Objectives: Describing the technique used by the author for 17 years to augment the gluteal region with intramuscular filling.

Introduction: The demand for gluteal volume continues to rise, traditional invasive techniques like liposuction and silicone implants face limitations. Injectable fillers provide a minimally invasive and natural alternative. This article shares the author's 17-year of employing long-lasting fillers, particularly polymethylmethacrylate, at the muscular level. A comprehensive review involving over 1 million cc of filler product underscores the significance of this approach.

Materials / method: Conducted across Brazilian cities—Sao Paulo, Rio de Janeiro, and Porto Alegre—this multicentric study tracks the journey of volumetric gluteal enhancement through intramuscular filling.
I will provide an update on an article I published in 2019 in the journal "Plastic and Reconstructive Surgery" (PRS) regarding gluteal volumetric augmentation using filler products.

Results: More than 1 million cc  (more than 6,000 procedures) of polymethylmethacryl product was applied to increase muscle volume.
The outcomes proved remarkable, displaying substantial volumetric gains while ensuring the product seamlessly integrates within the muscles, providing structural support rather than burdening the skin.

Conclusion: The study's conclusions are striking. Both medical professionals and patients endorse the highly satisfactory and natural results achieved through this approach, as substantiated by accompanying visuals. Minimal adverse effects were notably observed, particularly when compared to established methods like liposuction and silicone implants. Injectable fillers emerge as a natural, secure, and promising solution for achieving gluteal volumetric enhancement.

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Objectives: Share a new approach to weightloss using combination of semiglutide injection with devices targeted for fat loss, skin quality improvement and muscle toning and sculpting for rapid weightloss without causing "ozempic body"

Introduction: The glp-1 receptor medications have increased in popularity for weightloss. The negatives are deflated appearance to the face with deflated appearance to the body. We are now combining devices that target problem areas with more fat and using muscle sculpting. This enhances weightloss and allows for muscle growth causing aesthetically pleasing appearance.

Materials / method: Share case series of patients used different protocols to combine glp-1 medications for weightloss with cryolypolisis or radio frequency for fat loss and muscle stimulation technology.

Results: The result of this combination is dramatic rapid weightloss without deflated appearance. Patient have better muscle tone, contoured appearance and improved skin quality.

Conclusion: Combining glp-1 medications with body sculpting technology improves the overall outcomes of weightloss drugs by targeting larger fat deposits, building muscle and improving skin quality.

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请注明名称（个人，公司，学会等等）: KOL FOR CUTERA, LUTRONIC

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Objectives: Evaluate non-invasive treatments for lipedema through patients' experience and their improvement in life quality, self-esteem and body measures. We evaluated 16 patients that were submittted to cryolipolysis in legs, buttocks, calves and arms. All the patients were diagnosed with lipedema by an experienced vascular surgeon.

Introduction: Lipedema is a chronic feminine disease that causes abnormal fat deposition in lower limbs and occasionally upper limbs. Lipedema patients suffer from both physical and psychological disability. Despite the relatively high prevalence (about 20% in some female populations) and the impact on the quality of life, little is known about the disease.
There is no known curative therapy for lipedema. The primarily focus of treatment is to reduce its related lower extremity symptoms, disability, and functional limitations to improve patients’ quality of life, as well as preventing disease progression.

Materials / method: There is an increasing awareness of this condition, mainly due to social media. Therefore, dermatologists and aesthetic physicians are constantly facing patients with these symptoms, and they have little or no knowledge about diagnosis and managing these patients.
We performed cryolipolysis in 16 patients in legs, buttocks, arms and calves; combined with the conservative treatment, that includes oral medication and life habits changes. The results were demonstrated by ultrassound exams, body measures and patients' perception of improvement.

Results: We studied more than 10 cases at our clinic that were surgery candidates, but they didn’t want to submit themselves to this invasive treatment. At the end of the conservative treatment purposed by our team, they presented considerate improving on physical satisfaction, quality of life, body measures and fat consumption documented in ultrasound.

Conclusion: We purpose a new, available, easily reproducible and affordable treatment with significant and long-term results in aesthetic complaints regarding this disease.

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Objectives: To perform quantitative assessment of the patients’ expectations and satisfaction with cryolipolysis treatment at our facilities.

Introduction: Recently, the development of noninvasive body contouring devices has been remarkable. Among them, cryolipolysis has played a major role in the dramatic expansion of the body contouring and body shaping. At our clinics, the number of cases of cryolipolysis has been increasing year by year. In 2023 (as of November 28), cryolipolysis cases have already reached a record high of 55,896, and our group owns 66 cryolipolysis devices nationwide. In response to such a situation, more trustable data of the patients’ expectations and satisfaction with cryolipolysis is needed.

Materials / method: We started an investigation on the efficacy and safety of cryolipolysis in late June 2023, targeting cryolipolysis models (n = 1,000) at our clinics in Japan. The primary outcomes were adverse events (AEs) that occurred immediately after the procedure, 1 week, 1 month, and 3 months after the procedure, as well as the number of days required for the adverse events to disappear, patient satisfaction with pain, satisfaction with efficacy, and overall satisfaction.

Results: Of 1,000 participants, the data of primary outcomes, AEs disappearing days, various patient satisfaction values etc. At the time of the presentation at IMCAS World Congress 2024, these data will be analyzed and reported with some literature reviews.

Conclusion: Our investigations are ongoing, and we are going to gain further kinds of results from the study, which include not only patients’ satisfaction related data, but details of adverse events caused by cryolipolysis. They will be reported on and on in the future.

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Objectives: To demonstrate an innovative technique utilizing high G-prime hyaluronic acid filler to enhance the definition of the rectus abdominis, pectoral, and oblique muscles, while respecting anatomical principles and ensuring the safety and efficacy of the procedure.

Introduction: Sociocultural influences shape perceptions of bodily beauty. The rectus abdominis and pectoralis major muscles are pivotal in male body aesthetics. This paper presents an innovative technique employing high G-prime hyaluronic acid filler to enhance muscle definition, focusing on the abdominal, pectoral, and oblique regions, while prioritizing safety and efficacy.

Materials / method: This innovative technique, which uses high G-prime hyaluronic acid filler, is recommended for patients with a low body fat percentage, good physical condition, and the goal of enhancing muscle definition in the abdominal, pectoral, and oblique regions. The treatment is personalized according to the patient's anatomy and individual goals.

Results: The effectiveness of the technique was validated in more than 45 patients. The patients assessed the aesthetic outcome as "very much improved," and no adverse events were observed during the follow-up.

Conclusion: This innovative muscle enhancement technique using high G-prime hyaluronic acid filler has demonstrated positive and safe results in more than 45 patients. Patient satisfaction, with assessments of "very much improved," highlights the feasibility of this minimally invasive approach to enhance muscle definition in the abdominal, pectoral, and oblique regions. By providing immediate results and minimal adverse events, this technique emerges as an appealing alternative to more invasive surgical procedures, contributing to the promotion of body aesthetics in a safe and effective manner.

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Objectives: During several years of operation in the beauty clinic, we carefully examined the needs of more than 2000 patients in the field of body and hip beauty. We performed hyaluronic acid filler injection without surgery and all research documents and methods are available for review. Through research, I reached good scientific results and very few complications about the methods, techniques, and social needs of the patients. We also found that the square buttock mold is more and we found the best method and technique for the beauty of this repeated mold and implemented it on many patients

Introduction: We realized that in forms, techniques methods, and selection management, the type of filler, the type of technique, and the type of method, as well as the accuracy of studies, is only possible based on accurate scientific information. The choice of medical logic according to the field research carried out by a research team (completely independent and without the support of any scientific or governmental authority) brought very valuable results, including the relationship between BMI and needs. And we found the best non-surgical method with the least complications.

Materials / method: Our distinctive method involves multi-layer HA injection for buttock augmentation. The amount of filler used was adjusted with the patient's BMI from 150cc to 270cc.In addition, a post-injection regimen included the administration of 900 cc of normal saline to increase water absorption during the first two weeks. Follow-up evaluations were performed at 2, 4, and 6 weeks after the operation to evaluate the results and patient satisfaction. This satisfaction was associated with about 30% retention in two years after the injection and about 70% patient satisfaction after months.

Results: A comprehensive analysis of more than 200 cases showed an immediate satisfaction rate of approximately 60%, with satisfaction levels exceeding 75% after 8 weeks and maintaining a 50% satisfaction rate at the 6-month mark. Further subgroup analysis by BMI showed the most favorable results in the BMI range of 18 to 23, which included more than 200 cases. In particular, those with a BMI between 20 and 25 showed the highest satisfaction, and a significant success rate was observed in the entire group of 2,000 cases. We were able to collect this important information in a 200-page book.

Conclusion: Based on the use of less filler and on the basis of facing very few and limited side effects, we have found the best method to change the square shape of the buttocks to a rounder and more beautiful shape based on the patient's needs. We have found the best injection technique and suitable conditions for patients and meet their needs. We found out how to improve the injection of buttock fillers that are made and the best-identified indications and contraindications based on the logic of modern science. It was not possible to provide this amount of useful information in the article.

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这项工作的完成感谢以下机构的支持： btl

Objectives: A combined technique for buttocks reshaping and cellulites treatment using hyper diluted calcium hydroxyapatite (CaHA), incobotulinum toxin A and hyaluronic acid (HA) mixed in the same syringe and injected in the same session.

Introduction: The demand for body procedures is increasing, and buttocks beautification is one of the most sought-after procedures in dermatological and plastic surgery clinics. Several aspects affect the beauty of this area, including sagging, cellulite, contour irregularity, and volume reduction.Thinking about the cellulite physiopathology an action of a small muscle fiber located in the superficial fascia and/or septa may play an important role on that.

Materials / method: Six female subjects were enrolled to take part in the study. Each patient was treated with the combination of 6 syringes of hyper diluted CaHA ,100 U vial of Incobotulinum toxin type A reconstituted in 2ml of saline solution and 6 syringes of a high G prime, high cohesivity HA (CPM-HA V 26 mg/ml). 10 ml of sterile saline solution was added to the solution, resulting in a total volume of injection of 27 ml (final CaHA dilution 1:2 ).All patients answered the GAIS questionnaire every visitAll pictures were assessed by two independent investigators using the Merz Aesthetics scale .

Results: The results of 30 days GAIS questionary showed much improvement in 17% of the patients, moderate improvement in 67%, and 17% of patients whit improvement. For 90 days GAIS questionary, the results were 50% for much improvement and 50% for moderate improvement. The assessment by two independent investigators, using Merz scales to evaluate buttocks laxity, improvement of 50% of the patients at 1-point and 50% unchanged. The results for improvement of cellulite dimples(Merz scale for cellulites dimple) were 50% of the patients at 2 points improvement and 50% at 1 point improvement

Conclusion: The treatment is effective and safe. The fact that we carry out a single intervention favors adherence to treatment.

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请注明名称（个人，公司，学会等等）: Speaker Merz Aesthetics

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