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Objectives: Over the last 15 years, lasers have offered to patients and physicians a major breakthrough in varicose and spider veins treatment. From 980 nm, 1470nm radial devices to Nd:Yag ,we will describe the various sorts and uses of these tools in modern phlebology.

Introduction: First a quick reminder on physiology and physics will give us the clues to understand why and how to use lasers

Materials / method: First a full review of Great/ Short Saphenous Vein procedure with 1470 nm laser but also other possible indications.
And then a focus on reticular and spider veins managment with Nd:Yag combined with sclerotherapy

Results: It is now possible to offer our patients :
- a day surgery, painless and with long term efficiency in venous insufficiency.
- a needle-free, chemical-free aesthetical treatment

Conclusion: After decades of a trial and error process to find a way to lower recurrences, costs and improve confort, lasers have opened a new era in venous diseases treatments.

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Objectives: The footlift is an interesting answer for those who feel pain with high heels, using fillers injected in the anterior foot fat pad.

Introduction: The pain With high heels come from the fact that the body weight is to important for the squeletton architecture especially in regard of the head of the second metatarse. The idea is to inject Hyaluronic acid at this Level with a good plasticity to avoid pain.

Materials / method: We use half to once serynge of AH for each foot. Entry point is made in the anterior fat pad after cold anesthesia and using a microcanula 25G , the AH is deliver in regard of the head of the second metatarse.

Results: After over 100 treatments , the pain control is good for all, who can support high heels longer Time . The lasting effect is on average 6 to 9 months. The si de effect is rare , only small pain just after the treatment for few days.

Conclusion: The footlift is interesting treatment pain for high heels when the other kind of treatment are not efficient.We hope that we can use a long lasting filler like polylactic acid who seems to be used in some countries with longer effect.

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Objectives: The definition of a beautiful leg be described as in the following:
The beautiful leg demonstrates harmonious continuous contours in respect to shape and size of ankles, calves, knee and thigh in correspondence to the feet and the stem-part of the body. The transition zones within these parts of the leg show a characteristic proportional relationship to the main elements of the leg, which creates the picture of an harmonious development from a slim ankle to a twice the size of circumference proximal part the upper thigh.

Introduction: Anatomically, the perfect leg is shaped by the muscles of the leg as well as the deep fat pads of the leg and the thickness of the skin-fat-flap.
Tissue firmness is dependent on the quality of the connective tissue , and also for skin surface , good structural support by the connective tissue architecture will lead to a more smooth and flat skin .

Materials / method: Diagnosis: Legs are visually analysed as well as catogerized by visual inspection and standardized photograhy. Further examinations are done on site of the first consultation.

Results: Treatment: In order to shape the lower extremities, Liposuction with tumescent local anesthesia is the most commen and effective treatment in order to harmonized the shape and proportions and the size of the legs

Conclusion: Results: The results are demonstrated by B+A photographies and discussed by the podium

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Objectives: Legs Cutaneous pigmentation often causes cosmetic problems for the patients.
A short overview, After a short overview of the possible pigmentary lesions on the legs, we discuss the management and pathogenesis of stasis dermatitis or ochre dermatitis.
Stasis dermatitis occurs secondary to venous hypertension of the lower extremities.
Hemosiderin and/or melanin have been considered responsible for the brown pigmentation

Introduction: Melanin is the major determinant of the normal skin color. Other contributing chromophores are oxyhemoglobin (red), deoxygenated hemoglobin (blue), and carotene (yellow-orange). The mechanism of the ochre dermatitis suggested that iron (hemosiderin), various cytokines or growth factors derived from vascular inflammation might have an unproven effect on possible pluripotent stem cells which are involved in the development of dermal melanocytes inducing the pigmentation.

Materials / method: So what is it possible to propose to reduce the pigmentation?
It is possible to propose laser, IPL or peels. For laser for dermatologic disease most of them are efficient but the burn risk is high except with the Q-switched laser.
For peel, the difficulty is to obtain an homogenen penetration of active ingredients. We propose specific peels under occlusion during few hours to induce the skin epidermolysis for whitening the skin in case of ochre dermatitis.

Results: From some clinical cases we propose to illustrate this and to define therapeutic conduct.

Conclusion: Most of the time, pigmentary lesions are often the focus of attention on the face, hands or décolletage. The management of pigment disorders is complicated in the legs and even more so for ochre dermatitis.

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