Objectives: Non-surgical lifting of aging face can be achieved by tightening of superficial muscular aponeurotic system (SMAS). Pneumatically-driven liquid jet bypasses epidermis and spreads the drugs at SMAS, causing temporary tightening. Hypertonic glucose injected by liquid jet provides irritating effect on SMAS which may augment the lifting. Preliminary study evaluates efficacy and safety of this approach.

Introduction: Twenty Asian females (age 39-66 years) seeking correction of face sagging received single series of needle-free injections of 20% glucose by the jet system. Multiple injections were performed along the hairline, and in supra-auricular, pre-auricular, and mastoid areas. The photographs taken 3 months thereafter were compared to baseline for multi-reviewing blind assessment of improvement and measurements of the low face width. Patients’ satisfaction was graded from “very unsatisfied’ to “very satisfied” (1-5 scale).

Materials / method: There were no adverse reactions. Injection pain was minimal. Subjective and objective assessments of face contour and skin laxity demonstrated improvements in 82% patients using 5-grade scale, from “much worse” to “much improved”. Mild (1-5mm) and moderate (6-10mm) face narrowing was measured in 45% and 40% of patients, respectively (p>0.5). Ninety-five percent of patients were satisfied with the results; average satisfactory score 4.55 (“very satisfied”). Post-treatment pictures demonstrated a “sharpened” image with pronounced mandibular contour and reduced appearance of low face folds.

Results: Transcutaneous pneumatic injection of hypertonic glucose exerts mechanical stimulatory effects, immediate tissue shrinkage, and late tissue regeneration. When applied to facial deep skin, kinetic energy of the liquid jet along with irritating effect of hypertonic glucose result in immediate skin lift. The effect achieved in our group did not diminish natural mimics and facial expressions. The jet device allowed for the operator-controlled depth of penetration so glucose optimally reached superficial SMAS without damaging muscles or subcutaneous blood vessels.

Conclusion: Thanks to miniscule entry points, the induced micro-trauma was not associated with skin injury caused by thermal energy devices. Safety and efficacy of jet-injected hypertonic glucose was demonstrated for correction of skin laxity and improvement in facial contour in Asian patients.

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Objectives: Non-surgical lifting of aging face can be achieved by tightening of superficial muscular aponeurotic system (SMAS). Pneumatically-driven liquid jet bypasses epidermis and spreads the drugs at SMAS, causing temporary tightening. Hypertonic glucose injected by liquid jet provides irritating effect on SMAS which may augment the lifting. Preliminary study evaluates efficacy and safety of this approach.

Introduction: Twenty Asian females (age 39-66 years) seeking correction of face sagging received single series of needle-free injections of 20% glucose by the jet system. Multiple injections were performed along the hairline, and in supra-auricular, pre-auricular, and mastoid areas. The photographs taken 3 months thereafter were compared to baseline for multi-reviewing blind assessment of improvement and measurements of the low face width. Patients’ satisfaction was graded from “very unsatisfied’ to “very satisfied” (1-5 scale).

Materials / method: There were no adverse reactions. Injection pain was minimal. Subjective and objective assessments of face contour and skin laxity demonstrated improvements in 82% patients using 5-grade scale, from “much worse” to “much improved”. Mild (1-5mm) and moderate (6-10mm) face narrowing was measured in 45% and 40% of patients, respectively (p>0.5). Ninety-five percent of patients were satisfied with the results; average satisfactory score 4.55 (“very satisfied”). Post-treatment pictures demonstrated a “sharpened” image with pronounced mandibular contour and reduced appearance of low face folds.

Results: Transcutaneous pneumatic injection of hypertonic glucose exerts mechanical stimulatory effects, immediate tissue shrinkage, and late tissue regeneration. When applied to facial deep skin, kinetic energy of the liquid jet along with irritating effect of hypertonic glucose result in immediate skin lift. The effect achieved in our group did not diminish natural mimics and facial expressions. The jet device allowed for the operator-controlled depth of penetration so glucose optimally reached superficial SMAS without damaging muscles or subcutaneous blood vessels.

Conclusion: Thanks to miniscule entry points, the induced micro-trauma was not associated with skin injury caused by thermal energy devices. Safety and efficacy of jet-injected hypertonic glucose was demonstrated for correction of skin laxity and improvement in facial contour in Asian patients.

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Objectives: Melasma is a very complex condition and often seen as mind-boggling issue in South East Asia and darker skin type. We explore the many different treatment modalities and what works better for skin of colors.

Introduction: Melasma have always been a big concern for Asians, and treatment among darker skin types are even more challenging. Various treatment options are available, but results can be variable.

Materials / method: We look at patients being treated with combination therapy and the success rate of treatment are high with certain combination and less complications.

Results: We look at combination therapies that work for darker skin types, the treatment outcome and long term safety.

Conclusion: Combination of modalities is important in the attempt to manage melasma more effectively and safely.

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Objectives: To present novel and off label applications of micro focused ultrasound in dermatology

Introduction: Microfocused ultrasound has traditionally been used for facial lifting and body contouring. In this presentation, novel and off label applications, including treatment of hyperhidrosis, hypertrophic scars, vascular lesions and seborrhoea will be described.

Materials / method: Pilot studies of micro focused ultrasound in the treatment of axillary hyperhidrosis, hypertrophic scars, vascular lesions and seborrhoea were done at the Jose Reyes Memorial Medical Centre, Manila, Philippines.

Results: There was significant improvement in the primary outcomes ( depth by measurement on ultrasound in vascular lesions and hypertrophic scars, sebumeter readings for seborrhoea, Minor's test and sweating intensity visual scale for hyperhidrosis). Adverse reactions were transient and tolerable.

Conclusion: Micro focused ultrasound is an effective and safe alternative in the management of vascular lesions, hypertrophic scars, seborrhoea and axillary hyperhidrosis.

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