IMCAS

What I learned In my first 300 deep plane facelifts

Objectives: To identify the key differences between the SMAS facelift and the Deep Plane Facelift.

To understand the key landmarks and techniques for ligamentous release in Deep Plane Facelift Surgery.

To obtain an introductory understanding of performing the Deep Plane Facelift Procedure.

Introduction: Deep Plane Facelift is the latest “in vogue” treatment for facial rejuvenation. Many surgeons claim to perform Deep Plane Surgery, but truly only perform an extended Sub-SMAS procedure. Using the latest 300 Deep Plane Facelift procedures performed exclusively by the primary speaker, this talk demonstrates surgical videos and operative facts about true Deep Plane Facelift Surgery.

Materials / method: 300 patients undergoing Deep Plane Facelift Surgery with the Primary Surgeon are described, and their results/intraoperative videos are shared. The risk factors, complications, revision rates, and outcomes are deprived.

Results: Deep Plane Facelift surgery is dependent upon full ligamentous release of the zygomatic, masseteric, and mandibular ligaments of the face. Surgical video of this is shown and soft tissue release of the MIDFACE and lower face is demonstrated. After surgery, patient satisfaction was enormously high and post-operative photos are reviewed. 1% of patients had a hematoma after surgery, 15% had temporary facial weakness, 5% underwent a minor secondary tuck-up procedure, and 0% had permanent facial weakness.

Conclusion: Deep Plane Facelift techniques are the latest evolution in Facelift surgery. The outcomes are arguably more dramatic and natural, and longer lasting. The risks of complications are similar to SMAS facelift.

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Minimal invasive approach for scarless improvement of the neck area

Objectives: Neck rejuvenation including improved skin tightening and tissues repositioning is one of the most commonly issue in aesthetic practice. Due to ageing process or only as a genetic landmark, poorly defined cervicoangle may be a concern for the aesthetic patient. Treatment options include extended deep plane facelifts but many times patients are asking for more a stepwise approach in order to avoid long recovery and scarring. We propose a treatment plan for skin tightening and tissue reposition with a suspension system and radiofrequency assisted liposuction, done under local anesthesia with pun

Materials / method: A cohort of 63 patients with a median age of 41,2 years were operated by a single surgeon in a private practice accredited facility from January 2021 to July 2022. All cases were documented for associated medical issues and photos were taken preoperatively with patients consent. Mean follow up was 8 months (2 to 12 months). Single dose of antibiotic was administrated at the time of the microincision done with a puncture device. Preoperative bleeding control included 1g of tranexamic acid. All the surgery were done exclusively under local anesthesia. Suture suspension technique included anchori

Results: All the patients reported the surgery as completely painless and as a good experience they would repeat it if needed. The overall complication rate was 3%(n=3). Seven patients had prolonged edema for 3 months after the surgery and five patients reported hypoesthesia for more than 3 months after the surgery. There were no case of neuropraxia. Three patients were low-responders to the tissue contraction with Facetite device. One patients has limited tissue reaction to the suture material that required anti-inflammatory treatment without needing suture removal.

Conclusion: Combing suture suspension and radiofrequency assisted liposuction improvement of the cervicomental angle may be obtained with minimal downtime and high grade of satisfaction among patients.

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An extreme case of hidrosadenitis supurativa involving 10% of body surface area

Objectives: - the importance of early treatment of this disease
-the importance of multidisciplinary approach
-the financial impact of this disease on the public health system

Introduction: Hidrosadenitis supurativa represents a disease with a relatively low prevalence and different degrees of severity. The treatment is often multimodal, both medical and surgical. The patient that presented to our clinic had an involvement of approximately 10% body surface area - axillas, lumbar regions, buttocks, perineum and inguinal regions bilaterally. A team of general surgeons, dermatologists, nutritionists, gastroenterologists and psychiatrists coordinated by the plastic surgeon treated the patient

Materials / method: personal case

Results: The treatment of the patient lasted about 4 months. He underwent a colostomy, multiple debridement sessions and multiple skin grafts. During his hospitalisation he developed several complications: depression, pneumothorax, recurrent infections and an acute pancreatitis. The dressings were changed every other day under general anesthesia.
For months later all the wounds completely healed, but the scarring remains severe - the complete abduction of one arm is impossible

Conclusion: Hidrosadenitis supurativa although it remains a rare disease has a huge impact of the patient life both in the short and in the long run. Moreover, the financial impact of the public health system is non negligible. The key of a successful management remains the early multidisciplinary treatment.

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Custom facial chin implants

Objectives: The aim of this study was to compare the satisfaction index of 10 randomly chosen patients operated on in our service with two different techniques for mentum advancement.

Introduction: Custom facial chin implants are made from bespoke solid PMMA. A prosthesis is planned and manufactured for each patient, making each one have a unique result.
Implants have two basic functions: to deliver quality of life and aesthetics, which has an impact on the patient's emotional and social life.
Thus, we understand that facial implants are a lasting and advantageous alternative to aesthetic procedures such as facial harmonization with hyaluronic acid (fillers) and silicone implants in the face region.

Materials / method: We carried out a retrospective study with a series of cases operated on by our team, comparing the satisfaction index using a visual analogy scale (VAS 0-10), with five (05) patients undergoing chin advancement surgery with facial prostheses, and five (05) patients who had silicone implants.
All ten (10) patients had the intention of harmonizing the face.
The patients were submitted, after 12 months of surgery, to indicate their index of satisfaction with the procedure.

Results: Of the five (05) patients who underwent chin advancement surgery with personalized chin prostheses, 04 indicated a satisfaction rate of 10 (VAS 0-10), and 01 indicated a satisfaction of 8. The patient (VAS-8) reported that he still had a slight edema and asymmetry.
Of the (05) patients who underwent silicone implants, 02 indicated a satisfaction rate of 10 (VAS 0-10), and 02 indicated 7. Both (VAS-7) patients reported that they still had mobility and asymmetry. And 01 patient indicated satisfaction 0, as the prosthesis would have to be replaced, due to bone resorption.

Conclusion: As noted in the literature, our study also presented a case of bone resorption with silicone implants.
In customized facial chin implants, we observed a high biocompatibility. They are produced in PMMA, and surgically fixed with 2.0 system screws. This stability reduces the chances of promoting bone resorption in the implant region.

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Chin augmentation by individual made implant

Objectives: The aim is to determine the possibility and effectiveness of using individually selected and 3D-printed mandibular implants in the long term in patients with microgenia, to investigate their quality of life and satisfaction with the aesthetic result.

Introduction: Reduced chin, which in science is called microgeny, is a significant aesthetic problem. There are several methods for assessing a poorly protruding chin, but most of them are inaccurate when it comes to choosing the right size and shape of the implant. The choice is also complicated by the standard sizes of commercially available chin implants. Most implant manufacturers offer only three or four categories of implants (small, medium, large, etc.) that vary in size from one company to another. Our paper discusses a new approach to accurately determining the size and shape of the chin implant.

Materials / method: The study was conducted in 14 patients, women – 9 (64.3%), men - 5 (35.7%). The mean age of the patients was 25.2 ± 5.3 years, it was the main group who underwent chin augmentation by using 3D imaging and printing to create a custom fit PEEP implants that was fixed by titanium screws. The control group - 38 patients who underwent chin augmentation by standart silicone implants. In both groups we used intraoral incision, that closed by Vicryl 5-0.

Results: The average duration of surgery was 49.3 ± 4.8 minutes in the control group, 56 ± 5.5 minutes in the main group. During 1 year follow up in the main group there was no implant displacement and no another complication (0%). In the control group main complications developed in 12 patients (23.7%) (p < 0.05). The complication was dislocation and visible movement of implants in all 12 cases, and all patients were unsatisfied.

Conclusion: Individual produced chin PEEP implants can be used to produce very nice aesthetic result with minimal complications and very high satisfaction rate.

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Role of lower abdominal flap fixation in abdominoplasty for optimizing scar positioning

Objectives: To define the ideal shape of the abdomen following abdominoplasty with reasonable position of the scar in order to limit its upper migration and settle a method to enhance the results and fix the scar in its position

Introduction: Abdominoplasty is one of the most commonly performed cosmetic procedures.Achieving functional and aesthetic outcome is a major goal.Perfect scar is a main aim and a hidden scar is one of the most desirable issues.
Aim of study:is to assess the result of fixation of the lower abdominal flap in abdominoplasty and it’s long term impact on scar positioning

Materials / method: 50 patients were enrolled in this study divided into 2 groups with group A underwent abdominoplasty without lower flap fixation and groupB with lower flap fixation.Objective and subjective assessment including measurements ,scar scale and satisfaction for both patients and doctors

Results: Upward shifting of the scar was more in group A.The upward shifting was more in midline than other measurement points .Patients’ as well as surgeons’ satisfaction scores were excellent in 80% in group B and 60% in group A

Conclusion: Symmetry and proportion are essence of aesthetic surgery.Fixation of lower abdominal flap in abdominoplasty is highly advised according to our results,reaching a cosmetic balance and patients‘satisfaction with a hidden well designed symmetric scar

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Profiloplasty with fat grafting in Asian patients

Objectives: German surgeon, Neuber described the first human auto-fat grafting in 1893, and fat grafting continues to be applied clinically because of the ease of fat harvesting, the abundance of graft material, and the lack of transplant rejection. However, fat survival and retention rates are unpredictable, and complications such as abscesses, cysts, nodulation, and neurovascular injury may occur.

Introduction: Asians often look to enhance the appearance of the nasal dorsum and chin profile due to certain ethnic deficiencies. Various nasal and chin implants have been adopted for this purpose. In 1963, Dr. Landazuri was the first surgeon to use the term “profiloplasty,” defined as rhinoplasty plus mentoplasty. However, the results seemed unsatisfactory, and potential morbidities were often bothersome. In past decades, fillers have garnered attention, despite complications and other concerns such as allergy, the necessity of repeat injection, and cost-effectiveness.

Materials / method: There were 102 patients (92 female/10 male) with an average age of 43.5 receiving micro-autologous fat transplantation (MAFT) as a strategy for profiloplasty (nasal dorsum and chin augmentation/re-contouring) from Jan. 2010 to Dec. 2020. The autologous fat was mainly harvested from the lower abdomen and then processed and refined by centrifugation at 3 min 3000 rpm (~1200 g) for purification. An average of 2.5 mL (ranging from 3 to 12 ml) and 5.2 mL of the fat grafting was micro-transplanted evenly and precisely in the nasal dorsum and chin, respectively, under intravenous general anesthesia.

Results: The total mean procedural time of applying MAFT for chin augmentation was 45.5 minutes. All patients were uneventfully post-operatively without significant complications reported. The mild swelling and ecchymosis were found but subsided within 7~10 days. During the long-term follow-up (> 6 months) period, 78.0% of patients demonstrated good results (33% were very satisfied, and 45% were satisfied).

Conclusion: The accurate, precise micro-(from 1/60 to 1/240 mL per injection) controlling of fat parcels provides critical facilitation in fat survival with an innovative instrument. Moreover, the patent controlling mechanism facilitates surgeons to perform a superior fat graft as compared with traditional, which was unpredictable, with potential complications with higher survival/retention rate and good long-term follow-up. Micro-autologous fat transplantation appears necessary and determinant in fat grafting and serves as an alternative strategy in Asian profiloplasty.

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Время	Спикеры	Заголовок сессии	Абстракт	Номер
15:30	Доктор Sidney STARKMAN	What I learned In my first 300 deep plane facelifts	Посмотреть	122249
15:42	Доктор Andra Elena MARTIN	Minimal invasive approach for scarless improvement of the neck area	Посмотреть	122246
15:42	Доктор Cezar BUZEA	An extreme case of hidrosadenitis supurativa involving 10% of body surface area	Посмотреть	122247
15:54	Доктор Rodinei BUCCO	Custom facial chin implants	Посмотреть	122248
16:06	Доктор Orest PANCHUK	Chin augmentation by individual made implant	Посмотреть	122250
16:18	Prof Abdel Rahman ABDEL AAL	Role of lower abdominal flap fixation in abdominoplasty for optimizing scar positioning	Посмотреть	122251
16:30	Доктор I HSU	Profiloplasty with fat grafting in Asian patients	Посмотреть	122449

IMCAS World Congress 2023
Программа

ФОКУС НА OS S020

Open stage - Scientific lectures - Face & body surgery

Лекции сессии

Рекомендуемые сессии

IMCAS World Congress 2023 Программа

ФОКУС НА OS S020

Open stage - Scientific lectures - Face & body surgery

Лекции сессии

Рекомендуемые сессии

IMCAS World Congress 2023
Программа