Objectives: -Identify the power of the untapped Millennial market opportunity in aesthetics
-Identity the top five values of Millennial consumers when researching aesthetic providers
-Learn the top two factors that increase Millennial patient conversion the most, according to a cosmetic consumer analysis survey conducted with Google
-Learn how to build relationships and trust the right way to increase lifetime value and retention

Introduction: In 2020, it was forecasted that the global medical aesthetic industry will be worth $22.5B by the end of 2025 and grow at a 14.9% CAGR (compound annual growth rate). Within the total addressable market, Millennials represent the largest consumer group with full purchasing power, as well as the only generation that is expected to gain market share through 2025. This session will discuss effective strategies practices can implement to connect with, convert and build lifetime trust with the modern Millennial patient, to help fuel the growth and sustainability of your aesthetic practice.

Materials / method: cosmetic consumer analysis survey, published peer-reviewed research by the author

Results: Practices who capitalize on the Millennial movement in aesthetics will be the businesses that thrive in 2023 and beyond, given the fact that the Millennial generation is the only consumer group expected to pick up market share through 2025.

Conclusion: Practices who capitalize on the Millennial movement in aesthetics will be the businesses that thrive in 2023 and beyond, given the fact that the Millennial generation is the only consumer group expected to pick up market share through 2025.

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Objectives: to describe the author's personal experience with the new isomere of polylactic acid, PDLLA, compared with the well know isomer, PLLA. The presentation shows the differences in the preparation process of the two products and the aesthetic outcome.

Introduction: Recently a new trend is spreading in the aesthetic market. Practitioners and patients are looking for more natural procedures and devices, more discrete subtle results, trying to avoid fake, unnatural outcomes. In this light, some of the substances are emerging from the past living their second rebirth.
One of these substances is polylactic acid.

Materials / method: The author compares the two products present in the market. The outcome of the use of PDLLA is evaluated subjectively and objectively.

Results: The new isomer of PLA, PDLLA, seems to be as effective as PLLA. Nevertheless, the preparation of the new product based on PDLLA for the injections is much easier and faster, the suspension obtained is stable and smooth which makes it more comfortable for the practitioners.

Conclusion: The new isomer of PLA, PDLLA has the same collagen stimulation effect as PLLA. The technical details such as the preparation, the instant use, and the characteristics of the suspension make the injections of PDLLA trouble-free procedure interesting for everyday use even for the clinics with a very tight schedule.

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Objectives: To review the psychology of beauty and attractiveness in facial aesthetics and to determine the impact of hyaluronic acid soft tissue filler on the psychosocial dimension of health. Furthermore, to determine whether injecting more facial aesthetic units with HA soft tissue filler will improve the health-related quality of life dimension of patients.

Introduction: Hyaluronic acid (HA) soft-tissue fillers are popular for volumizing, sculpting, or rejuvenating the face. Their effect beyond these cosmetic benefits remains poorly defined, especially the changes in the psychological and social dimensions of health.

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

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

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

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

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Objectives: This abstract discusses the potential benefits of exosomes as an adjuvant therapy with standard first-line energy-based treatments for severe acne scar remodeling. Atrophic acne scars with severe underlying fibrosis can be very challenging to treat, especially in the forehead, and temple areas, and is even harder in darker skin types. Exosomes, are small lipid bi-layered nanovesicles loaded with growth factors, nucleotides, proteins, and lipids that have shown promising improvement in wound healing, scar remodeling can offer synergistic benefits in the optimal correction of acne scars.

Introduction: Acne scars are the most common troublesome chronic inflammatory skin condition that leads to scarring and hyperpigmentation. Post-acne sequelae can have a significant impact on a person's self-esteem and quality of life. While traditional treatments such as peels, microdermabrasion, dermabrasion, subcision, laser therapy, and RF micro needling have shown some success in improving the appearance of acne scars, there is a growing interest in the use of exosomes as adjuvant therapy for these treatments. Exosomes offer excellent anti-inflammatory benefits in the treatment of acne scar revision.

Materials / method: We reviewed acne scar patients who received exosome and EBD combo therapy for 3 years from 2020 to 2023. These patients had all types of acne scars with various stages, depth, fibrosis, with or without erythema and hyperpigmentation. This was a 3 step procedure. All of them had subcision, followed by FRF or 1550 or both then had topical application of exosomes. Patients with forehead or temple scars with severe atrophy had microdisection/ hydrodisection with exosomes using 32g 4 mm needle instead of subcision. Finally LLLT was used to enhance the absorption of exosomes.

Results: Our patients noticed a visible improvement in the quality of skin after two sessions of exosomes combo treatment with EBD and subcision.They had a significant reduction of both acne breakouts, reduction of acne-induced erythema, and acne-induced hyperpigmentation without the use of vascular lasers or PICO lasers. My patients reported high levels of satisfaction with the brightening effect and smoothness with fewer sessions. Almost all of them had shorter recovery time, no side effects such as post laser PIE and PIH.

Conclusion: Exosomes offer a powerful anti-inflammatory & regenerative benefit that can synergistically work with energy-based treatments in patients with difficult or severe acne scarring. The exosomes reducing chronic inflammation, their effect on all 4 phases of wound healing, and reduction of erythema and pigmentation can be great adjuvant therapy for both the prevention and treatment of acne scars. The cell-free Exosomes adjuvant therapy with EBDs can be the future in preventing and treating acne scars, especially in high-risk SOC patients and severe acne scars with erythema and pigmentation.

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Objectives: To investigate in clinical practice the classical methods of prevention and treatment of the lower eyelid retraction and ectropion syndrome, as well as to develop new methods that could be more effective in similar cases.

Introduction: While performing aesthetic lower blepharoplasty, patients usually set a goal to remove the maximum amount of excess skin and at the same time leave the shape of the eye unchanged. However, simultaneous fulfilment of both of those conditions is complicated, therefore a moderate amount of the excess skin has to be removed in order to avoid round eye syndrome or eversion of the lower eyelid. In addition, patients quite often ask to eliminate the already existing deformations of the lower eyelids of this kind.

Materials / method: To eliminate deformities of the lower eyelid of congenital, iatrogenic, traumatic and
neurological etiology, as well as to prevent such deformities in blepharoplasty, along with the known methods, we used the a thread lifting method on the edge of the lower eyelid throughout, and strengthened it with special thread methods and thread bridge-like spacers.

Results: The application of the proposed method allowed us to improve the results of the treatment of patients with ptosis of the lateral canthus, ectropion , eyelid retraction and cicatricial deformities of the lower eyelid, in the presence of weakness of
the lower eyelid margin, as well as undesirable consequences after unsuccessful blepharoplasty. In almost all cases, it was possible to obtain a good or satisfactory stable effect.

Conclusion: In our experience, the presented technique is quite effective in eliminating lower eyelid deformities and can be successfully used in presence of certain indications.

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Objectives: General:
Describe the results of the mastoplasty technique in breast hypertrophies with bilateral triangular flaps and semi-moon skin closure at the upper edge of the areola.

1. Describe the general characteristics of the study sample.

2. Evaluate the results of the technique.

3. Identify the most frequent complications.

4. Know the satisfaction of patients.

Introduction: The usual techniques of breast reduction and pixies are performed with flaps of different pedicles and skin resection, usually with T, L, or J closure with a scar whose size causes dissatisfaction in the patient. The technique of breast reduction and pixie by resecting two horizontal bilateral triangular flaps (gland and fat), with skin closure of about 4 cmtrs in crescent in the upper third of the areola, is a useful resource. The present technique was proposed to solve mild and moderate hypertrophies of the breast with or without ptosis performing reduction and pixie.

Materials / method: Breast reduction and pexia surgeries performed over a 6-year period from January 2009 to December 2015 were reviewed. We analyze the data obtained routinely in our surgical practice, therefore the study is an experimental research carried out in the field, in a natural, retrospective, comparative, controlled environment. Important demographic and clinical variables were exploited in two groups, one called experimental consisting of 187 patients with inclusion and exclusion criteria who presented ptosis, hypoplasia and breast hypertrophy.

Results: The results were satisfactory in 77 patients out of 187 patients studied as shown by statistical analyses and clinical cases. We conclude that, with the scar in the upper third of the areola, the preparation of a subcutaneous tunnel and two lateral glandular-fatty triangles we achieve the same result in breast hypertrophy and ptosis surgery as obtained with vertical scar surgery or inverted T

Conclusion: 1- The sample studied was characterized by a predominance of married women, with white skin color and sexually active age; In them it was possible to reduce the breast volume without leaving alterations of the sensation after eight months of surgery.

2. The technique of breast reduction and pexia performing resection or imbrication of horizontal bilateral triangular flaps and closure of semimoon skin in the upper half of the areola, offered good results when performed in breasts with mild to moderate hypertrophy.

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Objectives: Objective: Despite the popularity of fat grafting, the isolation of adipose-derived cells (ADCs) and manipulation of fat tissue remain controversial. Since 2001, studies have confirmed the abundance of various cell types derived from fat tissue, but isolation, activation, and immediate use of these cells for fat transplant remains challenging. This study aims to demonstrate the evolution from chemical to mechanical dissociation techniques for isolating ADCs from adipose stroma since 2002.

Materials / method: Methods: Adipose tissue is collected from the abdomen of liposuction patients and processed using two selective methods: chemical and mechanical. The presence of mesenchymal stem cells in the pellets obtained from both methods is confirmed through indirect immunofluorescence and flow cytometer analysis.

Results: Results: From 2002 to 2020, 741 patients underwent autologous fat transplant preserving ADCs, with mechanical dissociation being the selected method for human use. On average, the mechanical method isolated 20-30 million mesenchymal stem cells/100ml of processed lipoaspirate, while the chemical method yielded 30-40 million cells. The mechanical method is collagenase-free, reproducible, and has been used in a long-term evaluation since 2006.

Conclusion: Conclusion: Fat tissue manipulation and ADC isolation have traditionally been done in the lab or with expensive processing machines and collagenase. The mechanical dissociation technique shows promise as a reproducible, collagenase-free method for isolating ADCs, with potential applications in regenerative medicine and new technologies.

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Objectives: 1. To review the pharmacodynamics of local anesthesia and its application for common aesthetic procedures
2. To demonstrate the utilization of local nerve blocks on certain aesthetic procedures for the scalp and the face
3. To highlight the advantages of doing local nerve blocks in the aesthetic surgery

Introduction: The advent of peripheral nerve blocks in the beginning of the 20th century has revolutionized the conventional delivery of anesthesia. In particular, the employment of local and regional anesthesia to the scalp and face has enabled dermatological and aesthetic practitioners to optimized the treatment management options for patients, in an office-based setting.

Materials / method: Local nerve blocks with the use of Lidocaine + Plain Normal Saline Solutions (PNSS) + 0.1 mL Epiphrine (1:100,000 dilution) have their applications to a variety of procedures such as hair regeneration, brow lift, jaw contouring, rhinoplasty, lip and chin augmentation, botulinum toxin injection and thread lifting to name a few.

Results: The utillization of local blocks demonstrated advantages such as reduction of significant pain, procedural cutting of economical costs, and improvement of patient and doctor satisfaction.

Conclusion: Superior knowledge of the head and facial landmark anatomy as well as understanding the pharmacodynamics of the anesthetic drugs are paramount of importance to methodically maximized patient's comfort using local anesthesia in aesthetic procedures without producing any inadvertent effects or complications.

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Objectives: Results of this study showed significantly better cosmetic appearance of the post vascular obstruction lesions following filler injection.

Introduction: Despite the fact that HA filler injection has become one of the most popular non-surgical cosmetic procedures, it may have various complications such as vascular occlusion and necrosis. Various treatment strategies have been proposed to reduce the complications of vascular occlusion caused by HA filler injection. But so far, the effect of botulinum toxin compared to control samples has not been investigated. .

Materials / method: 16 cases that suffered necrosis after HA filler injection in terms of scarring, pigmentation, delay in repair and acceleration of recovery in two groups A (hyaluronidase injection + medical therapy) and group B (hyaluronidase + medical therapy + botulinum toxin A) were investigated.

Results: In all cases, including the occurrence of scars, pigmentation, erythema and recovery time, significant effects were obtained with protocol B.

Conclusion: In this study, we investigated the possible effects of botulinum toxin A on the reduction of vascular occlusion complications caused by HA filler injection in four sections and showed how the effects of botulinum toxin on the reduction of complications. We suggest botulinum toxin A as an additional treatment to reduce the complications of vascular occlusion.

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