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Objectives: Make clear how important anatomy is in aesthetic medicine. The use of cannulas versus needles. The ophthalmic artery flow using CTScan images converting them into interactive 3D for greater understanding.

Introduction: The first case of blindness associated with injections with fillers dates back to 1900 when a sudden loss of vision after paraffin injection is described for the treatment of a saddle nose (Brawly, 1906, Feldman, 2000).The popularization of the use of hyaluronic acid as a filler material has reversed these percentages and now hyaluronic acid is the main responsible (Belezelay et al, 2019) followed by the Calcium Hydroxyapatite (Belezenay, et al, 2019).

Materials / method: CTS images converted into 3D interactive video show perfectly the flow of the main trunk of both carotid arteries and its connections to the OA. The goal is prevention and treatments options when the AO is affected

Results: 3D interactive CTS images will show how accurate the specialist need to be

Conclusion: Anatomy is a MUST is cosmetic and plastic surgery. We cannot accept blindness for a cosmetic procedure. Prevention and knowledge of the underlying tissue is the key .

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这项工作的完成感谢以下机构的支持： 3Dtech Omegazeta

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Objectives: To lose the fear of injecting hyaluronidase. To prevent patients to be unnecessesarily skin tested before the injection of hyaluronidase.

Introduction: Hyaluronidase is the antidot to dissolve injected hyaluronic acid making the hyaluronic acid (HA) fillers the only once with an antidot. Hyaluronidase (Hdase) is used in emergency situations of vascular occlusion, in case of an immunological reaction against an HA and far more to dissolve unwanted depots of HA. Although the use of licensed hyaluronidase is much safer compared to the use of injectable fillers people are still afraid to use it for two reasons: potential allergies against the product and the destruction of the bodies own hyaluronic acid depots.

Materials / method: Mostly eminence based. based on personal experience with the German hyaluronidas Hylase Dessau

Results: In Germany there is only one bovine hyaluronidase (Hdase) on the market, Hylase Dessau in a concentration of 1:150. It need to be diluted with saline. The 1:150 solution is usually diluted with 1 ml. Hdase acts immediately. Depots of unwanted HA dissolve in minutes. In case of vascular occlusion or an immunological reaction often repeated injections and in case of immunological reactions additional interventions are necessary. Allergic reactions (when using the bovine German hyaluronidase) are rare and mostly delayed. No clinical relevant tissue distruction has been reported after HDase.

Conclusion: Hyaluronidase is the best what could happen to HA fillers – making them the safest fillers around. There is a small risk of allergic reactions after an Hdase which should not be overrated (there is no need of before skin tests when using the German product) and usually do not pose a challenge for the physician as these reactions are mostly delayed and react to steroids. And last not least there is no relevant tissue distruction of the body's own hyaluronic acid. Otherwise Hdase would not be used to facilitate the spread of a local anaesthetic (another indication).

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这项工作的完成感谢以下机构的支持： the colleagues who refer their patients to me that have been mistreated with an HA or suffer an adverse event to an HA

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Objectives: The purpose of this investigation was to develop a realtime in-situ model to evaluate the kinetics of transarterial hyaluronidase in vivo.

Introduction: Retrobulbar hyaluronidase has been advocated as rescue treatment following inadvertent intravascular injection of hyaluronic acid (HA) filler resulting in retrograde embolism into the ophthalmic arterial system and central retinal artery occlusion. A prerequisite for this intervention to be successful in reversing visual loss is rapid transarterial passage of hyaluronidase in order that it can reach and hydrolyze the HA filler embolus.

Materials / method: 3 patients undergoing abdominoplasty had HA filler injected into ligated SQ arteries within the abdominal tissue destined for excision. 6 arteries (2 per patient) were selected. 0.3 to 0.5 mL of HA filler was injected into each vessel. Ovine testicular hyaluronidase was then injected to flood the soft tissue surrounding the arteries. Hyalase was also injected directly onto each artery to flood its external wall. A total dose of 750 IU of hyaluronidase waA total dose of 750 IU of hyaluronidase was used per arteriole.

Results: HA filler occluding the arterioles was not dispersed by exogenous hyaluronidase that flooded the
surrounding subcutaneous tissue and the external arterial walls. When hyaluronidase was then injected directly into the arterioles, dispersion of the HA filler due to hydrolytic degradation occurred within seconds. No complications were observed
during or after the evaluations.Available hyaluronidases and HA fillers appear to have differing physical properties that influence their interaction in a time and dose-dependent manner.

Conclusion: This real-time pilot evaluation demonstrated much less rapid transarterial passage of hyaluronidase in vivo than has been shown previously in cadaveric models. This suggests that permeability of the living arterial wall differs significantly from permeability in the cadaver. This may be due to absence or impaired integrity of the basal lamina in cadaveric arteries, which may begin to degrade shortly after death. Knowledge of the ways in which specific fillers interact with different hyaluronidases may help achieve better overall aesthetic outcomes and increase patient satisfaction.

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Objectives: The author decided to treat damaged skin emanating from burns and dermal induced vascular occlusion (devoid of bleeding and release of growth factors, signal messengers etc.) with potential to dermal scarring with ethical stem cells, signal messengers (USCs), growth factors (PRP) and an activating source (LLLT) to see whether it accelerated recovery and prevented scarring. I can see no literature references to whether this was done before

Introduction: : LLLT can either act directly on cells or initiate the release of specific mediators. Epithelial mesenchymal transition (EMT) occurs when epithelial cells lose their characteristics and become mesenchymal. These mesenchymal cells can return to an epithelial phenotype by mesenchymal-epithelial transition.

Materials / method: Adipose Stem Cells initially harvested from VASER
LED lamps for light therapy were provided by Omnilux, Birmingham UK, who developed in partnership for PDT with Cancer Research UK
Umbilical Stem Cells were provided without financial benefit from CellResearchCorp based in Singapore
Laser resurfacing provided by ActiveFx by Lumenis

Results: LLLT can either act directly on cells or initiate the release of specific mediators. Epithelial mesenchymal transition (EMT) occurs when epithelial cells lose their characteristics and become mesenchymal. These mesenchymal cells can return to an epithelial phenotype by mesenchymal-epithelial transition.

Conclusion: Dermal papilla cells irradiated by 633nm red light enhance keratinocyte proliferation, suggesting enhanced epithelial-mesenchymal interaction. The author advances theory that this process advances the production of epidermal tissue in the presence of a cell source and autologous and external signal messengers in patients traumatised in the absence of normal bleeding repair

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