Injectables Day I
Friday, October 8, 2021 - Starting 3:00 PM (EST - Toronto time)
All presentation details will be available soon...
Soft-tissue augmentation has been used with positive results for some time, but the focus within the facial aesthetic community, as a whole, of where to place volume has certainly changed and expanded. Dr Beatriz Molina will share her experience using combinations of needles and cannulas for treatments of male patients.
Investigating planes of insertion in Micrograft, hyaluronic acids, calcium hidroxylapatite, PRP, threads, desossicolic acid and micro knife treatments:
Background: The aim of the study is to analyze the facial layers in which the product is released in the most common practices in aesthetic medicine, such as volume augmentation by means of hyaluronic acid, calcium hydroxylapatite, PRP, micro/nanograft, volume reduction by dessicolic acid and ptosis correction by threads. The role of resection of ligaments by micro knife is also discussed.
Materials and methods: 40 cadavers head have been treated using several techniques imitating procedure on common practice in aesthetic medicine to properly restore age related volume loss. During the simulated procedures different materials have been used: hyaluronic acid, calcium hydroxylapatite, human fat harvested from cadavers, threads and saline solution simulating PRP and dessocolic acid. Different colors have been used for the different materials in order to identify them at the dissection.
The injection of hyaluronic acid has been executed using both 27 gauges blunt cannulas and 30 gauges sharp needles. Calcium hydroxylapatite has been injected using both 27 gauges blunt cannulas and 28 gauges sharp needles. Micrograft has been injected using 22 gauges blunt cannulas and 21 gauges sharp needles, while nanograft using both 22 gauges blunt cannulas and 25 gauges sharp needles.
The colored saline used to imitate PRP has been injected using 22 gauges blunt cannulas and 30 gauges sharp needles.
The threads has been placed using 18 gauge needle to insert them under the skin.
After the injections and threads placements all cadavers head have been dissected creating 5 anatomical layers: 1-skin, 2-superficial fat compartments, 3-SMAS, 4-deep fat compartments and masticatory muscle , 5 –bone. Colored materials has been searched along the layers.
Hyaluronic acid has been placed in layer 2 for 93% of the volume injected, calcium hydroxilapatite has been injected in 92% of the cases in the layer 4, Micrograft has been injected for 93% in the layer 3, nanograft for the 83% in layer 2 e 17% in layer 3; PRP has been injected for 89% in layer 2; threads have been placed for 92% along layer 2, Dessocolic acid has been injected for 92% in layer 2, the legaments were resected in the layers 2 and 3 in 96% of cases.
Conclusion: Cadaver dissection offers various insights over injections in aesthetic medicine, focusing the relationships between anatomical structures and injectables. The analysis of facial layers offers opportunity to optimize facial injection in order to have better aesthetic results.
Aesthetic anthropology is the study of the various ways in which different populations evaluate the beauty of the people around them. The K68 is an anthropological parameter of Koinophilia. Koinophilia is an evolutionary hypothesis proposing that during sexual selection, animals preferentially seek mates with a minimum of unusual features.
3 groups of evaluators are recruited: Group 1, people living in Milan and Bejing, group 2 culturally isolated people from Papua New Guinea (without electric power, internet, magazine, etc), group 3 “aesthetic medicine addicted” (people younger than 25 years old who do at least 10 aesthetic treatments at year).
The attractiveness judgements of different groups of evaluators was tested by using a set of standardized full-color images
a significant agreement between the 3 groups of evaluators was demonstrated on images of people who didn’t do any kind of aesthetic treatment or who had a natural result from this treatment. At the opposite, extreme face modification determined statistically significant differences, in case of full facial tattoo from group 1 and 3 to group 2, and in case of lip augmentation with big volume of Hyaluronic acid from group 1 and 2 to group 2.
CONCLUSION:The results of this study is a typical example of overgeneralization. The attractiveness of normal faces is lower when compared whit tattooed faces when evaluated group 2. In fact, Melanesian culturally isolated population overgeneralizes the tattoo as sign of strong girl.
As the same time, unnatural results of extreme aesthetic medicine are appreciated only by the “aesthetic medicine addicted” group, who overgeneralize injection of a big volume of Hyaluronic acid in the lips of famous people of TV as sign of beauty and success.
The aim of a non surgical rhinoplasty is to correct minor deformities when surgical procedure is undesirable. In last decades multiple approaches were proposed: different levels (subcutaneous or supraperiosteal), different tools (blunt cannula or sharp needle), different products (high or low G’ HA filler, Calcium hydroxyapatite filler, botulinum toxin).
Nose filler requires an extensive anatomy and product knowledge, experience in dealing with complications.
The author has an important experience with asian patients, especially nose filler. The most frequent patients’ desire is to improve the dorsum hight, obtaining mid face projection and more proportional appearance. The aim of this presentation is to describe personal experience evaluating over 200 patients treated in the past 3 years, product choice, average outcome and patients satisfaction.
Patients undergone the treatment presented with low nose dorsum, low radix and drooping tip. Patients underwent previous post traumatic or aesthetic surgery were excluded.
The treatment was performed with blunt cannula, 25G x 50mm, using a high G’ hyaluronic acid filler.
The average amount of used filler was 1mL. Corrections, when needed, were performed 2 weeks after.
Of 215 treated patients treated 1 vascular complication was reported, treated with hyaluronidase with no consequences, only 6 required more than 1 mL of product and 1 patient required hyaluronidase because was not satisfied with the result.
In order to achieve a satisfying result in asian patients, the choice of the proper product is mandatory: a low G’ HA will create an enlargement of the treated area with a high dissatisfaction rate.
Single entry point with cannula from the tip of the nose is recommended to obtain an homogenous result, and allows to achieve a Strut graft like effect.
The results can last up to 18 months.
Dr. Anna FogliMD, Aesthetic Physician
Dr. Anna Fogli received her double degree in Pharmaceutical Chemistry and Technologies from the Università degli studi di Torino – Faculty of Pharmacy and in Medicine and Surgery. She completed a 2-year Master in Aesthetic Medicine and Well-being from the IAF Institute in Roma, Italy.
Clinical hospital Pharmacist, Azienda Ospedaliera S.Giovanni Battista di Torino.
Observership in the Reproductive Medicine Department, Assisted Conception Unit, in the King’s College Hospital
Fellowship in the Endocrinology, Dietology and Metabolic Diseases S.C. Mauriziano Umberto I Hospital, Torino
Aesthetic Doctor and Clinical Monitor and Instructor for Rigenera HBW Centre for Regenerative Medicine Graziano D’Aquino, Corso Gallileo Ferraris 63, Torino
Aesthetic Doctor for Pico Global LTD, specialized on Asian Beauty.
Member of Associazione Italiana Di Ginecologia Estetica e Funzionale (AIGEF, Italian association of aesthetic and functional gynecology).
IMCAS Annual world congress 2019, VI EURASIAN CONGRESS OF DERMATOLOGY, COSMETOLOGY AND AESTHETIC MEDICINE, Astana Kazakhstan speaker
Speaker at Forthcoming congres: IMCAS AMERICAS 2019, Cartagena
Dr. Beatriz MolinaMD, Aesthetic Physician
Dr Beatriz Molina is a leading name in the UK aesthetic industry and travels around
the world as an international speaker on dermal fillers and botulinum toxin.
Beatriz studied medicine in Malaga, Spain, becoming MD in Medicine and Surgery
in 1993. Beatriz arrived in the UK in early 1994, where she started her surgical
rotation in Frenchay Hospital, Bristol.
Dr. Mario GoisisMD, Maxillofacial Surgeon
Mario Goisis is the director of Doctor’s Equipe, a group of 9 clinics and medical offices in Italy. He obtained his MD at Milan University. In 1999. He is Certified in Maxillofacial Surgery. Dr. Goisis is often called upon by National and International medical and scientific groups to inform and teach doctors on the recent advances in medical and aesthetic cosmetic correction.
As an invited speaker, he has lectured extensively in Europe and America. In recent years Dr. Goisis has lectured in Europe and in the United States about regenerative medicine and in aesthetic invasive and non invasive procedures.He has patented many instruments for aesthetic, reconstructive and regenerative treatments.
He has written scientific articles about aesthetic medicine and surgery for American and European journals. He is the editor of the Atlas of Aesthetic Treatments published by Springer, an Atlas with a step-by-step description of full-face treatment and body remodeling with fillers. This atlas is edited in many languages, included Corean and Chinese. He is the Author of the book Five Layers simple anatomy.
Regarding aesthetic and regenerative medicine techniques, he has more than 15 years of experience.
Atlas of Full-face and Full-body Treatment | Goisis, Mario (Ed.) 2014, CCXXIV, 12 p. 874 illus. in color. ISBN 978-88-470-5360-1
Breast augmentation after Macrolane filler injections | Aesthetic Plast Surg. 2011 Aug;35(4):684-6.
Hyaluronic acid breast injections: difficulties for mammographic monitoring | Cir Esp. 2011 Feb;89(2):125;
Is hyaluronic acid gel a good option for breast augmentation? | Aesthetic Plast Surg. 2011 Feb;35(1):134-6;
Enucleation vs evisceration. | Ophthalmology 2007 Oct;114(10):1960
Surgical approaches to cavernous haemangiomas of the orbit. | Br J Oral Maxillofac Surg. 2007 Sep;45(6):457-62
Primary intraosseous hemangiomas of the orbit. | Orbit. 2006 25(2):137-9.
Fibrous Dysplasia of the Orbital Region: Current Clinical Perspectives in Ophthalmology and Cranio-Maxillofacial Surgery. | Ophth Plast Reconstr Surg. 2006 22(5):24-29
Relining contracted sockets. | Plast Reconstr Surg. 2005 115(1):347, 2005
Treatment and long-term outcome of patients with orbital cavernomas. | Am J Ophthalmol. 139(4):750, 2005
Submental Orotracheal Intubation: An Alternative to Tracheotomy in Transfacial Cranial Base Surgery. | Skull Base: An Interdisciplinary Approach. 13(4):189-195, 2003.
Access to the maxillary sinus using a bone flap on a mucosal pedicle. | J Cranio-maxillofac Surg 30(4):255-260, 2002.
Conservative treatment of arteriovenous malformations of the mandible. | Int J Oral Maxillofac Surg 30(5):397-401, 2001.
Reconstruction of the orbital walls in surgery of the skull base for benign neoplasms | Int J of Oral Maxillofac Surg 29(5):325-30, 2000.