Objectives: Laser skin Rejunavation and Microdermabrasion was performing on split faces for 15 ladies .These treatments have used for removing hyperpigmentation also to improve skin textures of these clients to compare which treatments are working better .we cleans the skins Well then preforming skin analysis well to recognize skin type and doing face map ,after that we split faces in two part ,in one part we are doing Microdermabrasion and the other part doing Skin Rejunavation with IPL. After that we apply Hydration or calming Masque around 10-15 Minutes ,and we put Serum ,Moisturizer and sunscreen .

Introduction: Microdermabrasion is a form of mechanical exfoliation and is a powerful electronic vacuum. Microdermabrasion can be used to diminish the following condition :Sun damage ,Pigmentation, open and close Comedones ,fine lines ,.....Skin Rejunavation is a system for non-traumatic removal of skin surface layers in a treatment to induce Neocollagenesis in the dermis to reduce wrinkles and improve the architectures of dermal layers.

Materials / method: Products:1-Cleansing Tools :Microdermabrasion Machines
2-Toner Laser Skin Rejunavation (IPL )
3-Masque
4-Serum
5-Moistuizer
6-Sunscreens
Method :After consultation prepare clients take a picture before ,1-Cleans skin well 2- doing skin Analysis 3-Do Microdermabrasion for half of skin faces and SR for other part 5-Apply toner 6-Apply hydration or soothing and calming Masque for about 15 minutes ,Clean skin and apply serum ,Moisturizer and sun screens

Results: Results after skin Rejunavation: 1-The new skin layer will be cytological and architecturally resemble a young and more normal ,healthy skin .
2- following the removal of surface of skin layers at a particular depth, the body`s natural would -healing response begins to regenerate the epidermis and underlying wounded skin layers .
Result after Microdermabrasion: Surface exfoliation ,also vacuum mechanism stimulates metabolism and blood flow and remove dead cell ,cleans white head and black head ,closed and open comedones.

Conclusion: 1-Glowy Skin In both Treatments
2-Removing Texture and Hyperpigmentation 20%in Skin Rejunavation laser
3-Removing Texture and Hyperpigmentation In Microdermabrasion
4- Darkening of Hyperpigmentation after Skin Rejunavation Laser

Totally :Skin Rejunavation laser is more Deeper and stronger procedure compare to Microdermabrasion ,However at least we must apply 4 seasons in 4 months to visit of result of tightening and producing collagen in skin , However Microdermabrasion is a nonabrasive treatment , more safe and cheap and accessible in any spa and for pregnant women

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Objectives: To explore the shifting standards in clients' aesthetic desires, particularly with the aim of achieving a natural youthful appearance, and to elucidate the optimal techniques and treatments to meet these evolving demands.

Introduction: Client expectations in aesthetic services fluctuate, with desires ranging from looking naturally youthful to appearing as if they have undergone cosmetic enhancements. The challenge lies in understanding and adapting to these shifting standards while educating both clients and beauticians.

Materials / method: Emphasis was placed on understanding the natural aging process, which includes bone resorption, fat repositioning, and the effects of gravity on facial features. Aesthetic restructuring methods involved the manipulation of fat and skin folds using various techniques. Devices such as radiofrequency devices, high-intensity focused ultrasound (HIFU), and 4D lasers were explored alongside injectables like skin boosters, botulinum toxin, cross-linked HA, and collagen bio-stimulators. Additionally, the use of threads as a viable method for feature enhancement was examined.

Results: Techniques were evaluated based on their effectiveness in restructuring facial features, taking into account individual aging patterns and client preferences. Results indicated specific suitability and efficacy of different treatments, such as lifts for bone structure remodeling and fills for addressing fat repositioning and volume loss.

Conclusion: The study concludes that aesthetic treatments should be customized on a case-by-case basis to achieve the most natural look, respecting both the natural aging process and individual client desires. A comprehensive understanding of aging anatomy, combined with skillful application of various aesthetic techniques, is crucial for fulfilling subjective beauty standards and enhancing natural youthfulness.

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Objectives: The objective of this study was to analyze the effect of cannula brand and gauge on the risk of vascular penetration.

Introduction: Vascular penetration during aesthetic filler injections can cause serious side effects such as skin necrosis and blindness.

Materials / method: The minimal force to penetrate the superficial temporal artery with 3 cannula brands and 1 needle brand in 4 sizes (22, 25, 27, and 30 gauge) was measured in 4 fresh frozen cadavers utilizing a force gauge that measured as low as 0.1 Newtons. Tissue penetration force in the subdermal plane of the nasolabial fold was measured and compared with retrospective training data in live humans. The arterial penetration test was repeated at a second site on 1 fresh cadaver with 2 different force gauges.

Results: Significantly lower forces were needed with all size needles vs the same gauge cannulas in all brands to penetrate the cadaveric artery and advance in the subdermal plane of the nasolabial fold in both cadavers and live humans. To successfully enter the artery in a cadaver with any cannula, numerous attempts were necessary. The tissue penetration force in the subdermal plane of the nasolabial fold in a cadaver was not significantly different than in a living person; however, it was
significantly higher than the arterial penetration force in a dissected cadaver.

Conclusion: All gauge cannulas (including 27 and 30 gauge), require more force than the same size needle to penetrate an artery. However, it appears that friction coefficient and flexibility, not the arterial penetration force, are the most important factors in keeping the instrument outside the vessel.

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Objectives: Collagen is injected to improve the tear troughs and dark circles under the eyes, and threads are implanted to tighten the loose skin around the eyes. The simultaneous application of the two products prevents the Tyndall phenomenon and puffiness that can occur with hyaluronic acid injections.

Introduction: This technique allows for soft collagen to be injected and improve aging around the eyes. Coagulated collagen can be injected as a volume supplement, while non-coagulated collagen can be injected superficially for skin improvement and dark circle coverage.

Materials / method: 1.Collagen - cannula or needle（micro bolus injection)
2.Thread - in the deep fat layer(net-like injection)

Results: Tear trough depressions, dark circles under the eyes, and mild skin laxity can be effectively improved with natural results and no recovery period after the procedure.

Conclusion: The combination of collagen and threads effectively improves aging around the eye area and prevents complications due to hyaluronic acid injections.

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Objectives: The objective of this lecture is to highlight the importance of neuroscience applied to aesthetic medicine and marketing, aiming at patient assesment and best results with improvement of our patitent's well-being and quality of life.

Introduction: Attractiveness and the concept of beauty have conscious and unconscious aspects of extreme relevance to the aesthetician. Among the conscious aspects, there are cognitive biases such as the heuristics of similarity and the halo effect, and among the unconscious ones, the perceptions arising from archetypal symbols that activate regions of the limbic system, especially the amygdala and reward system.

Materials / method: A literature review was performed to validate the concept of the current IMAGE-ID (visual identity) and the desired IMAGE-ID. A casew of patients treated with a combination of techniques such as botulinum toxin, fillers and technologies will be presented to highlight the importance of lines and shapes in IMAGE-ID analysis, as well the important impact on self-esteem of patients with the results regarding the new IMAGE-ID after treatment.

Results: Patients treated with a holistic approach based on neuroscience and visagism show significant improvement in self-perception, mood, interpersonal relationships and, consequently, in quality of life.

Conclusion: Neuroscience provides us important subsidies that can help us communicate with patients, diagnose their current IMAGE-ID and treat them to achieve the desired IMAGE-ID, thus improving their self-esteem and quality of life.

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Objectives: To discuss marketing practices that promote nutritional supplements in an honest and responsible manner

Introduction: Nutritional Supplement marketing has become a highly competitive arena where the aim is to create effective strategies that will translate to increased product sales. However, the manufacturer is duty-bound to maintain ethically-sound practices with the goal to maintain company and product integrity, effectively protecting the consumer.

Materials / method: Ethical marketing of nutritional supplements include the following considerations:
1. Customer support
2. Evidence-based
3. Full ingredient disclosure
4. Full product disclosure
5. Regulatory compliance
6. Honest testimonials
7. Accurate before and after photos

Results: Ethical marketing of nutritional supplements is mutually beneficial to both manufacturer and consumer. This will effectively build credibility that will ensure consumer loyalty, leading to a robust business climate.

Conclusion: Adhering to ethical standards of practice ensures a brand presence with integrity, creating a foundation for long-term effective product marketability.

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Objectives: * Hair restoration & Hair thickening
* Manage early phases of androgenetic alopecia
* Non to minimally invasive technique to stop hair falling in AGA
* simple procedure with almost no downtime & high satisfaction rate

Introduction: Many people around the world suffer from Androgenetic Alopecia (AGA). There are well-known and approved medications such as Minoxidil and Finasteride, in addition to hair transplant surgery. Recently the use of micrografting technology showed promising results when used for patients with specific conditions. There are constraints when it comes to the benefits of using this technology.

Materials / method: Micrografting achieves autologous cell suspension by mechanical fragmentation of subcutaneous and adipose tissue from the occipital area.
By using hexagonal blade kits with special devices for cutting, mixing, centrifuging

Results: The use of micrografting technology can stop or slow down hair falling, increase hair density and thickness, regrow new hair fibers from the viable grafts and moreover, it affects the hair color.

Conclusion: After treating over 1900 AGA patients in my clinic using micrografting technology and by applying a specific treatment protocol for each case, which involves the use of topical solutions such as minoxidil along with Concentrated Growth Factor (CGF) and other supplements. Promising results were achieved for male and especially for female patients in which hair transplants were avoided. Furthermore, the use of micrografting technology is a treatment for all parts of the head with minimum to null recovery time.

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Objectives: The objectives is to illustrate clinical experience with a new product and highlight the use of PrabotulinumtoxinA injections as an alternative therapeutic option for Raynaud's, focusing on its ability to improve microvascular circulation and alleviate associated symptoms.

Introduction: Raynaud's phenomenon is a vascular disorder characterised by episodic vasoconstriction in response to cold or emotional stress, primarily affecting the extremities, such as the fingers and toes. While oral treatments are commonly used to manage Raynaud's, some patients do not respond adequately or are averse to these treatments due to systemic side effects.

Materials / method: The standard injection technique was employed, with 5 units of PrabotulinumtoxinA administered into each side of the base of every digit of a 75-year-old male patient with Raynaud's affecting both hands. The dilution ratio used was 0.5 ml
per 50 units vial. 100 units injected in total.

Results: Following the PrabotulinumtoxinA injection protocol, the patient reported a significant improvement in hand circulation. Notably, the patient experienced a complete cessation of fingertip cracking, which had been a persistent and distressing symptom.

Conclusion: The successful outcome observed in this case study suggests that PrabotulinumtoxinA injections may offer a promising therapeutic option for Raynaud's phenomenon, particularly in cases where traditional oral treatments have proven
ineffective or are not preferred due to systemic side effects. The improvement in microvascular circulation and the resolution of fingertip cracking contributes to the growing body of evidence supporting the use of PrabotulinumtoxinA as a therapeutic approach for Raynaud's phenomenon.

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Objectives: Understanding the science of Cellular medicine and Peptides: how it translates into regenerative application for beauty and health utilizing our aesthetic toolbox and science

Demonstrate how we can combine EBD, biostimulators with other biologics for rejuvenation and overall health utilizing peptides

Introduction: Defining Cellular Medicine and its applications
How to combine cellular medicine with EBD
How can we slow down aging process externally as well as our biologic clock internally

Materials / method: Scientific data vs anecdotal data

Clinical trials utilizing EBD, biostimulators with stem cells/SVF with exosomes and dividing into 2 groups (One with vs one without these biologics)

Implementing Peptides to improve longevity, internal wellness for external skin, hair, and physical health

Results: Comparing treatments with same EBD/settings yet one set with biologics and peptides vs another set without biologics or peptides

Conclusion: Patients having implemented various biologics and peptides saw improved skin quality/health as well as improved feeling of wellness.

Internal health reflects through skin, hair, physical stamina and cognition which is why we need to combine rather than focus on individual areas.

These combined protocols work synergistically for health/beauty optimization

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Objectives: To introduce innovative protocol in treatment of stretch marks, with expectance to reduce them at least 80%, smaller stretch marks would be diminished and overall significantly better aesthetic appearance would be obtained .

Introduction: Stretch marks are often aesthetic problems related to women’s skin, nevertheless men are not an exception. This is a type of scar that develops when skin stretches or shrinks quickly. After childbirth, hormonal changes, weight gain or vitamin deficiency, extensive training, skin tends to stretch and due to the lack of it’s elasticity stretch marks may appear. The abrupt changes cause skin’s main support, collagen and elastin, to rupture. Risk factors that promote the stretch marks: gender, family history, rapid growth in adolescence, rapid weight gain, cortico or anabolic steroids.

Materials / method: 10 female patients, age 25 - 35, 5 had postpartal stretch marks at the lower abdomen, the other 5 had them after weight and hormonal imbalance at outer gluteal region. Protocol: 3x injectable collagen every 15 days, 22 G cannula, criss cross technique, in two layers, at depth of 2-4mm. Between the sessions: collagen booster (between 1. and 2. collagen session), skin nourishing peptides (between 2. and 3. collagen session ), skin booster ( after 3. collagen session), 30G, nappage SID. After 3 weeks 1-5 x Co2 laser was applied. Maintenance 1x a month injectable collagen next 6 months.

Results: Expectations are to permanently eliminate stretch marks up to 80% after 6 months of treatment which will be visible at the dermatological appointment.
Results recorded on the medical photography depict significant stretch mark improvement. Many of the smaller stretch marks were not visible, while bigger and deeper ones had improved aesthetic appearance. Overall skin in treated region had much better elasticity and turgor.

Conclusion: Stretch marks are challenging aesthetic problem for every practitioner, regardless to their maturity, depth, and size, nevertheless with high quality collagen products, good therapy plan and protocol great results may be achieved

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Objectives: There are many conditions in dentistry that do not see a complete solution by applying conventional methodologies. Botulinum toxin in this regard can often be used as an alternative therapeutic treatment modality.

Introduction: The use of botulinum toxin has been widely accepted for over twenty years, by the international scientific community, in medicine in various aesthetic and non-aesthetic conditions. Of particular interest are the applications of the toxin in the maxillofacial region, related to dentistry. The neurotoxin offers a transient, reversible and relatively safe treatment option for many dental conditions in the head and neck region.

Materials / method: The uses of the toxin in the maxillofacial field can be divided into cosmetic applications including vertical lip wrinkles, gummy smile, dental aesthetics, marionette wrinkles, mandibular contouring and square appearance of the face due to hypertrophy of the masseter muscle. And non-cosmetic mainly represented by hypertrophy of the masseter and temporal muscles, disorders of the temporomandibular joint, bruxism, Frey's syndrome, drooling, implantology and diagnostics.

Results: Continuous research has paved the way for innovative uses of the neurotoxin in dentistry.

Conclusion: Botulinum toxin offers substantial benefits as an adjunct to cosmetic dental procedures, as well as a minimally invasive alternative to conditions that are refractory to routine medical management or require surgery.

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Objectives: in the skin aging process, in addition to skin laxity, there is a loss of volume in some areas of the face. The purpose of the report is to draw attention to the importance of replenishing volumes, even after performing a thightening action on the tissues

Introduction: mechanism of action of fractionated bipolar radiofrequency. Main clinical indications

Materials / method: Study on 250 patients.
In 100 patients I use the double approach ( RF and Injectables) to perform the result, with high satisfactions and long lasting result

Results: Using injectables ( botulinum toxin, HA, polynucleotides , CaHa) with Bipolar RF means to give an attractive and natural result

Conclusion: I use this technology since 2021, with high satisfaction of my patients,but definitely the best choice is the double approach

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Укажите лица (индивидуальное, предприятие, организация): Inmode Italy. Teoxane Italy

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Укажите дату....: 50 patients treated
и статус: 2022

Эта работа не была поддержана никаким прямым или не прямым финансированием. Находится под собственной ответственностью автора.

Objectives: Case report: A 48-year-old healthy woman underwent an aesthetic procedure using Calcium Hydroxylapatite filler intradermally performed by a non-medical injector. According to the medical consensus, the best treatment results can be achieved by combining 5-FU with triamcinolone and diluting using 2% lidocaine. However, both substances are inaccessible in Poland. Instead, we used medication that is available within our country leading to a similar therapeutic outcome we would like to share with the audience.

Introduction: The product was injected intradermally with the "deposit technique" in the neck and decollete areas.It resulted in the formation of visible nodules and granulomas. In our case, due to the limited accessibility of the recommended medications, we altered the treatment protocol recommended in publications.

Materials / method: We used medication that is available within our country leading to a similar therapeutic outcome: 25 mg/ml bevacizumab; dose: 0,5 mg and 6,43 mg betamethasone dipropionate; dose: 1 ml vial mixed with 2% lidocaine. This treatment was repeated every 4 weeks. Additionally we injected tropocollagen with citric acid and nicotinamide in order to support metabolism within the nodules. Before the first treatment session we performed a surgical biopsy for a hist-pat exam. Upon microscopic examination the entire lesion represents a classical example of foreign body granuloma.

Results: Our treatment protocol including injectable tropocollagen with citric acid (CA) and nicotinamide for the valuable nature of CA - it is a powerful accelerant for cellular metabolism that also helps minimize scar tissue formation. CA activates the cell apoptosis through the caspase-dependent pathway, which is beneficial in which is beneficial in case of granulomas and nodules and, at the same time, increases the skin renewal rate. Altering the treatment protocol led to a satisfactory outcome.

Conclusion: The described situation occurred due to several reasons:
a. access to and use of a medical product by an unlicensed injector
b. usage of incorrect technique and plane - intradermal deposits
c. hot baths which increased the inflammatory reaction.
Calcium Hydroxylapatite is an effective and relatively safe biostimulatory filler, however, it should never be used or sold to unlicensed entities without medical education. The proposed treatment is an effective alternative to the international consensus. It is also necessary to continue developing the treatment guidelines for the best accessibility.

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Objectives: The objective of this study is to enhance the precision of facial cosmetic procedures, especially botulinum toxin injections, by establishing reliable methods for identifying facial expression muscles based on surface landmarks. Through detailed analysis of various facial muscles, this study aims to offer a concise anatomical guide, ultimately contributing to improved outcomes and reduced side effects.

Introduction: Anatomical knowledge of the muscles of facial expression is crucial for cosmetic surgery, as it helps minimize side effects and increase the success rate by allowing for accurate prediction of the muscles’ positions. This study aims to suggest methods for predicting the locations of facial expression muscles based on surface landmarks and includes an examination of the positions of these facial muscles.

Materials / method: In this study, we utilized 24 hemifaces from 12 embalmed adult cadavers to conduct precise measurements of various facial muscles. The analyzed aspects, each referenced to specific facial lines, included: 1) the lateral and inferior borders of the orbicularis oculi muscle, 2) the origin location of the levator labii superioris muscle, 3) the levator labii superioris alaque nasi muscle, 4) the zygomaticus major muscle, 5) the risorius muscle, 6) the depressor anguli oris, and 7) the depressor labii inferior muscle.

Results: The orbicularis oculi muscle's details are given, including inferior borders and lateral positions along specific facial lines. The levator labii superioris originates at two points on facial lines. The levator labii superioris alaque nasi muscle shows variation. The zygomaticus minor and major muscles' crucial points are highlighted, with a bifid variant in the zygomaticus major noted in 30% of cases. The risorius muscle starts 58% along a defined line. The depressor anguli oris muscle’s superior border and other key points are precisely measured.

Conclusion: We can predict the location of facial muscles through this study. This study may be helpful for cosmetic surgeries such as face lifting and botulinum toxin injections, and it can also aid in medical illustration, muscle modeling, and routine anatomical dissection.

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Objectives: By using dermal fillers how to turner the corner of the mouth upward
How to create a horizontal plane
Ensuring patient safety and satisfaction .

Introduction: A downturned oral commissure is due to several factors :
loss of skin elasticity
Subcutaneous tissue loss , jowling and pronounced borders of DAO, with formation of marionette lines.
A depressed position of oral commissure is associated with sadness and ageing
Patients are often fixated on improving and reversing the downturned corners of the mouth .

Materials / method: Using a 23 gauge cannula as a subcision tool to separate skin from from the depressor muscles creating a plane to be filled with HA acid
Application of HA in various layers using medium or high G prime HA to allow good product tissue integration.
With a needle small aliquots are placed to correct prejowl sulcus .
The marking for the entry point is shown.
And a video with injection technique will be presented

Results: Procedure is relatively safe as there are no important underlying structures beneath entry point.
Procedure is done by a cannula .
Dividing the ligament in a subcutaneous plane improves this area
Subcised area smooths out the skin indentation caused by subcutaneous extension of retinacular cutis.
Subcision and separation of the labiomandibular ligament releases the oral commissure from downward pull .
Separation of skin from depressor muscles creates a plane to be filled with HA.

Conclusion: This technique turns the corner of the mouth upwards.
It creates horizontal oral commissures.
Homogenizes amount of volume on both sides of labiomandibular ligament .
Achieve uniformity and evenness
It has minimal side effects like discomfort and bruising .
It is relatively safe And is usually associated with patient satisfaction

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Objectives: Understand the reasons why patients undergo (or not) minimal-invasive non-surgical aesthetic procedures. Address needs and fears of the patients.

Introduction: The number of aesthetic minimally invasive treatments increases every year. In 2021 were performed 17.7% more botulinum toxin treatments and 30.3% more hyaluronic acid treatments than in the previous year. The reasons why patients undergo such treatments have been poorly studied.

Materials / method: Based on a validated questionnaire (Face-Q) on social self-esteem and psychological well-being, a questionnaire was created and distributed anonymously via social media (Instagram). Participants were divided into two groups according to whether or not they had already undergone an aesthetic minimally invasive treatment.

Results: Of 586 participants, 130 (22.2%) had already undergone aesthetic minimally invasive treatment and 456 (77.8%) not. Botulinum toxin was the most common procedure performed in 76 (58.5%) cases. Of the 130 already treated, 115 (88.5%) would like to repeat the treatment. The main reasons for an aesthetic minimally invasive treatment were the desire to slow down the aging process (52.4%) or to improve attractiviness (42.7%). Of the 456 respondents who had never undergone aesthetic minimally invasive treatment, 110 (24.1%) would like to undertake it, 118 (41.2%) would not, and 158 (34.6%) were indec

Conclusion: Patients treated with Botulinum toxin and hyaluronic acid have better self-esteem and psychological well-being than untreated. Furthermore, a significant increase in psychological well-being as well as in the perception of one's own attractiveness is shown by the treatments with botulinum toxin and/or dermal fillers.

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Objectives: Starting from a proper assessment of the lower face and following the anatomic knowledge and latest findings, I apply a vertical superficial technique that can be adapted to every patient with a customized approach. A single or double layer of multidirectional injections of hyaluronic acid in the submucosa allows me to obtain natural and harmonic results.

Introduction: Lips have always been a special “communication tool” in woman’s world, with them it is possible to show feelings, attitudes, desires and ideas.
Throughout the years the way they are expressly shown as part of the feminine beauty has changed.
Since lip filler has been established as one of the most required aesthetic medicine treatment, we have to consider that we are dealing with the focus of beauty and attractiveness of the face, though, as doctors, we have to be prepared to listen to patients’ desires and make them understand their real needs.

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Objectives: Evaluate the efficacy and safety of the combined use of exosomes and microneedling in dermatological clinical practice

Introduction: Exosomes, small extracellular vesicles secreted by various cell types, have garnered significant attention in recent years for their diverse roles in intercellular communication and tissue regeneration. In the field of dermatology, their potential goes beyond enhancing skin quality. This abstract explores the emerging applications of exosomes in dermatology, including skin repair post laser, hair restoration, and treatment for various skin disorders such as melasma,rosacea and photodamage.

Materials / method: 20 Patients were treated with exosomes and microneedling at time 0, after one month (time 1), after 2 months ( time 2) and after 3 months( time 3).
Patients were assessed using digital morphometry methods for skin conditions and dermoscopy for alopecia . Griffith, DLQI, Norwood and Ludwig scale were used in the study.

Results: All patients completed the study with improvement in the scores of the different evaluation scales

Conclusion: Exosomes appear promising not only in the management of aging but may have a role in dermatological clinical practice

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Objectives: • To understand the "prejuvenation" concept
• To review the evidence for cosmetic botulinumtoxinA (BoNTA) injections in young adults
• To review dosage when treating younger vs. older adults with toxins

Introduction: There is an influx of young adults seeking botulinumtoxinA treatment to prevent wrinkles. Millennials and Generation Z (Gen Z) correspond to the generations born between 1981 – 1996 and 1997 – 2012, respectively. Together, they constitute the age group that received more than a third of all BoNTA performed worldwide in 2020, and it is estimated that they will be the most significant users of BoNTA by 2025. However, what is the evidence for "preventative tox", and what dosage should we use?

Materials / method: An evidence-based literature review was performed to evaluate the current evidence on BoNTA injections for cosmetic indications in millennials (born between 1981 and 1996) and young adults. A cross-sectional online survey was distributed to aesthetic practitioners from different countries to assess their current practice with BoNTA.

Results: • Wrinkle prevention is the most common reason for seeking treatment in young adults
• There is a paucity of evidence on '" preventive tox."
• On average, younger adults receive fewer units of BoNTA at the glabella, forehead, and crow's feet

Conclusion: The literature review supports the efficacy of BoNTA for correcting wrinkles in millennials. Our findings provide further insight into the dosing pattern of cosmetic BoNTA and motivating factors for seeking treatments in young adults.

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Objectives: In the clinical setting enhance the ability to decipher the proper diagnosis, and act promptly and sufficiently to diminish sequelae of our patients in conditions with HA-filler complications.

Introduction: Complications following injections of HA-filler divert from mild to very severe, e.g. blindness as the most feared complication. For the professional and experienced aesthetic physician prompt and relevant intervention is expected in these situations although specific treatment algorithms for most of the HA-filler-related complications are lacking.

Conclusion: A schematic overview of the complications with clear statements for treatment solutions will be presented based on the up-to-date findings and most recent published recommendations in the literature.

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Objectives: Demonstrate the effectiveness of the biomodulating solution for thickening, strengthening and stimulating the hair bulb.

Introduction: Androgenic alopecia is an androgen-dependent hereditary disease that affects 70% of men and 57% of women and is due to various genetic and acquired causes.

Materials / method: 19 male and female patients suffering from androgenetic alopecia were selected and evaluated using the Hamilton-Norwood scale. Each of them underwent an injection protocol of 4 sessions 15 days apart. Furthermore, each patient underwent a pre- and post-treatment photographic check 1 month after the end of the injection cycle.

Results: The analysis of the post-treatment results demonstrated an improvement in the initial clinical picture thanks to the biostimulation exerted by the product used.

Conclusion: From the analysis of the results obtained, an improvement in the initial clinical picture was demonstrated thanks to the biostimulation exerted by the product used. Considering the aforementioned results after just one treatment cycle, it is likely that further cycles every six months can significantly combat hair loss and thicken the areas affected by alopecia.

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Objectives: Understand the background and the relevant anatomical principles for effective and safer aesthetic injection techniques in the hand

Understand the Anatomically Based (AB) injection techniques in the hand for dermal fillers (FAB technique) and skin boosters (BAB technique) described by the author

Introduction: Non-surgical rejuvenation has historically been focused predominantly on facial treatments, with facial injection techniques being one of the commonest topics in aesthetic courses. Although the importance of addressing aesthetic hand concerns is becoming increasingly acknowledged, the existing literature and training remain limited only to some aspects.
This anatomically based approach to dermal filler and skin booster injections aims to address the gaps in the current literature and general non-surgical medical aesthetics practice on hand rejuvenation injections.

Materials / method: The techniques described are based on consolidated and widely known anatomical concepts, further confirmed by the author’s own experience both as a hand and wrist surgeon and aesthetic physician and on his cadaveric hand dissections.

Results: An anatomical study with the author's proposed clinical applications for hand rejuvenation injections is described. The injection sites and treatment principles are based on the anatomical features of the hand, not only in order to address specific aesthetic concerns but also to reduce the risk of accidental damage to hand vessels, nerves, tendons, muscles, ligaments and joints.

Conclusion: Anatomical knowledge with awareness of the risks and potential complications is paramount and always required for any invasive procedure. Accurate and safer planning and performance of aesthetic hand injections can be obtained following anatomical principles.

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Эта работа представлена благодаря поддержке: Relife (Menarini group) covered some expense

Objectives: Our presentation aims to equip doctors in the field of medical aesthetics with the knowledge, strategies, and inspiration to embrace a collaborative, ethical, and sustainable approach to business growth, while respecting the values of the industry and enhancing the care provided to patients.

Introduction: Introducing a groundbreaking approach to ethical business growth in medical aesthetics. In a shifting landscape where traditional advertising raises ethical concerns, this presentation offers an innovative path forward, harnessing the power of collaboration, referrals, and trust.

Materials / method: Our approach hinges on the cultivation of trusted professional networks, fostering genuine relationships among medical aesthetics practitioners. We emphasize collaboration, referral-based marketing, and ethical promotion techniques, offering a transformative alternative to conventional advertising methods

Results: By embracing collaborative networking and ethical promotion, practitioners can experience sustainable business growth, increased patient trust, enhanced professional relationships, and a paradigm shift in the industry's approach to marketing, all while respecting ethical standards and values

Conclusion: Our collaborative approach heralds a transformation in the medical aesthetics industry. By prioritizing ethical promotion and relationship-based marketing, we empower practitioners to attain enduring success, uphold industry values, and pioneer a new era of business growth. Be at the forefront of this industry evolution

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Objectives: To learn the importance and role of Digital Image in our Aesthetic Practice
To show effective use of Digital Image for marketing and branding
To creatively showcase doctor’s end product (before & after photos) as an art guided by medical science

Introduction: In recent decades, technology has become a big part of marketing in introducing one’s service and product. The biggest media material that most of us are using is Digital Image. Mobile phones images, print ads, digital billboards and prints are creatively done to showcase the information, product and service that needs to be translated and understood at a glance.

Materials / method: In this lecture, I will be sharing my creative process in creating an effective ad. Examples of video clips and photos on my works will be shown to demonstrate the concepts.

Results: The creative process for generating ads is a multi-faceted process—from how to properly shoot before and after photos, preparing artwork, working effectively with a creative team, to uploading and promoting the image in social media. Digital image when used wisely and effectively, will provide credibility to the practice and consequently translate into revenue.

Conclusion: Digital Image is a very important tool in showcasing doctor's practice. A creative strategy in producing digital image is an essential tool to effectively promote your practice. This will help improve the branding, showcase the quality of the doctor’s work and effectively promote the business.

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Objectives: Simulating the anatomy of the lip requires meticulous knowledge of the lip anatomy and vasculature.
Along with the artistic side of the doctor’s eyes to obtain a well-proportioned face.
The 3D lip technique offers a detailed explanation of the simulation, enhancement and/or creation of the anatomy of the lip.
Starting with the evaluation of the whole face along with treatment planning,
infra orbital and mental nerve block techniques, and finally creation of an anatomical enhancement of the lip components with a safer technique that provides a natural appearance in front and profile poses

Introduction: Since the market size of the lip fillers alone is around 2.3 billion USD in 2020
Doctors are compelled to provide the best outcome for the most sought-after cosmetic procedure.
Facial enhancement has been evolving greatly with new technological advances, yet patient demands keep triggering the innovation of new techniques that give the patient the results they aspire to.
Facial optimization has become a very popular concept where patients tend to have a more anatomical simulation or enhancement rather than pure augmentation.

Materials / method: The normal upper lip to lower lip ratio is 1:1.6
And starting from superior to inferior, those landmarks are:
The philtrum and philtrum column
The white roll
Cupids bow
The vermillion border
Tubercles
Oral commissures
recreation of the fore mentioned landmarks to fit with the remaining facial features.
And a detailed explanation of each step.
The proposed techniques have been done on a number of 30 patients ranging between the age of 25-55, all females, medically free from any systemic diseases.
medium line particle size HA material between 0.15-0.28mm was used to ensure homogenous appearance

Results: Patients were satisfied with the detailed definition of the lip anatomy
infra-orbital and mental nerve block provided profound numbness with relaxed anatomical features and a good patient experience
pyramid shaped philtrum and definition of its columns allowed for a natural looking lip from front and profile views
cupid's bow and oral commissures tailored definition allowed for the exposure of the naturally existing lip bulk without material waste.
moulding technique provided the maximum definition of the anatomical elevations and depressions.
90% of the patients recommended the procedure

Conclusion: The 3D Lip technique offers a great opportunity for patients seeking a naturally looking facial enhancement procedures
Angulation of the needle during the injection allows for a safer option and conservation of vascular integrity
profound block anesthesia allows for a comfortable procedure and excludes the errors resulting from infiltration anesthesia
Anatomical simulation of each lip anatomy allows for naturally looking lip while the filler is decomposing
Treatment was efficient using only 1ml syringe for each patient allowing for maximum results with minimal amount of material being used.

Objectives: Define skin rejuvenation, microneedling, mesotherapy
Understand the principles of microneedling and mesotherapy
Identify advantages of using a multi suction injector for effective transdermal delivery of drugs

Introduction: Microneedling is performed not just for skin rejuvenation but also to address multiple dermatologic conditions. It is followed by topical application of cosmeceutical products are performed for better skin penetration. Microneedling is even combined with mesotherapy injection techniques in order for products to be delivered into the deeper layers. A multi suction injector has been introduced which aims to combine microneedling with mesotherapy principles, allowing advanced solution delivery using multi needles with vacuum function to minimize solution leakage, pain and shorten treatment time.

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Objectives: It is essential for injectors to enhance their skills and incorporate the use of canula in aesthetic injections throughout the face. It is crucial to comprehend the back-flow mechanism through the layers of the treated areas, other untreated areas, and its impact on both immediate and long-term aesthetic results.

Introduction: We have been utilizing needles, or some of us prefer to refer to them as needle-like injectors. However, it is no longer just a personal preference. It is now the opportune moment to educate ourselves on the usage of cannulas. By doing so, we can enhance the precision of our procedures and elevate the quality of our aesthetic results. It is essential as we now know about Hyaluronic acid fillers longevity and the migration mechanisms.

Materials / method: Utilizing ultrasound as our primary tool for real-time scanning, I have been able to observe the retrograde movement of hyaluronic acid fillers as they flow back through the layers during needle injections. By comparing this phenomenon to the controlled and gradual backflow than happens with the use of a cannula, I have gathered valuable insights. Moreover, I have conducted ultrasound scans on patients who have undergone mid-face treatments using both needle and cannula techniques, allowing me to obtain evidence on the long-term aesthetic outcomes and more details about migration mechanisms.

Results: ultrasound scans of needle usage has revealed that our initial expectations regarding filler placement have not been fully realized. The fillers, it end up placed into different layers, the part placed into fascia tend to migrate through the fascia due to its inherent contractions. Consequently, they may end up far from the intended treatment areas. Moreover, the sharpness and penetration ability of the needle vary with each puncture, often failing to reach the desired layers for filler placement. In certain instances, the needle may even inadvertently hook onto vessels along its path.

Conclusion: It is important that we familiarize ourselves with the proper use of the canula during our medical procedures. The utilization of the canula not only ensures precision but also guarantees a safer experience. This is due to its minimal, slow and manageable backflow. It is vital to note that the effectiveness of the canula is contingent upon the proficiency of the user, which can be can be enhanced through practice and training. This will enable us to place fillers with utmost accuracy, ensuring long term aesthetic results.

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Objectives: The objective of this paper is to demonstrate the effectiveness of applying intramuscular fillers, in
4725 cases, to correct deformities, volume losses, asymmetry and irregularities.
With the demonstration of the correct application plans, adequate volume, correct technique for the desired results with 2,1% of complications

Introduction: Between 2009 and 2022 we performed a total of 4725 buttocks filling procedures with filler intramuscularly.
Almost 1 million ml of filler was used in these 4,725 procedures, administered through an atraumatic cannula, under local anesthesia with the patient monitoring the procedure in real time.

Materials / method: Intramuscular filler was used, with a cannula, between the years 2009 and 2024, almost 5 thousand filling
procedures with almost 1 million filler used.

Results: We show the complications observed in this sample, 2.1% of complications, no serious complications observed in this
sample. Nodules and seroma were the most common complications, both with a rate of 0.5%, followed by hemtama and pain,
both treated and eliminated in less than 30 days.

Conclusion: By applying the correct technique, adequate volume and manual skill, it is possible to successfully perform body
corrections in the gluteal area. With this procedure that I have been carrying out daily for over 10 years, I can restore
self-esteem, promote quality of life and make women feel more confident and happy with themselves.

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Objectives: We have been injecting glabellar neurotoxin wrong for the last 35 years. The standardised injection patterns increase the risk of side effects and by modifying our injection protocols - both site and spread of toxin - we can get better results with lower risk of complications

Introduction: The standardised injection points for the glabellar as per the SPC for toxins are wrong. The standard injection points we’ve been teaching for over 25 years for glabellar injection are wrong. The injection sites are too high, leading to spread of the toxin into the frontalis and consequent adverse events. A tighter field of effect would allow for more accurate neurotoxin placement directly into the actual corrugator muscle itself.

Materials / method: Using a novel neurotoxin found to have a tighter field of effect, we have treated hundreds of patients using a modified injection pattern. This injection pattern actually injects directly into the muscles that are used to create the frown in the glabellar complex, whereas the injection points as per the SPC are specifically designed to stay "1cm above the orbital rim" to avoid spread into levator palpebrae superioris - a problem that some eminent injectors (Michael Kane) believe doesn’t actually happen. Follow the actual anatomy and you will get improved results

Results: This modified injection pattern has led to better results in terms of speed of onset, longevity (presumably due to increased amount of active toxin within the corrugator muscles) and a reduction in medial brow droop (caused by weakening of the medial fibres of frontalis). It has not led to an increase in lid ptosis, as would be predicted if toxin were to spread inferiorly from these novel injection points into the levator palpebrae superioris.

Conclusion: Using a neurotoxin with a tighter field of effect - either due to the characteristics of the product or by hypodilution - allows for more accurate placement of the glabellar toxin injections. This gives superior results with less risk of adverse effects

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Objectives: 1. To compare different kinds of nonsurgical rhinoplasty.
2. To share experiences using different products and methods of injection (needle vs cannula)
3. To recommend a safer approach based on findings and differentiation of techniques.

Introduction: Nonsurgical nasal augmentation is already a popular approach in Asia in which it is marketed as safer and less downtime. It can be done thru either using dermal filler, PDO/PCL threads or combination, with and without neurotoxin. However, there are already studies stating that half of the cases of blindness associated with injecting dermal filler according to location is at the nasal area. The goal of this study is to share experiences using different products and methods of injection (needle versus cannula) for lesser risk nonsurgical augmentation.

Materials / method: A retrospective analysis using patient's records before and after photos in 380 cases from 2019 to 2023. Patients' age were 18 to 50 years old. There were 50 patients used filler alone injected by a sharp needle. Injected with cannula were 100 while
210 combinations of fillers plus PDO/PCL threads. Excluded were patients who had a history of previous rhinoplasty and lost to follow up A routine feedback satisfaction scores were asked through clinical follow up, social media, personal messages after 2- week and 6-month-period.Consent were done for the procedure and photos.

Results: For the total number of patients, there was a 97% interviewed upon follow up with satisfactory results. Only one case was observed to have upward bulge at the angular artery immediately after the injection of filler using a gauge 27 needle but hyaluronidase was immediately used.

Conclusion: Lesser risk in nonsurgical rhinoplasty can be achieved by choosing cannula over sharp needles. By combining with more threads, it can lessen the need of more dermal filler product. Using ice packs before injection can help in narrowing the vessels before injection. Overall, there is a significant patient’s aesthetic satisfaction six months after the procedure.

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Objectives: 1)review the rehabilitation of patients with facial palsy in acute (<3 months after the onset) and late (>3 months after the onset) periods of the disease;
2)assess the effectiveness of various techniques in different periods of the disease and develop the optimal approach for recovery.

Introduction: Patients with facial nerve palsy suffer from asymmetry of the face and impaired muscle activity. This symptoms dramatically reduce patient's quality of life and can lead to severe psychological problems, including low self-esteem, social isolation, anxiety and depression. That is why the rehabilitation after the facial nerve palsy is extremely important for patients in both, aesthetic and psychological aspects.

Materials / method: Patients were divided into two groups : acute (4 patients) and late stage (6 patients) of facial palsy.
For the patients in acute stage only botulinum toxin was injected into hyperactive muscles on the healthy side.
In the late stage group the botulinum toxin was injected on both paralyzed and non-paralyzed sides in hypertonic and synkinetic muscules. Then hyaluronic acid fillers were injected to achieve symmetry in the volume of the face and produce myomodulation. The House-Brackmann scale was used for evaluation in the acute stage and the Sunnybrook scale — in the late stage of the disease.

Results: Improvement on the House-Brackmann scale was observed in 100% patients with acute nerve injury.The botulinum therapy accelerated the recovery of nerve function in comparison with the control group.
Four patients (66.6%) in late stage of facial palsy showed significant improvement according to the Sunnybrook scale in two weeks after the botulinum therapy. Injection of hyaluronic acid fillers helped to achieve visible symmetry of the face and improve the deficit of volume in both affected and non-affected side.
Of note, both patients without effect in the late stage had complete facial palsy.

Conclusion: 1) Botulinum therapy is a good therapeutic option for the rehabilitation of patients after facial palsy in both acute and late stage of the disease.
2) Hyaluronic acid fillers are recommended for achieving the symmetry in volume of the face .
3) Complete facial palsy in the late postoperative period is a negative prognostic factor for the effectiveness of botulinum therapy.

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Objectives: We sought to assess the compliance, efficacy, and safety of Heterologous Type I Collagen (HTIC) intradermal injections in female and male patients with biopsy-proven activegenital lichen sclerosus, who had shown limited response to topical steroid treatment.

Introduction: Genital Lichen Sclerosus (GLSc) is a chronic, progressive, inflammatory dermatosis predominantly affecting genital mucous membranes in both sexes. Advanced GLSc significantly impacts patients' quality of life and escalates the risk of squamous cell carcinoma in genital regions. Currently, there is no definitive cure or universally effective treatment for GLSc.

Materials / method: In this study, we evaluated the compliance, efficacy, and safety of Heterologous Type I Collagen (HTIC) intradermal injections in nine patients (six females and three males) with biopsy-proven active GLSc, who had shown limited responsiveness to topical steroid treatment. Each patient received four treatments at two-week intervals.

Results: Remarkably, all patients experienced a reduction in lesion size after the first treatment, with complete resolution observed after either the third (five females and two males) or fourth (one female and one male) treatment. Additionally, pruritus, soreness, discomfort, and dyspareunia significantly improved, with complete resolution after the second treatment. Importantly, patients remained symptom-free and did not experience relapses during a 24-month follow-up period with minimal maintenance treatment.

Conclusion: HTIC demonstrates promise as a novel treatment approach for GLSc, deserving further exploration through rigorous randomized controlled trials.

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Objectives: Fortunately, blindness when performing fillers is an uncommon complication, however it is the most terrifying adverse event we can think of and has been underreported with devastating outcomes. With the worldwide increase in daily procedures everyone should be mindful of this complication so that they may be better prepared in the instance it occurs.

Introduction: Blindness its associated with poor mental health, decreased quality of life and possible institutional care. Base on a blindness case I explain what we can learn from it. If you find yourself confronted with the adverse complication of blindness this will help prepare you for proper diagnosis and management, as well as treatment protocol and possible prevention measures.

Materials / method: A procedure done in the forehead (cannulation of the superficial branch of the suprorbital artery) that end up with a patient blanching in the ophthalmic angiosome (supraorbital, supratroclera and frontonasal segment) on the right of the patient, and after a few seconds the patient presented intense headache, bilateral ptosis and nausea. The patient end up Hospitalized with ptosis, ophtalmoparesis and bulk vision, that also developed frontal alopecia and skin involvement after.

Results: Partially (25/20) recover vision after filler procedure. What was done correctly, how we can learn from it and what to do if face with this scenario.

Conclusion: As physicians and injector we should know how to be prepare for this complication from any part of the face, even if we know most of this complication comes from the ophthalmic angiosome. From a review from different treatments options, what we can do from the bedside in our office to try to get the best result possible for our patient.

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Objectives: Objectives This study aims to analyze safety, effectiveness, an patient satisfaction not just about aesthetics but also regarding improvement of the sexual life and self esteem and eventual symptom related to ageing, by injections of a moderate and adeguate quantity of a cross-linked Ialuronic acid (C-L HA), with rheology specifically studied for reshaping of labia majora (LM).Vulva area remodeling, in some cases, allows us to minimize surgery in all cases in which Labia Minora hypertrophy is coexistent with Labia Majora hypotrophy.

Introduction: External female genitalia lose elasticity and volume with age or due tue specific pathological conditions. In the international literature, several techniques address the hypertrophy of the labia minora, but only few reports describe the augmentation of labia majora with fat grafting and filler hyaluronic acid based [1-2-3].

Materials / method: We analyzed 76 patients affected by hypotrophy of the labia majora: 38 Caucasian patients were treated with cross-linked hyaluronic acid (25mg/ml) filler with the rheological characteristic tan-delta close to “zero”, between November 2022 and December 2023. and 38 patients were not treated. The technique used was according with the parameters previously published by the author[3].

Results: The preliminary results achieved on treated patients were analyzed by photography and through GAIS, PSS, LIKERT Scale, FSFI, NRS and VAS questionnaires filled by them were encouraging compared with the patients not treated. No complications were recorded.

Conclusion: Hyaluronic acid infiltration of the labia majora is able to provide a significant rejuvenation with a relatively simple outpatient procedure. We achieved significant improvements achieved thanks all investigative methods with one infiltration, in all 39 treated cases. Bibliography
1. Labia Majora Augmentation: A Systematic Review of the Literature - Jabbour S, Kechichian E, Hersant B, Levan P, El Hachem L, Noel W, Nasr M.- Aesthet Surg J. 2017 Oct.
2. VAGINAL REJUVENATION: A Systematic Review of the Literature - Gianna Wilkie- Deborah Bartz-OBSTET. GYNECOL SURV-May 2018
3. The safe practice of

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Objectives: The telomers represent the end of the cromosomes. As the cells divide the telomers become shorter. Longer telomers mean longer life and better health, shorter telomeres means oposite. The question is can we influence of the telomer lenght to prolong the life and improve health ?

Introduction: Our life style, stress, lack of sleep and other factors promote shortening of the telomers. The most accurate way to measure the telomere length is telomer test which is genetic test. It s based on the intraoral swab. Telomer test gives the most acurate biological age. With telomer test we can measure the lenght of the telomers before and after the treatment for prolonging telomers. Today we have succesful treatments to prolong telomers.

Materials / method: In the trial we have treated 20 clients of both sex, age range was 38 to 67 years. All of them we did telomer test before and after the treatment. We have used different treatments based on the infusions, suplements, egzosomes and stem cells from the fat. We had 5 groups, each group had 4 clients.

Results: The best result was in the group which was treated with the stem cells. Other groups reported also elongation of the telomers but like the group treated with the stem cells.

Conclusion: For the first time we can influence to prolong the life and improve the health with the telomer treatments. The stem cells seems to be to most effective way to prolong the life and improve the health.

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Objectives: Validate the efficacy (aesthetic improvement) and reproducibility (injection technique) of a full face treatment with hyaluronic acid.

Introduction: Treating the whole face with injectables is still full of risks and poor outcomes. The market is nowadays full of HA fillers with different rheology and indications. The need of a standardized injection technique together with a clear analysis of the patient uniqueness should be the first outcome to achieve.

Materials / method: 80 patients were enrolled (72 women and 8 men), age: 23 to 59 years, treated with the same injection technique by 3 doctors in a min. of 3 anatomical areas: zygomatic - malar area, temporal area, chin, mandibular edges, nose. We used high G’ hyaluronic acid fillers, the quantity of product injected was between 4 and 10 ml ( 2 to 6 session in total were performed). We evaluate the patients 30 days after the end of the program with the GAIS scale and a survey made by 3 questions (quality of life; own realization; relationships; natural result) with a score between 0 and 4.

Results: We found no difference in terms of complications between the 3 groups (each group was treated by a different doctor with the same injection technique). The mean value of treatment effectiveness was 3.1 in the survey analysis; the score 1 (excellent result) of GAIS scale was obtained in 82% of patients. The most frequent complication was the hematoma (22%).

Conclusion: The investigated treatment method is safe, effective and reproducible. Moreover, the improvement of quality of life and “natural” look results gave to the patient uniqueness, maintaining its own characteristics. However, it is mandatory to expand the study sample and include more systems of quality analysis.

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Objectives: At present the use of HA dermal fillers for Non Surgical Rhinoplasty (NSR) are based on the concepts learned from surgery, and are injected into the deep or superficial planes. However, this technique is not free of certain controversy due to the risk of adverse events, and it is fundamental to select the right candidate to undergo this procedure. The main goal of this paper is to present 3 case-study patients in order to show the versatility and safety and of an innovative injection technique for nose sculpturing with hyaluronic acid (HA) filler.

Introduction: Rhinoplasty is one of the most popular surgeries worldwide, with more than 852.000 procedures worldwide performed in 2020. Despite rhinoplasty has experienced significant advances over the last years, it remains currently one of the most challenging surgical aesthetic procedures. Due to the development of new hyaluronic acid dermal fillers, nonsurgical rhinoplasty (NSR) has become increasingly popular among patients who want to improve the aesthetic aspects of their nose. Additionally, NSR has been associated with lower cost, lower risk of adverse effects and shorter downtime.

Materials / method: Three types of patients: A - standard indication for NSR (nose with minor aesthetic flaws); B - post Surgical Nose (one year after surgical procedures); C - Extreme NSR (patient with surgical indication who couldn’t undergo surgery). A 25 mg/mL HA filler was administered by using a syringe with a fixed microneedle (30G/8mm). All patients were injected at three key nose points: Radix and Dorsum (maximum 0.3 mL); Tip (maximum 0.2 mL) and Columella (maximum 0.3 mL). Primary endpoint was patients' satisfaction at 12 months which was assessed by using a five-points Likert scale.

Results: The average volume of HA injected was about 0.6 mL (from 0.2 to 1 ml). Patient B was treated with a much lower volume (0.2 ml) compared to others. Touch-up was performed one month after the first treatment (range 0.1 -0.3 ml). All patients were very satisfied with the outcomes and would like to undergo a new treatment. One year after the first session the volume of filler injected in the second session was between 0.1 and 0.5 ml. Only moderate reactive events immediately after procedure (such as swelling and hematoma) were reported and successfully controlled with medical therapy.

Conclusion: This technique was versatile, effective, predictable and relatively safe, with high patient satisfaction. An adequate knowledge of nose anatomy is essential for avoiding adverse events and obtaining satisfactory outcomes. NSR is indicated for the correction of mild aesthetic/cosmetic nose deficits in different types of patients including those which do not accept the costs/risks of surgery.
Giammarioli, G, Liberti, A. Non-surgical rhinoplasty technique: An innovative approach for nasal reshaping with hyaluronic acid fillers. J Cosmet Dermatol. 2023; 22: 2054-2062. doi:10.1111/jocd.15669

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Objectives: Cutaneous atrophy and connective tissue degradation cause wrinkling, laxity, roughness and volume loss in ageing facial skin. We prospectively evaluated a novel regimen devised for patient preparation, autologous treatment and post-application recovery for full facial lift, volume restoration and multi-layer skin rejuvenation.

Introduction: We diligently contrived a novel facial rejuvenation regimen comprised of specific nutritional and skin treatment evaluations/instructions/restrictions and carefully selected products (4), methodologies (3) and procedure kits (2) for autologous biologics traced from market and literature. We aimed for a holistic approach with natural-looking, long-term results based on autologous regenerative technologies and injectable techniques.

Materials / method: 100 healthy participants (78F/22M): Groups A (38p), aged 33-45yo (Mdn 42), and B (62p), aged 46-68yo (Mdn 57) selected, examined & supplemented for 10days. Then, both groups received 1 autologous Platelet-Rich (PR) treatment (Day1). Afterwards, study split in 2 legs: Group A, 2 x PR (D35/65), Group B, 2x PR/Plasma-Filler (D35/120). 4 biopsies/evaluations: Days 1, 35, 65, 160. Both Groups provided with autologous creams. Validated facial skin assessment involved clinical, immunohistochemical, histopathologic, photographic, and ultrasound analyses.

Results: Both groups exhibited remarkable clinical improvement after treatment that maintained till the end of the follow‐up period (12 mo.). We report statistically significant increase (p < 0.01) of: epidermis thickness, dermal–epidermal junction length, collagen volume, skin elasticity, keratinocyte & fibroblast proliferation, skin evenness and hydration, and significant reduction in superficial and deep wrinkle severity and tear trough rating.

Conclusion: The novel facial rejuvenation regimen delivered a marked increase in participant satisfaction and analysed parameter improvement compared to previously tested regenerative technologies and protocols. We claim that the preparation and follow up regimen is equally important as the application itself. The extensive list of parameters monitored provided extensive data of deep tissue regeneration and visual phenotype with lasting effect. Follow up period now extended to 18mo.

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Objectives: The purpose of the study was to study the groups of the most frequently occurring delayed edema after filler injections into various areas of the face and their treatment.

Introduction: The high popularity of using hyaluronic acid-based fillers for volumetric facial correction contributes to an increase in the likelihood of post-procedural complications, including edema. Patients are injected with fillers of different manufacturers and properties, as well as with varying degrees of purification. As a result, foci of chronic subacute inflammation exist in the tissues for a long time, which can periodically worsen and create discomfort for the patient.

Materials / method: The study involved 50 patients who complained of swelling in different areas of the face at least 6 months after filler injections. Difficult cases of diagnosing edema were confirmed using ultrasound examination of soft tissues.

Results: The presentation presents schemes and results of treatment of delayed edema after injection of fillers with a combination of physiotherapeutic, injection and other procedures.

Conclusion: 1. Before injecting fillers, it is necessary to find out from the patient whether injections of hyaluronic acid fillers or other fillers have been performed in the previous 6 months.
2. In case of periodic occurrence of spontaneous edema, it is necessary to treat the patient according to one of the regimens proposed in the study.
3. Treating a patient with delayed edema prior to new filler injections significantly reduces the incidence of adverse events following the procedure.

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Objectives: Easterners gradually experience changes in their facial features such as bone resorption, widening of ligament gaps, skin laxity, and accumulation of superficial fat pads that move inward and downward. These changes Directly leading to a series of stacked aging appearances in the middle and lower facial regions,such as skin wrinkles, sagging, pigmentation and so on.How to achieve Facial rejuvenation in the middle and lower parts through the "efficient point" injection strategy?

Introduction: The author effectively evaluates the beauty seeker before surgery, using systematic aesthetic evaluation method,with which guide clinical operations.Through injection,the Facial aging problem in the middle and lower parts has been solved in multiple dimensions and aspects,with a total of over 200 clinical cases. And a clinical summary will be presented here.

Materials / method: Use materials such as HA or PCL to inject at specific locations in the outer contour area of the face

Results: The volume of the outer contour has been increased, and the capacity of the atrophic bone and deep fat pad has been supplemented, achieving the reduction of the sagging shallow fat pad and the purpose of lifting the face outward and upward, presenting a youthful state.

Conclusion: Through the injection of specific positioning points in the outer contour area of the face, we can achieve the facial rejuvenation in the middle and lower parts.

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Objectives: In the present study, we examine the effectiveness of combined HIFU and eye booster treatment performed in a specific protocol plus botulinum toxin A, as a way to correct periorbital skin aging. As these treatments target structures that are located in different anatomical level, it is of great importance to evaluate the efficacy and interaction of them when combined together, as well as the safety and patient satisfaction.

Introduction: High-intensity focused ultrasound (HIFU) treatment heats the reticular dermis and SMAS to greater than 60 οC, provoking the contracture of denatured collagen and promoting neocollagenesis.
Specific eye boosters improve under eye and lateral canthal wrinkles, sagging skin, dark circles and the tear valley.
In this study, we used Onabotulinum Toxin A injected in crow’s feet and the lower eyelid, combined with eye booster (0.5ml per eye, consisting of hyaluronic acid 2mg/ml, amino acids, niacinamide and glutathione). In addition, HIFU was performed, involving 2 mm depth transducers at 0.4J/mm2.

Materials / method: 53 patients (39 women, 14 men, mean age 46) with medium to severe skin aging were included in the study. All patients had undergone Botulinum toxin A in the past as monotherapy.
Neurotoxin was performed in crow’s feet in all patients (15iu on orbicularis oculi) and in the lower eyelid (4iu in the inf. pretarsal portion) in 15 patients.
In 15 days, 3 monthly eye booster sessions were initiated, performed on day 15,45 and 75 after neurotoxin.
HIFU was performed in 3 monthly sessions on days 30, 60 and 90 after neurotoxin.
Photographs were taken on day 1 and 2 months after the last session.

Results: A significant reduction of lateral canthal and under eye wrinkles was noticed 15 days after the last treatment, with a patient satisfaction rate of up to 85% on month 4, compared with 55% when neurotoxin was used alone.
The patients reported better results in static wrinkles, duration of the result, skin elasticity, sagging and dark circles. Nearly all patients mentioned a better appearance in the skin tone, hydration and tired – eye effect, whilst none of them complained about any severe side effects, except for a mild erythema after HIFU and minimal bruising after injectable eye booster.

Conclusion: The combination of HIFU plus eye booster with botulinum toxin A is a safe, minimally invasive therapeutic approach with great results in periorbital skin rejuvenation. The combined protocol targets all periocular structures that contribute to periorbital skin aging.
In addition, botulinum toxin A seems to have better performance and longer duration when applied as part of Energy Based Device and injectable booster protocol.

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Objectives: This presentation aims to assess the efficacy and long-term outcomes of using fiber optic lipolysis in lower eyelid blepharoplasty. It focuses on the procedure's impact on periorbital aesthetics, reduction of lower eyelid fat, and sustained results. The presentation aims to contribute insights into the potential role of fiber optic lipolysis in lasting lower eyelid rejuvenation, addressing patient satisfaction and safety considerations.

Introduction: Lower eyelid blepharoplasty represents a cornerstone in facial rejuvenation, addressing concerns related to periorbital aging. This study investigates the application of fiber optic lipolysis as an innovative and minimally invasive technique in lower eyelid blepharoplasty, aiming to assess its effectiveness and long-term outcomes.

Materials / method: A retrospective analysis was conducted on a cohort of patients who underwent lower eyelid blepharoplasty with the incorporation of fiber optic lipolysis. The study focused on evaluating aesthetic outcomes, including improvements in periorbital contour, reduction of lower eyelid adiposity, and overall patient satisfaction. Long-term follow-up data, extending beyond 12 months post-procedure, were collected to provide a comprehensive understanding of sustained results.

Results: From March 2019 to December 2022, a total of 261 patients underwent fiber optic lipolysis in the lower eyelid. Photograph data evaluation indicates a 90% improvement in the appearance of eye bags (P<0.05).The procedure took 25 min on average. Total energy of 150 J-510 J (average = 220.35 J) was delivered by fiber optic. The procedure effectively targets and reduces excess fat deposits, resulting in enhanced lower eyelid contour and diminished signs of aging. Patient satisfaction remained consistently high throughout the extended follow-up period.

Conclusion: Fiber optic lipolysis emerges as a valuable adjunct in lower eyelid blepharoplasty, offering sustained aesthetic benefits and high patient satisfaction over an extended follow-up period. This study contributes to the growing body of evidence supporting the efficacy and longevity of fiber optic lipolysis in the realm of facial rejuvenation, particularly in addressing the unique challenges posed by lower eyelid aging.

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Objectives: We have developed our own aesthetic approach and reviewed the anatomical features and characteristics of Asian individuals through clinical case studies.

Introduction: Based on oriental esthetic and anatomic features, the authors have proposed "Future Codes," which are designed in Chinese calligraphy to describe the art of facial rejuvenation in Asians and assist doctors in performing well.

Materials / method: The concept of "Future Codes" encompasses a systematic overall design for the art of facial rejuvenation in Asians. We established a treatment center for managing complications of injectable embolization and, by collecting severe complication cases and considering their relationship with anatomy, we have summarized patterns.

Results: This method is associated with beautiful meanings and is easy to learn and perform safely. We receive 200 cases of complication diagnosis and treatment annually. We have identified safe facial injection areas specifically targeting facial vascular embolism.

Conclusion: The highest level of aesthetic treatment not only serves as a procedure but also as an artistic creation within the limitations of medicine. It aims to discover and create potential, personalized, and vibrant beauty in harmony with nature. By following the guidance of "Future Codes" and considering aesthetic evaluations and clinical anatomical characteristics, we can better provide aesthetic services for Asian individuals while reducing the occurrence of complications.

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Objectives: Presenting my own experience- as a fully authorised licenced provider for Neurotoxin intracavernous injection (BOCOX) in UK- in cases of Erectile Dysfunctions.
-started cohort prospective cases over 3 months (10 cases so far) from March 2023

Introduction: Neurotoxin intracavernous injection was studied in a famous Egyptian Randomised Controlled Study and showed that Neurotoxin injection was useful in intractable casees of ED.
As an authorised provider of Neurotoxin (BOCOX) intracavernous injection in UK, i found it dutiful to start my own case series to document my own success rate and any recorded side effects. Ten cases were done so far over 3 months (and ongoing)

Materials / method: A prospective cohort study had been started from March 2023. So far ten cases were selected for BOCOX injection according to the criteria set in the Egyptian RCT.
Inclusion criteria: as in RCT, mainly in refractory cases of ED
Exclusion criteria: not for less than 25 year old, not in acute infections (systemic or local) and the usual contraindication for Neurotoxin.

Results: own series of cases' success rate and any side effects of BOCOX injection- will be presented.

Conclusion: -it is imperative for every provider of BOCOX injection to start her/his own practice case series to document her/his own success rate, safety, and side effects after immediate injection and every 3 months.

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Objectives: To introduce the relevant literature reports of Microfocused Ultrasound(MFU) for Facial Skin Tightening and share our treatment experience.

Introduction: In recent years, microfocused ultrasound(MFU) has become more widely accepted as a rejuvenation treatment for facial relaxation.It is necessary to systematically review and analyze the relevant literature.We would like to share our experience in using MFU in the clinic.

Materials / method: A systematic search was performed (Pubmed) to assess the efficacy of single MFU treatments for facial skin tightening.  A retrospective study was conducted on 30 Asian patients who underwent MFU facial treatment.Skin test and satisfaction evaluation were performed before and after treatment.

Results: The relevant literature reported that MFU alone, combined with botulinum toxin or combined with hyaluronic acid injection have obtained satisfactory tightening effect.In our retrospective study,skin test results and satisfaction evaluation showed that all patients achieved facial satisfaction after MFU treatment.

Conclusion: MFU alone and combined with botulinum toxin or hyaluronic acid therapy is effective in tightening female patients’ lax facial skin.

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Objectives: Take home message
When treatments are combined for double chin removal as Liposuction, heating with radiofrequency or laser, treads for tightening and Hyaluronic Acid for the reconstruction of the chin there are significantly better results compared to traditional liposuction of this area.

Introduction: Double chin removal is one of the most commonly requested treatments in the field of aesthetics. There are many options available, such as the fat dissolving injection, cryolipolysis, liposuction, thread lifting, laser, radiofrequency, fillers, and more.
When analyzing a double chin, it is very common to find not only fat deposits but also neck skin laxity and an underdeveloped chin/jawline area.
All of these factors should be taken into consideration when planning the treatment.

Materials / method: My preferred approach is always an individualized treatment plan based on liposuction, skin tightening with laser and/or radiofrequency, thread lifting for skin tightening, and chin tip reconstruction.

Results: With my treatment combination, results can be achieved in a single session that could never be attained with the treatments as individual therapies, and these results are sustainable for years. You can see the outcome even on the operating table. Due to the combination, there is no need for post-treatment. Compression treatment is not necessary.

Conclusion: For the treatment of a double chin, liposuction is the most efficient treatment option. However, in many cases, along with the fat in the double chin, there is also loose skin and an underdeveloped chin area. Combining liposuction with skin tightening using heat-based methods (laser or radiofrequency), along with a thread lift and chin tip reconstruction using hyaluronic acid, leads to sensational, immediately visible, and long-lasting results.

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Objectives: To educate doctors about current research and data on underlying causes of common cosmetic concerns and aging patterns to help better assist safety and wellbeing as well as efficacy of results

Introduction: Common cosmetic concerns (wrinkles formation, droopy face, periorbital (dark circles, sunken eyes, wrinkles, dry eyes etc), bone loss, fat distribution, tired appearance, dark pigments and vitiligo, lower face heaviness and others) can be addressed more effectively if both superficial cosmetic treatments and the underlying concern are treated. It grows patient's loyalty, overall health, and is a paramount of medicine holistic care

Materials / method: Current published research, textbooks and published articles involving common cosmetic concerns and aging process and what were researched as a treatment of the underlying causes.
Overview of current research from a point of view of a practical doctor.

Results: Correction of an underlying cause itself provides better outcome. We can also use a combination protocols in treatment of cosmetic concerns.

Conclusion: Combination treatment of an underlying cause and cosmetic procedures for the concerns provides more holistic and effective approach for patients

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Objectives: Understand the difference between static and pulsed magnetic fields. Learn about the current and potential role of Pulsed Electromagnetic Field Therapy in cosmetic and antiaging medicine. Understand why there is such a limitation of our knowledge base and challenges to future refinement of protocols. Gain an understanding of wide range of clinical applications in which research is currently underway.

Introduction: Magnets in one form or another have correctly or incorrectly been used in healing for hundreds of years. Over the last century, our knowledge has continued to grow on the mechanisms in which pulsed magnetic fields induce biological change. In the 1980s, the first PEMF device was approved by the FDA for bone healing for non union fractures. Since then, we have seen the benefit of PEMF in wound healing, apoptosis of cancer cells, drug delivery, osteoporosis and many other conditions. The role of PEMF for cosmetic and antiaging medicine will be discussed.

Materials / method: Review of literature through literature search.

Results: Over the last 30 years there has been a significant increase in the amount of research being done as to the role of PEMF for all aspects of medicine. Literature search reveals that what was once considered "alternative" is now being understood on a scientific level. PEMF is now seriously being investigated for a role in wound healing, orthopedic, neurologic, psychiatric, cancer and drug delivery.

Conclusion: The potential benefit of PEMF in all aspects of medicine are evident. With respect to cosmetic and anti aging medicine clinics, PEMF can aid in post procedure healing, acne, general tissue repair, osteoporosis management and more. Clinics can incorporate PEMF as an in office procedure or educate clients on home use.

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Objectives: 1. Review new techniques for pain prevention in EBDs where patient pain impedes series treatment compliance, or results in negative patient experiences and risks facial heat induced lipolysis.
2. Review mechanism of additional benefit of preventing EBD heat induced facial lipolysis, or atrophy.
3. Review protocol enhancing nonsurgical suspensory ligament contraction with EBD energy stacking
4. Review benefit of regenerative approaches applied as final step for EBD energy stacking

Introduction: I would like to review a simple technique for anesthetizing the face, (or other area), which give a painless pt experience when stacking EBDs. Benefits beyond pain prevention, include;
1) Prevents heat induced lipolysis by creating aqueous paths of least resistance for energy to travel through adipose.
2) downtime post treatment is minimal
2) Nonsurgical contraction of suspensory ligaments below and above the SMAS, in addition to the SMAS ,are achieved, allowing for greater laxity reduction in addition to dermal contraction and other benefits.

Materials / method: This method utilized a version of tumescent local anesthesia (TLA) placed in small blebs around the boarders of face and hairline with a 30 ga needle. Then a 25ga 2" cannula, or similar, was used to infuse approximately 40-60cc total of TLA in thin layers throughout the supra-periostial, sub-SMAS, supra-SMAS, subcutaneous, intra-adipose / deep dermal facial tissue spaces. HIFU, and RF were then sequentially stacked in the tissue from supra-periostial to upper dermal layers to achieve full thickness anesthesia of the face.

Results: 28 patients (27 female, 1 male) received this TLA protocol. 0 reported pain beyond the initial bleb's before the TLA. HIFU & RF EBDs were stacked at 12mm, 8mm & 4.5mm (where appropriate), 3.5mm, 3mm, and 1.5mm (HIFU, then RF microneedling at each layer, 2-3 passes each 80-100% max. Photographic comparison at 10weeks, and 6 mo post treatment showed significantly greater laxity reduction, and dermal layer contraction, without lipolysis of facial adipose or other unintended heat injury to tissue. All patients self -reported noting changes at 10 weeks and greater change at 6 months.

Conclusion: This simple method resolves pain with EBDs known to be prohibitively painful for patients. Additionally the following significant benefits are also apparent:
1) aqueous pathways created in facial adipose with TLA, likely prevents heat induced lipolysis and other unintended tissue heat injury.
2) SMAS and suspensory ligament contraction appears more significant than isolated EBD approaches.
3) Post procedure PRP, topical SC; POD/1 eliminated redness, & most edema for all patients.
4) Strategic full thickness TLA may reduce pain, facial lipolysis and heat injury while improving outcomes

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Objectives: The purpose of this study is to investigate and discuss the complications and side effects of microneedling

Introduction: MN brings significant positive changes, although this method also has side effects. The side effects and complications are multifactorial, and the author based on her experience categorized them into six fields.

Materials / method: In this paper microneedling side effects and complications are discussed in A. Procedures and materials used; operator; D. Sterile device and skin; Standard Device; neglected aftercare and patient factor.

Results: Procedures and materials used; operator; D. Sterile device and skin; Standard Device; neglected aftercare and patient factor leads to different complications and side effects

Conclusion: MN adverse events, though uncommon, are significant as they may leave patients seeking treatment for cosmetic reasons with disfiguring results. There is a need to inform these classified complications so that doctors who work in this field can learn about the methods of prevention and management of these complications.

Декларация COI

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