Objectives: The purpose of this presentation is to show a personal experience in various indications for carbon dioxide therapy , such a collagen stimulation, facial firmness, stretch marks, cellulite, localized fat, hyperchromias, scars, obtaining great results.

Introduction: Carboxytherapy, a technique of CO2 infusion through the skin, that has been in practice since the 1930s, it has been used for many therapeutic purposes, from treatments of varicose ulcers, to improvement of the body contour and facial rejuvenation.
In recent times, with the advances of other tecnologies, this treatment has been underestimated or unknow for some.
However, the possibilities of treatments are numerous and the incidence of side effects is practically nil and with an excellent cost-benefit.

Materials / method: The author will show many results in different patients and indications.
The CO2 was infused through the skin by needles connected to a machine, in different levels and number of sessions, according to the indication.

Results: Patients had a improvement in all cases, sometimes not only aesthetic, but also functional.
The only side effects were temporary bruises and edema.

Conclusion: Carboxytherapy should be used more than currently indicated , taking in account the results, safety and the excellent cost benefit.

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Objectives: * 1: Offer in-office treatment to cellulite.
* 2: Offer non-surgical treatment to cellulite.

Introduction: As gynecologist, 70% of my patients ask me if there is "something good" for cellulite/skin laxity treatment other than liposuction/surgery. Few years ago, I could do nothing for them but tell them to go see a plastic surgeon. Now, still as a gynecologist but one that uses EBD for aesthetic gynecology, I tell them that I can help treat them with in-office painless procedures and no downtime. With the same Er:YAG and Nd:YAG lasers that I used for aesthetic gynecology, I can treat adiposities and cellulite, and also restore skin elasticity and firmness.

Materials / method: With the Nd:YAG laser, the objective is to deeply heat the skin with long pulses so the heat transmits to the fat layer and there increases the microcirculation and deep thermo-contraction with a lipolytic effect. With the Er:YAG laser in non-ablative short pulses, the heating of the skin results in collagen remodeling with improved skin elasticity and firmness. The number of sessions depends on the thickness of the fat layer and total area of treatment, with 3-4 weeks interval. The time used for each session is usually 20 minutes.

Results: Improvement in the skin appearance is noticeable as soon as 2 weeks, and for skin firmness, 4 weeks after the first session. In thin fat deposits, the reduction starts to be noticeable after 4 weeks, but in thicker layers could take at least 2 sessions to start noticing. When treating thick fat layers, I recommend lymphatic drainage after the session. Not always you will eliminate 100% of cellulite, but the improvement of the body appearance increases with the number of sessions, and with them, the patient’s satisfaction.

Conclusion: This non-invasive combined in-office procedure shows to be safe, comfortable, fast, painless and effective in the cellulite treatment and skin improvement of patients that won't or can't have surgical treatment.

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Укажите лица (индивидуальное, предприятие, организация): Fotona Latin America

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Objectives: Simplify facial approach with injectables through three simple points for full face rejuvenation

Introduction: Though minimal invasive procedures rank among the most frequent performed rejuvenation techniques in the face, the lifting effect of soft–tissue fillers on the face has not been quantified, so far. In this presentation we propose a simple way to approach the face which has been scientifically proven though a cadaveric study.

Materials / method: 20 fresh hemi-faces obtained from 10 Caucasian body donors (7 females, 3 males) with a mean age of 83.5±6.8 years and a mean BMI of 25.3±4.3 kg/m2 were injected with soft – tissue fillers following a predefined treatment algorithm. 3D surface scanning procedures were performed using the Vectra H1 system (Canfield Scientific, New Jersey, USA). Regions scanned were the forehead, temple, medial midface, lateral midface, perioral region and jawline.

Results: 1 cc injections in the medial aspect of the face i.e. forehead, medial midface and perioral were shown to increase the local surface volume (0.67 cc, 0.56 cc, 0.87 cc) and a local lifting effect was shown and quantified. In the lateral aspect of the face i.e. temple, lateral midface and jawline the change in local volume was 0.45cc, 0.02cc and -0.38cc for the investigated regions. The deep temporal injection resulted in a lifting effect locally (temple: 0.57 y-value) and regionally in the lateral midface: 0.55 (y-value) but was limited in its effect in the lower face (0.03 y-value).

Conclusion: The present cadaveric study provides evidence that soft tissue fillers can be used to induce lifting effects of the face albeit classified as volumizers. In the medial midface, soft tissue fillers have a greater potential to volumize and locally lift.

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Укажите, пожалуйста, лица (индивидуальное, предприятие, организация): SINCLAIR

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Objectives: The first stage of non-surgical nasal reshaping is the initial consultation combined with a good knowledge of anatomy and practical skills in order to clarify the practical approach (filler versus PDO thread) for such a procedure. The physicians need to think of maximum achievement with a minimum risk of complication. There are different fillers and suspension devices in the market. A good selection of these as well as patient’s selection would make this procedure a success.

Introduction: Non-surgical rhinoplasty (more literally known as 'nose filler') is an aesthetic treatment rising in popularity with women and men alike. the demand for such procedures has increased by 35% in the past year. While the injection of fillers are so popular in nose reshaping, the suspension devices also has a significant role in forming and shaping the nose with less risk of vascular compromise as well as fillers migration.

Materials / method: We compare two nasal reshaping with fillers with two nasal shaping with PDO threat. The patient selection was not random and was based on the practitioner chosen method. We use PDO threads in cases that we believed there are more risks of migration of fillers.

Results: Although We believe the PDO threads is a better approach but more studies with a larger sample are needed in order to achieve a conclusion with a lesser bias. We found insertion and performing suspension devices easier and less stressful in comparison to injecting filler. Having said that, PDO has restriction in reaching some places in nose specially when there is some obstruction on its way like a notch or hump. this means a direct injection with filler would be a perfect solution or approach.

Conclusion: Nose reshaping by PDO threads is getting more popular among physician and patients. This approach is safer than the injection of fillers in terms of arterial occlusion and consequently necrosis of nasal tissue. the PDO threads are not migrating in comparison to fillers. A good knowledge of Anatomy and practical skills of PDO threads insertion, would make this approach suitable for future nose shaping. Having said that, it has limitation like access to the far distance nasal anatomical tissue from the tip specially if there is a notch or hump on the way of insertion of threads.

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Objectives: -a) .- The method is simple, safe and reproducible and is an alternative or to improve the angle of the jaw and neck.
b) .- The management of micro lipo grafting achieves natural and long-lasting results.
c) .- It is an alternative that can be combined with aesthetic surgeries such as rhinoplasty, lifting, blepharoplasty, mentoplasty, bichectomy and / or placement of PDO threads or SMAS threads.

Introduction: -The Facial Contour technique is presented for cases in which there is an imbalance between the volume of the lower third, and the appearance of excess fat of the lower facial and cervical third, by means of a cutaneous ligament replacement technique, and micro-lipotransference through minimal incisions. .

Materials / method: Traction of the auriculo-platysmal fascia is performed, through the rotation and traction of the ear and the facial SMAS, with minimal incisions and fixation to the deep fascia and periosteum, this technique has been carried out in two modalities: the first with traction exclusive of the fascia in the retroaricular areas and minimal ear rotation, and the second with rotation of the auricle and auriculo platysmal fascia. In the same surgical time, the necessary volumes of micro-grafts in the facial region are restored, with special emphasis on mandibular angle and melolabial

Results: 32 cases were followed surgically with follow up of up to 4 years, with excellent results in 80%, good in 13.3%, and regular in 6.6%. The 15 cases with microlipograft application in predetermined amount, presented over its life, in a percentage higher than 80%.
This last year, 10 cases were intervened in which this procedure was combined with a face lift, with excellent results in all cases.
The areas with notable changes were: mandibular angle, facial cervical angle, upper third of the neck, mandibular line and jowls area.
In addition, a clear aspect of facial thinning was observed, especiall

Conclusion: The traction and fixation of the auricle platysmal fascia to the periosteum of the mastoid process, either alone or in conjunction with the rotation of the ear, produces a remarkable re-tension of the cervical region mandibular angle and mandibular line that is maintained over time without need to perform dissection or removal of skin tissue. In association with atrial rotation, and retroposition of the same, it is possible to re-tension the SMAS of the cheek and the atrium - cheek fascia that provides a tense and natural appearance of the cheek.

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Objectives: Clinicians will learn to apply relevant biological scientific data to comprise individualized combination aesthetic treatment modalities with greater degree of safety and far improved outcomes. The presentation will also help to learn advanced cellular biology and principles of guided tissue regeneration.

Introduction: Presentation shows algorithm to achieve optimal results Basic tenet of almost all of non-surgical aesthetic procedures is designed to utilize application of a controlled trauma that is within the biological corridor of tissue response leading to a full regeneration.Full regeneration is a desirable outcome that is mediated by the cascade of biostimulation. The repair(scar) pathway may occur if a delicate balance is exceeded.The 3d outcome is also possible when no desirable result has been achieved due to improper trauma dosage or cancelling mechanisms being present or activated.

Materials / method: 54 patients were treated. Preop conditions and postop results were compared based on patients' initial concerns, overall global assessments of tissue before and after as well as the longevity of the results. The modalities used were CO2 and ErYAG lasers full field and / or fractional, 1470 Diode fractionated laser, BBL / IPL of various (visible light) wavelength, fractional RF. PRP, PLLA and HA based fillers, selective lypolysis, suspending threads, preoperative and postoperative skin care regimens with specific mode of action.

Results: Clinical findings and analysis of postoperative outcomes strongly favored combined multileveled AND step-by-step approach ascending and culminating in relatively aggressive treatment versus a single modality or "stacked /all-at-once" treatments.

Conclusion: Such results believed to be due to development of the tissue "preconditioned" for the best and well-coordinated regenerative response to injury. Development of extracellular matrix appears to be the most crucial factor in guided tissue regenerative response

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Objectives: Here we aimed to investigate the levels and longevity of patient and physician satisfaction after the treatment of glabellar lines (GLs) with abobotulinumtoxinA (aboBoNT-A), by performing a systematic literature review.

Introduction: AboBoNT-A is a botulinum neurotoxin type A approved for aesthetic use in treatment of GL, with current dosing guidelines recommending a minimum treatment interval of ≥12 weeks. Previous clinical studies investigating patient and physician satisfaction post-injection, have shown that levels of satisfaction can be sustained for up to 6 months. Patients’ satisfaction with the outcome of their treatment is highly important in the evaluation of aboBoNT-A in aesthetic use.

Materials / method: This systematic review identified English-language publications from the following databases: PubMed/MEDLINE, Embase, Cochrane Library and Google Scholar. The research question was framed in terms of population, interventions, comparators, outcomes and settings (patients with aesthetic indications, including GL and wrinkles; aboBoNT-A; no restrictions [nothing, placebo, other medications, usual standard of care]; satisfaction, both patient and physician; clinical, respectively). A structured data extraction form was used to enable inter-study analysis.

Results: Of 280 papers screened, 30 original research papers assessed patient/physician satisfaction. Patient satisfaction at Week 2 was assessed by 6 out of 12 placebo-/comparator-controlled studies, all reporting improved satisfaction from baseline (n=3) or >50% of patients ‘satisfied’/‘very satisfied’ (n=3). Of 11 studies with assessments at ≥4 months (n=4 at 6 months), all had patients still reporting satisfaction. Of 9 uncontrolled studies (follow-up: 2 weeks–7 months), patient satisfaction (n=9) ranged from 66–100% and physician satisfaction (n=1) was high (98–100%).

Conclusion: This systematic literature review demonstrated that levels of patient satisfaction with aboBoNT-A treatment are high at Week 2 post-injection, and be maintained for up to 6 months in some patients, despite the current recommended interval of ≥12 weeks. These results suggest that aboBoNT-A is an efficacious and durable treatment for GL.

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Эта работа представлена благодаря поддержке: MEDICAL WRITE BY IPSEN

Objectives: NECK REJUVENATION WITH ABSORBABLE THREADS
Can be either a conference or live procedure

Introduction: A flabby and aging neck reveals a person's actual age, but by using techniques with absorbable threads it is possible to redefine the features of a youthful and beautiful neck.

A differentiation will be made between techniques with anchoring and self-sustaining techniques.

What is the best technique for flaccid dewlaps?

Materials / method: 4D PDO threads

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Objectives: To demonstrate the efficiency of pressure therapy on wounds, the value of Rosewhip oil in scar treatments, the advantage that silicone can provide and the possibility to have all of this benefits in one single innovative product.

Introduction: Compression therapy has been known to have positive effects on healing skin by reducing the cohesiveness of collagen fibers in pressure-treated scars, preventing hypertrophy. With a variety of techniques, compression treatments normally consist of elastic adhesive bandages, wraps and silicone dressings.
We hypothesized that the surgical scar may recover faster and better when combining a silicone sheet, that has a technological design that provides compression therapy and reduces tension in the wound, with an adhesive layer with drug delivery system of vitamin E and Rosehip oil.

Materials / method: In this case report, we used a novel adhesive silicone dressing with a drug delivery layer to prevent post-surgical keloid formation in a 54-year old woman with history of keloid formation in surgical scars. This patient was submitted to a knee replacement procedure resulting in a vertical 20 cm long surgical wound across the genicular joint, a high tension area known to be associated with widened scars. We have followed-up the patient for a 8-month period recording the scar development. The silicone dressing was applied onto the surgical site immediately after removal of surgical stitches.

Results: After an 8 months follow up we had satisfying results, without keloid formation or hypertrophic scars, demonstrating a wide range of positive results such as acceleration in scar maturation, a faster decrease in scar hyperemia and reduction of the pruridus. The patient reported a aesthetic scar, especially in comparisson with previous surgical scars and also an improvement in confort during the use of the product.

Conclusion: A scar on joints and high-tension areas are frequently unaesthetic, secondary to enlargement, hypertrophy or keloid, providing a difficult management of the scar.
At final conclusion, this case report presents a novel technology that combines mechanical and chemical properties in one single product, offering a very satisfactory result, without affecting joint mobility, providing comfort sensation and improving aesthetic results.

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Укажите дату....: Published in 16/04/2019
и статус: Deposited in 29/09/2017

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Objectives: Permanent makeup is a rage amongst all age groups with varying degrees of success. Common modalities for permanent make up removal are Lasers, Dermabrasion, Chemical peeling and surgical excision.

The objective of this case report is to emphasise the efficacy of PRP combined with counselling for rectification of a permanent tattoo gone wrong.

Introduction: 26 Year Old aspiring actress presented with hyperpigmentation, swelling, indurations, pain and ulcerations arising post Q-Switch laser sessions to remove excessive pigment from permanent blush.

Materials / method: Treatment Approach:
Oral and topical antibiotic therapy to allow natural wound healing process for a month followed by PRP sessions undertaken once every 3 weeks for 11 consecutive months resulting in >80% improvement in skin, tone and texture. Significant improvement in pigment density and lesion size observed. Patient has been on PRP maintenance therapy once every 2 months since the last one year. Further improvement noted.

Results: -Improvement in facial lesions from third session onwards
-Improvement with reduction in induration, Superficial Scarring, PIH
followed by erythema after third session
-Outcome Post 6th Session: Significant Improvement in Skin Thickness, Reduced Scarring. Concurrently Significant Improvement in Skin Pigmentation
-Complete reduction of PIH, Induration, superficial scarring and drastic improvement in tattoo with little/no residue

Conclusion: PRP is indeed a high efficacy procedure with sustained effect and minimal adverse reactions for permanent tattoo removal. It can nullify the need for a surgical procedure. More studies are required to establish the same.

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Objectives: Melanoma, SCC, BCC and rosacea should not be missed or taken mistakenly by similar presentation of sun damage lesions in initial assessment and consultation. psychological assessment of client is paramount in treating the sun damage facial skin as well as exclusion of the above skin lesion in order to achieve a better result and outcome with patient compliance.

Introduction: An accumulation of an elastotic material is a major histological characteristic of sun‐damaged skin. This elastotic material consists primarily of elastin fibers. Histological studies show loss of collagen in the dermis of chronically sun‐damaged skin. There is a significant correlation between decreases in length, width and total area of oxytalan fibers and severity of wrinkles

Materials / method: Peter, a 62 years old Caucasian man,presented with extensive sun damaged skin. On assessment his DLQI score was determined as 24. He was embarrassed of Lichenificationof facial skin appearance. His facial skin was covered in deep wrinkles and uneven brown patches.He was diagnosed with severely sun damaged skin, AK, possible Rosacea and depression. He underwent a psychodermatological management concurrently with dermatology treatment.
His dermatological treatment combined both: oral medications and cosmetic interventions. He was prescribed a Lymecycline 408mg OD followed by Metronidazole.

Results: His depression resolved within 4 months’ with taking Prozac 20mg OD and CBT therapy sessions. Peter regained his confidence with smother and more even facial skin as opposed at the beginning of his treatment with his combination facial skin rejuvenation therapy of ; a Lymecycline 408mg OD followed by Metronidazole,3 sessions of TCA-chemical peel , microneedling and one session PRP(Platelet Rich Plasma).

Conclusion: A holistic approach is necessary when multi- skin damage is presented with consideration of the effect of skin disorders and mental state. The DLQI was designed to be simple and easy to use in a busy clinical setting: wide experience of its use has confirmed the appropriateness of this concept. Combination facial skin rejuvenation therapy as above in severely skin damage provides a better result in comparison to mono-therapy. Physician should consider and provide such a combination therapy in sever sun damage case

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Objectives: Clinical studies have been published on focused ultrasound showing results averaging 2 cms Body Circumference Loss (Waist, Tummy, Flanks, Hips) per treatment, from the Manufacturer to the End Users (Aesthetic Centers). But they are usually “stand alone” with no holistic slimming program (professional advice on Obesity Management by trained Medical Doctors, Figure Consultants, Slimming Counselors & Nutritionists). This study is aimed to compare if better results were achieved if done in Slimming Centers with additional combined treatments including Obesity Management.

Introduction: Focused Ultrasound breaks the fat cell membrane to release liquid fat. The previously “trapped” fat in problem areas are now ready to be used as energy. But the treatment does nothing to promote calorie burning so if the patient still has a positive energy balance, triglycerides will just redeposit in other areas. Patient must have a slightly negative energy balance to burn the released liquid fat. Obesity Management is therefore key to ensure better results, as well as combining other slimming treatments.

Materials / method: Patients would undergo Medical History & Physical Examination of Center MD. The M.H. includes a questionnaire to rule out any Contraindications for the treatment while the P.E. includes assessment of the requested target area if there is Indication for removal of excess subcutaneous fatty tissue (> 1.5 cms SCT). The specific target areas are the tummy, flanks and outer thighs. Inclusion & Exclusion Criteria are not the same as the Indications and Contraindications for the treatment. Indications are localized protuberant fatty areas while Contraindications are specific medical conditions.

Results: A chronologic sample of 1,344 Focused Ultrasound treatments of 527 patients coming from 9 Slimming Centers were given in 3 Treatment Centers. After applying the Inclusion Criteria, 374 treatments of 201 clients remained while after further applying the Exclusion Criteria, 306 treatments of 184 clients remained. The average centimeter loss per treatment by median is 3 cms (10 cms highest, - 4 cms lowest), by mode is 3.0 cms, 2.0 cms and 4.0 cms (48, 46 & 31 respectively), and by mean is 2.7 cms (819.5 cms / 306 treatments). Other published studies have less than 20% of the population used here.

Conclusion: The average of 3 cms decrease in circumference of patients in Slimming Centers is better than the 2 cms results of most clinical studies were Focused Ultrasound was used solely. Any weight gain during the multiple Focused Ultrasound treatments would diminish the success of decreasing the circumference of fatty body areas mapped by the Medical Doctor and targeted by the computer. Healthful tips on diet and activity enough to maintain weight is already enough to produce good results even without any weight loss.

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Objectives: Using available evidence from aesthetic clinical trials with repeat-treatment study designs, we aimed to examine the clinical response characteristics of abobotulinumtoxinA (aboBoNT-A) and patient satisfaction with treatment.

Introduction: The aesthetic treatment of glabellar lines, caused by procerus and corrugator supercilii muscle activity, using abobotulinumtoxinA is approved in many countries. Patient satisfaction with treatment is often affected by clinical response characteristics (e.g. onset and duration of effect).

Materials / method: We assessed studies with repeat cycle of aboBoNT-A in aesthetic indications (glabellar lines and other wrinkles of the upper face), including 2 Phase 3 open-label studies and 2 routine practice observational studies, for available clinical evidence of duration of response. We also investigated characteristics of BoNT-A products using data reported in recent non-clinical investigations, to investigate why differences in duration may be observed.

Results: Investigator assessment reported a median duration of effect between 88 and 116 days for patients treated with aboBoNT-A in the Phase 3 trials, versus patient assessment of between 84 and 94 days. Median duration was between 152 and 198 days in the observational studies and was similar between cycles. Treatment satisfaction was high (96–100%) across the studies. Pre-clinical research revealed comparable molecular activity of BoNT-A products; however, a higher quantity of active BoNT-A was reported in aboBoNT-A at total recommended doses (glabellar lines) versus onaBoNT-A or incoBoNT-A.

Conclusion: Based on aboBoNT-A phase 3 and observational studies, aboBoNT-A offers patients a long duration of response for sustained aesthetic outcomes associated with high rates of patient satisfaction. A number of head-to-head clinical studies, showing longer duration of response with aboBoNT-A compared with comparator BoNT-A products, further support the clinical evidence. An important factor to explain the clinically observed long duration of response is hypothesized to be the greater amount of active BoNT-A in aboBoNT-A compared with other products.

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Эта работа представлена благодаря поддержке: MEDICAL WRITE BY IPSEN

Objectives: Collate all research results on electromagnetic stimulation in body shaping.

Introduction: High-intensity electromagnetic stimulation represents the only non-thermal modality for non-invasive body contouring. Without any controlled cooling or heating, the technology is widely claimed to simultaneously bulk muscles and affect subcutaneous fat. In order to validate or disprove these claims, this study focuses on collating all available clinical research that has been published or presented to the community since the technology became available. This allows us to present a more comprehensive clinical profile of the technology than a single published study can do.

Materials / method: A total of 13 studies were published and/or presented at major conferences since April 2018. One more study is in progress as per its registration in public clinical study databases. Overall, the studies enrolled 300-350 patients of various age, gender and anthropometric profile. Measurements included (but were not limited to) ultrasound, CT, MRI, tape measures, satisfaction, and three of the studies were based on histopathological evaluation of tissue biopsies.

Results: Most of the data refers to changes in muscle thickness (average growth of 15-23%) and subcutaneous fat thickness (average reduction of 19-27%). Several studies also reported 10-11% reduction in abdominal separation. These changes were quite consistently observed across different time points (follow-up periods ranged between 1 month and 1 year). Histological studies reported increasing fat apoptotic levels and significant muscle tissue hypertrophy.

Conclusion: We conclude that all the clinical data that is available is consistent with the widely accepted indication of use of HIFEM technology. Due to relative novelty of the technology, further research is strongly encouraged.

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Objectives: To evaluate the aesthetic impact of the combination of available surgical techniques to improve harmony on the genital area.

Introduction: Cosmetic intimate surgery procedures are popular nowadays, patients are seeking to enhance their intimate anatomy to improve self-esteem, confidence in preserving their genitalia function and sensations. A comprehensive approach of the female external genitalia by the combination of surgical techniques gives better results than isolated procedures.

Materials / method: The combination of surgical techniques such as Mont Venus liposuction, labia majora augmentation by autologous fat grafting, clitoral hood reduction plasty and labiaplasty when indicated were used to improve female genital aesthetic outcome.
Ancillary procedures as peelings with the trichloro-acetic acid can be performed to reduce hyperpigmentation on the area.

Results: For the last 5 years combined labiaplasties with clitoral hood resection and or labia majora augmentation by fat grafting were performed. Aesthetic and functional outcome was evaluated.

Conclusion: A comprehensive approach of the female external genitalia with the clever combination of available surgical techniques creates harmony, aesthetic and functional results with high levels of satisfaction.

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Objectives: Main objective is To know the use of botulinum toxin type A in patients with seborrheic dermatisis and acne as a co-adjuvant treatment to reduce the sebaceous secretion as well as the safety and efficacy obtained

Introduction: One of the main causes of patients with acne is hypersecretion of the sebaceous gland
Among the causes of the same can enter various factors, such as hormonal pattern, infectious pattern as main agents
Which the hormonal pattern plays a fundamental role in the sebaceous gland and exocrine production of triglycerides by means of neuronal and endocrine stimulation
Therefore, treatment with type A toxin is initiated as an SNARE inhibitor as an objective treatment

Materials / method: Botulinum toxin type A was used to which a vial of toxin of the incobotulinum type to demonstrate its efficacy and safety in the treatment
In which the dilution was 1ml in a 1: 1 bottle in a matter of units.
Subsequently, only 30 units of botulinum toxin of 150kd were obtained for the treatment
Microneedles were performed where those 30 units of botulinum toxin was diluted in 1.5 of saline to use it as a topical type, the penetration rate of the microneedles was 0.5mm

Results: As a result, there was a notable decrease in the degree of seborrheic dermatitis and the presentation of acne by means of electronic dermatoscopy.
The acne pattern had a lot of decrease in appearance, with a degree of decrease or disappearance of at least 5 months in patients who used this type of treatment
The degree of satisfaction was 8-10 in patients who underwent the treatment.

Conclusion: The use of botulinum toxin has been evolving every day; Since its inception every day there are new ways to use it.
In this case, the inhibition of SNARE to reduce the secondary acneic pattern to seborrheic dermatitis is a good expectation in patients who are refractory to conventional treatments.

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Objectives: Here we aimed to investigate the time to onset and duration of effect of abobotulinumtoxinA (aboBoNT-A) for the treatment of glabellar lines (GL), by performing a systematic literature review of published studies.

Introduction: AboBoNT-A is a botulinum neurotoxin type A approved for aesthetic use in the treatment of GL, with the current dosing guidelines recommending a minimum treatment interval of ≥12 weeks. A number of double-blind, randomised, placebo-controlled studies have reported sustained aboBoNT A efficacy for up to 4–5 months in the treatment of GL, with a duration of response of up to 6 months reported in some patients after multiple injection cycles. A median time to onset of action of 2–3 days has been reported for aboBoNT A; however, some patients respond within 1 day.

Materials / method: This systematic review identified English-language publications from the following databases: PubMed/MEDLINE, Embase, Cochrane Library and Google Scholar. The research question was framed in terms of population, interventions, comparators, outcomes and settings (patients with aesthetic indications, including GL and wrinkles; aboBoNT-A; no restrictions [nothing, placebo, other medications, usual standard of care]; efficacy, including onset of action and duration of effect; clinical, respectively). A structured data extraction form was used to enable inter-study analysis.

Results: Of 280 papers screened, 42 original research papers were relevant to aboBoNT-A onset and duration. 21 studies evaluated efficacy during Week 1 of treatment, reporting a response on day 1 (n=6 studies), days 2–4 (n=9), or within 7 days (n=6). Of 7 placebo-controlled studies, significant efficacy vs. placebo was observed at 4 months in all studies evaluating this time point (n=4). AboBoNT-A had a longer duration vs. comparators (≤5 months) in 4/16 studies (methodologies may differ); in non-comparator studies, efficacy was observed at ≥4 months in 11/19 studies and at 6 months in 7/19 studies.

Conclusion: This systematic literature review demonstrated that aboBoNT-A consistently had a rapid onset of action (<4 days) and a long duration of action (>4 months). Despite current guidelines recommending ≥12 weeks between injections, these studies suggest that the duration of efficacy appears to be longer.

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