nasal region. Hypochromic macules on trunks and lower limbs. Scarring in the region of the right iliac crest and right antelope (Shagreen's patches). Partial resection of the lesions on the forehead was defined, with subsequent sectored outpatient resections on the face.

Results: The patient was assintomatic after the procedimentn so she was released with orientation in regards to local care and dressings and, after healing, use of sunscreen. Subsequent evaluations were performed on the 7th, 14th and 30th postoperative days, and then monthly for the first six months. After one month of follow-up she received new shaving and coagulation of the lesions.There were not signs of scars or cutaneous atrophis. After the fourth postoperative month she had recurrence of there lesions in forehead nodulos - like. Again were done shaving and coagulation of those lesions.

Conclusion: Tuberous sclerosis (TS) is a neurocutaneous genodermatosis very stigmatizing. And facial angiofibromas brings social harm with serious consequences. The purpose of this study was to provide a simple and effective alternative in the treatment of these cutaneous manifestations. The treatment was successful in getting the patient back to social life and a great improvement was noted in regards to cosmetic aspect and hygiene.

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Hypersensitivity reaction to hyaluronic acid filler associated with Herpes simplex and Streptococcus infection, COVID-19 vaccination and infection

Objectives: We report the case of a woman who underwent application of hyaluronic acid (HA) on lips with progression to Herpes simplex and Streptococcus infection after manipulation. Then, with Pfizer COVID-19 vaccination, the patient presented with delayed hypersensitivity reaction (DHR) in lips where HA was previously applied. Afterwards, the patient got a positive test to COVID-19 and was diagnosed with DHR again. We describe this rare association of Hypersensitivity reactions and our procedures, therefore, aesthetic professionals should be aware of this possibility and advise patients accordingly.

Introduction: In 2019, according to the International Society for Aesthetic Surgery, Brazil ranked second for the number of aesthetic procedures performed. The rapid growth in the use of HA is due to: diminished social stigma surrounding their use and reversibility of injected HA using intralesional hyaluronidase enzyme. In addition, HA have favorable safety profiles with rare adverse effects. However, complications as Herpes simplex and Streptococcus infection can occur. After the COVID-19 vaccination, It has been reported patients presenting DHR in the area where HA was previously applied.

Materials / method: On october 2021, 1 ml of HA was applied on lips of a healthy woman aged 42 years. During the last four years she did the same procedure with the same product. After two days, the patient felt local burning and a pustule on superior lip, she thought it was a pimple and manipulated it. She took acyclovir and corticosteroids on his own during ten days with no improvement. 20 days later, when she came into contact, she had local edema. So, hialuronidase was realized associated with more days using acyclovir. She have never had herpes.

Results: 14 days after, on exam she had a nodular lesion with erythema on upper lip. Drainage was performed, the material was analyzed and we did hyaluronidase application and red LED. Cytology of the material was positive for Herpesvirus and Culture identified Streptococcus gordonni and viridans. Initiated Valaciclovir, Clarithromycin, Ampicillin and 48 hours later, she had significant improvement.
On December 2021, 15 days after COVID-19 Pfizer-BioNTech vaccine, burning and local pain starts in the superior lip. Local drainage was performed and Ampicillin prescribed.

Conclusion: End of December 2021 she got a positive test to COVID-19 and 15 days later: erythema and local edema, but no palpation of a nodular lesion. Started Valaciclovir with important improvement, then we maintain daily oral Acyclovir until now.
It is still not known which individuals progress to DHR after COVID-19 vaccination, how long the application of HA is most likely to produce a reaction, and the wait time after COVID-19 vaccine for HA dermal filler. Our report is important for aesthetic professionals to be aware of this events and advise patients of this possibility.

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Non-invasive reshaping volume and bio-stimulation of tissue - Clinical and histological presentation after needle shaping

Objectives: The aim of this experimental study was to assess that Needle Shaping (Vibrance)- Autologous Threads is an innovative anti-aging method, which achieves reorganization of the elastic fibers and production of collagen type ΙΙΙ, without the individual using any kind of external/chemical material, with the results being equally good.

Introduction: Vibrance-Needle Shaping is an innovative technique of wrinkle filling and reshaping without material injection and without surgery. This microsurgical technique is capable of increasing the volume of the skin in areas such as the lips, nose, cheeks, neck decolleté and generally the whole face without the addition of other exogenous materials. It also has fascinating results in tightening the body in difficult areas such as arms, inner thighs, knees, buttocks.

Materials / method: Acupuncture needles are placed on the face or body in the places where we want the treatment to take place, while the Vibrance device produces galvanic current, which increase efficiency. With the help of the acupuncture needles, we wrap the collagen and elastic fibers, so that in these points more tissue volume is formed.

Results: The results of this study showed very good anti-aging activity with impressive histological findings of elastic fiber reorganization, while patients’ satisfaction was evaluated as: very good 40% and excellent 60%.
With this treatment we have 300 more production of collagen, the filling of wrinkles or the tightening of the skin without material, making autologous threads that change the direction of elastic fibers from horizontal to vertical.

Conclusion: This is an innovative technique that shows great promise for the increasingly frequent patients with autoimmune diseases that cannot make use of eterologous treatments, as the Needle Shaping creates threads with the patient’s very own collagen.

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Horas	Palestrantes	Título da apresentação	Resumo	Número
10:12	Dr Nancy LABIB	Guidelines for injection techniques complete facial rejuvenation using the 3D vectoring lift	Visualizar	113033
10:24	Dr Irada HUSEYNOVA	Correction of age-related changes in the face with the combined usage of thread methods and calcium hydroxyapatite	Visualizar	116510
10:36	Dr Yu Feng CHANG	Topical agents in the treatment of melasma	Visualizar	116634
10:48	Dr Ludmila RAMOS	Treatment of chondrodermatitis nodularis helicis with intralesional hyaluronic acid injection: case report	Visualizar	116628
11:00	Dr Merve YILDIRIM	Plant exosome based regeneration: BioburnTM smart messengers for body contouring	Visualizar	116642
11:12	Dr Polen KOCAK	Exosomes and hybrosomes in regenerative medicine	Visualizar	116609
11:24	Dr Angela CAPPONI	Light and Bright protocol: a real alternative to ablative procedures	Visualizar	116639
11:36	Dr Donghye SUH	Perfluorodecalin-infused silicone patch in picosecond laser-assisted tattoo removal: clinical and histopathologic finding	Visualizar	116504
11:48		LUNCH BREAK		116777
13:18	Dr Shunsuke NAGURA	The experience of 2030 cases of thread lift combined with liposuction	Visualizar	116507
13:30	Dr Mohamed KHATER	Evaluation of the clinical efficacy and adverse effects of long pulsed Nd:YAG laser in the treatment of seborrheic keratosis	Visualizar	116448
13:42	Prof Hwa Jung RYU	Skin rejuvenation effects of a combined Triple-wavelength laser (755nm, 810nm and 1064nm) for hair removal	Visualizar	116452
13:54	Dr Esther RISTORI BOGAJO	Hyaluronidase is not always the best option	Visualizar	116484
14:06	Dr Ayman EL ATTAR	Botulinum toxin in management of vaginismus	Visualizar	116430
14:18	Dr Yougun WON	Pelvic augmentation for ideal waist hip ratio (Hourglass body) for female attractiveness: a short-term preliminary report	Visualizar	113810
14:30	Dr Jyoti ANEJA	Bio-Enhancers for the ageing neck - New kid on the block	Visualizar	116212
14:42	Dr Julieta SPADA	Prevention and treatment of medical rhinoplasty complications including blindness	Visualizar	116295
14:54	Dr Nicola PITTONI	The importance of anchor points in a Fast Face Lift	Visualizar	116545
15:06	Dr Anjali Sharad GHATGE	Botulinum toxin type A injections for sculpting the lower third of face: a case report	Visualizar	116298
15:18	Dr Patricia FABRINI DE ARAUJO	Eletromagnetic field: actions beyond muscle hypertrophy	Visualizar	115004
15:30	Dr Adriana RODRIGUEZ VALERA	Hyperbaric oxygen therapy in aesthetic surgery	Visualizar	115013
15:42	Dr Nenad STANKOVIC	Periorbital rejuvenation using chemical blepharoplasty with combination of deep phenol peel and botulinum toxin injections	Visualizar	116511
15:54	Dr Haidar ALQUSOUS	Non-traditional treatment of Bruxism	Visualizar	113411
16:06	Dr Thais SAKUMA	Chin augmentation with soft tissue fillers	Visualizar	113743
16:18	Dr Christie MOEY	1+1=3? Does combining microfocused ultrasound and radiofrequency yield extra benefit or causing more harm?	Visualizar	113800
16:30	Dr Mohsen NARAGHI	The role of soft tissue fillers in secondary rhinoplasty with over-resection	Visualizar	116612
16:42	Dr Ceres BARROSO	Treatment of facial angiofibromas with electrocautery - A case report	Visualizar	116548
16:54	Dr Giuliana ANGELUCCI MIRANDA	Hypersensitivity reaction to hyaluronic acid filler associated with Herpes simplex and Streptococcus infection, COVID-19 vaccination and infection	Visualizar	116745
17:06	Dr Sotirios TSIOUMAS	Non-invasive reshaping volume and bio-stimulation of tissue - Clinical and histological presentation after needle shaping	Visualizar	114696

IMCAS World Congress 2022
Programa

S197-S201

Open Stage talks

Apresentações desta sessão

Sessões recomendadas

IMCAS World Congress 2022 Programa

S197-S201

Open Stage talks

Apresentações desta sessão

Sessões recomendadas

IMCAS World Congress 2022
Programa