IMCAS

Negative wound pressure therapy in for high risk patients in aesthetic breast surgery

Objectives: A retrospective analysis of 90 patients whom performed breast reduction, mastopexy or complex secondary breast surgery. The patients included the following characteristics: BMI greater than 30, smokers, operative time more than 6 hours, postbariatric status.

Introduction: Recently published studies have demonstrated clinical effectiveness of closed-incision negative-pressure therapy in many fields of surgery including vascular, cardiac, colorectal, orthopedic, and reconstructive surgery. Limited studies were done on aesthetic surgery about the benefits of negative wound pressure therapy dressings.

Materials / method: A retrospective analysis of 90 patients whom performed breast reduction, mastopexy or complex secondary breast surgery. The patients included the following characteristics: BMI greater than 30, smokers, operative time more than 6 hours, postbariatric status.

Results: No discomfort was associated with the use of negative wound pressure therapy. No major complications were noted. Mean time of drain removal was 2 days. One patient had superficial wound dehiscence treatment conservative. Scar quality was appreciated “very good” in 90% of the cases 6 months after the surgery.

Conclusion: Negative wound pressure therapy might reduce the rate of minor local complications in high risk patients undergoing body-contouring procedures, improving surgical outcomes. A cost analysis may be done depending on the surgical facility.

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Deep neck lift: How to achieve the V-shaped contour?

Objectives: 1) The ideal neck appearance.
2) How to analyze your patient’s neck ?
3) How to surgically manage each case ?

Introduction: The ideal shape of the neck includes a sharp well defined mandibular border, a flat submental region with a cervico-mental angle of 90-120°. Neck contouring surgeries have evolved from aggressive liposuction to deep neck lift with deep tissue contouring. Despite the popularity of neck lift surgeries, deep tissue management of the neck has always been a point of controversy between plastic surgeons.
The goal of this study is to be able design the proper plan of management of each neck to recreate the youthful, contoured neck appearance with the least complications.

Materials / method: Between March 2021 and March 2024, 40 female patients complaining of unpleasant neck appearance. with the minimal follow up period for all patients was 6 months.

Results: All patients were properly assessed preoperatively, 5 of them had lateral neck lift only, 10 of them had deep neck lift without submandibular gland reduction and the remaining 25 had full deep neck job involving skin, subcutaneous fat, platysma muscle, subplatysmal fat, anterior belly og digastric and submandibular gland.
The surgery was successful in all patients, two of them had seroma at the post auricular area, and one patient with unilateral marginal branch neurapraxia.

Conclusion: In this study I present the importance of proper preoperative assessment of the neck in in order to be able to manage each case accordingly and design the ideal surgical technique to achieve the optimum neck results.

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Maximizing the results of the deep neck lift

Objectives: Understand the Anatomy: Gain a comprehensive understanding of the relevant anatomical structures involved in deep neck lift surgery.

Identify Indications: Recognize the appropriate candidates for deep neck lift surgery and understand the indications and contraindications for the procedure.

Master Techniques: Learn the step-by-step surgical techniques, including preoperative planning, incision placement, tissue manipulation, and suturing methods.

Manage Complications: Identify potential complications and learn strategies for their prevention and management to ensure optimal patient outcomes.

Introduction: Deep Neck Lift Surgery is known for definition and rejuvenation of the neck contour, addressing the underlying structures that contribute to aging and aesthetic concerns. This talk will cover the intricate anatomy, patient selection, detailed surgical techniques, and complication management. By the end, patients will have a thorough understanding of how this advanced technique can enhance patient outcomes and boost confidence in your surgical practice.

Materials / method: The Deep Neck Lift begins with a detailed preoperative assessment to identify suitable candidates. Anesthesia is administered, followed by a well-placed incision under the chin. Through this access, I meticulously remove excess fat, reduce digastric muscles, contour the submandibular glands, and reposition platysma muscles for optimal contour. Over 200 surgeries annually have honed my technique, ensuring minimal scarring and excellent, natural-looking results.

Results: The Deep Neck Lift consistently yields high patient satisfaction with improved neck contours and a more youthful appearance. Surgical results show a well-defined jawline and smooth neck, addressing sagging skin, excess fat, and muscle laxity. Postoperative care involves monitoring, wearing compression garments, managing swelling, and scheduled follow-ups. Complications are rare but include infection, hematoma, nerve injury, and minimal scarring. Effective management ensures quick recovery. Overall, the procedure provides excellent, natural-looking results, and enhancing patient confidence.

Conclusion: In conclusion, Deep Neck Lift Surgery offers remarkable results in redefining the neck contour and enhancing patient satisfaction. When combined with a Deep Plane Facelift, the overall facial rejuvenation is significantly enhanced, addressing both midface and neck aging comprehensively. This combination ensures a harmonious and natural appearance, providing superior aesthetic outcomes. By mastering these techniques and integrating them effectively, surgeons can achieve transformative results that boost patient confidence and satisfaction, solidifying the importance of these advanced procedures

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Innovative approaches to treating male gynecomastia: A comprehensive review of surgical techniques

Objectives: By the end of this presentation, participants will be able to:
1. Understand the different grades of male gynecomastia and their corresponding surgical challenges.
2. Identify and apply appropriate surgical techniques for each grade of gynecomastia, focusing on optimal aesthetic and functional outcomes.
3. Recognize the role of adjunctive procedures such as liposuction, excisional techniques, and fat grafting in enhancing surgical results.

Introduction: Gynecomastia, characterized by the benign enlargement of male breast tissue, is a condition that affects a significant number of men worldwide, impacting both their physical appearance and psychological well-being. Effective management of gynecomastia requires a nuanced approach, with surgical techniques tailored to the degree of breast hypertrophy and ptosis. This presentation explores innovative surgical methodologies designed to treat varying grades of gynecomastia, emphasizing techniques that achieve superior aesthetic and functional results.

Materials / method: This review encompasses a comprehensive analysis of surgical interventions tailored to different grades of gynecomastia:

- **Grade 1 Gynecomastia:** A combination of liposuction and pectoral fat grafting is employed to address minimal breast enlargement, improving the contour of the pectoral region.
- **Grade 2 Gynecomastia:** Liposuction and pectoral fat grafting are combined with peri-areolar skin excision to manage moderate enlargement and mild skin redundancy.
- **Grade 3 Gynecomastia:** Axillary excision, peri-areolar excision, and nipple-areola complex (NAC) repositioning are performed

Results: The implementation of these tailored techniques has demonstrated significant improvement in the aesthetic and functional outcomes for patients with varying degrees of gynecomastia. Patients reported high satisfaction rates with the surgical outcomes, noting improved chest contour, reduced scarring, and enhanced confidence. The integration of fat grafting with traditional surgical methods proved beneficial in achieving a natural and masculine appearance.

Conclusion: The treatment of male gynecomastia requires a personalized approach that considers the severity of breast enlargement and skin ptosis. By employing a strategic combination of liposuction, excisional techniques, and fat grafting, superior aesthetic outcomes can be achieved for patients across all grades of gynecomastia. These innovative techniques provide versatile and effective solutions in clinical practice, ensuring that patients receive the highest standard of care tailored to their specific needs.

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How to break the spell of deep plane facelift: Preoperative planning & stages of surgery

Objectives: 1. Understanding the steps of deep plane face lift surgery.
2. Pre operative assesment of the aging face.
3. Detail planning of the surgery.
4. Achieving the best possible results.

Introduction: Deep Plane Face Lift is a surgical procedure that has changed our view of facial rejuvenation. Introduced by Sam Hamra over 34 years ago, it was modified and re-introduced to the surgical world by A. Jacono.The effects achieved, in the age of social media, have made it synonymous with modern face lifting.

Materials / method: Despite its growing popularity, it is still wrongly perceived as technically more difficult than classic face lifting methods. In my presentation, I will try to point the necessary elements of pre-operative facial analysis and procedure planning. I will also present the key stages of the operation illustrated with video material to show the advantages of Deep Plane Face Lifting as a more intuitive method and, with good knowledge of facial anatomy, easier for the surgeon.

Results: Deep Plane Face Lifting is a procedure that allows for very natural and long-lasting results. Thorough knowledge of the surgical technique enables safe operation and achieves significantly better outcomes than traditional methods.

Conclusion: The three general principles of effective operation presented here will help "demystify" this procedure, making it easier and more intuitive.

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Systematic approach to deep plane facelift

Objectives: I would like to present my approach to Deep Plane Facelift. This systematic step-by-step approach allows the procedure to be taught to an aspiring surgeon, and to be done in a safe and reproducible manner.

I have taught this technique to a number of my colleagues, wishing to learn the Deep Plane Facelifting, who encouraged me to share this with a wider audience. I am in a process of preparing a manuscript for publication.

Introduction: I was introduced to Deep Plane Facelift in Dr. Sam Hamra’s operating room over 20 years ago, and have modified my technique over the years, with some novel surgical maneuvers. The technique has 4 distinct steps, done in a specific order. First, the composite cheek flap is elevated in 3 distinct sequential steps; then the cheek is vectored and fixated in place using a unique surgical maneuver. This systematic approach makes the procedure safe and reproducible. I have presented my technique at a few national and international meetings, where it was met with some acclaim.

Materials / method: The presentation includes clear intraoperative videos; didactic slides and a number of long term (2-3 year) postoperative results.

Results: 136 consecutive single surgeon cases were reviewed. No flap necrosis, no infection, one hematoma, 3 temporary neuropraxia.

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My approach to preservation deep plane facelift

Objectives: This technique, blending aspects of the Extended Deep-Plane and High Lateral SMAS Facelifts, aims to optimize outcomes while minimizing risks and recovery duration. The term "Preservation facelift" refers to limited skin dissection in the face and neck areas to reduce complications while achieving extended deep plane facelift results

Introduction: Facelift surgery has witnessed a significant surge in popularity, particularly in the context of social media influence and heightened aesthetic awareness. In response to evolving patient preferences for less invasive procedures with faster recovery times, the Preservation Facelift technique has emerged as a promising approach.

Materials / method: It also aims to preserve anatomical structures as much as possible. The "Preservation Facelift with a Twist" presents a unique maneuver to deepen the submandibular space. The "twist" of the procedure corresponds to placing a rotating pedicled SMAS flap along the jawline. This maneuver aims to define the gonial angle and the jawline. Better neck contouring is achieved through more conservative methods such as the "platysma hammock" with unique quilting sutures. This quilting technique will cable the lateral platysma flap to the mastoid process fascia.

Results: Through a retrospective analysis of 134 patients undergoing face and neck lift procedures, we compared outcomes between Preservation Facelift and Deep-plane Facelift.
Results indicated shorter drainage durations and lower complication rates in the Preservation Facelift group, underscoring its efficacy and safety

Conclusion: While our study provides valuable insights into the Preservation Facelift technique, Future research should incorporate objective outcome measures such as patient-reported satisfaction surveys to further elucidate its benefits.
Overall, the Preservation Facelift with a Twist represents a nuanced approach to facelift surgery, prioritizing both aesthetic refinement and patient safety in pursuit of natural-looking results.

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To demonstrate the benefits of preserving the orbicularis oculi muscle during upper eyelid blepharoplasty, enhancing both aesthetic and functional out

Objectives: To demonstrate the benefits of preserving the orbicularis oculi muscle during upper eyelid blepharoplasty, enhancing both aesthetic and functional outcomes, and minimizing complications such as eyelid malposition and compromised blink reflex.

Introduction: Upper eyelid blepharoplasty traditionally involves excising portions of the orbicularis oculi muscle, potentially leading to functional and aesthetic issues. This presentation introduces a refined technique focusing on the preservation of the orbicularis oculi muscle to improve surgical outcomes and patient satisfaction.

Materials / method: A meticulous surgical approach was employed to preserve the orbicularis oculi muscle during upper eyelid blepharoplasty. The technique involved careful dissection to maintain muscle integrity while achieving desired aesthetic results. Patient outcomes were evaluated through clinical assessments and patient feedback.

Results: Preservation of the orbicularis oculi muscle resulted in superior functional and aesthetic outcomes. Patients experienced fewer complications, such as eyelid malposition and compromised blink reflex, and reported high levels of satisfaction with their postoperative appearance and eyelid function.

Conclusion: Preserving the orbicularis oculi muscle during upper eyelid blepharoplasty offers significant advantages, reducing complications and enhancing both aesthetic and functional outcomes. This technique should be considered a preferred approach for achieving optimal results in upper eyelid surgery.

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Mastopexy with the method of "dermograndular autoaugmentation" (Three-flap method)

Objectives: To develop and introduce into practice a technique of mastopexy based on the use of a modified Ribeiro flap, as well as elements of tissue movement and fixation designed to increase the stability of postoperative mastopexy. In addition, to give indications for the application of this surgical technique.

Introduction: In modern plastic surgery, there are a large number of breast lift techniques.Due to the spreading information about the "side effects" of silicone implants, interest in implant-free mastopexy is increasing year after year.
However, despite the variety of techniques, patients sometimes do not get full satisfaction from the results of mastopexy because of the unexpressed filling of the upper pole, extended anchoring postoperative scars and sometimes because of obtaining an aesthetically unattractive breast shape. The stability of the result after mastopexy depends on many factors, includin

Materials / method: We operated on 103 patients aged 18 to 53 years from 2019 to 2023 according to the reported method. These were patients with primary mastopexy, secondary mastopexy, and also patient with implant removal and one-stage mastopexy. The patients were followed up for 12 months to assess the stability of the result.

Results: Observing the patients, we noted greater stability of the breast shape and upper pole filling compared to the conventional classical methods. We did not have to resort to anchoring scars. In 90 percent of cases, a inverted T-shape scar was used. In 10 percent, the J-scar was used.
The quantitative distribution of complications identified among the operated patients is as follows:
− worsened healing of the junction of vertical and horizontal sutures at the period of 1-1.5 months after surgery - 15 patients; at treatment with ointment method healing was observed in 7-30 days;− permanent loss

Conclusion: Thus, in the world of plastic surgery methods of breast lift continue to improve, which is especially relevant in modern times, due to the increased attention to this operation.
The author's proposed method of mastopexy with glandular autoflap allows obtaining in most cases a stable result, a fuller breast shape, avoiding the presence of extended anchoring scars, and also preserves the possibility of lactation.
The author of this article has obtained a patent for invention for this method of mastopexy..

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请注明日期: The patent for the invention has been issued
和审阅情况: Patent for invention No. 2819736 dated 05/23/2024

这项工作没有任何直接或间接的资金支持。由作者自己承担责任。

Upper body lift in massive weight loss patients: lifting in the chest area, back bra lift, L-type brachioplasty, lateral body lift

Objectives: Isolated removal of soft tissue excess in the pectoral area in male patients - emphasis is placed on preserving the subcutaneous soft tissue reserves in the area that projects onto the pectoral muscle in order to preserve the projection in that area. Brachioplasty is often combined with bra line back lift and/or mastopexy and/or lifting in the chest area in male patients.
Lateral Tension Upper Body Lift - wavy shape of the excision aims to prevent the possible hypertrophic scar.
BackBra lift - emphasis is placed in the position and quality of the scar.

Introduction: Upper Body Lift is a surgical procedure aimed at removing excess skin and subcutaneous adipose tissue from the chest area, and the procedure may refer to: isolated removal of excess cutaneous-subcutaneous skin in the pectoral area in male patients; mastopexy techniques in female patients; brachioplasty procedures; isolated tissue lifting and removal of cutaneous-subcutaneous excess from the back area; isolated tissue lifting and removal of cutaneous-subcutaneous excess from the lateral chest and combination of simultaneous treatment of the specified areas.

Materials / method: Body contouring in patients after massive weight loss at Vderm clinic private plastic surgery practice, Sofia, Bulgaria - Dr Evgeni Sharkov - plastic surgeon and owner of the practice.
Textbook: Body Contouring Surgery: The Role of Non-Invasive, Minimal-Invasive and Surgical Technologies. Author - Evgeni Sharkov, MD

Results: 400 patients with obesity and/or weight loss and/or massive weight loss in a 4 years period of time done with different types of excisional procedures in order to eliminate the excess of soft tissue in all body areas.

Conclusion: Excisional procedures in patients after massive weight loss in the upper body area are often combined in between each other with the ultimate goal of achieving optimal long lasting results. Those procedures aim to contour the area of the chest and arms. Markings, type of excision and fixation sutures are point of interest in order to reduce the possibility of hypertrophic visible scars. Proper distribution of the soft tissues during the surgery in the chest area in male patients is of extreme importance to maintain the masculine appearance .

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Liposuction deformities: How to avoid & how to treat

Objectives: Due to increasing popularity of liposuction and liposuction combined surgeries, deformities related to those procedures have been rapidly increasing over the last decades. The aim of this presentation is to list the reasons of post liposuction deformities and surgical techniques for treatment.

Introduction: Due to increase of the popularity of liposuction and liposuction combined surgeries, deformities related to those procedures have been rapidly increasing over the last decades. The aim of this presentation is to list the reasons of post liposuction deformities and surgical techniques for treatment.

Materials / method: 142 patients who underwent secondary liposuction procedures between january 2018 - january 2024 were investigated. The reason of deformities were listed as undercorrection , over correction , fibroseptal adhesion deformities ( fibrosis) and abdominal soft tissue deformities. The treatment methods can be listed as liposuction, lipofilling, taping, adhesion release, capsulectomy , abdominoplasty , abdominal soft tissue reconstruction.

Results: out of 142 patients , 96 patients were suffering from either undercorrection or over correction problems. Liposuction, lipofilling, taping and adhesion or combination of these techniques were used for treatment options. 41 patients were suffering from fibroseptal adhesion problems with different degrees. liposuction, adhesion release, lipofilling, reverse or standart abdominoplasty and casulectomy were performed in these cases. In 5 cases , abdominal soft tissue reconstruction were needed due to severe deformities.

Conclusion: Due to increase of the popularity of liposuction and liposuction combined surgeries, deformities related to those procedures have been rapidly increasing over the last decades. The aim of this presentation is to list the reasons of post liposuction deformities and surgical techniques for treatment.

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The utility of fat transfer in the correction of Poland syndrome chest wall deformity

Objectives: - to describe the anatomical abnormalities associated with Poland Syndrome
- To enumerate the different surgical options in the correction of Poland syndrome chest wall abnormalities
- To show the utility of fat grafting as a safe and effective method in correcting the chest wall in Poland Syndrome patients

Introduction: Poland Syndrome is a congenital condition characterized by the absence of the pectoral muscles, short webbed fingers, short ribs, lack of fat, breast and nipple abnormalities on one side. It was first described by sir Alfred Poland in 1841. We describe a case of a 48 year-old with Poland Syndrome who wanted correction of his chest wall. The sternocostal portion of his pectoralis major was absent. He had no functional impairment, and his past medical and surgical history was unremarkable.

Materials / method: After explaining the risks, benefits, and complications of the procedure, the patient underwent fat transfer to the left lower chest wall. Approximately 200 ml of fat was harvested from his abdomen and hips, using power-assisted liposuction. Fat was then harvested using a closed system technique, using a disposable canister and gravity-filtration system. 100 ml of fat was injected to the lower left chest wall.

Results: The chest wall appeared symmetrical after the procedure, with slight overcorrection of the left chest, allowing for a certain degree of fat resorption. The left nipple, which was higher pre-operatively, remained unchanged. There were no complications postoperatively.

Conclusion: Surgical management of the chest wall deformities in Poland Syndrome still remains the mainstay. Fat transfer to the chest is a viable and useful option, as shown in this case. Multiple sessions of fat transfer may be required to attain the desirable cosmetic result.

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小时	讲者	演讲标题	讲稿摘要	数字
10:30	Elena MARTIN 医师	Negative wound pressure therapy in for high risk patients in aesthetic breast surgery	查看	140403
10:39	Mohamed MAMDOUH 医师	Deep neck lift: How to achieve the V-shaped contour?	查看	140404
10:48	Sidney STARKMAN 医师	Maximizing the results of the deep neck lift	查看	140405
10:57	Ahmed ABDELAZIZ 医师	Innovative approaches to treating male gynecomastia: A comprehensive review of surgical techniques	查看	140406
11:06	Michal CHARYTONOWICZ 医师	How to break the spell of deep plane facelift: Preoperative planning & stages of surgery	查看	140408
11:15	Boris M ACKERMAN 医师	Systematic approach to deep plane facelift	查看	144430
11:24	Kevin S SADATI 医师	My approach to preservation deep plane facelift	查看	144432
11:33	Amir MORADI 医师	To demonstrate the benefits of preserving the orbicularis oculi muscle during upper eyelid blepharoplasty, enhancing both aesthetic and functional out	查看	144433
11:42	Maksim BARSAKOV 医师	Mastopexy with the method of "dermograndular autoaugmentation" (Three-flap method)	查看	144434
11:51	Evgeni SHARKOV 医师	Upper body lift in massive weight loss patients: lifting in the chest area, back bra lift, L-type brachioplasty, lateral body lift	查看	144431
12:00	Burak ERSEN 医师	Liposuction deformities: How to avoid & how to treat	查看	144910
12:09	Brian ANG 医师	The utility of fat transfer in the correction of Poland syndrome chest wall deformity	查看	145069
12:18		Q&A		140409

2025 英卡思巴黎国际年会
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From deep face lift to body contouring and breast let's discover our new talents - Contributed talks

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