IMCAS

Fascia in aesthetics: what it is & why it matters (ultrasound findings-based study)

Objectives: -Fascia ( SMAS & temproparietal) was thought to be passive, like a rubber band, elongating when we stretch, then returning to its original length. 2004 iwas the first evidence that fascia, is a living,
-How can one diagnose a fascia problem caused by incompatible Fillers ?
-role of dynamic fillers in this area
- the benefits for patients

Introduction: fascia forms a 3D, full-length bodystocking that keeps everything separate and at the same time connected.
Fascia assists in organizing and coordinating our every movement. It helps keep us flexible and supple.
Problems can occur when our bodystocking begins to get stuck.
accumulation of fascial restrictions serves to functionally shorten some muscles, while letting others lengthen, becoming overly stretched or loose. Over time this can visibly distort posture and make even simple movements difficult or painful.
Fortunately, fascia is a two-way street. What is restricted can
become smooth agai

Materials / method: Fascia does not show up on standard imaging tests like X-Rays or MRIs, but it can be seen nicely on ultrasound. Since ultrasound imaging is performed in real-time, one can easily see the layers sliding on each other as well as restrictions in fascial movement.
Ultrasound shows abnormal Masseter contractions and dense fascia due to incompatible fillers with strong muscles contractions and continuous movements
Choosing low G- prime H.A fillers is the key to avoid this type of complications
Dynamic fillers of low G-prime work well with area of injection with these physical & physiological proper

Results: Dynamic fillers on ultrasound don’t tend to form the usual oval shape of fillers usually seen on ultrasound beneath the fascia,

patients report positive outcomes:
significant reductions in depression;
significant improvement in mood, fatigue, sleep and well-being;
a more proactive role in overall health.

Conclusion: We should not forget that we are doctors at the first place, we give our patients younger look beautiful faces and also quality of life
To Respect and understand the anatomy is a must to avoid a type of complications that affects the patients quality normal usual activity, sleep and life

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A new approach for nose augmentation: over 10000 patients

Objectives: In contrast to surgical rhinoplasty, non-surgical rhinoplasty is a quick and painless injection procedure performed easily under local anesthesia in as little as 15 minutes. The lower fee, less invasive nature, and fewer adverse effects of filler rhinoplasty make it attractive compared to surgical cosmetic procedures. Also, this technique could be used to manage post-rhinoplasty complications.

This article describes a liquid rhinoplasty technique that has been used on over 10000 patients. To augment the nose, physicians have used retrograde and direct percutaneous injection techniques. In add

Materials / method: İnjection Procedure

All injection procedures were performed with a 30G or 29G 13 mm needle. Depending on the need, the physicians administered the filler on Day 0 -a maximum of 0.5-0.6 cc and then, after about three weeks, -a maximum of 0.5 mL.

A standard injection sequence was designed due to the common features of recessed mid-faces, poor tip projection, and weak columella structural support.

In order to ensure that the skin envelope remained intact over the course of the study, the study product was injected slowly, and the dosage of the product was limited.

Results: Firstly, after contact with the maxillary spine, we give 0.05-0.1cc product, then we enter the ligament between medial crus under the septum and give 0.05 and raise the septum well.
Secondly, we give 0.1-0.2cc filler under the subcutaneous fat tissue at the supratip or tip region.
Then we fill the gap between the supratip and the dorsum and inject it into the midline through the subcutaneous adipose tissue.
Finally, we inject 2 linear 0.05-.0.1cc fillers into the lower 1/3 of the nasofrontal angle between the glabella and the dorsum, so superficial that the needle is visible from the surface.

Conclusion: Injecting filler into the nose gradually disappears over time. Thus repeating the procedure is necessary. Despite this, the relatively low level of bruising or swelling compared to surgery means that the patient can live an everyday life without feeling any discomfort or inconvenience. A further advantage of this procedure is the lack of side effects, such as nasal curvature and nasal tip thinning or sharpening due to contracture.

It has been demonstrated that this HA filler is safe and effective for specific nose augmentation procedures.

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The science to support an effective and complete profile rejuvenation treatment

Objectives: 1. How has Profile and Facial Assessment changed over the years?
2. What does the latest research in Facial Ageing show?
3. Full Face Cannula vs Needle techniques for obtaining a natural but effective result - Presenting a 5 step protocol for an effective mid and lower face rejuvenation that can be modified based on each individual patients anatomy, needs and expectations.
4. A review of our 250 patient and practitioner survey into how we can increase patient satisfaction.

Introduction: Following a practitioner and patient analysis of over 250 cases of Full Face Treatments, the goal of my study was to develop an insight into how aesthetic consultations and treatments are evolving with the latest literature. The practitioner data collected was to understand how they are assessing patients at their initial consultation and what their evidence base is for choosing a particular technique when performing a Dermal Filler treatment. Next we focused on what evidence and preference practitioners have for using a cannula vs needle and how this corresponds to the literature.

Materials / method: 1.Comprehensive searches of MEDLINE, EMBASE, Cochrane Library and CINAHL from between 2020-2022. Inclusion criteria included all empirical human research studies specific to facial ageing features, written in the English language.
2. A 25 point practitioner survey was performed to understand when a needle and cannula technique was employed when treating the full face and this was corresponded to the latest evidence available.
3. A patient survey was performed to first time patients to determine patient satisfaction post treatment.

Results: 1. A total of 322 papers met inclusion criteria for analysis. Pathways concerning only new evidence were subdivided into intrinsic (such as genetics, generation of ROS and hormonal changes etc) and extrinsic (such as photoageing and damage to skin layers etc) mechanisms.
2. 35% of practitioners surveyed felt their consultation could be more holistic, 40% did not have an evidence based protocol for selecting a cannula vs needle in a full face rejuvenation. As such we created a 5 point protocol to be followed.
3. Sharing 3 tips we learnt to improve patient satisfaction from our survey.

Conclusion: Based on our survey study and the published literature analysed, we would like to present an updated summary of both the facial ageing process and how practitioners can employ certain techniques to ensure a natural but effective, non-surgical, full face rejuvenation result. I present a 5 point protocol that allows for an effective mid and lower face rejuvenation that can be modified based on each individual patient. Our 250 patient survey highlights multiple areas to be considered by a practitioner and again we would like to present this as a means of improving the patient journey.

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HA fillers as an adjunct to lower blepharoplasty surgery: an alternative to fat transfer or repositioning

Objectives: To describe the author's experience using hyaluronic acid based fillers as an adjunct to lower blepharoplasty surgery.

Introduction: Purely subtractive lower blepharoplasty surgery often leads to hollowing along the inferior orbital rim and a possible tear trough deformity. Common approaches to mitigating this problem include fat repositioning or fat transfer at the time of surgery. Disadvantages to these approaches include prolonged healing time, inconsistent "take" and lumps. Grafted fat will also change as a patient gains or loses weight.

Materials / method: This author prefers fat removal at the time of lower blepharoplasty surgery, followed by soft tissue augmentation with dermal fillers to the tear trough and/or midface several months after surgery. Example surgical patients will be presented and discussed.

Results: The author has performed more than 1000 lower blepharoplasty surgeries using this technique with a high degree of patient satisfaction.

Conclusion: Soft tissue augmentation with dermal fillers is an excellent adjunctive treatment to lower blepharoplasty surgery. The author's experience with this technique and the advantages and disadvantages of this approach will be discussed.

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The elective use of hyaluronidase

Objectives: This presentation will provide an overview of the elective uses of hylauronidase (HYAL) for reversing hyaluronic acid (HA) fillers, including management of misplaced product, micro doses for reduction of product volume to improve aesthetic outcome or mitigate swelling, as well as the resolution of early and late-onset nodules. The talk will also review ultrasound guided management of these issues

Introduction: One of the key features of HA dermal fillers underlying their success is reversibility. The injectable enzyme HYAL cleaves the linkages between subunits of HA chains, including crosslinked chains present in HA gel fillers, rendering them prone to diffusion and further degradation by native hyaluronidases. In contrast to high-dose protocols for vascular compromise where repeated flooding of the area is needed to completely dissolve the product,2 elective use of HYAL requires a more tailored and/or targeted approach.

Materials / method: Findings from the literature are coupled with the author’s clinical experience to develop a review of elective HYAL use.

Results: This presentation will provide an overview of the elective uses of HYAL for reversing HA fillers, including management of misplaced product, micro doses for reduction of product volume to improve aesthetic outcome or mitigate swelling, as well as the resolution of early and late-onset nodules.Given that many patients presenting with issues which require the use of HYAL have been injected in other practices, ultrasound represents an especially important development for diagnosis and guided management of these issues.

Conclusion: The activity of HYAL makes it a valuable tool for improving the overall safety of filler injection, as well as an important option for managing misplaced or excessive HA filler. Elective use of HYAL provides an important avenue for management of HA filler once it has been injected. Targeted doses, administered with ultrasound are a valuable approach for management of product misplacement and nodules.

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Dynamic lips - Lip enhancement with dynamic fillers: tailored approach for natural and harmonious results in static and dynamic

Objectives: To show the importance of a tailored approach in lip enhancement procedures, in different kind of patients, to achieve natural results, against standardization and unnatural look.

Introduction: Lip filler is an increasingly common and popular medical-aesthetic procedure, requested by patients of all ages and sexes. But there should be a tailored approach to lip filling, in order to respect the individuality of each patient and get natural results.

Materials / method: Female patients of different ages were treated. Dynamic fillers of monophasic resilient hyaluronic acid, of different modification degree and G', were used for the procedures, with the aid of a high-tech injection electronic device. Pictures before and after treatment were performed to show the results, both in static and dynamic.

Results: The author, through the analysis of pre and post treatment images of different clinical cases, exposes his personal approach to obtaining harmonious lip filler outcomes in each patient.

Conclusion: Tailored approach in lip filler treatments is mandatory to achieve natural results, both in static and in dynamic and to respect the uniqueness of each patient.
Knowledge of lip anatomy, aging degree, correct technique and product choice are pivoltal key points to guarantee optimal outcomes in lip enhancement procedures.

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Multimodal injectable treatment for skin quality improvement

Objectives: To be able to improve skin quality using micro toxin and dermal filler combination

Introduction: Skin improvement is the most sought after treatment in any aesthetic clinic. Facial rejuvenation is a type of cosmetic treatment that uses non-invasive or minimally invasive procedures to restore the skin elasticity and improve the appearance of the skin.

Materials / method: Combination of Intradermal Hyaluronic Acid Filler and Intradermal Botulinum Toxin has been a trend in Asian countries for treatment of younger patients for pore minimization, sebum control and skin lifting.

Results: Hyaluronic Acid filler once injected into the dermis, binds to 500 to 1000x its own weight of water in the extracellular matrix and induces it to swell, restoring the skin hydrobalance, creating some volume, increasing skin turgor, and improving its structure and elasticity. The purpose of injecting this type of cross-linked Hyaluronic Acid is for skin rejuvenation and hydration, not volume.

Botulinum Toxin when injected intradermally realigns the imbalance of the facial muscles by weakening the downward pull of the depressors and allowing the levators to contract in a compensatory fashion.

Conclusion: Multimodal Injectable Treatment is an emerging trend. This is a safe, quick, easy to perform and a very effective aesthetic procedure with high patient satisfaction and retention.

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A new approach of the aging face assessment – Jaw contour-focused

Objectives: Presenting and discussing cases where appropriate technique and correct choose of products were performed in order to obtain jawline definition and to correct mild-to-moderate mandibular bone resorption, with no surgical procedures and with immediate and complete recovery.

Introduction: A well-contoured jawline and a proportional well-positioned chin are highly desirable for men and women of all ages, it gives a perception of beauty, youth and other emotional attributes.
Injectors have a wide variety of products to choose with different properties and rheologies turning up to be a real challenge to perform the right assessment, using appropriate techniques and, of course, achieving desired results.
Injectable fillers and calcium hydroxylapatite can reshape the jawline, lift soft tissues, and improve facial proportions, effectively improving the appearance of the face.

Materials / method: A full assessment of the face were performed, understanding the main areas of bone and fat compartiments reabsorption; followed by the injection of dermal fillers with crosslinked hyaluronic acid with diferents rheologies for bones, fat compartiments and mucosa; and injection of calcium hydroxylapatite in the jawline, to provide lift, focal collagen stimulation and improve firmness. 27G needles were used for application in the periosteum and mucosa and 22G 50mm cannulas for safe application in fat compartments. The focal point is in definying which aging process is dominant in each patient.

Results: Nonsurgical jawline augmentation using injectable fillers and calcium hydroxylapatite can be effectively and safely performed with adequate background knowledge of the regional anatomy, appropriate patient and product selection and the correct technique. The results are immediate, downtime is virtually zero. Small areas of edema, bruising and discrete pain can eventually occur.

Conclusion: Jawline rejuvenation is a key component to global facial aesthetic rejuvenation, but it is still an area of great difficulty for injectors, with poor results and low patient satisfaction. Basic knowledge of anatomy along with proper choice of products and technique provide great results that will be easily reproducible and with a short recovery time, exponentially increasing patient satisfaction.

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Natural filled lips - Easy and reproducible technique

Objectives: Understand lips anatomy and how to enhance your results with filler.
There are several described techniques to volumize, contour and hydrate lips. Nevertheless there are few described techniques that give natural results and are reproducible for those who are beginning in the aesthetic medicine. This presentation will demonstrate two techniques, one for begginners in fillers, easy to perform and have beautiful results, and the other one for more advanced injectors who are more trained and already have familiarity with both injection devices, needle and cannula .

Introduction: The lips are one of the most important features considering face beauty. Its impossible to have a true, strinking beautiful face without an adequate lip
( taking into consideration the other elements of the face, appropriate contour, adequate proportions between the upper and lower lips, correct projection, depressions, points of light and shadow which will provide all together an harmonic result ). The lips have to be in conformity with the personality of the person who has it. It is important in the first consult to understand the personality of your patient to propose the correct treatment

Materials / method: Patients treated with one seringe (1cc) of hialluronic filler, medium to low rheology and high mouldability in thow different techniques.
The first one is easy for the professionals who are beginning in the aesthetic field hence is only used cannula, bolus technique ( so it demands less hand ability to deliver the right amount of product ) and superficial plane ( which minimizes the risk of intravascular injection ).
The second technique demands a certain familiarity with both injection devices, cannula will be used for volume and projection, and needle to details and contour.

Results: Natural results can be achieved with both techniques and you can refine your technique while already from the first moment providing beautiful results for your patients.
With the cannula only technique is possible to shift tubercles, enhance the volume, give contour and shape and hydrate the lips.
With the mixed technique using also needle the results can reach the next level and give even more natural results, evert borders and treat sclerotic lips which are hard to treat with only cannula.

Conclusion: Lips are a central feature of the face, they represent sensuality, strength and power of communication. A beautiful lip can be created, and it can separate a medium facial beauty from a striking impactant face. Imagine Angelina Jolie without her powerful lips , would she be the same ? Lips have the power to seduce and enchant.
Due to lack of knowledge about anatomy and beauty proportions several bad and unaesthetic results are seen in social medial, but its our duty as Medical doctors to learn the proper technique and change the scenario .

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Malar bags: etiology, classification, pathogenesis, and treatment

Objectives: Report has detailed anatomic reasoning for malar bags formation as well as methods of nonsurgical correction of this aesthetic defect taking into account the proposed classification.

Introduction: Malar bags are anatomic lumps under eyes which pose a big problem not only to the majority of our patients but also to the doctors who set their hearts on harmonic rejuvenation and complex appearance correction.

Materials / method: Treatment. In the therapeutic correction of true malar bagsWe used HI-FU of 60 crosswise lines for SOOF area; hyaluronic acid 24 mg for Ligament line and RF with a frequency of 2 Hz, penetration depth 2-3 mm was used for stimulation.False malar bags are more often caused by the presence of hydrophilic substance (unstabilized and stabilized hyaluronic acid). More often we face a problem of the inadequate technique of hyaluronic acid administration or aministartion into superficial fat pad or drug migration under the action of the circular muscle of the eye. We suggest to use only hyaluronidase.

Results: The proposed treatment regimens demonstrate a satisfactory result of the correction of paint bags. Аlso demonstrates a high degree of patient satisfaction with the treatment.

Conclusion: 1. Knowing anatomy and physiology of "malar bags" allows us to choose a method of complex correction.
2. It's important to differentiate false and true "malar bags".
3. The method of treatment is chosen after some diagnostic.
4. The method might be surgical as well as cosmetological.

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Penile enlargement - Focus on injection

Objectives: Injectable fat, poly-L-lactic acid (PLLA) and hyaluronic acid (HA) have been used for soft tissue augmentation of the glans and the shaft of the penis for more than a decade in the world. The terms "Small penis anxiety" have been used in sexology to refer to a man's excessive concern about the size and/or shape of his completely normal penis.
The aim of our research was to achieve the enlargement effect of HA injection into the penis and to evaluate the improvement of the patients' psychosexual status.

Introduction: This sometimes unfounded desire that men have to have “large sex organs” leads them to seek out and use augmentation methods that are often pseudo-scientific and non-medical. These interventions often cause inflammation, necrosis, deformation of the organ, and even a loss of erectile function.
There are various surgical and non-surgical methods for lengthening and thickening of the penis.
Although surgical methods have a positive effect, they give a certain percentage of complications. That's why we focused on injection.

Materials / method: We used HA for penis girth enlargement in 39 patients who suffer from "Small penis anxiety". The method consists in injecting hyaluronic acid interfascially into the shaft of the penis and into the superficial layer of the glans. The total volume used for 1 patient was 14 ml. Measurements were performed 1 month and 10 months after the injection.
The effectiveness was also evaluated with the Self-Esteem And Relationship (SEAR) questionnaire before and 3 months after the procedure.

Results: Baseline mean penile girth was 7.8 ± 0.12 cm. 1 month after the injection – 9.55 ± 0.1 cm and 10 months – 9.05 ± 0.11 cm. Mean girth increase was 1.75 ± 0.12 cm and 1.25 ± 0.11 cm after 1 and 10 months, respectively. The complications after the procedure we observed in 2 patients: nodal formations and irregular filler distribution. These complications were resolved with hyaluronidase injections.
Regarding the SEAR questionnaire, the satisfaction of sexual life and self-esteem improved significantly compared with the results before surgery by 8.6 ± 0.46 (P < 0.001) points.

Conclusion: The data above shows that this method increases penile girth and the effect lasts more than 10 months without significant changes. This provides a more quick, visible and long-lasting cosmetic effect and, as a result, more satisfied patients.
The injection method of penile augmentation significantly improves the psychosexual status of the patients. It could be considered for the management of small penis syndrome after more detailed research as a safe and effective alternative to conservative approaches to therapy.
Other methods for penis enlargement are also discussed.

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Customized and individual approach for forehead botulinum toxin injection in the line of new published data

Objectives: To relate the fascial anatomy of the forehead to the effectiveness of neuromodulator treatments by conducting a clinical, prospective, interventional split-face study in which injections for the treatment of horizontal forehead lines are performed differently between facial sides.

Introduction: Differences in the effectiveness of neuromodulator treatments for horizontal forehead lines dependent on depth of product administration have been described. However, knowledge in respect to the fascial anatomy of the forehead still remains elusive.

Materials / method: This study included a total of n = 14 patients with a mean age of 35.71 (7.8) years and mean body mass index of 21.9 (3.0) kg/m2 . One side of the forehead was injected superficially by positioning the product in the superficial fatty layer, whereas the contralateral side was injected deep targeting the supraperiosteal plane (random selection). The treatment outcome was rated by the physician and by two independent observers according to a forehead line severity scale (0-4) at 14 and at 30 days.

Results: All three observers agreed in their ratings (ICC: 0.942) that the deep injection technique resulted in a superior outcome: D14 (superficial vs deep) 0.17 (0.4) vs 0.14 (0.4; P = .583) at rest and 1.26 (0.6) vs 0.43 (0.5; P < .001) for frontalis contraction; D30 0.17 (0.4) vs 0.14 (0.3) at rest (P = .583) and 1.21 (0.6) vs 0.43 (0.5; P < .001) for frontalis contraction.

Conclusion: The results of this study underscore how detailed anatomic knowledge can enhance results of aesthetic interventions, in this case horizontal forehead line treatment with neuromodulators.

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Is more better? Benefits of HA soft tissue filler on the psychological and social-related quality of life dimensions

Objectives: What is the impact of hyaluronic acid soft tissue filler on the psychosocial dimension of health?

To determine whether injecting more facial aesthetic units with HA soft tissue filler will improve the health-related quality of life dimension of patients

Introduction: Hyaluronic acid (HA) soft-tissue fillers are popular for volumizing, sculpting, or rejuvenating the face.

Their effect beyond these cosmetic benefits remains poorly defined, especially the changes in the psychological and social dimensions of health.

Materials / method: A prospective study was conducted to assess the psychological and social benefits of treating multiple facial aesthetic units with HA soft-tissue filler using 3 validated FACE-Q scales at baseline and 4 weeks posttreatment between January and August 2022.

Results: Data for 28 participants (n = 26 females [93%]; mean age: 49.7 ± 10.1 years) are available and reveal significant improvements on the psychological (+24.5; P < .001) and social functioning (+18.5; P < .001) FACE-Q scales and a reduction in the appearance-related distress score (−17.8; P < .001) posttreatment compared to baseline. A mean volume of 4.7 ml (range 1.0-15.2 ml) was injected. However, patients who had more than 2 facial aesthetic units injected did not statistically score better on the FACE-Q scales.

Conclusion: Facial treatment with HA fillers was associated with a marked improvement in the health-related quality of life dimension.

While understanding patients’ aims and motivation, an individualized treatment approach is strongly encouraged instead of a “whole-face” approach.

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Successful cosmetic treatment in a patient with connective tissue disorder with calcium hydroxylapatite filler - Case report

Objectives: Considering the availability of a biocompatible and effective dermal filler and its sensible use in reconstructive and aesthetic medicine, this study aims to report a case of good response after a CaHA (calcium hydroxylapatite) filler treatment to improve skin quality in a patient with stable scleroderma.

Introduction: Cosmetic treatments in patients with connective tissue disorders (CTD) is controversial, since there is a theoretical risk of ret-triggering the disease by immune activation. Despite this concern, recent studies have demonstrated that dermal fillers may be safe in patients with CTD. Among the different types of fillers, the choice for patients with CTD should be based on collagen stimulating properties, safety, and low potential to generate inflammation. Several studies have shown that average-sized CaHA microspheres stimulate neocollagenesis with minimal inflammatory response.

Materials / method: Case report of 72-year-old woman diagnosed with scleroderma complaining of sagging and aged skin. Prior cosmetic procedure was performed with a PLLA filler. However, she presented a serious reaction following the application. Upon presentation, her disease was stable for 5 years, it was observed loss of facial contour and sagging. After informed consent was obtained, three separate sessions of CaHA diluted with 1,5 ml of lidocaine were performed, using fanning technique in the sub-dermal plane and 0,1ml aliquots were distributed to cover areas of middle and lower face.

Results: The result observed was an improvement of flaccidity, in skin quality, and facial contour, including in the vector analysis, which was noticeable up to 1 year following the applications. The patient did not experience any adverse effects.

Conclusion: This report shows that CaHA fillers are apparently possible alternatives for aesthetic treatments in patients with CTD. The biocompatibility and suitability of the CaHa filler for aesthetic correction are also applicable in reconstructive procedures for stable scleroderma, in a safe and minimally invasive way, with excellent aesthetic results. . More studies are needed to more accurately compare the properties of the different fillers available, regarding their mechanism of collagen induction, amount of collagen produced, durability and safety in the CTD population.

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Por favor indique a entidade (pessoa ou empresa): merz

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New hybrid fillers are good option in masculinization treatment, full-face protocol with HA and CaHA

Objectives: The hyaluronic era has opened way to the era of collagen stimulators, the future could be the combination of both, the hybrids have come to join the two worlds, giving immediate results and prolonging them.

We wonder that premixing CaHA with HA can improve and prolong the effect of the filler treatment for male treatment.

Introduction: The effect of HAs is mainly based on strategic deposition of filler in the different facial tissue layers resulting in volumization. The effect of CaHA is mainly mediated by neocollagenesis, inducing indirect volumization, tissue-lifting and skin- tightening.
The three major landmarks of volume and mass that dominate male facial topography include the nose, the zygomatic prominences, and the chin and jawline. Men have a squarer face than women, with a sharp jawline and a more pronounced jaw angle.
We wonder that premixing CaHA with HA can improve and prolong the effect of the treatment.

Materials / method: We generate one protocol to masculinization, in which only use hybrid product to volume reposition and redefine bone structure. We treated with filler compounds by HA (20mg/ml) and CaHa (55’7%),
The masculinization treatment was done with 7,5ml of hybrid, and infiltrated with 22Gx50mm cannula. The hybrid filler was distributed through vector fan overlaying all zones to treat in subdermal region.
The treatment was done projecting and repositioning volume in zygomatic, jaws and chin areas, in these structures we remark the angles to highlight masculinization.

Results: We observe low grade of inflammation after injection, this process was resolved five days behind. We follow up the patients to 3 months after treatment, we could observe important voluminization in injection areas, and more definition in zygomatic, jawl and chin region; this patient present thinner and masculine and definition result

Conclusion: In conclusion, we propose treat with hybrid product for full face treatment, because this shown efficacy/safety and in our opinion initial better result that improve over time than HA or CaHa alone fillers.

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Safety and long-term durability of commercial hybrids filler (Calcium hydroxyapatite and hyaluronic acid) - Study with 3272 patients

Objectives: We wonder what the durability of new hybrid is injectable, and what is the safety of this hybrid with hyaluronic acid (HA) and calcium hydroxyapatite. For this reason, analyse 3272 patients and we did sonography study in 3 women 18 months after infiltration.

Introduction: Treatments with injectable hybrids combine the capacities of hyaluronic acid together with calcium hydroxyapatite. Retrospective study with 3272 patients was done to analyse safety and efficacy of commercial hybrid fillers. Although there are various studies on the durability of hyaluronic acid fillers according to their rheology, and calcium hydroxyapatite; little is known about the degradation of hybrid fillers; although some studies analyse duration only with visual effects, we show 3 cases to analyse the long-term durability during 18 months by ultrasound.

Materials / method: Our study includes 3272 patients. Three women between 48-55 years old were studied by sonography at 18 months after infiltration. Theses woman were injected with 1 syringe of Harmonica (1,25ml) per each hemi-face; the hybrid was infiltrated into the zygomatic, ramus and jaw line, and photography follow was done after, post-immediately, 1 month and 1.5 years after injection.
We study one case of late inflammatory response with sonography 15MHz probe.

Results: Our experience in 3272 patients indicate that infiltration with this commercial hybrid filler shown normal acute inflammation after infiltration and only 3 patients shown late inflammatory process, which effects were resolve several days after of the nodule appeared.

The three patients shown an aesthetic improvement 1.5 months after treatment, which were visible until 18 months after.
Through the ultrasound study, the presence of a material in hyperechogenic bands was observed in the injection regions ; showing that after 18 months the commercial injectable hybrid is present.

Conclusion: The ultrasound and photographic study show that injectable hybrids until 18 months after infiltration, obtaining a greater aesthetic result than that described only for hyaluronic acid fillers and calcium hydroxyapatite separately.
Late events with hyaluronic acid are estimated in 0.01-0.1%. Our study showed 0.09% incidence and is correlated with adverse effects with HA.

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Vascular anatomy of the temple - In search of a safe injection plane

Objectives: Demonstrate the vascular anatomy of the temple through authors dissection of both fresh and preserved cadaver. Correlate these anatomical findings with Angiography of the temple. Evaluate the Supra-periosteal space for inherent vascular danger zones.

Introduction: Injection of the temple hollows has been a debated topic. More FDA clinical trials are on the way in the US. This is one of the most vascular regions in the Face with potential for significant adverse effects.

Materials / method: Author has performed dissection on Three Cadaver Heads and Correlated these findings with Vascular radiography to better demonstrate the vascular and compartmental anatomy of this region

Results: The entire temporal region is mostly supplied by Superficial, Middle and Deep Temporal Arteries. The Deep Temporal Artery Lies over the Periosteum and is at increasing risk of inadvertent occlusion with sever consequences.

Conclusion: Injection in the temples need to be performed with extreme caution especially when deep injection over the Periosteum is performed

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Lips filler technique using exclusive cannula, more security and less risk of vascular injury, with natural and beautiful results

Objectives: To describe a safer technic for lip enhancement using only cannula 22G, increasing the safety of the procedure and reducing the risk of vascular obstruction due to ischemic events. The vascular injury is a constant fear among injectors, and provide a safer technic can bring more confident for those who are beginning.

Introduction: The lips have a high risk of vascular injury due to the labial artery, which can transit through different layers due to anatomical variations. But they are also a central structure and of great beautifying power. For these reasons, we need a safe technique that is able to provide a beautiful and natural result.

Materials / method: We used canulla 22 G and hyaluronic acid as filler. We start in the superior lip with a V-shape sticks to draw the cupid's bow and microbolus. Soon after, we do retroinjections in different volumes and different areas for contour, volume and eversion. On the lower lip, we drew the tubercles with two boluses and smoothed them with retroinjection. During all the procedure we remain our device in the subcutaneous layer to improve the security of the procedure.

Results: All treated patients reported a high degree of satisfaction, with natural and beautiful lips enhancement, less bruises, and a smaller chance of artery obstruction.

Conclusion: This is an easy execution technique compared to other filling techniques, presents less risk of vascular injury and high aestetichs results. Can easily be done for a beginning injector.

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Horas	Palestrantes	Título da apresentação	Resumo	Número
12:00	Dr Noor EL BANNA	Fascia in aesthetics: what it is & why it matters (ultrasound findings-based study)	Visualizar	120299
12:12	Dr Meryem Ozlem OZTURK	A new approach for nose augmentation: over 10000 patients	Visualizar	120301
12:24	Dr Gaurav KATARIA	The science to support an effective and complete profile rejuvenation treatment	Visualizar	121989
12:36	Dr Mitesh KAPADIA	HA fillers as an adjunct to lower blepharoplasty surgery: an alternative to fat transfer or repositioning	Visualizar	121992
12:48	Dr Karim SAYED	The elective use of hyaluronidase	Visualizar	122196
13:00	Dr Silvia CABONI	Dynamic lips - Lip enhancement with dynamic fillers: tailored approach for natural and harmonious results in static and dynamic	Visualizar	121986
13:12	Dr Iris TEMPLORA	Multimodal injectable treatment for skin quality improvement	Visualizar	121987
13:24	Dr Fernanda DACACHE JUNQUEIRA	A new approach of the aging face assessment – Jaw contour-focused	Visualizar	121990
13:36	Dr Radassa HERCULANO	Natural filled lips - Easy and reproducible technique	Visualizar	121993
13:48	Dr Ekaterina KRUGLIK	Malar bags: etiology, classification, pathogenesis, and treatment	Visualizar	120298
14:00	Dr Mykola BOIKO	Penile enlargement - Focus on injection	Visualizar	121988
14:12	Dr Kristina DAVIDOVIC	Customized and individual approach for forehead botulinum toxin injection in the line of new published data	Visualizar	122438
14:24	Dr Alain MICHON	Is more better? Benefits of HA soft tissue filler on the psychological and social-related quality of life dimensions	Visualizar	121991
14:36	Dr Rossana VASCONCELOS	Successful cosmetic treatment in a patient with connective tissue disorder with calcium hydroxylapatite filler - Case report	Visualizar	120303
14:48	Dr Esther RISTORI BOGAJO	New hybrid fillers are good option in masculinization treatment, full-face protocol with HA and CaHA	Visualizar	122439
15:00	Dr Antonio Jose FUSTES MORALES	Safety and long-term durability of commercial hybrids filler (Calcium hydroxyapatite and hyaluronic acid) - Study with 3272 patients	Visualizar	124146
15:12	Dr Amir MORADI	Vascular anatomy of the temple - In search of a safe injection plane	Visualizar	124147
15:24	Dr Ana Luiza PUPPE MAGALHAES	Lips filler technique using exclusive cannula, more security and less risk of vascular injury, with natural and beautiful results	Visualizar	124148

IMCAS World Congress 2023
Programa

OS S003 TO S006

Open stage - Scientific lectures - Injectables

Apresentações desta sessão

Sessões recomendadas

IMCAS World Congress 2023 Programa

OS S003 TO S006

Open stage - Scientific lectures - Injectables

Apresentações desta sessão

Sessões recomendadas

IMCAS World Congress 2023
Programa