IMCAS

The periocular challenge for the aesthetic physician

Objectives: This presentation will focus on the periorbital anatomy, topographic age-related changes and the structural aetiology behind these changes in addition to the correct use of nomenclature. In particular, a solid knowledge of the intrinsic age-related changes by the aesthetic physician can be effectively used to target the treatment regimens to obtain the most optimal results aesthetically, but also in a prophylactic manner to reduce the impact of future facial aging signs.

Introduction: The periocular region is the part of the face that plays the most significant role in our social interactions as our "window' to the world, since this part of the face is always exposed to others, and the one we tend to focus on when we interact socially. However, it is also the first to demonstrate signs of facial aging, and changes in this region lead many patients to the aesthetic clinics seeking for advice and treatment options.

Conclusion: The periocular area is the first to show signs of facial aging, but also a part of the face that is the most 'tricky' to rejuvenate. This presentation will provide practical tips and guidance for the aesthetic physician to obtain the most optimal results aesthetically, but also in a prophylactic manner to reduce the impact of future facial aging signs.

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BIGSHOT: A Noteworthy, Natural Non-Surgical Penis Enhancement Technique.

Objectives: Best and safe practice technique for non-surgical penis enhancement
Relevant Penis Anatomy
Minimization of complications

Introduction: Natural, non-surgical male-focused treatments to increase both the girth and length of the penis have gained significant traction as a safe, primary treatment modality over the past decade.

Materials / method: BIGSHOT is the application of platelet-rich gel matrix (PRGM) to the penis shaft, a composite gel consisting of hyaluronic acid (HA) filler mixed with platelet-rich plasma (PRP). This gel is natural, low risk, rapidly available, and completely reversible like HA fillers, however, it lasts for several years. The longevity of BIGSHOT is attributed to the collagenesis that is produced by the combination of HA with PRP.

Results: In a study of 30 men, the application of BIGSHOT, yielded a mean increase in flaccid length of 1.53 inches. The mean increase in shaft girth at the base was 1.94 inches, as well as a mean increase of 1.16 inches girth in the corona. Average injected volumes in the shaft were 75 cc and in the corona, 12 cc.

Conclusion: While BIGSHOT enhancements are impressive, there is no change in sensitivity or performance, there are minimal complications and risks and the procedure takes around 30 minutes to complete. Pain is minimal and normal sexual activity and be resumed after 7 days. BIGSHOT may indeed represent the most ideal solution for natural, non-surgical penis enhancement to date.

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请注明日期: pending
和审阅情况: Summer 2023

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Treatment of Gluteal Myofascial Retraction with Assisted Subcision: A Case Series

Objectives: To report three clinical cases of patients with gluteal myofascial retractions treated with a minimally invasive assisted subcision technique, aimed at correcting aesthetic deformities and relieving discomfort, without significant functional impairment of the lower limbs

Introduction: Gluteal myofascial retraction can negatively affect both the aesthetic appearance and well-being of patients. While the etiology is often linked to repeated intramuscular injections, effective treatment for these retractions remains challenging. The assisted subcision technique, performed with the patient standing, allowed for a more precise treatment, releasing retracted fibers and distributing the biostimulators effectively.

Materials / method: Three female patients, aged between 45 and 56, presenting with gluteal myofascial retractions, were treated using an assisted subcision technique with needles. The probable etiology of the retractions was attributed to multiple intramuscular injections received during childhood, leading to local fibrosis. The procedure was performed with the patients in a standing position, using needles to release deep fibrous retractions. In addition, biostimulating substances were applied to promote tissue regeneration, improve skin quality, circulation, and stimulate collagen production.

Results: All three cases showed positive outcomes with the assisted subcision technique. After three to six sessions, there was significant improvement in skin appearance, with a reduction in myofascial retractions and greater uniformity in subcutaneous fat distribution. Patients also reported relief from symptoms such as sitting discomfort, and improved mobility and quality of life. The use of biostimulators contributed to healthier skin, with results maintained for up to 18 months.

Conclusion: The assisted subcision technique proved effective in treating gluteal myofascial retractions, providing long-lasting aesthetic and functional results, with rapid recovery and high patient satisfaction. Further studies with larger sample sizes are needed to confirm and refine these findings.

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FACIAL MULTILAYER REJUVENATION USING A COMBINATION OF THREADS AND FAT GRAFTING

Objectives: - Evaluate facial contouring results, including lifting and filling effects, with a focus on reduced nasolabial folds, refined jawlines, and filled hollow areas (forehead, temples, malar) that enhance overall facial shape.
- Assess changes in skin quality, such as increased moisturization, thickness, brightness, and reduction of fine lines.
- Evaluate complications
- Measure patient satisfaction with the outcomes of the procedure.

Introduction: Facial rejuvenation is a key concern for aesthetic physicians and clients. Facial aging is a complex, multidimensional process affecting bones, muscles, ligaments, fat pads, and skin, with each layer influencing the others. Aging is driven by genetics, lifestyle, and environmental factors, leading to changes in skin texture, loss of elasticity, and fat redistribution, which alters facial shape and contour. Minimally invasive procedures, using a combination of PDO/PCL threads and fat grafting, target over 70% of these aging issues by rejuvenating multiple facial layers.

Materials / method: Patients undergo liposuction to collect fat, which is filtered to remove impurities. We use 50 mL of refined fat for facial grafting and 50 mL is processed into nanofat.

For deep layer rejuvenation, we fill hollow areas (forehead, temples, malar) with fat grafts and use 19G PDO threads in the SMAS layer and 21G PDO threads in the fat layer for lifting.

For the skin layer, we use mesotherapy technique using nanofat along with 30G PCL Mono threads across the entire face.

Patients are followed at 1, 3, 6, and 12 months

Results: 73 patients underwent with this procedure, averaging 45 years old.

Facial contouring improvements are noticeable after surgery & more pronounced after 2-4 weeks. Skin quality enhancements are seen after 1-3 months.

Common complications include bruising, swelling, discomfort during facial movements, asymmetry, and thread migration. There have been no cases of infection or permanent nerve damage.

After one month, 92% of patients were satisfied. However, at 3 and 6 months, some noticed slight to moderate reductions in contouring effects. 60% of patients willing to undergo the treatment again.

Conclusion: Combining different types of threads with various fat grafting techniques provides a safe and effective method for multi-layered facial rejuvenation. While improvements in contouring and skin quality are clear, it's essential to also prioritize minimizing complications and increasing the longevity of the contouring (lifting and filling) results. In addition to innovations in thread structures, combining pure fat with SVF, stem cells, exosomes, or growth factors represents a promising approach for enhancing treatment outcomes.

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The use of botulinum toxin type-A in treating hypertrophy of the masseter muscle: aesthetic and functional benefits

Objectives: The primary objective of this study was to investigate on the functional and aesthetic benefits of injecting botulinum toxin type-A to treat masseter muscle hypertrophy.

Stepwise approach:
1. Diagnose masseter muscle hypertrophy
2. Identification and drawing of the injection points
3. Management of masseter muscle hypertrophy with botulinum toxin type-A
4. Results at follow up: aesthetic and functional benefits

Introduction: Masseter muscle hypertrophy is a common yet underdiagnosed condition which can alter facial appearance by projecting jaw angles, resulting in a more masculine aspect of lower third of the face. This condition, which is often the result of bruxism or clenching of the teeth, can also lead to functional symptoms such as jaw aches, cervicalgia and tension headaches.
Injecting botulinum toxin type-A in the masseter muscle can reduce its hypercontractility and therefore hypertrophy and has proven effective in relieving functional symptoms and restoring facial harmony by slimming the jaw angle.

Materials / method: Six female patients affected by masseter muscle hypertrophy conditioning functional symptoms and aesthetic facial changes were treated by injecting 30 to 50 units of botulinum toxin type-A into each masseter muscle. Four weeks after treatment, these patients were evaluated to assess modifications in functional symptomatology and in the projection of the jaw angles.

Results: All six patients reported functional benefit with reduction of cervicalgia, headaches or jaw pain. All six patients also reported aesthetic improvements with slimming of the jaw angles leading to a more feminine appearance.

Conclusion: In this small cohort study, botulinum toxin type-A has proven effective in treating hypertrophy of the masseter muscle, leading to improvement in both functional and aesthetic symptoms derived from this condition. Larger-scale studies and longer follow-up times are needed to further assess long-term benefits of this treatment.

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Neck Sliming: Effective methods to achieve a Slim Neck

Objectives: Deliberate and demonstrate how i have been using the molecules and procedures at our disposal as practicing dermatologists, to help achieve a slim and slender neck for my patients.

Introduction: We all would agree that one of the key dimensions of beauty is a ‘Slim & Slender Neck’. Though I believe that focusing only on Neck is not enough, for a more complete outcome, we need to also treat the Shoulder which would add overall aesthetic value to a Slim Neck. There are ways and methods suggested by dietitians, physiotherapists, and gym instructors to achieve a slim Neck. Though it’s easier said than done. Today with advancement of Aesthetic medicine, we have at our disposal molecules and procedures that can help achieve a slim and slender neck for our patients.

Materials / method: In my presentation I would deliberate on how we can leverage our existing skills and most familiar injectables (Botulinum Toxin) to achieve the desired result in a very short time and which is long lasting. Botulinum toxin injections selectively target hyperactive neck and shoulder muscles, effectively reducing muscle bulk and enhancing contour definition. The session highlights procedural nuances, including injection site selection, dosing strategies, and patient management protocols essential for achieving optimal outcomes.

Results: The delegates will gain insights on the effective way of using Botulinum Toxin for achieving a very nuanced aesthetic outcome, which when done gives immense satisfaction to our patients.

Conclusion: This session explores advanced non-surgical techniques for neck and shoulder slimming, emphasizing the integration of botulinum toxin injections alongside injection lipolysis.
Benefits to practicing dermatologists include expanded treatment offerings, improved patient satisfaction, and increased practice revenue.

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Non-surgical eyebrow reshaping using combined methods: Barbed threads, Botulinum toxin type A and Fillers.

Objectives: The aim of this study is to investigate the clinical efficiency of combining three
modalities: threads, botulinum toxin type A (BTX), and Hyaluronic acid (HA) fillers in
non-surgical eyebrow reshaping and patient satisfaction.

Introduction: The eyebrow form and overall eye shape hold a remarkable significance in enhancing facial beauty. The eyebrows serve as an artistic frame, harmonizing facial features and accentuating the eyes. Patients often seek an eyebrow lift to achieve a refreshed andyouthful appearance. The aim of this study is to investigate the clinical efficacy ofcombining barbed threads, Botulinum toxin type A (BTX), and Hyaluronic acid (HA)fillers for the treatment of brow ptosis.

Materials / method: 7 patients were treated with non-surgical lift of the eyebrows. Patients were assessed for brow ptosis, eyelid skin excess, lower and upper temple hollowness, presence of A frame deformity, and the constrictor effect of the orbicularis oculi. Patients had BTX treatment initially, followed two weeks after by polycaprolactone and polylactic acid barbed threads, and temple filler using HA fillers if indicated. Results were compared based on filled FACEQ questionnaires direct after the threads, 1 month and 6 months later.
Adverse effects were looked at 48 hours after thread treatment.

Results: Combining the 3 modalities for non-surgical eyebrow lift and reshaping, achieved a
significant patient satisfaction level and no complications.

Conclusion: Combining the 3 modalities for non-surgical eyebrow lift and reshaping, achieved a
significant patient satisfaction level. The followed methodology in this study can help exploring the proper etiologies for brow ptosis in the treated patient and showed that addressing the volume loss, muscle hyperfunction, and skin laxity can optimize theresults. Studies with higher number of included subjects are needed to achieve more conclusive results.

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Ultracodes: a new technique to improve microfocus ultrasound results based on anatomy with minimum shots

Objectives: To show that microfocus ultrasound is possible to be done with a few shots just based on anatomy knowledge, delivering
excellent results to all patients done, independently of the brands used. We will review and validate a new microfocused ultrasound technique based on the anatomy of facial ligaments to achieve an effective and rapid lifting effect. Respecting the anatomy of the ligaments is crucial to obtain results.

Introduction: The application of microfocused ultrasound in facelift has revolutionized aesthetic dermatology. Microfocused ultrasound has emerged as a non-invasive and effective alternative for facial rejuvenation, stimulating collagen production and improving skin tightening. In this presentation, we will explore the effectiveness, benefits, and impact of microfocused ultrasound as an advanced treatment option in the pursuit of a rejuvenated and natural appearance with a new technique: Ultracodes

Materials / method: The tecnhique is based on the ligamentar line of the face, when we mark these ligaments:: superior temporal septum, orbicularis retaining ligament, zygomatic cutaneous ligaments, masseteric cutaneous ligaments, mandibular cutaneous ligament. After we do a line, connecting them and this area we have the topography to apply the transducers. We applied the microfocused ultrasound over this line with the deeper linear transducers and also with the pen (when it's available).

Results: The results are satisfactory in our experience with 389 cases. This technique has been extremely effective for achieve a lifting effect when used to enhance traditional microfocused ultrasound techniques. In our experience, we validated this technique with different types of microfocused ultrasound technologies from 4 different brands to make sure it works correctly.

Conclusion: Microfocused ultrasound in non facelift represents a groundbreaking approach in aesthetic dermatology. Its potential to stimulate collagen production and enhance skin tightening, delivering remarkable results. In conclusion, this technique is an effective and non-invasive alternative for facial rejuvenation, providing patients with a younger, more natural appearance and making a positive impact. Besides that, the Ultracodes technique is cost-effective, improving the physician's performance and making it more accessible for patients to achieve desired effect.

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The eyes have it: non-ablative fractional periorbital rejuvenation with drug delivery

Objectives: 1 Analysis of the periorbital clinical conditions
2 Prepare a tailored approach of non-ablative fractional treatment plus Drug Delivery
3 Select appropriate active substance to be combined according to each clinical condition

Introduction: The periorbital area is the first to show signs of aging. The main techniques currently in use for the treatment of the periorbital area are: surgical and non-surgical. Skin resurfacing is one of the basic techniques of aesthetic medicine and dermatology. Drug delivery can increase the penetration and absorption of various active substances through the creation of transcutaneous channels.

Materials / method: 50 patients with different clinical conditions were treated, modifying the substances applied for drug delivery depending on the clinical condition. The application of the substances takes place at the end of the treatment and continues at home for the following 6 hours.

Results: The non-ablative fractional periorbital rejuvenation with drug delivery protocol was found to be safe, painless and effective. No adverse events were reported.

Conclusion: Combining the non-ablative fractional rejuvenation and the action of active substances, through drug delivery, improves the quality of results and broadens the therapeutic indications.

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Strategies for Gluteal Contouring: Integrated Techniques for Enhanced Aesthetic Results

Objectives: The goal is to underscore the significance of personalized global gluteal treatment, which incorporates both the gluteal area and adjacent regions. We will explore the strategic use of products such as dermal fillers, biostimulators, and volumizers, alongside the integration of various technologies to enhance aesthetic outcomes. Our focus will be on customizing this treatment to fit the unique needs of each patient, aiming for a holistic improvement in the gluteal region.

Introduction: As interest in minimally invasive aesthetics continues to rise, gluteal augmentation procedures have become increasingly relevant. However, traditional isolated methods for enhancing the glutes often do not meet patient expectations. This highlights the necessity for a more integrated approach: comprehensive gluteal treatment. Such an approach addresses not only the gluteal region but also neighboring areas, using a strategic combination of techniques to enhance volume, projection, contour, firmness, and skin texture.

Materials / method: We conducted a thorough assessment and applied global gluteal treatment to a cohort of patients, taking into account not only the gluteal area but also adjacent zones such as the flanks, cleft, and “banana fold.” A range of techniques and products was utilized, including hyaluronic acid fillers, collagen biostimulatory agents, and volumizers, combined with specific technologies to optimize results. These interventions were carefully implemented to improve contour, volume, projection, skin firmness, and to refine skin texture and fat distribution.

Results: The comprehensive gluteal treatment approach led to notable enhancements in the aesthetics and overall appearance of the treated areas. Patients reported high levels of satisfaction, indicating improvements in contour, volume, and skin firmness, as well as a smoother and more even skin texture.

Conclusion: The strategic use of combination therapy allowed us to achieve natural and balanced results tailored to each patient's individual needs. We emphasize the necessity of a thorough assessment and a personalized treatment plan to attain superior and satisfying aesthetic outcomes in both the gluteal region and surrounding areas.

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IN-VIVO AND IN-VITRO BIO-FILLER DISSOLVING BY PROTEASE, PHYSIOLOGICAL SALINE, ALTEPLASE, COLLAGENASE AND HYALURINIDASE

Objectives: Learning the effectiveness of the saline, hyaluronidase, protease, alteplase and collagenase in dissolving of bio-filler in-vitro and in-vivo.

Introduction: Bio-fillers are popular aesthetic applications and are better tolerated than high-density hyaluronic acid fillers. However, there is not enough data about management when complications develop. In this study, we aimed to evaluate the effectiveness of dissolvent substances such as hyaluronidase, protease, alteplase, saline and collagenase .

Materials / method: 6 male New Zealand rabbits weighing 3-4 kg were used and the approval of the Akdeniz University Ethics Committee was obtained (protocol no: 12122024.04.004). Rabbits were treated under ketamine and xylazine anesthesia; the ear scalp was shaved and the posterior auricular artery was identified. Biofiller was applied by 0.2 ml and the other substances were applied by 1 ml intraarterial injection. Rabbits were observed and photographed on days 0, 1, 2, 4 and 7.
For in vitro studies, 250 μι biofiller and solvents. The Mixtures were cantified eith image analysis software.

Results: After intraarterial injection of bio-filler, the ears gradually turned dark blue. At the end of the 7th day, the ears were pinker in the filler+protease and filler+physiological groups of filler, while partial pinkness was seen in the filler+collagenase group. In the filler+alteplase group, echimose was observed in the first days and pinkness on the 7th day. In the filler+hyaluronidase group, the ears remained blue-black.
According to our in vitro results, the highest average particle count was seen in the bio-filler+protease group. The second,, third highest were saline, collagenase ggroups.

Conclusion: In our study, the most effective dissolving substances in bio-filler applications were determined as protease, physiological saline and alteplase; collagenase was found to be less effective.

The data obtained suggest that the use of protease in arterial pressure and vascular complications requiring sudden and rapid intervention during bio-filler filling applications, diluation with physiological saline or the use of products containing protease and collagenase, alteplase can eliminate an advanced complication.

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EVALUATING THE EFFECTIVENESS OF USING HYALURONIC ACID FILLER FOR LIGAMENT LIFTING IN MIDDLE AGED PATIENTS

Objectives: The study aimed to investigate the efficacy and safety of using hyaluronic acid filler for facial lifting.

Introduction: Facial aging in middle-aged individuals is influenced by intrinsic and extrinsic factors. In the anatomical overview for aging, three main structures are affected, including fat deflation, bone resorption, and ligament attenuation. Aging changes in ligaments contributed to facial sagging along with volume loss. To support sagging in facial layers and gravitational related, targeting the facial ligaments with the right characteristic of hyaluronic acid filler in a minimal amount offers more refined and maximal lifting support.

Materials / method: This clinical trial study recruited seventeen female participants aged 30-55 with mild to moderate skin laxity. A total of 3.3 ml high G prime hyaluronic acid filler was delivered by 27G sharp needle; we have developed seven injection points to target facial retaining ligaments; by injecting the zygomatic cutaneous ligaments, mandible angle, mandibular septum, mandibular cutaneous ligament, pyriform fossa, platysma-auricular fascia and residual filler were used to correct the chin. Clinical outcomes were evaluated by MEAN volume difference by Vectra.

Results: The clinical evaluation of patients' satisfaction scores showed a great improvement from the immediate post-injection. Our data demonstrated a significant result in the lifting effect, with an increase in volume change in the mandible and chin area from the baseline. The pyriform fossa also showed improvement, and the results lasted until six months. Notably, with the lifting in the zygomatic region, the results showed more refining, contouring, and lifting in the mid-cheek area. Some adverse effects were observed during the study such as edema, erythema, wheal, bruising, and mucocele.

Conclusion: Our clinical study has shown that our seven-point lifting techniques provided a predictable outcome of facial lifting for middle-aged female patients. These findings are significant as they underscore the key factors for achieving maximal facial lifting effects, which consist of the right patient selection, the right techniques, corrective injection plan, and using hyaluronic acid filler with high G prime and high lifting capacity. This study's findings have the potential to significantly impact the field of facial rejuvenation.

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小时	讲者	演讲标题	讲稿摘要	数字
10:30	Jesper THULESEN 医师	The periocular challenge for the aesthetic physician	查看	140661
10:40	Cory TORGERSON 医师	BIGSHOT: A Noteworthy, Natural Non-Surgical Penis Enhancement Technique.	查看	140664
10:50	Amanda Mirella KIYOMURA DE PAULA 医师	Treatment of Gluteal Myofascial Retraction with Assisted Subcision: A Case Series	查看	140665
11:00	Ngoc Quynh Nhu DINH 医师	FACIAL MULTILAYER REJUVENATION USING A COMBINATION OF THREADS AND FAT GRAFTING	查看	140666
11:10	Martina DELL ' ERBA 医师	The use of botulinum toxin type-A in treating hypertrophy of the masseter muscle: aesthetic and functional benefits	查看	140667
11:20	Falguni SHAH 医师	Neck Sliming: Effective methods to achieve a Slim Neck	查看	140668
11:30	Ana BENDITO 医师	Non-surgical eyebrow reshaping using combined methods: Barbed threads, Botulinum toxin type A and Fillers.	查看	142834
11:40	Daniela PEREIRA NUNES RIBEIRO 医师	Ultracodes: a new technique to improve microfocus ultrasound results based on anatomy with minimum shots	查看	142836
11:50	Francesco LINO 医师	The eyes have it: non-ablative fractional periorbital rejuvenation with drug delivery	查看	142837
12:00	Bruna VALLCORBA 医师	Strategies for Gluteal Contouring: Integrated Techniques for Enhanced Aesthetic Results	查看	140663
12:10	Ayse AKMAN KARAKAS Prof	IN-VIVO AND IN-VITRO BIO-FILLER DISSOLVING BY PROTEASE, PHYSIOLOGICAL SALINE, ALTEPLASE, COLLAGENASE AND HYALURINIDASE	查看	140662
12:20	Polen TE 医师	EVALUATING THE EFFECTIVENESS OF USING HYALURONIC ACID FILLER FOR LIGAMENT LIFTING IN MIDDLE AGED PATIENTS	查看	142835

2025 英卡思巴黎国际年会
大会日程

Open Stage - Non-sponsored scientific lectures

本场演讲内容

推荐会议

2025 英卡思巴黎国际年会 大会日程

Open Stage - Non-sponsored scientific lectures

本场演讲内容

推荐会议

2025 英卡思巴黎国际年会
大会日程

本场演讲内容