FINAL PROGRAM 6TH EDITION - EuroMediCom

6 TH EDITIONFINAL PROGRAM+250 International Speakers6 Conferences Rooms+50 Workshops+200 International Companies+3500 Participants+90 NationalitiesANTI-AGING MEDICINE:Environmental medicineEndocrinology, Hormone TherapiesFitness MedicineGenetic TypingGerontologyNeurologyNutrition, nutrients, VitaminsStem Cells, cutting edge medicineHot new topicsControversies, debatesAnd more...AESTHETIC DERMATOLOGY & SURGERYTransversal approachCombined techniques with Anti-agingBotulinum ToxinDemal Fillers, Hyaluronic AcidF.A.T. Fat Aesthetic TreatmentsLasersPeri-oral, Peri-orbital areas, BreastComplications managementNew ideas and innovations...

Save the Date: March 19-20-21, 2009Anti-Aging Medicine World Congress 2009Grimaldi Forum - MONACOSessions in Anti-Aging MedicineSessions de Médecine Anti-AgeSchedule At-A-Glance / Planning du CongrèsAMWC 2008Sessions in Aesthetic Dermatology & SurgerySessions de Dermatologie & Chirurgie EsthétiquesAnti-Aging WorkshopsAesthetic WorkshopsBLUEAUDITORIUMROOM / SALLEMAILLOTROOM / SALLE252 ABROOM / SALLEPASSYROOM / SALLE242 ABROOM / SALLE251THURSDAY APRIL 1010.3014.0016.0016.3018.30BOTULINUM TOXINSYMPOSIUMSOFT TECHNIQUES OFFACIAL REJUVENATIONGENETICTYPINGMEETING WITH THELEADERS OFANTI-AGING MEDICINE10.30: Conference Registration Open12.00: Congress and Exhibit OpenningCONTRIBUTING LECTURESIN AESTHETICDERMATOLOGYAND SURGERYTHE COSMETICCONSULTATIONCoffee BreakABC WORKSHOP OFANTI-AGING MEDICINE-----------------WORKSHOP 2EFFICIENT NUTRIENTSFOR A HEALTHY AGINGHEAVY METALS &CHELATIONTECHNIQUESWORKSHOP 1MEDIGEM CO.WORKSHOP 3TUXEDO CORPORATIONWORKSHOP 5Q-MED RESTYLANEWORKSHOP 7MEDIFORM18.30 - 19.30 OPENING CEREMONY - WELCOME COCKTAILWORKSHOP 2REGENLABWORKSHOP 4POLLOGENWORKSHOP 6AQUAMIDWORKSHOP 8EVOLENCE7:00: Conference Registration Open - 8.00: Exhibit OpeningFRIDAY APRIL 118.3010.3011.0013.0014.0016.0016.3018.30LIP ARTISTRY ANDLOWER FACEREJUVENATIONNON ABLATIVEAND ABLATIVESKIN REJUVENATIONPERIORALREJUVENATIONENHANCEMENT OF THEFACETHE BEST FILLINGTECHNIQUESSEXOLOGY ANDSEXUALENDOCRINOLOGYOPTIMALNEUROLOGYSTEM CELLS----------------BORDERLINEENDOCRINOLOGYANTI-AGINGGASTROENTEROLOGYFATFAT AESTHETICTREATMENTSPART 1WORKSHOPALLERGANSKIN AND HAIRDISORDERSFATFAT AESTHETICTREATMENTSPART 2Coffee BreakLunch BreakCoffee BreakWORKSHOP 3TREATMENTS OF SKINDISORDERSJAPAN ANTI-AGINGMEDICINEWORKSHOP 4SKIN AND FOOD----------------------WORKSHOP 5CANCER TREATMENTCONTRIBUTINGLECTURES INANTI-AGING MEDICINEWORKSHOP 6GENETIC TYPING TESTS-------------------------WORKSHOP 7ANTI-AGING THROUGHSPA THERAPYSPEAKERS DINING COCKTAILWORKSHOP 9LCA PHARMACEUTICALWORKSHOP 11NORDIC AESTHETICSWORKSHOP 13ANTEISWORKSHOP 15ADODERMWORKSHOP 17TEOXANEWORKSHOP 20PROMOITALIAWORKSHOP 22Q-MED MACROLANEWORKSHOP 10LUTRONIC CORP.WORKSHOP 12AESTHETIC DERMALWORKSHOP 14PROCYTECHACTIVECOSMETHICSWORKSHOP 16FILORGALABORATORIESWORKSHOP 18LIPOTOMY AQPWORKSHOP 19THERMAGEWORKSHOP 21MEDIFORMWORKSHOP 23CAREGENSATURDAY APRIL 128.3010.3011.0013.0014.0016.0016.3018.3020.30REJUVENATIONOF THE EYESPART 1REJUVENATIONOF THE EYESPART 2IDEAS& INNOVATIONSFATFAT AESTHETICTREATMENTSPART 3COMMUNICATIONSIN FOREFRONTANTI-AGING MEDICINE--------------CUTTING-EDGEANTI-AAGING MEDICINEGLOBAL WARMING& RISKYENVIRONMENTNUTRIENTSAND THE SKIN-------------------FITNESS MEDICINEONCOLOGY:HOW TO LIVELONGER DESPITECANCER7:30: Conference Registration Open - 8.00: Exhibit OpeningHAND REJUVENATION: WORKSHOP 8AN INCREASING TESTOSTERONE IN MEN--------------------DEMAND FROM THEWORKSHOP 9PATIENTSSTEM CELLSCoffee BreakWORKSHOP 10DIGESTIVE SYSTEMBREAST----------------------REJUVENATIONWORKSHOP 11OPTIMAL BRAIN AGINGASSESSMENTLunch BreakWORKSHOP 12THE AGING SKIN: RELAXIN & OXYTOCINEVALUATION AND ----------------TREATMENTS WORKSHOP 13GLOBAL WARMINGCoffee Break - Drawing of lots on Teoxane’s boothWORKSHOP 14CONTRIBUTING LECTURES HOW TO RUN ANANTI-AGING CLINIC ?IN AESTHETICDERMATOLOGYAND SURGERYWORKSHOP 15HOW TO INCREASESEXUAL PLEASUREWORKSHOP 24TUXEDOWORKSHOP 26ANTEISWORKSHOP 28TEOXANEWORKSHOP 30Q-MED RESTYLANEWORKSHOP 32ALLERGANWORKSHOP 34LUMENISWORKSHOP 36AURIGAINTERNATIONALWORKSHOP 38TO BE ANNOUNCEDExceptional Gala Evening at the Intercontinental Hotel - ParisWORKSHOP 25REGENLABWORKSHOP 27ANTI-AGINGMEDICAL SYSTEMSWORKSHOP 29PROMOITALIAWORKSHOP 31PRODERMAWORKSHOP 33Q-MED MACROLANEWORKSHOP 35ATLEANWORKSHOP 37SKINZONWORKSHOP 39RIOBLUSH

SCIENTIFIC DIRECTORS ANTI-AGING MEDICINE, PREVENTION & LONGEVITYThierry HERTOGHE Anti-Aging Medical Doctor Brussels BelgiumChristophe de JAEGER Geriatrist, Gerontologist Paris FranceClaude DALLE Anti-Aging Medical Doctor Paris FranceNicolas BACHOT Dermatologist Paris FranceJean-Christophe BICHET Plastic Surgeon Paris FrancePhilippe BLANCHEMAISON Phlebologist Paris FranceOlivier CLAUDE Plastic Surgeon Paris FranceMonika GOLKOVA Neurologist Prague Czech Rep.Fabio INGALLINA Plastic Surgeon Catania ItalyMichael KAMINER Dermatologist Boston USAMario KRAUSE Anti-Aging MD Hannover GermanyCédric KRON Plastic Surgeon Paris FranceArgentinaJulio FERREIRA, MDGustavo LEIBASCHOFF, MDRuben MULHBERGER, MDAustraliaBill ANTON, MDBelgiumKoenraad de BOULLE, MDGeorges MOUTON, MDDidier VOCHELLE, MDBrazilWilmar J. ACCURSIO, MDChina & Hong KongDavid MC CHAN, MDClaude CHAUCHARD, MDWalter KING, MDDavid LAI, MDCzech RepublicMonika GOLKOVA, MDANTI-AGING MEDICINEWORLD CONGRESS 2008FranceEtienne-Emile BEAULIEU, Prof.Patrick CHERIN, Prof.Claude DALLE, MDRonald VIRAG, MDGermanyEckart HANEKE, Prof.Mario KRAUSE, MDGreeceParaskevas KONTOES, MDHungaryImre ZS-NAGY, Prof.ItalyDamiano GALIMBERTI, Prof.Ilaria GHERSETICH, Prof.Ascanio POLIMENI, Prof.JaponYoshikazu YONEI, Prof.Toshikazu YOSHIKAWA, Prof.ABRAMO Carlos-Antonio Plastic Surgeon London, UKABYAD Abdulrazak Anti-Aging Medical Doctor Tripoli, LebanonACCURSIO Wilmar Endocrinologist, Nutritionist Sao Paulo, BrazilANDRÉ Pierre Dermatologist Paris, FranceAZZAM Carole Plastic Surgeon Marbella, SpainBACHOT Nicolas Dermatologist Paris, FranceBARANOVA Helena European Expert “Genomics for Health" Nice, FranceBAULIEU Etienne-Emile Professor at Collège de France Paris, FranceBENEDETTO Anthony Dermatologist Philadelphia, USABENSLIMANE Fahd Plastic Surgeon Casablanca, MoroccoBERSTEIN Lev Professor of Oncoendocrinology St Petersburg, RussiaBEUSTES-STEFANELLI Matthieu Hand SurgeonBordeaux, FranceBICHET Jean-Christophe Plastic Surgeon Paris, FranceBJERRING Peter Professor of Dermatology Vejle, DenmarkBLANCHEMAISON Philippe PhlebologistParis, FranceBON Marc-Henri Plastic Surgeon Paris, FranceCALABRESE Pasquale Neurologist Bochum, GermanyCARDOSO DE CASTRO Claudio Plastic SurgeonRio de Janeiro, BrazilCEDERBERG Hokan Biochemist Engineer Monsteras SwedenCHIN Elaine Anti-Aging Medical Doctor Toronto, CanadaCLAUDE Olivier Plastic Surgeon Paris, FranceCOMAR Philippe Prof. of Morphology at the Ecole des Beaux Arts Paris, FranceCOTTERILL John Dermatologist Leeds, UKCULP Michael Nutritional Biochemistry London, UKDALLE Claude Anti-Aging Medical Doctor Paris, FranceDASIOU-PLAKIDA Dimitra Dermatologist Athens, GreeceDE ANGELIS Francesca Plastic Surgeon Naples, ItalyDE BENITO Javier Plastic Surgeon Barcelona, SpainDE BOULLE Koenraad Dermatologist Aalst, BelgiumDE GREY Aubrey PhD in Biology Cambridge, UKDE JAEGER Christophe Geriatrist, Gerontologist Paris, FranceDELAY Emmanuel Plastic Surgeon Lyon, FranceDEPREZ Philippe Aesthetic Medical Doctor Empuriabrava, SpainEDEAS Marvin Preventive Medicine La Valette, MaltaEMPERAIRE Jean-Claude Endocrinologist, Gynecologist Bordeaux, FranceEVENOU Philippe Dermatologist Paris, FranceFLECHAS Jorge Anti-Aging Medical Doctor Hendersonville, USAFLECHET Marie-Laure Dermatologist Paris, FranceFOGLI Alain Plastic Surgeon Marseille, FranceFORENZA Anna Maria Clinical Pathologist & Anti-Aging Medical Doctor Roma, ItalyGALIMBERTI Damiano Anti-Aging Medical Doctor Milano, ItalyGALLUCCI Marco Plastic Surgeon Pise, ItalyGARDE Claude Angiologist Paris, FranceGHERSETICH Ilaria Professor of Dermatology Florence, ItalyGOLKOVA Monika Neurologist Prague, Czech RepublicGUARNER Francisco Professor of Gastroenterology Barcelona, SpainSCIENTIFIC COORDINATORSINTERNATIONAL SCIENTIFIC ADVISORY BOARD MEMBERSSCIENTIFIC DIRECTORS AESTHETIC DERMATOLOGY & SURGERYPierre ANDRÉ Dermatologist Paris FrancePhilippe PETIT Mesotherapist Paris FrancePatrick TRÉVIDIC Plastic Surgeon Paris FranceGustavo LEIBASCHOFF Cosmetic Surgeon Buenos Aires ArgentinaDavid LAI Anti-Aging MD Hong Kong ChinaAlain MICHEL Plastic Surgeon Montbéliard FranceGeorges MOUTON Functional Medicine Velroux BelgiumAntoine PARASKEVAS Plastic Surgeon Paris FranceFrançois PETIT Plastic Surgeon Paris FranceEric PLOT Plastic Surgeon Paris FranceMario TRELLES Plastic Surgeon Cambrils SpainRonald VIRAG Vascular Surgeon Paris FranceMalaysiaDato HARNAM, Prof.Janethy BALAKRISHNAN, MDNetherlandsMartino NEUMANN, MDEmar VOGELAAR, MDPhilippinesRoland ANGELES, MDPolandStefan ZGLICZYNSKI, Prof.Ryszard RATAJCZAK, Prof.RomaniaBogdan Dimitrie NICULAE, MDCatalin ENACHESCU, MDRussiaLev BERSTEIN, Prof.Vladislas BARANOV, Prof.South AfricaBruce MUIR, MDSCIENTIFIC SESSIONS LECTURERS AND FACULTYSpainJosé MARQUEZ-SERRES, MDMario TRELLES, MDSwitzerlandPhillip LEVY, MDEleonora LUKA PILLA, MDWalter PIERPAOLI, PhDThailandNopadon NOPPAKUN, Prof.Chariya PETCHNGAOVILAI, MDPakpilai THAVISIN, MDUnited KingdomMarios KYRIASIS, MDMichael PERRING, MDSohail MANSOOR, MDUSAMichael KAMINER, MDSuzie SCHUDER, MDGUIGNÉ Ewa Dermatologist Paris, FranceHANEKE Eckart Professor of Dermatology Friburg, GermanyHARDELL Lennart Oncologist Orebro, SwedenHASTERT Véronique Anti-Aging Medical Doctor Paris, FranceHAYOT Bernard Oculoplastic Surgeon Paris, FranceHEDEN Per Plastic Surgeon Stochkolm, SwedenHEINRICH Karl-Georg Plastic Surgeon Vienna, AustriaHERTOGHE Thierry Anti-Aging Medical Doctor Brussels, BelgiumHIBINO Sawako Anti-Aging Medical Doctor Doshisha, JapanHILTON Said Dermatologist Dusseldorf, GermanyHUBER Johannes Prof. Gynecology and Endocrinology Vienna, AustriaHUMBERT Philippe Professor of Dermatology Besançon, FranceIBLHER Niklas Plastic Surgeon Friburg, GermanyINGALLINA Fabio Plastic Surgeon Catania, ItalyIONESCU JohnProfessor of Biochemistry & Immunology Neukirchen, GermanyJUDODIHARDJO Harryono Dermatologist Cardiff, UKJURASUNAS Serge Doctor of Naturopathic Medicine Lisbon, PortugalKAMINER Michael Professor of Dermatology Boston, USAKANSKI AndrésPhD, Clinical Immunology & Prev. Medicine Caracas, VenezuelaKATSAMBAS Andreas Professor of Dermatology Athens, GreeceKEMP Paul CSO Intercydex Manchester, UKKLUGER Nicolas Dermatologist Montpellier, FranceKORCZYN Amos Neurologist Tel Aviv, IsraelKRAUSE Mario Anti-Aging Medical Doctor Hannover, GermanyKREYDEN Oliver Dermatologist Muttenz, SwitzerlandKRON Cédric Plastic Surgeon Paris, FranceLAFAURIE Patrick Plastic Surgeon Paris, FranceLAFONTAN Max Professor, Research Director Toulouse, FranceLAGIER Jacques Maxillo Facial Surgeon Nice, FranceLAFFORGUE Christine Prof. Unit of Dermapharmacology & Cosmetology Paris, FranceLAI David Anti-Aging Medical Doctor Hong Kong, ChinaLANDAU Marina Dermatologist Herzlia Pituach, IsraelLASSEL Taous Health & Innovation Manager-Danone Research FranceLEFEBVRE-VILARDEBO Marc Vascular SurgeonParis, FranceLEIBASCHOFF Gustavo Cosmetic Surgeon Buenos Aires, ArgentinaLETESSIER Serge Dermatologist Paris, FranceLEVY Jean-Luc Dermatologist Marseille, FranceLEVY Phillip Dermatologist Geneva, SwitzerlandLIM Peter Professor of Urology and Andrology SingaporeLOTTI Torello Professor of Dermatology Florence, ItalyLUCERO Florencio Q. Plastic Surgeon Manila, PhilippinesLUPIN Mark Dermatologist Victoria, CanadaMANISSIER Patricia RD Director, Innéov Paris, FranceMANSOOR Sohail Dermatologist Londo, UKMARECHAL Thierry Anti-Aging & Aesthetic Medical Doctor Paris, FranceMARINI Leonardo Dermatologist Trieste, Italy

Traduction simultanée en FrançaisTraducción simultánea en EspañolMARQUEZ-SERRES José Plastic Surgeon Sevilla, SpainMARTY Jean-Paul Unit of Dermopharmacology and Cosmetology Paris, FranceMASSOUD Karim Professor of Plastic Surgery Cairo, EgyptMENNE Bettina Senior Officer, Global Change and Health Program Rome, ItalyWorld Health Organisation of the United Nations (WHO)Nobel Peace Prize winner alongside with Al GoreMICHEL Alain Plastic Surgeon Montbéliard, FranceMISSIKA Patrick Professor of Oral Implantology Paris, FranceMODELSKA ZIOLKIEWICZ Anna Anti-Aging Medical DoctorPoznan, PolandMOLNAR Michael E. Chief Scientist Bio-Cellular Newark, USAMONTONERI Sebastiano Plastic Surgeon Paris, France / Catania, ItalyMOOKHERJEE Robin Plastic Surgeon Paris, FranceMORGANTI Pierfrancesco Professor of Applied Cosmetic Dermatology, Naples, ItalyMOUTON Georges Sports & Functional Medicine Liege, BelgiumNAGY Kàroly Genetic Internal Medicine Consultant Budapest, HungaryNIFOROS René-François Plastic Surgeon Lyon, FranceOLIVERES-GHOUTI Catherine DermatologistParis, FranceOQUINARENA Eric Dental Surgeon Marseille, FrancePARANQUE Armand Maxillo Facial Surgeon Paris, FrancePARASKEVAS Antoine Plastic Surgeon Paris, FrancePENNA Vincenzo Plastic Surgeon Friburg, GermanyPERRING Mike Andrologist, Psychotherapist London, UKPETCHNGAOVILAI Chariya Dermatologist Bangkok, ThailandPETERSON Robert Plastic Surgeon Honolulu, USAPETIT François Plastic Surgeon Paris, FrancePETIT Philippe Mesotherapist Bordeaux, FrancePICOT André Professor of Toxico Chemistry Paris, FrancePICOTO Antonio Professor of Dermatology Lisbon, PortugalPLOT Eric Plastic Surgeon Paris, FrancePOETSCH Bernhard Gynecologist, Endocrinologist Leibnitz, AustriaPOLIMENI Ascanio Neuroendocrinologist Roma, ItalyPOMAREDE Nadine Dermatologist Paris, FranceRAMELET Albert Adrien Dermatologist, Angiologist Lausanne, SwitzerlandRASPALDO Hervé Facial Plastic Surgeon Cannes, FranceRAWLINGS Tony MD, AVR Consulting Ltd. Northwich, UKREITER Russel Professor of Neuroendocrinology San Antonio, USAREYGAGNE Pascal Dermatologist Paris, FranceRICHTER Erik-Alexander Industry Butchen, NetherlandsACCARDO Ciro Plastic Surgeon Naples, ItalyAMGAR Gilbert Aesthetic Medical Doctor Paris, FranceBEILIN Ghislaine Aesthetic Medical Doctor Paris, FranceBELHAOUARI Lakhdar Plastic Surgeon Toulouse, FranceBOISNIC Sylvie Dermatologist Paris, FranceBUIDIN Régine Dermatologist Anderlecht, BelgiumCHUNG Yongji Aesthetic Medical Doctor S. KoreaCZUWARA Joanna Dermatologist Warsaw, PolandDAVID Jacques-André Maxillo Facial Surgeon & Anti-Aging MD Paris, FranceDIMITROV Dimitre Dermatologist Sofia, BulgariaDURAND Jacques Aesthetic Medical Doctor Jakarta, IndonesiaFORTE Riccardo Aesthetic Surgeon Como, ItalyGALL Yvon Dermatologist Lourdes, FranceGAY Christian Angiologist Paris, FranceGHITA Camelia Anti-Aging Medical Doctor Bucharest, RomaniaHADIDA Claudine Aesthetic Medical Doctor Paris, FranceHOEYBERGHS Jeff Anti-Aging Medical Doctor Genk, BelgiumHOUDRET Jean-Claude Aesthetic & Anti-Aging Medical Doctor Paris, FranceHUSS Gertrude Dentist Jersey, UKKIM Beomjoon Dermatologist Seoul, S. KoreaASSASSA Sam President of the AAAMS Beverly Hills, USABENADIBA Laurent Plastic Surgeon Paris, FranceBROZMANOVA Maria Aesthetic Medical Doctor Bratislava, SlovakiaCAMBLIN John Plastic Surgeon Paris, FranceDEUTSCH Roger Anti-Aging Medical Doctor Deerfield Beach, USAGANSS Christoph Surgeon, Specialist Stem Cells Cutlure Heidelberg, GermanyGOERDIN Rock Aesthetic Surgeon, Gynecologist Genk, BelgiumGOISIS Mario Maxillo Facial Surgeon Milano, ItalyGUBANOVA Elena Dermatologist Moscow, RussiaHAJDUK Peter Plastic Surgeon Moscow, RussiaHAMANAKA Satoko Aesthetic Medical Doctor, Psychiatrist Tokyo, JapanHANNOUN Sonia Aesthetic Medical Doctor Paris, FranceHERTZOG Bernard Aesthetic Medical Doctor Paris, FranceISHAY Avraham Endocrinologist Afula, IsraelAMWC 2008English simultaneaous translationWORKSHOPS / SYMPOSIA SPEAKERSCONTRIBUTING LECTURES SPEAKERSRussian simultaneaous translationTraduzione simultanea in ItalianoROBERFROID Marcel Professor in Pharmaceutical Sciences Louvain, BelgiumSALTI Giovanni General Surgeon Florence, ItalySANDHAUS Sami Professor of Stomatology Lausanne, SwitzerlandSATTLER Gerhard Dermatologist Darmstadt, GermanySCHEFLAN Michael Plastic Surgeon Tel Aviv, IsraelSHIRASAWA Takuji Molecular Genetics of Aging Gene Tokyo, JapanSCHNEEBERGER Christian Professor of Biochemistry Vienna, AustriaSCHROETER Careen Laser Therapy Maastricht, NetherlandsSIMONCINI Tullio Oncologist, Endocrinologist Roma, ItalySITBON Brigitte European Center of Permanent Make-Up Paris, FranceSLEE Adrian Nutritional Medicine Doctor London, UKSOUDANT Etienne Chronobiologist, Research Director Paris, FranceSPIRU LuizaProfessor of Gerontology, Gerontopsychiatry Bucharest, RomaniaSTEJSKAL Vera Professor of Immunology Danderyd, SwedenTEMPFER Clemens Professor of Gynecology and Oncology Vienna AustriaTHAVISIN Pakpilai Dermatologist & Anti-Aging Medical Doctor Bangkok, ThailandTOURNESAC Philippe Anti-Aging Medical Doctor Paris, FranceTRELLES Mario Plastic Surgeon Cambrils, SpainTREVIDIC Patrick Plastic Surgeon Paris, FranceUWABU Masashi Aesthetic Medical Doctor Tokyo, JapanVALSAMIS Mario Phlebologist Athens, GreeceVAN DER LUGT Claudia Doctor in Preventive & Cosmetic Medicine Meijel, Netherlandsvan LIMBURG STIRUM John Doctor in Integrative Medicine Zurich, SwitzerlandVANNINI Fulvio Aesthetic Medical Doctor, Anesthesiologist Naples, ItalyVERNER Ines Dermatologist Savyon, IsraelVERSCHOORE Michèle Dermatologist Paris, FranceVIRAG Ronald Vascular Surgeon, Sexual Medicine Paris, FranceVOCHELLE Didier Dermatologist Brussels, BelgiumWAGNER Gorm MD, PhD in Sexual Medicine Copenhagen, DenmarkWATANABE Shaw Epidemiologist, Nutrologist, Pathologist Tokyo, JapanWEBER Bernard Professor of Medical Virology LuxembourgWESSOLLY Johannes Anti-Aging Medical Doctor Ludwigsburg, GermanyWIEST Luitgard Dermatologist Munich, GermanyYAMAGUCHI Satoru Plastic Surgeon Tokyo, JapanYONEI Yoshikazu Anti-Aging Medical Doctor Kyoto, JapanYUE Samuel Pain Management Physician Lake Elmo, USAZERBINATI Nicola Dermatologist Milano, ItalyLLEAL Silvia Aesthetic Medical Doctor Barcelona, SpainLORENC Paul Aesthetic Medical Doctor New York, USAMALET Philippe Aesthetic Medical Doctor Lyon, FranceMARCHAL Alfred Chemist, Pharmacologist Brussels, BelgiumMARTHAN Jules Aesthetic Medical Doctor Vauvert, FrancePADEY Hervé Maxillo Facial Surgeon Cannes, FrancePASCAL Gérard Gynecologist Paris, FrancePEUCHANT Christine Aesthetic Medical Doctor Bordeaux, FrancePICCOLO Stefano Plastic Surgeon Roma, ItalyPIRMEZ Thierry R&D Manager RPAC ltd Brussels, BelgiumPROTOPAPA Carmelo Aesthetic Medical Doctor Brindisi, ItalySITO Giuseppe Aesthetic Medical Doctor Naples, ItalySOLISH Nowell Dermatologist Toronto, CanadaTRETTI-CLEMENTONI Mario DermatologistMilano, ItalyTURCU Ileana Anti-Aging Medical Doctor Bucharest, RomaniaWAHL Gregor Dermatologist Berlin, GermanyWEIDMANN Michael Dermatologist Augsburg, GermanyWOO Jung Ho Gynecologist Seoul, S. KoreaWU Woffles Plastic Surgeon SingaporeJAGDEO Jared Dermatologist, Research Fellow Brooklyn, USAKLEINE-GUNK Bernd Anti-Aging Medical Doctor Fürth, GermanyKOUTNA Nina Aesthetic Medical Doctor Prague, Czech RepublicLUKA PILLA Eleonora Internal Medicine, Immunology Geneva, SwitzerlandMAVRIDOU Maria Dermatologist Athens, GreeceMICHEELS Patrick Aesthetic Medical Doctor Geneva, SwitzerlandNATAF Robert Biologist Paris, FrancePIPIC Nedim ENT and Facial Plastic Surgeon Vienna, AustriaRICHART Tom Anti-Aging Medical Doctor Linkhout, BelgiumRUBBANI Sofia Plastic Surgeon New York, USASHIM Insoo Aesthetic Medical Doctor Seoul, South KoreaTEMPELS Francine Aesthetic Medical Doctor Genk, BelgiumZIEMANN Wolfgang PhD Analytical Biochemist Kiel-Wellsee, GermanyElite SponsorThe AMWC 2008 drawing of lots will take place on TEOXANE booth on Saturday 12 at 4.00 pm.1 st Price: A travel of 8.000 Euros value - 2 nd Price: A travel of 4.000 Euros valueDiamond SponsorsGold SponsorsSilver Sponsors

AESTHETIC DERMATOLOGY AND SURGERYANTI AGING MEDICINE14.00 - 16.00Thursday April 10 / Jeudi 10 Avril10.30 am : Conference Registration Opening12.00 pm : Congress and Exhibit OpeningTWENTY YEARS OF BOTULINUM TOXIN: WHERE ARE WE TODAY ? / VINGT ANS DE TOXINE BOTULIQUE : OÙ EN EST-ON AUJOURD’HUI?Chair: ANTHONY BENEDETTO DERMATOLOGIST (PHILADELPHIA, USA) - OLIVER KREYDEN DERMATOLOGIST (MUTTENZ, SWITZERLAND) Anatomy of the face: The basics to know prior to injecting Botulinum ToxinAnatomie du visage : les bases à connaître avant d'injecter de la toxine botulique How to make Botulinum Toxin-A better? / Comment rendre la toxine botulique de type A meilleure ? How to avoid the pitfalls whilst treating the upper face?Comment éviter les effets secondaires dans le traitement du haut du visage ? How to avoid the pitfalls whilst treating the lower face and the neck?Comment éviter les effets secondaires dans le traitement du bas du visage et du cou ? Which differences between Botox ® , Dysport ® and other botulinum toxins?Quelles différences entre Botox ® , Dysport ® et les autres toxines botuliques ? Treating the Whole Face with Botulinum ToxinTraiter l’ensemble du visage avec la toxine botulique Non aesthetic indications of Botulinum toxin: Common and uncommon indications in focal HyperhidrosisIndications non esthétiques de la toxine botulique : indications communes et rares de l’hyperhidrose16.00 - 16.30 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITION16.30 - 18.30FACIAL REJUVENATION: DO THE SOFT TECHNIQUES REALLY WORK? / RAJEUNISSEMENT DE LA PEAU : LES TECHNIQUES DOUCES MARCHENT-ELLES VRAIMENT ?Chair: ILARIA GHERSETICH PROFESSOR OF DERMATOLOGY (FLORENCE, ITALY) - PETER BJERRING PROFESSOR OF DERMATOLOGY (VEJLE, DENMARK) Cosmeceuticals: From science to clinical results / Cosméceutique : de la science aux résultats cliniquesILARIA GHERSETICH (ITALY) Facial rejuvenation: Why to use mesotherapy? / Pourquoi utiliser la mésothérapie pour le rajeunissement facial? PHILIPPE PETIT (FRANCE) IPL for superficial rejuvenation / IPL pour le rajeunissement superficielLEONARDO MARINI (ITALY) LED: From science to clinical results / LED : de la science aux résultats cliniquesMARIO TRELLES (SPAIN) Superficial peels: Indications and clinical results / Peelings superficiels : indications et résultats cliniquesNICOLAS BACHOT (FRANCE) I2PL and photo-dynamic therapy with ALA photo-spray to treat skin damages in a softer, gentler wayPETER BJERRING (DENMARK)I2PL et thérapie photo-dynamique au photospray ALA pour traiter les problèmes de peau en douceur Radio-frequency (mono/bi polar systems): Indications and clinical resultsMICHAEL KAMINER (USA)Radiofréquence (systèmes mono/bipolaires) : indications et résultats cliniques Non-ablative lasers: Personal experiences with the new fractional CO2 laser and radiofrequencyANTHONY BENEDETTO (USA)Lasers non ablatifs : experiences personnelles avec le nouveau laser CO2 fractionnel et la radio fréquenceROOM / SALLE MAILLOT14.00 - 16.00GENETIC TYPING: THE LATEST ADVANCE IN ANTI-AGING AND PREVENTIVE MEDICINE: EASY LEARNING FOR ALLLE GÉNOTYPE : LA DERNIÈRE AVANCÉE DANS LA MÉDECINE ANTI-AGE ET PRÉVENTIVE : UNE APPROCHE FACILE POUR TOUSChair: DAVID LAI - ANTI-AGING MD (HONG-KONG, CHINA) - ANDRÉS KANSKI CLINICAL IMMUNOLOGY AND PREVENTIVE MEDICINE (CARACAS, VENEZUELA) The future direction of preventive genetic diagnosis in the new milleniumL'orientation des diagnostics génétiques préventifs dans le nouveau millénaire The ABC basics of anti-aging genetics: Easy learning for beginnersLes bases de la génétique anti-âge pour les débutants Personalized medicine: Integrating preventive genetics into clinical practice. The Canadian experienceMédecine personnalisée : la génétique préventive intégrée à la pratique clinique. L'expérience canadienne How does genetic typing help reduce the risk of diabetes and metabolic syndrome?Comment le génotype aide-t-il à réduire les risques de diabète et de syndrome métabolique ? Individualized nutritional program of great anti-aging value: The role of genetic typingProgramme nutritionnel individualisé à haute valeur anti-âge : le rôle du génotype Conception in the middle age: How to use genetic typing to safegard the health of aging pregnant mom?La grossesse à la cinquantaine : comment utiliser le génotype pour la protection de la femme enceinte ? How to use genetic typing to lower the risk of gynecological cancers: Practical pointsComment utiliser le génotype pour diminuer le risque de cancers gynécologiques : aspects pratiques Your parent suffered from stroke and heart attack: How to use genetic typing to lower your own risk?Antécédents familiaux d'AVC et de crise cardiaque : comment utiliser le génotype pour réduire vos propres risques ? Safer hormone replacement therapy guided by genetic typing / Le traitement hormonal substitutif plus sûr grâce au génotype16.00 - 16.30 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITIONBLUE AUDITORIUM / AMPHI BLEUHERVÉ RASPALDO (FRANCE)ANDREAS KATSAMBAS (GREECE)ANTHONY BENEDETTO (USA)PHILLIP LEVY (SWITZERLAND)DIDIER VOCHELLE (BELGIUM)CHARIYA PETCHNGAOVILAI (THAILAND)OLIVER KREYDEN (SWITZERLAND)JOHANNES HUBER (AUSTRIA)CHRISTIAN SCHNEEBERGER (AUSTRIA)ELAINE CHIN (CANADA)KÀROLY NAGY (HUNGARY)JOHANNES WESSOLLY (GERMANY)BERNHARD PÖTSCH (AUSTRIA)CLEMENS TEMPFER (AUSTRIA)ANDRÉS KANSKI (VENEZUELA)DAVID LAI (CHINA)16.30 - 18.30MEETING WITH THE LEADERS OF THE ANTI-AGING MEDICINE: International renowned anti-aging experts from around the world speakabout the best anti-aging medicine and what the future looks likeRENCONTREZ LES LEADERS DE LA MÉDECINE ANTI-AGE : des experts mondialement reconnus présentent le meilleur de la médecine anti-âge etleur vision du futur dans la lutte contre le vieillissementChair: THIERRY HERTOGHE ANTI-AGING MEDICAL DOCTOR (BRUSSELS, BELGIUM) - JORGE FLECHAS ANTI-AGING MEDICAL DOCTOR (HENDERSONVILLE, USA) Prospects for defeating aging altogether / Perspecives d’avenir pour combattre le vieillissement tous ensemble AUBREY DE GREY (UK) How longevity medicine may progress / Comment faire progresser la longévitéETIENNE-EMILE BAULIEU (FRANCE) Age-related reduction of endogenous melatonin: Implications for declining healthRUSSEL REITER (USA)Réduction de la mélatonine endogène liée au vieillissement : les implications sur le déclin de la santé Sexuality and lifespan / Sexualité et longévitéGORM WAGNER (DENMARK)OPENING CEREMONY - WELCOME COCKTAIL18.30 -19.30 CÉRÉMONIE D’OUVERTURE - COCKTAIL DE BIENVENUE

AESTHETIC DERMATOLOGY AND SURGERYROOM /SALLE 252 AB14.00 - 16.00CONTRIBUTING LECTURES IN AESTHETIC DERMATOLOGY AND SURGERY / CONFÉRENCES PARTICIPATIVES EN DERMATOLOGIE ET CHIRURGIE ESTHÉTIQUESChair: NICOLAS BACHOT DERMATOLOGIST (PARIS, FRANCE) - OLIVIER CLAUDE PLASTIC SURGEON (PARIS, FRANCE) A case report: Intractable body dysmorphic disorder - effect of psychiatry consultation after undergoing frequent SATOKO HAMANAKA (JAPAN)cosmetic surgeries / Un cas concret : trouble dismorphique incurable - les effets d'un suivi psychologique après de nombreusesopérations chirurgicales cosmétiques Striae distensae treatment in accordance with their depth and classification / Traitement des vergéturesPHILIPPE DEPREZ (SPAIN) Comparative study of hyaluronan gels at D0 and D14 / Etude comparative des gels hyaluroniques à D0 et D14PATRICK MICHEELS (SWITZERLAND) The 4 R'S of Facial Rejuvenation / Les 4 "R" du rajeunissement facialSAM ASSASSA (USA) The vertical temporal lifting: A short pre-capillary scar / Le lifting temporal vertical : une petite cicatrice pré-capillaire JOHN CAMBLIN (FRANCE) Forehead and brow rejuvenation. An alternative aproach / Rajeunissement du front et du sourcil : une approche alternative NEDIM PIPIC (AUSTRIA) A new generation of hyaluronic acids / Une nouvelle generation d'acides hyaluroniquesLUITGARD WIEST (GERMANY) Twelve-month persistency and safety of Glymatrix Collagen in the cosmetic correction of nasolabial foldsPAUL LORENC (USA)Persistance d'un an et sécurité du collagène Glymatrix pour les retouches cosmétiques des plis nasolabiaux Skin defects filling and face remodelling in the same session. Atlean ß TCP: A new and innovative approachRICCARDO FORTE (ITALY)to face rejuvenation / Comblement des imperfections de la peau et remodelage du visage en une seule séance.Atléan ß TCP : une approche nouvelle et innovante de rajeunissement du visage The assessment of recovery time and impact of dermal filler section: The E-ART StudyNOWELL SOLISH (CANADA)Evaluation de la durée de récupération et place des produits de comblement : l'étude d'E-ART Remodelling the face with Voluma tm / Remodelage du visage avec Voluma TMBERNARD HERTZOG, SONIA HANNOUN (FRANCE) Study for assessment of efficacy of a non animal stabilized hyaluronic acid (Restylane®) on biomechanical ELENA GUBANOVA (RUSSIA)properties of lips. Prospective clinical study / Etude de l'efficacité d'un acide hyaluronique stabilisé non-animal(Restylane®) sur les propriétés biomécaniques des lèvres. Etude clinique prospective Autologous fibroblasts grafting for face rejuvenation / Greffe de fibroblastes autologues pour le rajeunissement facial CHRISTOPH GANSS (GERMANY)16.30 - 18.30Thursday April 10 / Jeudi 10 Avril10.30 am : Conference Registration Opening12.00 pm : Congress and Exhibit Opening16.00 - 16.30 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITIONTHE COSMETIC CONSULTATION: "COMMON BUT COMPLEX SITUATIONS " / LA CONSULTATION COSMÉTIQUE : “SITUATIONS COMMUNES MAIS COMPLEXES”Chair: ANTONIO PICOTO PROFESSOR OF DERMATOLOGY (LISBON, PORTUGAL) - GERHARD SATTLER DERMATOLOGIST (DARMSTADT, GERMANY) How to evaluate the psychological profile of a new patient in cosmetic surgery?JOHN COTTERILL (UK)Comment évaluer le profil psychologique d’un nouveau patient en chirurgie esthétique ? Evaluation of patient's health before cosmetic surgery / Evaluation de la santé du patient avant intervention chirurgicale GERHARD SATTLER (GERMANY) Appropriate plan to use or avoid medications before and after medico-surgical proceduresANTONIO PICOTO (PORTUGAL)Plan adapté pour la prescription éventuelle d’un traitement avant et après une procédure medico-chirurgicale Advices to patient about face enhancement: From cosmetics to surgerySERGE LETESSIER (FRANCE)Recommandations au patient pour embellir le visage : de la cosmétique à la chirurgie Advices to patient before and after laser and IPL treatmentLEONARDO MARINI (ITALY)Recommandations au patient avant et après un traitement laser ou IPL Tattooing: Significance, risks, and removing procedures / Tatouage : importance, risques et techniques d’effacement NICOLAS KLUGER (FRANCE) Piercing: Significance and risks / Piercing : importance et risquesNICOLAS KLUGER (FRANCE)ROOM /SALLE 242 AB ROOM /SALLE 251AESTHETIC WORKSHOPS14.00 - 15.00 Workshop 1 proposed by MEDIGEM Co.Advanced contour thread: J.J.Miracle liftDerniers progrès sur les fils de suspension : J.J.Miracle liftJUNG HO WOO (S. KOREA)14.00 - 15.00 Workshop 2 proposed by REGENLABRegenKit, the new autologous cell therapie for wrinkle and skinregenerationRegenKit, le nouveau traitement cellulaire autologue de régénérationfaciale et comblement de ridesJEAN-CLAUDE HOUDRET - GILBERT AMGAR - CLAUDINE HADIDA (FRANCE)15.00 - 16.00 Workshop 3 proposed by TUXEDO CORPORATION 15.00 - 16.00 Workshop 4 proposed by POLLOGENNew long lasting, degradable filler: Safety and effectiveness ofTripolar radiofrequencyREMAKE TM hydrogelRadiofréquence tripolaireLe nouvel agent de comblement longue durée et dégradable : sécuritéet efficacité de l'hydrogel REMAKE TMJACQUES-ANDRÉ DAVID (FRANCE)16.00 - 16.30 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITION16.30 - 17.30 Workshop 5 proposed by Q-MEDRESTYLANE® Master Class: Advanced techniques with RestylaneLipp and Male esthetics with the Restylane RangeTechniques avancées avec Restylane Lipp et esthétique chez l’hommeavec la gamme RestylaneGERTRUDE HUSS (UK) - HERVÉ PADEY (FRANCE)GHISLAINE BEILIN (FRANCE) - SYLVIE BOISNIC (FRANCE)16.30 - 17.30 Workshop 6 proposed by CONTURA INTERNATIONALSharing 7 years experience of AQUAMID® with live demonstrationPartager 7 ans d’expérience avec AQUAMID® - Démonstration en directSTEFANO PICCOLO (ITALY)17.30 - 18.30 Workshop 7 proposed by MEDIFORMREVITACARE ® : Mesoplastia integral facial treatmentREVITACARE ® : La mésoplastie, traitement facial intégralSILVIA LLEAL (SPAIN)17.30 - 18.30 Workshop 8 proposed by COLBAR LIFESCIENCEEVOLENCE®: Techniques for optimal enhancementEVOLENCE®: Les méthodes pour une augmentation optimalePAUL LORENC (USA) - NOWELL SOLISH (CANADA)OPENING CEREMONY - WELCOME COCKTAIL18.30 -19.30 CÉRÉMONIE D’OUVERTURE - COCKTAIL DE BIENVENUE

ANTI AGING MEDICINE14.00 - 15.00Anti Aging Workshop 1ABC of anti-aging medicine: Basic hormone therapyABC de la médecine anti-âge : bases de la thérapie hormonale15.00 - 16.00Anti Aging Workshop 2Efficient nutrients for a healthy agingLes nutriments efficaces pour vieillir en bonne santéThursday April 10 / Jeudi 10 Avril10.30 am : Conference Registration Opening12.00 pm : Congress and Exhibit OpeningABC OF ANTI-AGING HORMONE THERAPY / ABC DES TRAITEMENTS HORMONAUXNUTRIENTS AND ANTI-AGING / NUTRIMENTS ET MÉDECINE ANTI-AGE16.00 - 16.30 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITIONOPENING CEREMONY - WELCOME COCKTAIL18.30 -19.30 CÉRÉMONIE D’OUVERTURE - COCKTAIL DE BIENVENUEROOM / SALLE PASSYCLAUDE DALLE (FRANCE)GÉRARD PASCAL (FRANCE)HOKAN CEDERBERG (SWEDEN)ERIC ALEXANDER RICHTER (THE NETHERLANDS)16.30 - 18.30HEAVY METALS AND CHELATION TECHNIQUES / METAUX LOURDS ET TECHNIQUES DE CHELATIONChair: CHRISTOPHE DE JAEGER GERIATRIST, GERONTOLOGIST (PARIS, FRANCE) - VERA STEJSKAL, PROFESSOR OF IMMUNOLOGY (DANDERYD, SWEDEN) Metabolism of heavy metals / Métabolisme des métaux trace toxiques Evaluation techniques of the poisoning by heavy metalsTechniques d'évaluation de l'intoxication par les métaux lourds Breast tumours strongly accumulate transition metals: New therapeutical implicationsLes tumeurs du sein accumulent fortement les métaux de transition : nouvelles conséquences thérapeutiques Reverse premature aging caused by heavy metals: Most recent data on heavy metal detoxification to reversepremature aging / Inverser le vieillissement prématuré induit par les métaux lourds : les dernières donnéessur la désintoxication des métaux lourds pour contrer le vieillissement prématuré Teeth and heavy metals: Diagnosis and treatments / Dents et métaux lourds : diagnostic et traitementsANDRÉ PICOT (FRANCE)VERA STEJSKAL (SWEDEN)JOHN IONESCU (GERMANY)VERA STEJSKAL (SWEDEN)ERIC OQUINARENA (FRANCE)SAMI SANDHAUS (SWITZERLAND) Interest of local techniques of chelation / L'intérêt des techniques locales de chélation Interest of oral and intraveinous techniques of chelation / L'intérêt des techniques locales et intraveineuses de chélation PHILIPPE TOURNESAC (FRANCE) Discussion

Friday April 11 / Vendredi 11 Avril7.00 am : Conference Registration Opening8.00 pm : Congress and Exhibit Opening8.30 - 10.30SEXOLOGY AND SEXUAL ENDOCRINOLOGY: OXYTOCIN, THE SEXIEST HORMONE EVER? RELAXIN, THE FORGOTTEN HORMONE?SEXOLOGIE ET ENDOCRINOLOGIE SEXUELLE : OCYTOCINE, LA PLUS ATTIRANTE DES HORMONES ? RELAXINE, L'HORMONE OUBLIÉE ?Chair: RONALD VIRAG VASCULAR SURGEON, SEXOLOGIST (PARIS, FRANCE) - GORM WAGNER MD, PHD SEXUAL MEDICINE (COPENHAGEN, DENMARK) Oxytocin can provide women with multiple orgasm / L'ocytocine peut donner aux femmes de multiples orgasmes Oxytocin for men too? / L'ocytocine aussi pour les hommes ? Oxytocin and fibromyalgia / Ocytocine et fribromyalgie Relaxin: Its role in the pathogenesis of Fibromyalgia / Relaxine : son rôle dans la pathogenèse de la fibromyalgie Polyhormonal and metabolic influences in male sexual dysfunctionInfluences polyhormonales et métaboliques dans la dysfonction sexuelle chez l’homme Changes in the physiological responses to sexual stimulation during lifespan / Changements des réponsesphysiologiques à la stimulation sexuelle au cours de la vie10.30 - 11.00 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITION11.00 - 13.00ROOM / SALLE MAILLOTJORGE FLECHAS (USA)CLAUDE DALLE (FRANCE)JORGE FLECHAS (USA)SAMUEL YUE (USA)RONALD VIRAG (FRANCE)VÉRONIQUE HASTERT (FRANCE)GORM WAGNER (DENMARK)OPTIMAL NEUROLOGY IN 15 YEARS FROM NOW / NEUROLOGIE OPTIMALE DANS LES 15 PROCHAINES ANNÉESChair: MONIKA GOLKOVA NEUROLOGIST (PRAGUE, CZECH REPUBLIC) - LUIZA SPIRU PROF. OF GERONTOLOGY AND GERONTOPSYCHIATRY (BUCHAREST, ROMANIA) Neuroendocrinology of brain aging / Neuroendocrinologie du vieillissement du cerveau Brain building: Antioxidants, neurotransmitters, and food which improve your brain primDéveloppement cérébral : antioxidants, neurotransmetteurs et aliments améliorant vos capacités cérébrales Aging brain: How to avoid dementia? / Vieillissement cérébral : comment éviter la démence ? Cutting-edge diagnosis in brain aging preventionLe diagnostic de pointe pour la prévention du veillissement du cerveau Critical controversies in brain anti-aging therapy / Les controverses sur les traitements du vieillissement cérébral DiscussionLUIZA SPIRU (ROMANIA)MONIKA GOLKOVA (CZECH REPUBLIC)PASQUALE CALABRESE (GERMANY)LUIZA SPIRU (ROMANIA)AMOS KORCZYN (ISRAEL)ANTI AGING MEDICINE13.00 - 14.00 LUNCH BREAK AND VISIT EXHIBIT HALL / PAUSE DÉJEUNER ET VISITE DE L’EXPOSITION14.00 - 15.00STEM CELLS FOR A LONGER AND BETTER LIFESPAN / LES CELLULES SOUCHES POUR UNE ESPERANCE DE VIE PLUS LONGUE ET MEILLEUREChair: MICHAEL E. MOLNAR PROF. BIO-CELLULAR RESEARCHER (NEWARK, USA) - THIERRY HERTOGHE PRESIDENT WOSAAM (BRUSSELS, BELGIUM) Treatment of aging disease by stem cell transplantationLes traitements des maladies liées au vieillissement par la transplantation de cellules souches Placental growth factor in anti-aging therapyLe facteur de croissance placentaire dans la thérapie anti-âge15.00 - 16.00MICHAEL E. MOLNAR (USA)SAWAKO HIBINO (JAPAN)BORDERLINE ENDOCRINOLOGY / AUX FRONTIÈRES DE L'ENDOCRINOLOGIEChair: TULLIO SIMONCINI ONCOLOGIST, ENDOCRINOLOGIST (ROMA, ITALY) - SERGE JURASUNAS DOCTOR NATUROPATHIC MEDICINE (LISBON, PORTUGAL) Treating with human growth hormone growth–hormone deficient adults with lab tests with reference rangesTraitement des patients adultes déficients en hormone de croissance avec des tests dans les limites de la référence Treating testosterone deficient men with testosterone levels within reference rangesTraitement des hommes déficients en testosterone avec des niveaux de testosterone dans les limites de référence Hypothyroid patients with laboratory tests within reference rangesPatients hypothyroïdiens avec des tests thyroïdiques dans les limites de la référenceTHIERRY HERTOGHE (BELGIUM)ANNA MODELSKA ZOLKIEWICZ (POLAND)THIERRY HERTOGHE (BELGIUM)16.00 - 16.30 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITION16.30 - 18.30ANTI-AGING GASTROENTEROLOGY: CAN WE HEAL THE BODY BY IMPROVING THE GASTROINTESTINAL TRACT?GASTRO-ENTEROLOGIE ANTI-AGE : PEUT-ON GUÉRIR LE CORPS EN AMELIORANT LE SYSTEME DIGESTIF ?Chair: GEORGES MOUTON SPORTS & FUNCTIONAL MEDICINE (LIÈGE, BELGIUM) - MARCEL ROBERFROID PROF. IN PHARMACEURICAL SCIENCES (LOUVAIN, BELGIUM) Introduction to the mucosal immune system and to the gut microbial ecosystem,for a better understanding of the intestinal ecosystem / Présentation du système immunitaire muqueuxet de la flore microbienne intestinale, pour une meilleure compréhension de l’écosystème intestinal Increase of intestinal permeability leading to immune dysfunction: Autoimmunity prevalence and agingAugmentation de la perméabilité intestinale entraînant un dysfonctionnement immunitaire: auto-immunité et vieillissement Prebiotics, gut microbiota, gastrointestinal peptides and metabolic endotoxemia: Roles in appetite control,type II diabetes and obesity / Les prébiotiques, la flore microbienne intestinale, les peptides gastrointestinauxet l'endotoxémie métabolique : rôles dans le contrôle de l'appétit, le diabète de type II et l'obésité Revolutionary approach to inflammatory bowel diseases: Benefits from probiotics and prebiotics intakeApproche révolutionnaire des maladies inflammatoires de l'intestin : les avantages des probiotiques et prébiotiques Gut sweet taste receptors: How sweeteners contribute to obesityLes récepteurs de gout sucré intestinaux : comment les édulcorants contribuent à l'obésité DiscussionFRANCISCO GUARNER (SPAIN)MICHAEL CULP (UK)MARCEL ROBERFROID (BELGIUM)FRANCISCO GUARNER (SPAIN)GEORGES MOUTON (BELGIUM)18.30 END OF THE 2ND DAY - FIN DU 2E JOUR

8.30 - 10.30Friday April 11 / Vendredi 11 Avril7.00 am : Conference Registration Opening8.00 am : Congress and Exhibit OpeningROOM / SALLE 252 ABFAT SYMPOSIUM - THE BASIS ABOUT FAT / SYMPOSIUM SUR LA GRAISSE - LES FONDEMENTS PART 1Chair: GUSTAVO LEIBASCHOFF COSMETIC SURGEON (BUENOS AIRES, ARGENTINA) - PHILIPPE BLANCHEMAISON PHLEBOLOGIST (PARIS, FRANCE) Introduction to the philosophy of the Symposium / Introduction : philosophie du Symposium The normal adipose tissue and its physiopathology / Le tissu adipeux normal et sa physiopathologie Fat tissue and the lymphatic system / Le tissu graisseux et le système lymphatique Overview of the treatments which reduce fat cells and others that destroy adipose onesVue d'ensemble des traitements réduisant les cellules graisseuses et ceux détruisant les adipocytes The steps for a safe liposculpture / Les étapes de la liposculpture sans danger Lipofilling for the correction of the buttock depression according to the oval shape theoryLipofilling pour la correction de la dépression fessière selon la théorie de l’oval Fat and varicose veins: Which treatment first? Why? / Graisse et varicosités : que traiter en premier et pourquoi ?10.30 - 11.00 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITIONGUSTAVO LEIBASCHOFF (ARGENTINA)MAX LAFONTAN (FRANCE)ETIENNE SOUDANT (FRANCE)PHILIPPE BLANCHEMAISON (FRANCE)GUSTAVO LEIBASCHOFF (ARGENTINA)MARC-HENRI BON (FRANCE)CLAUDE GARDE (FRANCE)AESTHETIC DERMATOLOGY AND SURGERY11.00 - 13.0014.00 - 16.0016.00 - 16.30 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITION16.30 - 18.30AESTHETIC WORKSHOP PROPOSED BY ALLERGANChair: HERVÉ RASPALDO FACIAL PLASTIC SURGEON (CANNES, FRANCE) Exceeding patient expectations with the ALLERGAN FACIAL PORTFOLIODépasser les attentes des patients avec le PORTFOLIO FACIAL ALLERGAN13.00 - 14.00 LUNCH BREAK AND VISIT EXHIBIT HALL / PAUSE DÉJEUNER ET VISITE DE L’EXPOSITIONGIUSEPPE SITO (ITALY)LAKHDAR BELHAOUARI (FRANCE)GREGOR WAHL (GERMANY)PHILLIP LEVY (SWITZERLAND)SKIN AND HAIR DISORDERS / DÉSORDRES CUTANÉS ET CAPILLAIRESChair: ANDREAS KATSAMBAS PROFESSOR OF DERMATOLOGY (ATHENS, GREECE) - CATHERINE OLIVERES-GHOUTI DERMATOLOGIST (PARIS, FRANCE) Skin aging around the world / Le vieillissement cutané à travers le monde Cosmetics and cosmeceuticals / Les produits cosmétiques et cosméceutiques Pigmentary disorders: Clinical aspects and treatments / Les désordres pigmentaires : aspects cliniques et traitements How to deal with red face: Clinical aspects and treatments / Taches rouges : aspects cliniques et traitements Androgenic alopecia in male: Diagnosis and medical treatmentsL'alopécie androgénique chez l'homme : diagnostic et traitements médicaux Androgenetic alopecia in women: Diagnosis and medical treatmentsL'alopécie androgénique chez la femme : diagnostic et traitements médicaux Hair transplantation: What's new? / La greffe de cheveux : quelles nouveautés ? Autologous hair regeneration therapy : The ultimate solution to baldness / Thérapie de régénération autologuedu cheveu : l’ultime solution à la calvitie DiscussionMICHÈLE VERSCHOORE (FRANCE)NICOLAS BACHOT (FRANCE)TORELLO LOTTI (ITALY)CATHERINE OLIVERES-GHOUTI (FRANCE)PASCAL REYGAGNE (FRANCE)EWA GUIGNÉ (FRANCE)PATRICK LAFAURIE (FRANCE)PAUL KEMP (UK)FAT SYMPOSIUM - OVERVIEW OF THE SLIMMING TECHNIQUES: 10 MINUTES TO CONVINCE PART 2SYMPOSIUM SUR LA GRAISSE - VUE D'ENSEMBLE DES TECHNIQUES AMINCISSANTES : 10 MINUTES POUR CONVAINCREChair: MAX LAFONTAN PROF. RESEARCH DIRECTOR (TOULOUSE, FRANCE) - GUSTAVO LEIBASCHOFF COSMETIC SURGEON (BUENOS AIRES, ARGENTINA) The impact of the nutrition over fat tissue / L'influence de la nutrition sur le tissu graisseuxWILMAR ACCURSIO (BRAZIL) Impact of a mechanical massage technique on lipid mobilization in femoral adipose tissue: A microdialysis approach MAX LAFONTAN (FRANCE)Impact du massage mécanique sur la mobilisation lipidique dans la zone graisseuse fémorale : étude par microdialyse Mesotherapy: Does it really work on fat tissue? / La mésothérapie fonctionne-t-elle vraiment sur le tissu graisseux ? PHILIPPE PETIT (FRANCE) Phosphatydilcholine vs sodium deoxicholate / La phosphatydilcholine vs sodium deoxicholateGIOVANNI SALTI (ITALY) Ultrasounds: Are they all equivalent? / Ultrasons : sont-ils tous les mêmes ?PHILIPPE BLANCHEMAISON (FRANCE) Laserlipolysis / La lipolyse au laserNICOLA ZERBINATI (ITALY) Carboxitherapy: Does it really work on fat tissue?GUSTAVO LEIBASCHOFF (ARGENTINA)La carboxithérapie fonctionne-t-elle vraiment sur le tissu graisseux ? How does radiofrequency cause lipolysis? An in vivo tissue temperature study showing time is crucial CLAUDIA VAN DER LUGT (NETHERLANDS)Comment la radiofréquence entraîne-t-elle la lipolyse? Une étude in vivo de la température des tissus montrant l'importance du temps Hydrolipoclasia using greater volumes: The Brazilian experienceWILMAR ACCURSIO (BRAZIL)L'hydrolipoclasie avec de gros volumes : l'expérience brésilienne Blood loss evaluation in laser-assisted liposuction / L’évaluation de la perte de sang dans la liposuccion assitée au laser KARIM MASSOUD (EGYPT) Low frequency ultrasounds for the treatment of localized lipodystrophiesFULVIO VANNINI, ANNA MARIA FORENZA (ITALY)Les ultrasons à basse fréquence pour le traitement des lipodystrophies localisées Skin laxity improvement and body contouring using a combination of bi-polar radiofrequency, infrared light and tissue manipulationCombinaison radiofréquence bipolaire, lumière infrarouge et manipulation mécaniqueFRANCESCA DE ANGELIS (ITALY)18.30 END OF THE 2ND DAY - FIN DU 2E JOUR

Friday April 11 / Vendredi 11 Avril7.00 am : Conference Registration Opening8.00 am : Congress and Exhibit OpeningROOM /SALLE 242 AB ROOM /SALLE 2518.30 - 9.30HYALUDERM REVITALIZE: Anti-aging treatment for the skin bymicro-injections, made of natural hyaluronic acid, produced usinggenetic engineering technologyHYALUDERM REVITALIZE : traitement anti-âge de la peau par microinjections,composé d'acide hyaluronique naturel issu de génie génétiqueCHRISTINE PEUCHANT (FRANCE)9.30.10.30AMALIAN Product LineLa gamme de produits AMALIANWorkshop 9 proposed by LCA PHARMACEUTICALWorkshop 11 proposed by NORDIC AESTHETICSSAID HILTON (GERMANY)8.30 - 9.30 Workshop 10 proposed by LUTRONIC CORP.A new approach to fractional resurfacing by an Er:Glass laser based oncontrolled Chaos Technology: MosaicRelissage cutané : Nouvelle technique fractionelle par laser Er: GlassJEAN-LUC LEVY (FRANCE)9.30.10.30 Workshop 12 proposed by AESTHETIC DERMALEXELLDERM (monopolar non thermogenic radiofrequencies), BoNta 568and REPARESTIM : Differential no needle mesoliftEXELLDERM (radiofréquences monopolaires non thermogèniques), BoNta 568et REPARESTIM : le mésolift différentiel sans aiguillePHILIPPE DEPREZ (SPAIN)10.30 - 11.00 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITION11.00 - 12.00 Workshop 13 proposed by ANTEISESTHÉLIS and FORTÉLIS: The complementary approaches for“blanching” wrinkles very superficially and correcting folds in-depthESTHÉLIS et FORTÉLIS : Approches complémentaires pour “effacer” lesrides superficelles et corriger les rides profondesPATRICK MICHEELS (SWITZERLAND)11.00 - 12.00 Workshop 14 proposed by PROCYTECH/ActiveCosmethicsOUTLINE / NUTRIACTIVE: Simple techniques for global care of eachpatient: Fillers, peelings, patches, serums…OUTLINE / NUTRIACTIVE : Techniques simples de prise en charge globale dechaque patient : comblement, peeling, patchs, serums…SPEAKER TO BE ANNOUNCEDAESTHETIC WORKSHOPS12.00 - 13.00 Workshop 15 proposed by ADODERMVARIODERM: New generation of hyaluronic acidVARIODERM : nouvelle génération d'acide hyaluroniqueMICHAEL WEIDMANN (GERMANY)13.00 - 14.00 LUNCH BREAK AND VISIT EXHIBIT HALL / PAUSE DÉJEUNER ET VISITE DE L’EXPOSITION14.00 - 16.00Workshop 17 proposed by TEOXANEAdvanced course of face remodeling with TEOSYALCours avancé de remodelage facial avec TEOSYALMARK LUPIN (CANADA)16.00 - 16.30 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITION12.00 - 13.00 Workshop 16 proposed by FILORGA LABORATORIESAnti-Aging CE Mesotherapy: Full face polyrevitalizing treatment withNCTF 135 HALa mésothérapie CE anti-vieillissement : Traitement polyrevitalisant del'ensemble du visage avec NCTF 135 HAPHILIPPE PETIT (FRANCE)ROOM /SALLE 242 AB ROOM /SALLE 25114.00 - 15.00Workshop 18 proposed by THERMAGEAdvances in skin tightening and body shapingLes progrès dans le rafermissement de la peau et le remodelage de lasilhouetteMICHAEL KAMINER (USA) - JOANNA CZUWARA (POLAND)15.00 - 16.00 Workshop 19 proposed by LIPOTOMY AQPLipotomy AQP / Non surgical water liposcultureLipotomie AQP / Liposculpture non chirurgicale par l'eauTHIERRY PIRMEZ (BELGIUM) - JACQUES DURAND (INDONESIA)16.30 - 17.30 Workshop 20 proposed by PROMOITALIANew techniques for facial rejuvenation: Intradermal technique offibroblast stimulation and Micro-Targeted Fibrosis with bipolarelectrode and suspension of soft tissue with barbed absorbablethreads.Nouvelles techniques de rajeunissement du visage : techniqueintradermique de stimulation des fibroblastes et fibrose mico-cibléeavec électrode bipolaire et suspension des tissus mous par des filscrantés résorbables.FULVIO VANNINI - ANNA MARIA FORENZA - CIRO ACCARDO (ITALY)17.30 - 18.30Workshop 22 proposed by Q-MEDMACROLANE Master Class: Body shaping with MACROLANEMACROLANE Master Class: Remodelage de la silhouette avecMacrolane TMPER HEDÉN (SWEDEN)16.30 - 17.30Workshop 21 proposed by MEDIFORMCO2 LaserUniversal Fractional CO2 Adapter OMNIFIT by Alma LasersLaser CO2L'adaptateur universel du CO2 fractionnel OMNIFIT par Alma LasersSPEAKER TO BE ANNOUNCED17.30 - 18.30 Workshop 23 proposed by CAREGENFight against the aging process with Growth Factors and Peptide ComplexLutter contre le vieillissement avec un complexe de peptide et de facteurs decroissanceYONGJI CHUNG (KOREA)18.30 END OF THE 2ND DAY - FIN DU 2E JOUR

8.30 - 9.30Friday April 11 / Vendredi 11 Avril7.00 am : Conference Registration Opening8.00 pm : Congress and Exhibit OpeningAnti Aging Workshop 3 SKIN DISORDERS / TROUBLES CUTANÉSTreatment of chronic dermatoses and skin agingLe traitement des dermatoses chroniques et du vieillissement cutané9.30 - 10.30JAPAN ANTI-AGING MEDICINE / LA MEDECINE ANTI-AGE AU JAPONChair: YOSHIKAZU YONEI ANTI-AGING MEDICAL DOCTOR (KYOTO, JAPAN) Anti-Aging secrets of Japanese centenarians and elderly people / Le secret anti-âge des centenaires Japonais Global network of anti-aging activitiy from Japan / Le réseau global anti-âge au Japon Functional Food Factor: FOSU (Food of Specified Special Use)Le facteur d'alimentation fonctionnelle : FOSU (Nourriture d’emploi spécial prédéfini) Aging check system in Japan / Le bilan médical anti-âge au JaponROOM / SALLE PASSYJOHN IONESCU (GERMANY)TAKUJI SHIRASAWA (JAPAN)YOSHIKAZU YONEI (JAPAN)SHAW WATANABE (JAPAN)MASASHI UWABU (JAPAN)ANTI AGING MEDICINE10.30 - 11.00 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITION11.00 - 12.00Anti Aging Workshop 4 THE FOOD AND THE SKIN / LA NOURRITURE ET LA PEAUChair: CHRISTINE LAFFORGUE (PH.D.), UNIT OF DERMOPHARMACOLOGY AND COSMETOLOGY (CHÂTENAY-MALABRY, FRANCE) Practical tips to improve the skin nutrients / Conseils pratiques pour améliorer la peau avec des nutriments NADINE POMAREDE (FRANCE) Antioxydants: Latest scientific evidences / Antioxydants : dernières avancées et nouvelles perspectives MARVIN EDEAS (MALTE) Which food and cosmetics to improve the skin ? / Quels ingrédients alimentataires et cosmétiques pour la peau ? MARVIN EDEAS (MALTE) Discussion12.00 - 13.00Anti Aging Workshop 5 CANCER TREATMENT / LE TRAITEMENT DU CANCERHow to use efficiently an important overlooked treatment? / Comment utiliser efficacement un traitement généralisé ? TULLIO SIMONCINI (ITALY)More natural approaches to cancer treatment / Des approches plus naturelles du traitement du cancer SERGE JURASUNAS (PORTUGAL)13.00 - 14.00 LUNCH BREAK AND VISIT EXHIBIT HALL / PAUSE DÉJEUNER ET VISITE DE L’EXPOSITION14.00 - 16.00CONTRIBUTING LECTURES IN ANTI-AGING MEDICINE / CONFERENCES PARTICIPATIVES EN MEDECINE ANTI-AGEChair: ASCANIO POLIMENI ANTI-AGING MEDICAL DOCTOR (ROMA, ITALY) - JOSÉ MARQUEZ-SERRES ANTI-AGING MEDICAL DOCTOR (SEVILLE, SPAIN) Carnosine and skin aging / La carnosine et le vieillisement de la peauDAMIANO GALIMBERTI (ITALY) Complementary antioxydant function of caffeine and green tea polyphenols for the skinJARED JAGDEO (USA)Effet anti-oxydant complémentaire de la caféine et des polyphénols du thé vert sur la peau The increasing time-lag between scientifically based proof and clinical practice: Defining the causesJEFF HOEYBERGHS (BELGIUM)in relation to anti-aging medicine / Le décalage croissant entre les preuves scientifiques et la pratique médicale :détermination des causes liées à la médecine anti-âge How the best anti-aging physicians of Spain workJOSÉ MARQUEZ-SERRES (SPAIN)Méthodes de travail des meilleurs médecins anti-âge en Espagne Food, inflammation and the aging process / Nourriture, inflammation et processus de vieillissementROGER DEUTSCH (USA) Metabolic syndrome and insulin resistance in middle-aged women with subclinical hypothyroidismAVRAHAM ISHAY (ISRAEL)Le syndrome métabolique et la résistance à l'insuline chez les femmes souffrant d'hypothyroïdie subclinique à la cinquantaine Cleansing of the mucoid plaque by natural means / Nettoyage de la plaque mucoïde par des moyens naturels ELEONORA LUKA PILLA (SWITZERLAND) Oxydizing stress - The necessary evaluation / Le stress oxydant - La nécessaire évaluationROBERT NATAF (FRANCE) Mitochondrial medicine understanding and treating aging at a molecular levelBERND KLEINE-GUNK (GERMANY)Comprendre la médecine mitochondriale et traiter le vieillissement au niveau moléculaire Effects of obesity on cognitive function in otherwise healthy individualsLes conséquences de l'obésité sur les fonctions cognitives chez les individus sains par ailleursTOM RICHART (BELGIUM) Nature's answer to sexual hypofunction: The hormonomimetic and antioxidant properties of icariin in relation ROCK R. GOERDIN (BELGIUM)with male and female sexual wellbeing / La réponse de la nature à l'hypofonctionnement sexuel : l'hormonomimétisme et les propriétésantioxydantes de l'icariine associés au bien-être sexuel masculin et féminin The added value of extensive preliminary laboratory screening to very low caloric diets with high protein contentLa valeur ajoutée des larges examens de laboratoire préliminaires dans les régimes basses calories hyperprotéinés FRANCINE TEMPELS (BELGIUM) Salivary hormone testing: Do’s and don’ts / Tests hormonaux salivaires : que faire et ne pas faireWOLFGANG ZIEMANN (GERMANY)16.00 - 16.30 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITION16.30 - 17.30Anti Aging Workshop 6 GENETIC TYPING / LE GÉNOTYPEMen and women: How to work with the most important genetic typing tests?Hommes et femmes : comment travailler avec les meilleurs tests génotypiques ?17.30 - 18.30Anti Aging Workshop 7 ANTI-AGING THROUGH SPA THERAPY / ANTI-AGE ET SPAComplementary treatment for holistic anti-aging program: How alternative medicine assists on anti-agingAll these subjects will help the doctors understand what are Spa treatments, alternative medicine including massage, aroma therapy,hydrotherapy, chromotherapy, Chinese traditional medicine, acupuncture... all for more body and mind, not just hormone and medicineTraitement complémentaire pour un programme anti-âge holistique : comment les médecines douces assistent la médecine anti-âge (Spa,massages, aromathérapie, hydrothérapie, chromothérapie, médecine traditionnelle chinoise, acupuncture...)PAKPILAI THAVISIN (THAILAND)JOHANNES HUBER (AUSTRIA)ANDRES KANSKI (VENEZUELA)18.30 END OF THE 2ND DAY - FIN DU 2E JOUR

AESTHETIC DERMATOLOGY AND SURGERY8.30 - 10.3010.30 - 11.00 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITION11.00 - 13.0014.00 - 16.00Saturday April 12 / Samedi 12 Avril7.00 am : Conference Registration Opening8.00 am : Congress and Exhibit OpeningBLUE AUDITORIUM / AMPHI BLEUREJUVENATION OF THE EYES: MEDICAL AND SURGICAL APPROACHES PART 1LE RAJEUNISSEMENT DE LA ZONE PÉRI-ORBITALE : APPROCHE MÉDICALE ET CHIRURGICALEChair: CÉDRIC KRON PLASTIC SURGEON (PARIS, FRANCE) - ROBERT PETERSON PLASTIC SURGEON (HONOLULU, USA) Particularities of peri-orbital anatomy / Particularités anatomiques de la zone péri-orbitale “Fresh-eye-look" with BTX and fillers / Rajeunissement péri-orbital grâce à la Toxine Botulique et aux fillers Temporal lift by galeapexy / Le lifting temporal par galéapexie Place of canthopexy / canthoplasty in the rejuvenation of the regardPlace de la canthopexie/canthoplastie dans le rajeunissement du regard Upperface rejuvenation / Rajeunissement du haut du visage Periorbital rejuvenation by CO 2 infusion / Rajeunissement péri-orbital par l’infusion de CO 2 Treatment of unaesthetic veins in the periorbital areaTraitement des veines inesthétiques de la zone péri-orbitaleREJUVENATION OF THE EYES: MEDICAL AND SURGICAL APPROACHES PART 2LE RAJEUNISSEMENT DE LA ZONE PÉRI-ORBITALE : APPROCHE MÉDICALE ET CHIRURGICALEChair: CÉDRIC KRON PLASTIC SURGEON (PARIS, FRANCE) - SAID HILTON AESTHETIC DERMATOLOGIST (DUSSELDORF, GERMANY) Tricks for Asian upper blepharoplasties / Astuces pour les blépharoplasties chez le sujet asiatique Periorbital rejuvenation by HA / Rajeunissement péri-orbital par l’acide hyaluronique Tear trough rejuvenation by lipostructure / Rajeunissement de la vallée des larmes par lipostructure Tear trough rejuvenation with Lunch Time Lifting / Rajeunissement de la vallée des larmes avec le lift “Lunch Time” Periorbital rejuvenation by lasers / Rajeunissement péri-orbital grâce au laser Chemical blepharoplasty / Blépharoplastie chimique13.00 - 14.00 LUNCH BREAK AND VISIT EXHIBIT HALL / PAUSE DÉJEUNER ET VISITE DE L’EXPOSITIONIDEAS AND INNOVATIONS: "THINK DIFFERENT" / IDÉES ET INNOVATIONS : PENSER AUTREMENTChair: FRANÇOIS PETIT PLASTIC SURGEON (PARIS, FRANCE) - OLIVIER CLAUDE PLASTIC SURGEON (PARIS, FRANCE)INTRODUCTION - FRANÇOIS PETIT (FRANCE)PURE BUSINESS How to set up a successfull MediSpa ? / Comment créer une clinique Medispa qui réussit ? Cosmetic medicine and surgery: Should we team up a company or remain independent ?Médecine cosmétique et chirurgie : travailler pour une société ou rester indépendant ? ScarLock system : the ideal device to prevent "bad payers" in cosmetic surgeryLe système ScarLock : idéal pour prévenir les «mauvais payeurs» en chirurgie esthétique DiscussionPURE PRACTICE Macrolane injections: The ultimate tool for silhouette reshaping?Injections de Macrolane : l’outil ultime pour le modelage de la silhouette ? Laser-assisted lipolysis: Techniques and results / Lipolyse assistée par laser : techniques et résultats Carboxytherapy / Carboxythérapie Hyaluronidase: An efficient treatment for unaesthetic hyaluronic acid over correctionHyaluronidase : un traitement efficace pour les surcorrections inesthétiques par acide hyaluroniquePURE SCIENCE Adipose-derived stem cell in cosmetic medicine and surgeryLes cellules souches dérivés du tissu adipeux en médecine cosmétique et en chirurgie From fat transfert to stem cell transplantation: New methods in aesthetic bodyformingDe la greffe graisseuse à la transplantation de cellule souche : nouvelles méthodes de remodelage corporel Conclusion and discussionJACQUES LAGIER (FRANCE)SAID HILTON (GERMANY)ALAIN FOGLI (FRANCE)ROBERT PETERSON (USA)ROBERT PETERSON (USA)CARLOS ANTONIO ABRAMO (UK)ALBERT ADRIEN RAMELET (SWITZERLAND)ROBERT PETERSON (USA)NADINE POMAREDE (FRANCE)SEBASTIANO MONTONERI (ITALY & FRANCE)MARCO GALLUCCI (ITALY)JEAN-LUC LEVY (FRANCE)PHILIPPE DEPREZ (SPAIN)PAKPILAI THAVISIN (THAILAND)CAROLE AZZAM (SPAIN)FRANÇOIS PETIT (FRANCE)FAT SYMPOSIUM - PRACTICAL ROUND TABLE: HOW DO I TREAT THE DIFFICULT AREAS? PART 3FAT SYMPOSIUM - TABLE RONDE PRATIQUE : COMMENT TRAITER LES ZONES DIFFICILES ?Chair: PHILIPPE BLANCHEMAISON PHLEBOLOGIST (PARIS, FRANCE) - GUSTAVO LEIBASCHOFF COSMETIC SURGEON (BUENOS AIRES, ARGENTINA) The anterior thigh / La cuisse antérieure The internal side of the thigh / La zone interne de la cuisse Ankle and calf / Cheville et mollet The back of the arms / L'arrière des bras Liposuction of the breast / Liposuccion des seins Localized fatty areas of the back / Zones graisseuses localisées du dos Saddlebags / Culotte de cheval Lower abdomen with flacidity / Relâchement du bas-ventre Liposuction of the neck and jowls / Liposuccion du cou et des bajoues Localized fat on the face / La graisse localisée du visagePANEL SPEAKERSPATRICK TRÉVIDIC (FRANCE)ERIC PLOT - ARMAND PARANQUE (FRANCE)SEBASTIANO MONTONERI (ITALY & FRANCE)PIERRE ANDRÉ (FRANCE)FLORENCIO Q. LUCERO (PHILIPPINES)KARL-GEORG HEINRICH (AUSTRIA)CLAUDE DALLE (FRANCE)16.00 - 16.30 COFFEE BREAK AND “GRAND PRIX” DRAWING OF LOTS ON TEOXANE’S BOOTH / PAUSE CAFÉ ET TIRAGE AU SORT DU “GRAND PRIX AMWC” SUR LE STAND TEOXANE16.30 - 18.30WILMAR ACCURSO (BRAZIL)PHILIPPE BLANCHEMAISON (FRANCE)CLAUDE GARDE (FRANCE)CLAUDIA VAN DER LUGT (NETHERLANDS)FRANÇOIS PETIT (FRANCE)NICOLA ZERBINATI (ITALY)GERHARD SATTLER (GERMANY)ANTOINE PARASKEVAS (FRANCE)GIOVANNI SALTI (ITALY)THIERRY MARÉCHAL (FRANCE)20.30 EXCEPTIONAL GALA EVENING AT THE INTERCONTINENTAL HOTEL - PARIS

8.30 - 9.30Saturday April 12 / Samedi 12 Avril7.00 am : Conference Registration Opening8.00 am : Congress and Exhibit OpeningROOM / SALLE MAILLOT9.30 - 10.30COMMUNICATIONS IN FOREFRONT ANTI-AGING MEDICINE / COMMUNICATIONS DE PREMIER PLAN EN MEDECINE ANTI-AGEChair: DAMIANO GALIMBERTI PRESIDENT OF ITALIAN ASSOCIATION OF ANTI-AGING PHYSICIANS (MILANO, ITALY)JOHN IONESCU PROFESSOR OF BIOCHEMISTRY AND IMMUNOLOGY (NEUKIRCHEN, GERMANY) What's the future of DHEA's replacement therapy? / Quel avenir pour la thérapie de remplacement de la DHEA ? Sodium phenylbutyrate/tributyrate®: 350+ publications later, safe, effective and "cheap", will it ever see daylight as a treatment?Sodium phenylbutyrate/tributyrate®: sûr, efficace et bon-marché, après plus de 350 publications, verra-t-il la lumière du jour ? Aging and anti-aging medicine in the Middle-East / Vieillissement et médecine anti-age dans le Moyen OrientASCANIO POLIMENI (ITALY)HOKAN CEDERBERG(SWEDEN)ABDULRAZAK ABYAD (LEBANON)CUTTING-EDGE ANTI-AGING MEDICINE: THE MOST RECENT SCIENTIFIC STUDIESMÉDECINE ANTI-AGE DE POINTE : LES DERNIÈRES ÉTUDES SCIENTIFIQUESChair: CLAUDE DALLE ANTI-AGING MEDICAL DOCTOR (PARIS, FRANCE) - YOSHIKAZU YONEI ANTI-AGING MEDICAL DOCTOR (KYOTO, JAPAN) Cutting edge genetics / La génétique d'avant-garde The proper way to successful aging / La bonne voie pour bien vieillir Cutting edge hormone treatments: DHEA and GH / Les traitements hormonaux de pointe : DHEA et hormone de croissance Cutting edge information on testosterone in aging men and women / Les dernières informationssur les traitements par testosterone chez l’homme et la femme vieillissantsBERNARD WEBER (LUXEMBOURG)YOSHIKAZU YONEI (JAPAN)CLAUDE DALLE (FRANCE)JEAN-CLAUDE EMPERAIRE (FRANCE)10.30 - 11.00 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITIONANTI AGING MEDICINE11.00 - 13.00GLOBAL WARMING AND RISKY ENVIRONMENT: HOW TO AVOID THE PREMATURE AGING?RÉCHAUFFEMENT CLIMATIQUE ET ENVIRONNEMENT À RISQUES: COMMENT EMPÊCHER LE VIEILLISSEMENT PRÉMATURÉ ?Chair: MARIO KRAUSE ANTI-AGING MEDICAL DOCTOR (HANNOVER, GERMANY) - THIERRY HERTOGHE ANTI-AGING MEDICAL DOCTOR (BRUSSELS, BELGIUM) Effect of cell phones on the brain: A protective deviceCAREEN SCHROETER (THE NETHERLANDS)Effet des téléphones cellulaires sur le cerveau : un dispositif protecteur Global warming and health: The evidences / Réchauffement climatique et santé : état des lieuxBETTINA MENNE (ITALY) Environment illness: Latest data / Maladies environnementales : les derniers chiffresMARIO KRAUSE (GERMANY) Xenohormones: How to deal with? / Xénohormones : Comment agir ?LENNART HARDELL (SWEDEN) Human being, endangered species: The effects of endocrine disruptors on fertilityMARIO KRAUSE (GERMANY)La race humaine en danger : les effets des blocages endocriniens sur la fertilité Inflammation and toxicity due to metals : An important factor of premature agingInflammation et toxicité dûes aux métaux : un facteur important du vieillissement prématuréVERA STEJSKAL (SWEDEN)13.00 - 14.00 LUNCH BREAK / PAUSE DÉJEUNER14.00 - 15.00NUTRIENTS IN THE SERVICE OF AGE AND SKIN: LATEST SCIENTIFIC EVIDENCELES NUTRIMENTS AU SERVICE DE L’AGE ET DE LA PEAU : LES DERNIÈRES DONNÉES SCIENTIFIQUESChair: JEAN-PAUL MARTY UNIT OF DERMOPHARMACOLOGY AND COSMETOLOGY, FACULTY OF PHARMACY (CHÂTENAY-MALABRY, FRANCE) Poly Unsatured Fatty Acids (PUFA) and the skin / Acides gras polyinsaturés et peau Functional foods and dermonutrition: Essensis® / Aliments fonctionnels et dermonutrition : Essensis® A moisturizing / antiaging activity of lutein: Results from a double-blind clinical studyEffets hydratant et anti-âge de la lutéine : résultats d’une étude clinique en double aveugle Discussion15.00 - 16.00FITNESS MEDICINE: HOW TO INCREASE ENERGY AND QUALITY OF LIFE?MÉDECINE PHYSIQUE : COMMENT AMÉLIORER SA QUALITÉ DE VIE ET ÊTRE EN PLEINE FORME ?Chair: CLAUDE DALLE ANTI-AGING MEDICAL DOCTOR (PARIS, FRANCE) - ADRIAN SLEE NUTRITIONAL MEDICINE DOCTOR (LONDON, UK) Mineral and multinutrient supplements that improve fitnessLes suppléments minéraux et multinutritionnels qui améliorent la forme The age-related loss of muscle mass and potential therapeutic dietary interventionsPerte de masse mucsulaire avec l’âge et interventions diétéiques thérapeutiques Acid base medicine for better energy and endurancePlus d'énergie et d'endurance en rétablissant l'équilibre acide-baseTONY RAWLINGS (UK)TAOUS LASSEL (FRANCE)PIERFRANCESCO MORGANTI (ITALY)ERIK-ALEXANDER RICHTER (THE NETHERLANDS)ADRIAN SLEE (UK)JOHN van LIMBURG STIRUM (SWITZERLAND)16.00 - 16.30 COFFEE BREAK AND “GRAND PRIX” DRAWING OF LOTS ON TEOXANE’S BOOTH / PAUSE CAFÉ ET TIRAGE AU SORT DU “GRAND PRIX AMWC” SUR LE STAND TEOXANE16.30 - 18.30ONCOLOGY: HOW TO LIVE LONGER DESPITE CANCER? / ONCOLOGIE : COMMENT VIVRE PLUS LONGTEMPS MALGRÉ UN CANCER ?Chair: LEV BERSTEIN PROFESSOR OF ONCOENDOCRINOLOGY (ST PETERSBURG, RUSSIA) - PETER LIM PROFESSOR OF UROLOGY AND ANDROLOGY (SINGAPORE) Oxidative stress and cancer – Antioxidant therapyStress oxydatif et cancer - Traitements antioxydants Endocrinology of aging and cancer: Role of endocrine-genotoxic switching; Preventive potentialEndocrinologie du vieillissement et cancer : rôle des changements endocrino-génotoxiques ; potentiel préventif New cancer polymorphism to spot and improve anti-aging therapiesLe nouveau polymorphisme du cancer pour découvrir et améliorer les thérapies anti-âge The cancer is a fungus / Le cancer est un champignon Does testosterone cause prostate cancer? The evidence pro and contraLa testosterone cause-t-elle le cancer de la prostate ? Les preuves pour et contreSERGE JURASUNAS (PORTUGAL)LEV BERSTEIN (RUSSIA)HELENA BARANOVA (FRANCE)TULLIO SIMONCINI (ITALY)PETER LIM (SINGAPORE)20.30 EXCEPTIONAL GALA EVENING AT THE INTERCONTINENTAL HOTEL - PARIS

8.30 - 10.30Saturday April 12 / Samedi 12 Avril7.00 am : Conference Registration Opening8.00 am : Congress and Exhibit OpeningHAND REJUVENATION: AN INCREASING DEMAND FROM THE PATIENTSLE RAJEUNISSEMENT DES MAINS : UNE DEMANDE CROISSANTE DE LA PART DES PATIENTESROOM / SALLE 252 ABChair: MARC LEFEBVRE-VILARDEBO VASCULAR SURGEON (PARIS, FRANCE) - TORELLO LOTTI PROFESSOR OF DERMATOLOGY (FLORENCE, ITALY) The hand: What is the request for aesthetic treatments? Results of our surveyLa Main : quelles demandes de traitements esthétiques ? Les résultats de notre enquête Sclerotherapy of hand veins / La sclérothérapie des veines de la main Phlebectomy of hand veins / La phlébectomie des veines de la main Fat grafting of the hand / La greffe graisseuse de la main Indications for dystrophic hand veins : Dicussion from clinical casesIndications pour la dystrophie des veines de la main : Discussion sur des cas cliniques Treatment of hand pigmentary disorders (brown spots)Le traitement des troubles pigmentaires de la main (taches brunes) Hand rejuvenation with chemical peels and fillersLe rajeunissement de la main avec les peelings chimiques et les produits de comblement Aging nails / Le vieillissement des onglesMATTHIEU BEUSTES-STEFANELLI (FRANCE)MARIO VALSAMIS (GREECE)MARC LEFEBVRE-VILARDEBO (FRANCE)RENÉ-FRANÇOIS NIFOROS (FRANCE)PANEL SPEAKERSTORELLO LOTTI (ITALY)SOHAIL MANSOOR (UK)ECKART HANEKE (GERMANY)AESTHETIC DERMATOLOGY AND SURGERY10.30 - 11.00 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITION11.00 - 13.00BREAST REJUVENATION / RAJEUNISSEMENT DES SEINSChair: JEAN-CHRISTOPHE BICHET PLASTIC SURGEON (PARIS, FRANCE) - MICHAEL SCHEFLAN PLASTIC SURGEON (TEL AVIV, ISRAEL) Breasts in Art / Les seins dans l'ArtPHILIPPE COMAR (FRANCE) What needs to be considered in the aging process on the breastJAVIER DE BENITO (SPAIN)Ce qu'il faut prendre en compte dans le processus du vieillissement des seins Aesthetic lipomodeling of the breast: Assessment and precautions / Le lipomodelage des seins: indications et précautions EMMANUEL DELAY (FRANCE) Evolution of Macrolane® / L'évolution de Macrolane®SATORU YAMAGUCHI (JAPAN) - PER HEDEN (SWEDEN) Aesthetic surgical management of the aging breast with or without implantsMICHAEL SCHEFLAN (ISRAEL)La gestion chirurgicale esthétique, avec ou sans implant, du vieillissement des seins Mammary prosthesis with low projection: French survey, indications and problemsJEAN-CHRISTOPHE BICHET (FRANCE)Prosthèses mammaires de bas profil : étude française, indications et problèmes13.00 - 14.00 LUNCH BREAK AND VISIT EXHIBIT HALL / PAUSE DÉJEUNER ET VISITE DE L’EXPOSITION14.00 - 16.00THE AGING SKIN: EVALUATION AND POSSIBLE TREATMENTS / LE VIEILLISSEMENT DE LA PEAU : EVALUATION ET TRAITEMENTS POSSIBLESChair: PHILIPPE HUMBERT PROFESSOR OF DERMATOLOGY (BESANÇON, FRANCE) - ECKART HANEKE PROFESSOR OF DERMATOLOGY (FRIBURG, GERMANY) Clinical signs of aging skin / Les signes cliniques du vieillissement de la peau Evaluation of aging face: Clinical scales and lab's technologiesL'évaluation du vieillissement cutané : échelles cliniques et technologies de laboratoire Onychocosmeceuticals / La cosmétique des ongles Hypersensitive skin, a common complaint / La peau hypersensible, une plainte commune Nutritional supplementation and mature skin / Supplémentation nutritionnelle et peau mature Hormones and the aging skin / Les hormones et le vieillissement de la peauNICHOLAS BACHOT (FRANCE)PHILIPPE HUMBERT (FRANCE)ECKART HANEKE (GERMANY)MARIE-LAURE FLECHET (FRANCE)PATRICIA MANISSIER (FRANCE)CLAUDE DALLE (FRANCE)16.00 - 16.30 COFFEE BREAK AND “GRAND PRIX” DRAWING OF LOTS ON TEOXANE’S BOOTH / PAUSE CAFÉ ET TIRAGE AU SORT DU “GRAND PRIX AMWC” SUR LE STAND TEOXANE16.30 - 18.30CONTIBUTING LECTURES IN AESTHETIC DERMATOLOGY AND SURGERY / CONFÉRENCES PARTICIPATIVES EN DERMATOLOGIE ET CHIRURGIE ESTHÉTIQUEChair: PHILIPPE DEPREZ AESTHETIC MEDICAL DOCTOR (EMPURIABRAVA, SPAIN) - ALAIN MICHEL PLASTIC SURGEON (MONTBÉLIARD, FRANCE) Dark circles: A new approach / Les cernes noirs : nouvelle approche Tumescent anaesthesia for the cosmetic varicectomy / L'anesthésie tumescente pour la varicectomie cosmétique Female sexual rejuvenation: Nymphoplasty or aesthetical labiaplastyRajeunissement sexuel féminin : nymphoplastie ou labiaplastie esthétique Own experience in carrying out rejuvenating operations in the middle faceExpérience personnelle du rajeunissement du milieu du visage New approaches to the treatment of the aging face with ThreadLift: Complete, effective and quick resultNouvelles approches du traitement du vieillissement facial avec ThreadLift pour des résultats complets, efficaces et rapides Face volumetric re-harmonization utilizing crosslinked HA with Coesix Technology at different viscosityRéharmonisation volumétrique du visage avec un acide hyaluronique réticulé par la technologie Coesix Carboxytherapy in the treatment of scars / La carboxythérapie pour le traitement des cicatrices Advanced and safe peeling method of deep skin rejuvenation: PDSR (Pyun's Deep Skin Rejuvenation)Méthode de peeling perfectionnée et sûre de rajeunissement de l'épiderme profond : PDSR Fractional CO2 resurfacing: Our experience with Ultrapulse EncoreTraitement superficiel au CO2 fractionné : notre experience à l'Ultrapulse Encore The immediate effect of a new monopolar radiofrequency treatmentLes effets immédiats du nouveau traitement à radiofréquence monopolaire Effects of non-invasive monopolar radiofrequency as a single-procedure, single-modality for facial rejuvenationLes effets de la radiofréquence monopolaire utilisée seule pour le rajeunissement du visage A non invasive approach to tissue tightening using non ablative radiofrequencyApproche non invasive du raffermissement cutané par radiofréquence non ablativeJEAN-LUC LEVY (FRANCE)ECKART HANEKE (GERMANY)LAURENT BENADIBA (FRANCE)PETER HAJDUK (RUSSIA)CIRO ACCARDO (ITALY)ANNA MARIA FORENZA (ITALY)NINA KOUTNA (CZECH REPUBLIC)INSOO SHIM (S. KOREA)MARIA BROZMANOVA (SLOVAK REPUBLIC)SOFIA RUBBANI (USA)MARIA MAVRIDOU (GREECE)MARIO GOISIS (ITALY)20.30 EXCEPTIONAL GALA EVENING AT THE INTERCONTINENTAL HOTEL - PARIS

Saturday April 12 / Samedi 12 Avril7.00 am : Conference Registration Opening8.00 am : Congress and Exhibit OpeningRoom / Salle 242 AB ROOM / SALLE 2518.30 - 9.30 Workshop 24 proposed by TUXEDONon Invasive Body Contouring with ULTRALYSRemodelage non invasif de la silhouette avec ULTRLYSCARMELO PROTOPAPA (ITALY)9.30 - 10.30 Workshop 26 proposed by ANTEISRehydrate your patient's skin with MESOLIS and MESOLIS+Réhydratez la peau de vos patients grâce à MESOLIS et MÉSOLIS+CHRISTIAN GAY (FRANCE)8.30 - 9.30 Workshop 25 proposed by REGENLABRegenKit, the new autologous cell therapie for wrinkle and skinregenerationRegenKit, le nouveau traitement cellulaire autologue de régénérationfaciale et comblement de ridesJEAN-CLAUDE HOUDRET - GILBERT AMGAR - CLAUDINE HADIDA (FRANCE)9.30 - 10.30 Workshop 27 proposed by AA-Medical SystemsCarboxytherapy, Mesotherapy and other breakthrough techniques:Which winning combinations in the fat reduction process and thetreatment of wrinkles?Certificate of attendance delivered on siteCarboxytherapie, mésothérapie et autres techniques de pointe : quellecombinaison gagnante dans le traitement de la cellulite et celui des rides?GUSTAVO LEIBASCHOFF (ARGENTINA)10.30 - 11.00 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITION11.00 - 12.00Workshop 28 proposed by TEOXANEAdvanced Techniques using TEOSYAL Ultra DeepTechniques avancées avec TEOSYAL Ultra DeepJULES MARTHAN (FRANCE)11.00 - 12.00 Workshop 29 proposed by PROMOITALIAA global concept for beauty and wellness. Reharmonize your face with anew crosslinked hyaluronic acid with COESIX technology in sinergy witha new cosmetic lifting system and reshape your body with PROSLIMELTlow frequency ultrasound wavesUn concept global beauté et bien-être. Réharmonisez votre visage grâceà un nouvel acide hyaluronique réticulé avec la technologie COESIX ensynergie avec un nouveau système de lifting et remodelez votre corpsavec les ondes ultrasons à basse fréquence PROSLIMELT.ANNA MARIA FORENZA - FULVIO VANNINI (ITALY)AESTHETIC WORKSHOPS12.00 - 13.00Workshop 30 proposed by Q-MEDRESTYLANE® Master ClassAdvanced techniques with RESTYLANE SUBQRESTYLANE® Master ClassTechniques avancées avec RESTYLANE SUBQWOFFLES WU (SINGAPORE)13.00 - 14.00 LUNCH BREAK AND VISIT EXHIBIT HALL / PAUSE DÉJEUNER ET VISITE DE L’EXPOSITION14.00 - 15.00 Workshop 32 proposed by ALLERGANIntroducing volumetric contouring with VOLUMA ®.Remodelage volumétrique et contour avec VOLUMA ® Facial contours – The impact of aging / Contours faciaux : l’impact de l’âge Building experience and confidence with Voluma® / Acquérir expérience etconfiance avec Voluma® Questions from the Dermatologist / Les questions du Dermatologue Live Demonstration / Démonstration en directCHAIR: GREGOR WAHL (GERMANY)HERVÉ RASPALDO (FRANCE) - GREGOR WAHL (GERMANY)12.00 - 13.00 Workshop 31 proposed by PRODERMANew, MESOEXPERT: Techniques of mesotherapy and liposculpture forface and bodyNouveau, MESOEXPERT : Techniques de mésothérapie et liposculpturepour le visage et le corpsDIMITRE DIMITROV (BULGARIA)14.00 - 15.00Workshop 33 proposed by Q-MEDMACROLANE Master Class : Breast shaping with MACROLANEMACROLANE Master Class : le remodelage des seins avec MACROLANE TMSATORU YAMAGUCHI (JAPAN)15.00 - 16.00 Workshop 34 proposed by LUMENISNew rejuvenating techniques / Nouvelles techniques de rajeunissement Active FX and Deep FX fractional resurfacing / Relissage laser fractionnel Active FX et Deep FX Facial skin tightening with Aluma system / Traitement du relâchement cutané du visage avec le système AlumaMARIO TRETTI-CLEMENTONI (ITALY)CLAUDIA VAN DER LUGT (THE NETHERLANDS) - PHILIPPE MALET (FRANCE)15.00 - 16.00Workshop 35 proposed by ATLEANClinical renewal on facial aging with a safety stimulatory filler : ATLÉAN.Live Interactive demonstrationL'induction tissulaire sécurisée dans le traitement du vieillissement facial :ATLÉAN. Démonstration InteractiveRICCARDO FORTE (ITALY)16.00 - 16.30 COFFEE BREAK AND “GRAND PRIX” DRAWING OF LOTS ON TEOXANE’S BOOTH / PAUSE CAFÉ ET TIRAGE AU SORT DU “GRAND PRIX AMWC” SUR LE STAND TEOXANE16.30 - 17.30Workshop 36 proposed by AURIGA Int.Pigmentation treatment and last updates on Anti-Aging researchTraitement de la pigmentation & dernières avancées dans la rechercheanti-âge New technologies and new systems / Nouvelles technologies et nouveaux systèmes Use of vitamin C on dermatology / Applications de la vitamine C en dermatologie Specific treatments of cellulitis and skin slack / Traitement spécifique de lacellulite et des relâchements cutanés Oxygen cream and indications / Crème à l'oxygène et indications New peeling systems / Nouveaux systèmes de peelingCHAIR: PHILIPPE BLANCHEMAISON (FRANCE)PHILIPPE HUMBERT (FRANCE) - RÉGINE BUIDIN (BELGIUM)YVON GALL (FRANCE) - ALFRED MARCHAL (BELGIUM)17.30 - 18.30Workshop 38 to be announced16.30 - 17.30Workshop 37 proposed by SKINZONClinical application of Micro-Needling TherapyApplication clinique de la Micro-Needling Therapy17.30 - 18.30Workshop 39 proposed by RIOBLUSHBEOMJOON KIM (KOREA)Live Demonstration of C02 Rioblush Riojuvenation TechnologyDémonstration de la Technique CO2 RiojuvenationCARLOS ANTONIO ABRAMO (UK)20.30 EXCEPTIONAL GALA EVENING AT THE INTERCONTINENTAL HOTEL - PARIS

Saturday April 12 / Samedi 12 Avril7.00 am : Conference Registration Opening8.00 am : Congress and Exhibit OpeningROOM / SALLE PASSY8.30 - 9.30Anti Aging Workshop 8Testosterone therapy in men / Le traitement par testostérone chez l'homme9.30 - 10.30Anti Aging Workshop 9TESTOSTERONE THERAPY / TRAITEMENT PAR TESTOSTERONESTEM CELLS / CELLULES SOUCHESThe use of stem cell xeno-transplantation as a treatment of aging diseasesLa transplantation de cellules souches comme traitement des maladies liées à l’âgePETER LIM (SINGAPORE)ANNA MODELSKA ZOLKIEWICZ (POLAND)MICHAEL E. MOLNAR (USA)10.30 - 11.00 COFFEE BREAK AND VISIT EXHIBIT HALL / PAUSE CAFÉ ET VISITE DE L’EXPOSITION11.00 - 12.00Anti Aging Workshop 10DIGESTIVE SYSTEM / SYSTÈME DIGESTIFPractical session on how to improve the digestive system / Séance pratique sur l'amélioration du système digestifChair: GEORGES MOUTON (BRUSSELS) - MARCEL ROBERFROID (BELGIUM) Intestinal mucous membrane / La muqueuse intestinale Intestinal microflora / La microflore intestinaleMICHAEL CULP (UK)FRANCISCO GUARNER (SPAIN)ANTI AGING MEDICINE12.00 - 13.00Anti Aging Workshop 11New approaches to the diagnosis and treatment of neurodegenerative diseases: The epigenetic / metabolomic approach, among othersNouvelles approches diagnostiques et thérapeutiques des maladies neurodégénératives : l’approche épigénétique / métabolomiqueLUIZA SPIRU (ROMANIA) - AMOS KORCZYN (ISRAEL)ILEANA TURCU (ROMANIA) - CAMELIA GHITA (ROMANIA)14.00 - 15.00Anti Aging Workshop 12Relaxin, the new hormone: How to treat with it ? / Relaxine, la nouvelle hormone : son utilisation en traitementPractical oxytocin therapy in men and women / La thérapie à l'ocytocine chez l'homme et la femme en pratique15.00 - 16.00Anti Aging Workshop 13OPTIMAL BRAIN AGING ASSESSMENT / EVALUATION CÉRÉBRALE13.00 - 14.00 LUNCH BREAK AND VISIT EXHIBIT HALL / PAUSE DÉJEUNER ET VISITE DE L’EXPOSITIONRELAXIN AND OXYTOCIN / RELAXINE ET OCYTOCINEGLOBAL WARMING / RÉCHAUFFEMENT CLIMATIQUESAMUEL YUE (USA)JORGE FLECHAS (USA)Changing climate: Is there a necessity for anti-aging strategies at all?Devons-nous prendre en compte le changement climatique dans le développement de nos stratégies anti-vieillissement ?BETTINA MENNE (ITALY)16.00 - 16.30 COFFEE BREAK AND “GRAND PRIX” DRAWING OF LOTS ON TEOXANE’S BOOTH / PAUSE CAFÉ ET TIRAGE AU SORT DU “GRAND PRIX AMWC” SUR LE STAND TEOXANE16.30 - 17.30Anti Aging Workshop 14HOW TO RUN AN ANTI-AGING CLINIC ? / COMMENT MANAGER UNE CLINIQUE ANTI-ÂGE In Asia / En Asie In Europe / En Europe What makes a “good” anti-aging Doctor?/ Comment être un “bon” médecin anti-âge ?PAKPILAI THAVISIIN (THAILAND)JEFF HOEYBERGHS (BELGIUM)MIKE PERRING (UK)17.30 - 18.30Anti Aging Workshop 15SEXUALITY AND ANTI-AGING / SEXUALITÉ ET MÉDECINE ANTI-AGEHow to increase sexual pleasure? / Comment améliorer le plaisir sexuel ?Psychological responses to sexual stimulation in the female (film)Réactions psychologiques de la femme à la stimulation sexuelle (vidéo)RONALD VIRAG (FRANCE)GORM WAGNER (DENMARK)20.30 EXCEPTIONAL GALA EVENING AT THE INTERCONTINENTAL HOTEL - PARIS

Thursday April 10 / Jeudi 10 AvrilABSTRACTSAESTHETIC DERMATOLOGY & SURGERYBLUE AUDITORIUM / AMPHI BLEUAESTHETIC DERMATOLOGY & SURGERYSESSION 12.00 pm / 14h00TWENTY YEARS OF BOTULINUM TOXIN : WHERE ARE WE TODAY ?VINGT ANS DE TOXINE BOTULIQUE : OÙ EN EST-ON AUJOURD’HUI?CHAIR: ANTHONY BENEDETTO DERMATOLOGIST (PHILADELPHIA, USA)OLIVER KREYDEN DERMATOLOGIST (MUTTENZ, SWITZERLAND)ANATOMY OF THE FACE: THE BASICS TO KNOW PRIOR TO INJECTING BOTULINUM TOXINANATOMIE DU VISAGE : LES BASES À CONNAÎTRE AVANT D'INJECTER DE LA TOXINE BOTULIQUEHERVÉ RASPALDO(FRANCE)HOW TO MAKE BOTULINUM TOXIN-A BETTER?COMMENT RENDRE LA TOXINE BOTULIQUE DE TYPE A MEILLEURE ?ANDREAS KATSAMBAS(GREECE)The cosmetic use of Botulinum Toxin-A continues to increase since its approval some years ago. Despite the fact that more than 80%of patients using Botulinum Toxin-A are satisfied with the results, there still remains the 20% of patients who express dissatisfactionwith the final outcome.Moreover, even in successfully treated patients, there is still room for improvement.Some of the reasons for dissatisfaction include: inadequate dosing, lack of consultation and poor injection techniques.The reason for such unsuccessful treatments and the various ways of improving the degree of satisfaction will be discussed in furtherdetail.HOW TO AVOID THE PITFALLS WHILST TREATING THE UPPER FACE?COMMENT ÉVITER LES EFFETS SECONDAIRES DANS LE TRAITEMENT DU HAUT DU VISAGE ?ANTHONY BENEDETTO(USA)Rejuvenating the face with Botulinum toxin (BTX) has become a new and rewarding way to eliminate facial wrinkles in a minimallyinvasive manner that is relatively quick and easy to perform. The key to a successful treatment of a patient's facial rhytides with BTXis the proper pre-treatment evaluation of a patient's problems. Recently, injections of BTX of the face has complemented other facialrejuvenation techniques, by relaxing hyperkinetic muscles that either have caused excessive wrinkling at rest or distortion andasymmetry of a particular area of the face during animation. When planning a patient's facial remodeling with BTX, one should payparticular attention to the eyes, which usually reflect a patient's inner feelings and emotions to the casual observer. The perioculararea has four depressor muscles and one large levator muscle, which act in unison or in opposition to each other, intentionally orinvoluntarily to protect the eyes or express an emotion. It can be therefore somewhat challenging to produce a unified effect of theperiocular area with BTX injections without occasionally disturbing the symmetry of the upper face. Treating periocular rhytides withBTX requires an expert knowledge of the muscles in this area. An in depth evaluation of the patient and a corresponding managementplan using BOTOX ® to rejuvenate the face by reducing facial wrinkling and correcting asymmetries will be presented using clinicalexamples.HOW TO AVOID THE PITFALLS WHILST TREATING THE LOWER FACE AND THE NECK?COMMENT ÉVITER LES EFFETS SECONDAIRES DANS LE TRAITEMENT DU BAS DU VISAGE ET DU COU ?PHILLIP LEVY(SWITZERLAND)WHICH DIFFERENCES BETWEEN BOTOX ® , DYSPORT ® AND OTHER BOTULINUM TOXINS?QUELLES DIFFÉRENCES ENTRE BOTOX ® , DYSPORT ® ET LES AUTRES TOXINES BOTULIQUES ?DIDIER VOCHELLE(BELGIUM)35

TREATING THE WHOLE FACE WITH BOTULINUM TOXINTRAITER L’ENSEMBLE DU VISAGE AVEC LA TOXINE BOTULIQUECHARIYA PETCHNGAOVILAI(THAILAND)AESTHETIC DERMATOLOGY & SURGERYTreating the whole face with Botulinum toxin is a simple procedure for rejuvenation. Besides wrinkle reduction, Botulinum toxin createsface reshaping. By injecting the toxin into the muscles, the dynamic wrinkles are minimized. By injecting the toxin to adjust the balancebetween those two groups of facial muscles that counteract, the elevators to lift up and the depressors to pull down, face reshapingis achieved. Both conventional intramuscular and intradermal injection are applied in combination. Intramuscular injection isconsidered to block the muscle bundle while intradermal technique is applied to block only some of the superficial parts of the muscleand leave its deeper parts to compensate for performing its function. With this combination, strengthening and weakening of thedesignated muscles can be performed and the facial muscles are allowed to work in harmony, resulting in mini-facelift effect.NON AESTHETIC INDICATIONS OF BOTULINUM TOXIN: COMMON AND UNCOMMON INDICATIONS IN FOCAL HYPERHIDROSISINDICATIONS NON ESTHÉTIQUES DE LA TOXINE BOTULIQUE : INDICATIONS COMMUNES ET RARES DE L’HYPERHIDROSEOLIVER KREYDEN(SWITZERLAND)In dermatology botulinum toxin (BTX) became famous due to its aesthetic indications to treat wrinkles. However treatment for focalhyperhidrosis excists almost as long as the aesthetic indications. It was Bushara in 1996 who was the first to discover an anhidroticeffect on the cheek after treating patients for blepharospasm. Meanwhile BTX can be considered as the treatment of choice for axillaryhyperhidrosis. However, very little is known on the technique of rare indications such as palmoplantar, frontal, inguinal or submammaryHH or gustatory sweating after parotid surgery (Frey Syndrome). This session will cover the most important advanced indication in thefield of focal HH. Before treatment HH should be assessed objectively with the Minor stark test. The dilution of BTX should be 5ml -10ml per vial to achieve most possible diffusion. Since the diffusion capacity of BTX is about 1.0 - 1.5 cm in diameter the injections(2U/injection site) should be performed at a distance of approx. 1.5 cm to cover the whole hyperhidrotic area. While for axillary HH noanaesthetic treatment is necessary BTX-injections for palmoplantar HH need anaesthesia. Due to many side effects of nerve blocks(painful, incompletely block, impairment of motor activity, risk of nerve injury, vasovagal syncopal episodes, anaphylactic shocks) manytrials of regional anesthesia have been reported with different results. With a combination of iontophoretic administration of 2 percentlidocaine for fi hour (15 min. each extremity) and spraying of a controlled amount of liquid nitrogen cryotherapy injections can beperformed painless. Frey Syndrome is a common complication following parotid gland surgery or infection and can be treated veryeffectfully with BTX. However the clinic can differ from patient to patient which causes problems for the right documentation of thehyperhidrotic area. This problem can be solved by asking the patient to mark the hyperhidrotic area on a tracing paper at home oralternatively to perform a Minor Stark Test and document it on a plastic transparency during the consultation hour. Both documentationtechniques have the advantage that they can be recorded in the patient history or can be enclosed to the correspondence.SESSION 24.30 pm / 16h30FACIAL REJUVENATION: DO THE SOFT TECHNIQUES REALLY WORK?RAJEUNISSEMENT DE LA PEAU : LES TECHNIQUES DOUCES MARCHENT-ELLES VRAIMENT ?CHAIR: ILARIA GHERSETICH PROFESSOR OF DERMATOLOGY (FLORENCE, ITALY)PETER BJERRING PROFESSOR OF DERMATOLOGY (VEJLE, DENMARK)COSMECEUTICALS: FROM SCIENCE TO CLINICAL RESULTSCOSMÉCEUTIQUE : DE LA SCIENCE AUX RÉSULTATS CLINIQUESILARIA GHERSETICH(ITALY)Intrinsic and extrinsic aging of the skin follow different pathways, but the end result is similar. Treatment options includecosmeceuticals. Wrinkles now have a greater social impact because people live longer. Science and hedonism overlap in the searchfor causes, treatments and prevention of wrinkles.The cosmetic approach to wrinkles includes: Cleansing. Idratation and Photoprotection Active ingredients go well beyond simplemoisturisers and exert a more complex activity in protecting skin from external injuries, nourishing it and removing its superficial layers.Transport systems and excipients are increasingly effective. Functional agents currently include, retinoids, anti-enzymatic agents,antioxidants (including ascorbic acid, topic genistein, N.furfuryl Adenina, ursolic acid, vegetable isoflavones, green the, vitamin E,coenzyme Q10, lipoic acid, resveratorol, l-carnosine and taurine) as well as agaricic acid and various plant extracts...Cosmetics are becoming closer to drugs in preventing and treating wrinkles.The use of topical antioxidants is gaining favor amongdermatologists because of their broad biologic activity. Many are not only antioxidants but also have antiinflammatory andanticarcinogenic activities. Thus for dermatologists these cosmeceuticals have many potential applications. In general, topicalantioxidants exert their effects by down-regulating free radical mediated pathways that damage skin.The present study will describe the science behind some of the newest topical antioxidants and outline how they can be used as partof a comprehensive skin care regimen. Growth factors play an important role in reversing the effects of skin aging mediated bychronological and environmental factors.Excessive oxidation of intra- and extracellular components result in breakdown of collagen and elastin network in the dermis andproduce the effect of facial aging. Topical application of human growth factors in multiple clinical studies has been shown to reducethe signs and symptoms of skin aging, including statically significant reduction in fine lines and wrinkles and increase in dermalcollagen synthesis. More double-blind and controlled studies are needed to confirm the preliminary clinical effects of growth factorproducts, and more controls on product quality and stability need to be established.We present an update of the following categories of cosmeceuticals: antioxidants, growth factors, peptides, antiinflammatories/botanicals,polysaccharides, and various plant extracts.36

FACIAL REJUVENATION: WHY TO USE MESOTHERAPY?POURQUOI UTILISER LA MESOTHÉRAPIE POUR LE RAJEUNISSEMENT FACIAL ?PHILIPPE PETIT(FRANCE)EnglishThe means of prevention and treatment of the cutaneous ageing are numerous, but, whatever they may be, their efficiency is alwayslimited and they cannot totally prevent an inexorable evolution.But whatever the methods of prevention and treatment may be, obviously, you never will forget the elementary precautions and naturalprotection: ban the sun exposure, the tobacco, alcohol, and have a reasonable food and a way of life healthy.In aesthetic medicine, we attempt to fight against the cutaneous ageing by preserving as well as possible all the qualities of the skin,the dermis and the hypodermis.For it, we have various means: the beauty care advices, masks, fillers, laser, radio frequency, peelings, mesotherapy.Why did mesotherapy becomes an indispensable element in the prevention and the treatment of the cutaneous ageing in such a shorttime?Mesotherapy is not a standard treatment, but adapts itself to every individual, to every particularity and especially to the age of ourpatient, also the first consultation is essential even major.The Glogau's classification allows us to establish a diagnosis, a protocol, a rhythm and a number of the sessions.AESTHETIC DERMATOLOGY & SURGERYThis Glogau's classification defines 4 stages of photo ageing and their main signs and we are going to be directly able to adapt themesotherapic coverageSTAGE 1:25-35 years - Small wrinkles around the eyes, no skin relaxationTreatment : vasodilators - vitamins - procaïne - intra-epidermic ( I.E.D) technique1 treatment (rarely 2) of 4 sessions a year - 1 session a weekSTAGE 2:35-50 years - Wrinkles and keratosis rising, dyschromias, started then spontaneous cutaneous relaxation, at the beginning ofhypodermic thickening.Treatment :.1st syringe identical to the first one..2nd syringe: silicium - procaïne - vitamins - no reticular hyaluronic acid (AHNR) - calcitonin in I.E.D1 - 2 treatments of 4 sessions a year - 1 session every 2 weeks to alternate with the other means chosen according to the type of skin.STAGE 3 :50-65 years - Permanent wrinkles with confusions of the pigmentation and telangiectasias,spontaneously visible relaxation, ptosis.Treatment :1st syringe identical to the first one2nd syringe: silicium - procaïne - vitamins - HANR - calcitonin.Technique : papules and in superficial intradermic2 treatments of 4 sessions a yearSTAGE 4:65-75 years - Wrinkles of any types, ptosis, keratosis, and when cutaneous excess and fatty excess coexist.Treatment :1st syringe identical to the first one2nd syringe: silicium - procaïne - vitamins - HANR - calcitoninTechnique : papules and in superficial intradermic3rd syringe: lipolytic if need, to relieve the fat zones in excess loads with the phosphatidylcholine, or still much better by using thetechnique of mesodissolution2 treatments of 4 sessions a year1 session of lipolysis a week during 4 in 8 weeksConclusion: Mesotherapy is the indispensable assistant in the prevention and the treatment of the cutaneous ageing today.Its efficiency comes because at every stage a specific treatment is brought and this according to the anatomopathology.Mesotherapy must be mostly associated to the other means, chosen according to the specificity of every patient.Mesotherapy "does not invent". To have a perfect optimization, it must be learnt and understood and not used in "standard cocktails".And never forget the global care of our patient.FrançaisLes moyens de prévention et de traitement du vieillissement cutané sont nombreux, mais quels qu'ils soient, leur efficacité restetoujours limitée à savoir qu'ils ne peuvent pas totalement empêcher une inexorable évolution.Mais quelques soient les méthodes de prévention et de traitement utilisées, il ne faut évidemment jamais oublier les précautionsélémentaires de protection naturelle : proscrire l'exposition solaire, le tabac, l'alcool et avoir une alimentation et un mode de vieconformes et raisonnables.En médecine esthétique, nous nous attachons à lutter contre le vieillissement cutané en conservant le mieux possible toutes lesqualités de l'épiderme, du derme et de l'hypoderme.Pour cela nous avons différents moyens : les conseils cosmétologiques, les masques, les fillers, le laser, la radio fréquence, lespeelings, la mésothérapie.Pourquoi la mésothérapie est-elle devenue en si peu de temps un élément indispensable dans la prévention et le traitement duvieillissement cutané ?37

La mésothérapie n'est pas un traitement standard, mais s'adapte à chaque individu, à chaque particularité et surtout à l'âge de notrepatient, aussi la première consultation est essentielle voire capitale.La classification de Glogau nous permet d'établir un diagnostic, un protocole, un rythme et un nombre des séances.Cette classification de Glocau définit 4 stades de photo vieillissement et leurs principaux signes et l'on va pouvoir directement adapterune prise en charge mésothérapique.AESTHETIC DERMATOLOGY & SURGERYSTADE 1 :25-35 ans - petites ridules périorbitaires, pas de relâchement cutanéTraitement : vasodilatateurs - vitamines - procaïne - en intra épidermique (I.E.D.)1 cure (rarement 2) de 4 séances par an - 1 séance par semaineSTADE 2 :35-50 ans - rides et kératoses naissantes, dyschromies, relâchement cutané déclenché puis spontané, début d'empâtementhypodermique.Traitement :1e seringue identique à la précédente2e seringue : silicium - procaïne - vitamines - acide hyaluronique non réticulé (AHNR) - calcitonine en I.E.D.1 à 2 cures de 4 séances par an - 1 séance toutes les 2 semaines à alterner avec d'autres moyens choisis en fonction du type de peau.STADE 3 :50-65 ans - rides permanentes avec troubles pigmentaires et télangiectasies, relâchement spontanément visible, ptose.Traitement :1e seringue identique à la précédente2e seringue : silicium - procaïne - vitamines - HANR - calcitonine en papules et en intra dermique superficiel2 cures de 4 séances par anSTADE 4 :65-75 ans - rides de tous types, ptose, kératose, excédent cutané et excédent graisseux co-existent.Traitement :1e seringue identique à la précédente2e seringue : silicium - procaïne - vitamines - HANR - calcitonine en papules et en intra dermique superficiel3e seringue : lipolytique si nécessaire pour décharger les zones adipeuses de surcharge avec de la phosphatidylcholine ou bien mieuxen usant de la technique de mésodissolution.2 cures de 4 séances par an1 séance de lipolyse par semaine pendant 4 à 8 semainesConclusion : La mésothérapie est aujourd'hui l'auxiliaire indispensable dans la prévention et le traitement du vieillissement cutané.Son efficacité vient du fait qu'à chaque stade un traitement spécifique est apporté et ceci en fonction de l'anatomopathologie.La mésothérapie doit le plus souvent être associée à d'autres moyens, choisis en fonction de la spécificité de chaque patient.La mésothérapie " ne s'invente pas ". Pour avoir une optimisation parfaite, elle doit être apprise et comprise et non pas utilisée en "cocktails standards ".Et ne jamais oublier la prise en charge globale de notre patient.IPL FOR SUPERFICIAL REJUVENATIONIPL POUR LE RAJEUNISSEMENT SUPERFICIELLEONARDO MARINI(ITALY)Intense Pulsed Light sources have been proved quite successful in treating superficial UV-induced skin alterations. Better technologyallows more predictable spectral band emissions during each pulse and different spectral band intervals can be selected to effectivelyand safely treat a consistent number of skin alterations involving different skin phototypes. Longer pulse durations can also induce apositive bio-stimulation of dermal fibroblasts improving skin texture and elasticity. Recently intense polychromatic light sources havebeen combined with effective "treatment enhancers" like pre-application of low concentrations of 5-ALA (photodynamic rejuvenation),post-applications of low concentrations of TCA (photopeel), concomitant RF thermal modulation of dermal tissue (ELOS technology).All these combinations have proven to increase the efficacy of rejuvenation treatments, decreasing the number of sessions requiredto obtain favourable clinical results and increasing patients' satisfaction. Technique refinements are constantly presented confirmingthe positive interest of physicians to use combination treatment strategies.LED: FROM SCIENCE TO CLINICAL RESULTSLED : DE LA SCIENCE AUX RÉSULTATS CLINIQUESMARIO TRELLES(SPAIN)Excessive skin exposure to solar UV brings about detrimental histological changes in skin, which combine with and accelerate theeffects of chronological ageing, and which lead to the lax, dull and wrinkled appearance of "old skin".Among the various available new technologies that use light to repair skin damage caused by overexposure to light, the use of quasimono-chromatic light produced by LEDs is an interesting alternative, with the advantages of being painless, capable of obtaining38

improved skin characteristics and with an absence of complications and high patient compliance.LEDs offer a solid state, inexpensive, robust, electrically efficient and heat-free phototherapy source. Mounted in planar arrays, thephenomenon of photon interference coupled with the excellent scattering of light characteristics in the red and near-infraredwavelengths produces a zone of extreme photon intensity beneath the surface of the target tissue, in a completely athermal andatraumatic manner. Multiphoton absorption becomes an effective, photobiologically sound skin rejuvenation treatment.Although other photo-ablative techniques are regarded as the "gold standard" in the rejuvenation of seriously damaged aged skin, theuse of LED therapy is simply an excellent option alone or in combination with the other treatment modalities. For example, whenadjunctive LED therapy is given in a series of sessions after ablative resurfacing treatment, it shortens the downtime even further soLEDs can be factored into the equation of actions which have an effect on the total benefits that light can achieve in the rejuvenationof skin.LED therapy reduces wound tissue healing time and prevents possible long-lasting signs of erythema after fractional resurfacing.Combined LED therapy as an aid to fractional resurfacing should be implemented and continued in order to sustain the good resultsand maintain skin health.In addition, LED energy is an excellent activator of new liposome-delivered low- strength 5-ALA for painless skin rejuvenation, havingmuch more specificity for the target porphyrins than broad-band IPL energy.AESTHETIC DERMATOLOGY & SURGERYSUPERFICIAL PEELS: INDICATIONS AND CLINICAL RESULTSPEELINGS SUPERFICIELS : INDICATIONS ET RÉSULTATS CLINIQUESNICOLAS BACHOT(FRANCE)I2PL AND PHOTO-DYNAMIC THERAPY WITH ALA PHOTO-SPRAY TO TREAT SKIN DAMAGES IN A SOFTER, GENTLER WAYI2PL ET THÉRAPIE PHOTO-DYNAMIQUE AU PHOTOSPRAY ALA POUR TRAITER LES PROBLÈMES DE PEAU EN DOUCEURPETER BJERRING(DENMARK)RADIO-FREQUENCY (MONO/BI POLAR SYSTEMS): INDICATIONS AND CLINICAL RESULTSRADIOFRÉQUENCE (SYSTÈMES MONO/BIPOLAIRES) : INDICATIONS ET RÉSULTATS CLINIQUESMICHAEL KAMINER(USA)Radio-frequency treatments have evolved significantly over the past several years. Not only has predictability increased, but the qualityof the results for most patients has improved as well. Furthermore, radio-frequency skin tightening is performed not only on the face,but has now moved to other parts of the body with terrific success. Areas commonly treated include the abdomen, posterior upperarms, as well as cellulite changes on the thighs.Improvement in results has largely been obtained by using moderate fluences associated with multiple passes. This has been the casenot only with the Thermage technique, but with many other skin tightening devices. Multiple passes at lower fluences has proven todramatically improve the quality of results, improve safety, and increase the percentage of patients who respond to treatment.This lecture will review some of the latest updates in radio-frequency skin tightening, as well as useful patient selection techniques.NON-ABLATIVE LASERS: PERSONAL EXPERIENCES WITH THE NEW FRACTIONAL CO2 LASER AND RADIOFREQUENCYLASERS NON ABLATIFS : EXPERIENCES PERSONNELLES AVEC LE NOUVEAU LASER CO2 FRACTIONNEL ET LA RADIO FRÉQUENCEANTHONY BENEDETTO(USA)Radiofrequency technology is a non-ablative way to rejuvenate the skin by heating the dermis without visibly damaging the epidermis.Heating the dermis denatures damaged and senescent collagen and soft tissues thereby promoting neocollagenesis, which enhancessoft tissue volume while re-supporting and tightening the skin. Radiofrequency can be produced by monopolar or bipolar devices. TheAluma (Lumenis, Ltd., Yokneam, Israel) is a bipolar device that also uses a vacuum system to control further the depth and directionof the radiofrequency distributed within the dermis. Tightening and rejuvenation of the deeper strata of the skin complements the subablative,more superficial results of fractional CO2 laser, 'Active FX' resurfacing.CO2 "sub-ablative" technology is currently playing a new role in laser photorejuvenation. With the introduction of the new 'Active-FX'technique produced by the "Cool-Scan" technology utilized in the updated UltraPulse Encore CO2 laser (Lumenis, Ltd., Yokneam,Israel), "sub-ablative" fractionated epidermal and dermal treatments are proving to be highly effective in minimally invasive facialrejuvenation. 'Active-FX' settings use lower, less destructive fluences than the older ultrapulsed CO2 lasers while still providingepidermal and dermal ablation down to the superficial papillary dermis with the predictability needed to achieve the desired collagentightening and remodeling with minimal morbidity and downtime. The results are seen as an improvement in mild to moderate rhytides,skin tone and dyschromias with a reduced risk of scarring and pigmentary changes previously experienced with the higher pulsedensity and fluences of the older CO2 laser techniques.39

Thursday April 10 / Jeudi 10 AvrilAESTHETIC DERMATOLOGY & SURGERYROOM / SALLE 252 ABAESTHETIC DERMATOLOGY & SURGERYSESSION 3CONTRIBUTING LECTURES IN AESTHETIC DERMATOLOGY AND SURGERYCONFÉRENCES PARTICIPATIVES EN DERMATOLOGIE ET CHIRURGIE ESTHÉTIQUESCHAIR: NICOLAS BACHOT DERMATOLOGIST (PARIS, FRANCE)OLIVIER CLAUDE PLASTIC SURGEON (PARIS, FRANCE)2.00 pm / 14h00A CASE REPORT: INTRACTABLE BODY DYSMORPHIC DISORDER - EFFECT OF PSYCHIATRY CONSULTATION AFTERUNDERGOING FREQUENT COSMETIC SURGERIESUN CAS CONCRET : TROUBLE DISMORPHIQUE INCURABLE - LES EFFETS D'UN SUIVI PSYCHOLOGIQUE APRÈS DENOMBREUSES OPÉRATIONS CHIRURGICALES COSMÉTIQUESSATOKO HAMANAKA(JAPAN)Introduction: We are likely to encounter increasing numbers of patients who are never satisfied with cosmetic interventions, despitegood procedural outcomes. Some of these have a psychiatric disorder called 'Body Dysmorphic Disorder (BDD)'.We would like to present a typical case of BDD and the proper attitude cosmetic surgeon should adopt toward this kind of patients sothat we would like to raise your awareness of this disorder, discuss some simple screening questions and better ways for managingthis challenging disease.Case: 34-year old Asian maleOver the past 4 years, he had undergone 4 procedures on his nose eyes and cheekbones, in order to enhance his appearance. Andhe wanted another rhinoplasty because his nose was still 'wired like witch'. Actually the nasal exploration has shown nodysfunctionated, though he believed that his life would dramatically change after the 3rd rhinoplasty.When he left home, he always wore big dark pair of sunglasses, hat, and mask. He claimed that people take special notice of hissupposed defect.He was significantly less functional at school, in his social life, and in personal relations besides being more avoidant.He denied an excessive preoccupation with his appearance. He admitted, however, to spending 4-5 hours /day either thinking abouthis appearance or checking himself in the mirror. Also, he had some delusional thinking and delusions of reference.His surgeon was increasingly concerned that his perceptions of the flaws in his appearance were distorted and that additional surgerywould further exacerbate his distress.Treatment: After some persuasion, he agreed to a trial of a selective serotonin reuptake inhibitors (SSRIs). Paroxetine 30mg workedwell for his depressive mood and anxiety, but not for his delusional complaints. After 4 months of starting the treatment, he had onlylimited improvement. So we added antipsychotics. We started on risperidone 2mg, and was maintained at 4mg.Also he treated in small groups that met for 18 weekly 90-minute sessions. He improved over the course of treatment, with reductionsin BDD symptoms. About 7 months later, his concern about his appearance was declined, raised his self-confidence, and he could goout more often. Unfortunately, he has only got part-time jobs because of his intractable social phobia.Typical course of BDDIn general, it is said that the rate of BDD among cosmetic surgery patients ranges from 7% to 15%. Especially the rate of male patientswith BDD is higher than that of female.Even though BDD appears unlikely to get better with these treatments, many patients who initially consult surgeons or dermatologistsmay be reluctant to see a psychiatrist. Patients with BDD tend primarily to visit a cosmetic surgeon or dermatologist for relief withdistinct plans for surgical correction of their 'deformity'.Although most people are satisfied with cosmetic surgery, this doesn't appear to be the case for patients with BDD. Many cases ofBDD actually get worse after surgery or medical treatment. Psychiatric treatment is more likely to be helpful and is a much moreconservative approach. The results are not irreversible, as they may be with surgery. There is nothing to lose by trying it. A successfultreatment can relieve the patients from their distress and improve the quality of life substantially. Surgical results that are not acceptedby the patients can end in a tragedy for either the patients or the surgeons.We often use a combination of medications and psychotherapy.- Medications: Serotonin reuptake inhibitors (SSRIs) & Antipsychotics- Psychotherapy = Cognitive behavioral therapy(Helps the patients to enter social situations without covering up their defects)40Advice for many surgeons and dermatologists1- Assess the patient's attitude and emotions toward the aesthetic problem and the level of distress and disability associated with it.2- Determine whether there is any functional impairment, such as social avoidance, due to anxiety about the perceived defect.3- Be on the alert for unrealistic expectations about the outcome of a procedure.4- Review past cosmetic interventions, including the number of previous procedures and their cosmetic and psychosocial outcome.Be on the alert for patients who have had numerous procedures performed by many practitioners, particularly when they expressdissatisfaction with procedures that are actually technically acceptable.5- Take a through history of the patient's psychiatric background and current mental state.6- Listen but Do not agree.We would like to emphasize the need to assess patient vulnerability and psychological problems, primarily to avoid exposure topotential treatment stressors.

STRIAE DISTENSAE TREATMENT IN ACCORDANCE WITH THEIR DEPTH AND CLASSIFICATIONTRAITEMENT DES VERGETURESPHILIPPE DEPREZ(SPAIN)Until now, all the treatments of stretch marks have been disappointing, because of their complete or relative inefficiency or high risk ofside effects. New technologies are nevertheless available that allow to show good results in all types of striae distensae.Stages 1 and 2A could be enhanced by simple treatments combining a superficial abrasion of corneal layer and further topicalapplication of mixtures compounded of vitamins, trace elements, reparing and stimulating compounds mixed with hyaluronic acid.Abrasion allows a deep dermal penetration of active products, after what, non thermogenic monopolar radiofrequences applicationbrings the actives into the cytoplasm, through cells membranes and allow a maximal action of active repairing molecules.From stage 2B and further ones, chemical peelings will be a more effective treatment for these old and/or atrophic stretch marks butit has to penetrate very deeply in the skin to possibly enhance or (partially) remove striae distensae.So, as a precaution, we'll be careful selecting indications and depth of the protocol.This chemical treatment is a versatile combination of 3 techniques: sandbrasion to a precise level, followed by the application of EasyTCA peel solution and occlusion of the post peel mask of this peeling during a period of 12 to 24 hours. Any physician using thisprotocol should have a good experience of deep peels to be able to assume a difficult follow up. The patient should be followed up atdays 1,3 and 6 after the procedure and benefit of a prevention of PIH. (bleaching-blending cream and sun screen SPF 50 + HSPinducers). The number of necessary sessions depends on the depth and atrophy degree of the marks (between 2 to 6 sessions, oncea month ). The results depend on the depth of the treatment and the number of sessions. In the majority of cases of old atrophic stretchmarks, the patient considers that the skin is progressively better after each session.Conclusions: Different types of striae distensae can be progressively but definitively enhanced by different depths of treatments.AESTHETIC DERMATOLOGY & SURGERYCOMPARATIVE STUDY OF HYALURONAN GELS AT D0 AND D14ETUDE COMPARATIVE DES GELS HYALURONIQUES À D0 ET D14PATRICK MICHEELS(SWITZERLAND)Summary: Since 1996, we inject hyaluronic acid (HA) in our patients face. But, do we know exactly what we do, what we inject, whereH.A. is deposited, how it is digested, what we induce in the dermis after those injections?When you ask colleagues those questions, most of them will answer no!The aim of this presentation is to resume what we know about different gels of HA, present on the market, on the bio-chemical field,and more specially on the histological one. This histology is realised at D0, T0, just after injection and D 14.This is an introduction to a bigger study, not yet finished, in collaboration with the HCU Geneva, a long-term study on human patients,with human biopsies. Those universitary study results are not yet available.Introduction: Hyaluronic acid (HA), a natural component of the extracellular matrix is used since more than 11 years in the field ofAethetic Medicine.Because of its specific nature (natural sugar without any specificity of species or organ), H.A. seems to be the best wrinkles filler.In the skin, its natural half-live is very short (3 days). To obtain a long lasting effect, HA had to be cross-linked.Most often is BDDE used, the less toxic cross-linking agent, but other molecules may be used, like Di-Epoxy Octane.In the cross-linking process, there are 3 initial classic steps, described since more than 20 years.The manufacturers have tried to have a better cross-linking technology for a longer lasting effect.The result of the reactions gives gels different properties.We were schemed by some reactions we have observed since 11 years, and wanted to know better the products we inject in thepatients face.What we don't know exactly is :1. How does each gel take place in the dermisa. just after the injection?b. is there a immediate inflammatory reaction?c. after a short and a long time?d. what do those fillers induce in the dermis?Method: First of all, we have asked the companies to explain as best as possible the different techniques they use to cross-link thenatural HA.We have asked to the "Ecole Nationale Supérieure de Chimie" of Mulhouse-France and a private laboratory to examine some samplesof HA syringes of the swiss market.Bio-chemical composition, pH, Osmorarity, rheological propreties etc were subjects of investigation by different techniques.Some tests of elasticity, by simple traction of the gels with a Adson pliers and cohesivity, by mixing the gels into physiological serumwith some alcohol drops, were realised very simply in our own office.Some patients have agreed to have biopsies by punch of 3 mm after intradermal injection tests of 0.2 ml of different gels on thebuttocks, 10 cm outside the spinal line, and sometimes at 12 cm.The following gels were injected :NASHA ®HYLACROSS ® 24 HV from Europe and USAMatrice 3 D ® 24 XPCPM ®The biopsies, realised under local anesthesia with lidocaïne 1% were examinated by an independent histopathologist in a wellknownprivate laboratory of Geneva.The different colourations were classic, specially Alcian Blue and Colloïdal Iron stain. We have shown some biopsies at the HCUGeneva, were they also were examinated, specially by Colloidal Iron stain.41

Results:Thanks "Ecole Nationale Supérieure de Chimie" of Mulhouse-France and a private laboratory, we know that:A. Bio-chemically, all the H.A. fillers on the market are nearly the same.B. There are, for the moment, 2 types of gels : mono- and biphasique.AESTHETIC DERMATOLOGY & SURGERYBy the little experimentation in our office, we know that:A. some gels are cohesive, other non cohesiveB. some gels are elastic, other non-elasticC. some gels are changing from one year to another oneThe differences are essentially:1. the control of Osmolarity2. the cross-linking level, the technique of cross-linking and the calculation of this level.3. the nature of the gel : a. bi- or monophasic gelb. cohesive or non cohesive gelc. mono- or polydensified gel.BiopsiesAt D0, we may say that:1. There is no inflammatory reaction just after injection.2. There are, at D0, 3 different ways of diffusion-placement of the gels.3. This is probably a consequence of the different cross-linking processes.At D 14, no visible changes with all the different used colourationsConclusion: If there are some differences in cross-linking techniques, bio-chemical properties, final nature of hyaluronic acid gels, themost important thing to know, when we inject them, is to remember that, because of those differences, gels diffuse and are placed inthe dermis on different ways.Possibly, dermis structures also have an influence in the repartition of the different gels.There is, for the moment, we have a partial answer to questions c and no answer to question d. The results of the long-termcomparative study at HCU Geneva will probably give the answers we are waiting for.THE 4 R'S OF FACIAL REJUVENATIONLES 4 "R" DU RAJEUNISSEMENT FACIALSAM ASSASSA(USA)The 4 R'S of Facial RejuvenationIn order to achieve the best results in facial rejuvenation we need to understand and properly analyze the aging face. My presentation willcover the etiology of face aging, how to restore facial symmetry and create overall harmony of the face without causing any major in 3 Dapproach.This is an educational presentation to help attendees understand the aging process of face, put together a proper plan of action, by usingan integrated approach that combines proprer analysis of aging face and applying the 4RS of Face Rejuvenation to symmetry andharmony.The vertical temporal lifting: A short pre-capillary scarTHE VERTICAL TEMPORAL LIFTING: A SHORT PRE-CAPILLARY SCARLE LIFTING TEMPORAL VERTICAL : UNE PETITE CICATRICE PRÉ-CAPILLAIREJOHN CAMBLIN(FRANCE)EnglishPreceded by a liposuction of the oval and neck, this surgical technic gives satisfactory results in a simple manner and with quicksurgical cares.The skin is undermined to the corner of the mouth and the excess obtained by a strict vertical traction is resected : threedermoaponevrotic stitches of a non absorbable thread, malar, jugal and temporal are tied, giving a more lasting result. On the DVD,the patient has the facial ageing stigmas which necessitate a conventional face lifting. However, the vertical temporal lifting with a shortprecapillary scar gives the same effect and, perhaps, a more natural look.FrançaisLe lifting vertical temporal -Une incision précapillaire courte.Précédée d'une liposuccion de l'ovale et du cou, cette technique chirurgicale simple donne des résultats satisfaisants et des suitesopératoires rapides. La peau est décollée jusqu'à la commissure buccale et l'excédent obtenu par une traction strictement verticaleest alors réséqué : trois points de fil non résorbable, malaire, jugal et temporal, prenant le derme et l'aponévrose sous-jacente sontfaits, apportant un résultat durable.Sur le DVD, la patiente présente tous les stigmates du relâchement cutané facial et un lifting classique en est l'indication. Cependant,le lifting vertical temporal avec incision précapillaire courte donne un résultat identique et, peut être, un aspect plus naturel.permanent anesthesia of the scalp that can accompany Coronal and Trichophytic lifts. (More then 800 Patients)42

FOREHEAD AND BROW REJUVENATION. AN ALTERNATIVE APROACHRAJEUNISSEMENT DU FRONT ET DU SOURCIL : UNE APPROCHE ALTERNATIVENEDIM PIPIC(AUSTRIA)The endoscopic Trichophytic lift is an excellent and flexible alternative in brow and forhead rejuvenation.There is limited morbidity andelevation of the hair linie is avoided.The neurovascular bundle is minimally disturbed avoiding the prolonged and occasionallyA NEW GENERATION OF HYALURONIC ACIDSUNE NOUVELLE GENERATION D'ACIDES HYALURONIQUESMICHAEL WEIDMANN(GERMANY)AESTHETIC DERMATOLOGY & SURGERYIn the last years there were a lot changes and progress in the aesthetic procedures including the minimal invasive techniques.In the uge number of dermal fillers it is more and more important, that the physician has a knowledge about the production process ofthe different injection materials. So he has the possibility to treat the patients in an individual way.With the new developments of dermal fillers the risk of side-effects are sufficiently reduced.The newest developments in the field of hyaluronic acids are presented. The own experiences and results in the treatment of 50patients with a new hyaluronic acid generation will be shown in this presentation. An overview of the side-effect treatment of fillermaterials and new treatment options will also be presented.TWELVE-MONTH PERSISTENCY AND SAFETY OF GLYMATRIX COLLAGEN IN THE COSMETIC CORRECTION OFNASOLABIAL FOLDSPERSISTANCE D'UN AN ET SÉCURITÉ DU COLLAGÈNE GLYMATRIX POUR LES RETOUCHES COSMÉTIQUESDES PLIS NASOLABIAUXPAUL LORENC(USA)Background: Soft tissue augmentation has become increasingly important as more subjects seek to correct wrinkles and folds in theskin using techniques that do not require major surgical procedures. Injections of collagen were first used for cosmetic application in1977. Collagen products manufactured from bovine sources continue to require skin testing due to the prevalence of hypersensitivityreactions.Porcine Type 1 (dermal) collagen is known to have low immunogenicity and has therefore been used to correct dermal defects for overa decade. Glymatrix collagen has an extremely low immunogenic potential and does not require a skin pre-test. In the 6-month pivotalevaluation, 164 subjects were screened and received a skin test injection. One hundred, forty-nine subjects with bilateral nasolabialwrinkles (MFWS > 2) were randomized to receive both Glymatrix Collagen and HA on contralateral sides of the face. Subjects couldreceive one touch up injection 2 weeks after the initial injection if needed to obtain an optimal cosmetic result as assessed by theinjecting investigator.The majority of study subjects were female, Caucasian, and Skin Type I to III. Mean age was 55.7 + 8.3 years. Fifty-eight adverseevents were reported during the skin test safety evaluation period (prior to any facial injection). Of the screened subjects, 24 (14.6%)had events considered to be device-related with administration site reactions being the most frequently reported. Of the randomizedsubjects induration (noted in this trial by subjects and investigators) and bruising occurred more frequently with HA compared withGlymatrix collagen following initial injection (27.7% and 23% for induration; 23% and 18.2% for bruising respectively). Edema andbruising were more frequently observed with HA compared with Glymatrix collagen after touch up injection (34.2% and 29.9% foredema; 13.2% and 5.2% for bruising respectively). No subjects were discontinued during the 6-month inferiority period due to positivehypersensitivity reactions. In addition, following optimal cosmetic result, there was no difference in the wrinkle severity scale score(p0.05) noted. Thepurpose of this 9 and 12-month evaluation was to demonstrate Glymatrix collagen device persistency and to assess long-term safety.Methods: The Glymatrix collagen areas were further evaluated after unblinding at the 9 and 12-month time points. Device persistency(defined as having at least 50% of treated wrinkles maintaining a 0.5 correction on MFWS), Global Improvement Assessment (GIA),and adverse events were also assessed. Non-inferiority and statistical comparisons between dermal implants was not completed dueto insufficient statistical power.Results: One-hundred and forty-six subjects were evaluable at 9 months and 145 were evaluable at 12-months. Three subjects werediscontinued: one was loss to follow-up; one at the request of the subject; and one due to the diagnosis of chronic illness. Devicepersistency was maintained in over 75% of subjects at 9 and 12 months. The GIA, as assessed by the blinded evaluating investigator,was over 97% and over 86% improved at 9 and 12 months respectively. Adverse events were primarily related to injection sitereactions and were of a short duration, limited to the first few weeks of this study. Bleeding, bruising, and swelling were more commonfollowing the injection of HA, while subjects reported feeling their Glymatrix more frequently. No long-term adverse events or positivehypersensitivity reactions were noted.Conclusions: Glymatrix collagen demonstrated unequivocal device persistency in this, one of the largest long-term evaluations ofdermal fillers.43

SKIN DEFECTS FILLING AND FACE REMODELLING IN THE SAME SESSION. ATLEAN ß TCP: A NEW AND INNOVATIVEAPPROACH TO FACE REJUVENATIONCOMBLEMENT DES IMPERFECTIONS DE LA PEAU ET REMODELAGE DU VISAGE EN UNE SEULE SÉANCE. ATLÉAN ß TCP :UNE APPROCHE NOUVELLE ET INNOVANTE DE RAJEUNISSEMENT DU VISAGERICCARDO FORTE(ITALY)AESTHETIC DERMATOLOGY & SURGERYBackground: Skin defects correction, like furrows, wrinkles, scars and facial re-modelling, represent a large part of the patient'sdemand in medical aesthetic treatements.Many new products and tecniques has been introduced during the last years, however, not many of the large number of injectablesintroduced during the last years can claim uniques and original features and performances. Here I am discussing a product claimingto fill and to biostimulate during the same session.Patients Material Methods: 40 patients has been treated for indications wich are the same of fillers and biostimulators: furrows andwrinkles, loose skin, photoaging and lipoatrophy. The ideal patient is up to middle aged, is asking for immediate but long termcorrection and wish a general skin quality improvement as well, in addition, does prefere not to go thru a long and expensive serie ofinjection sessions.The product, Atléan ß TCP, is available in pre-filled 1 ml syringes, is biocompatible, requires no preliminary test, is total reabsorbableand the experience showed that is easy and practical to inject.The tecniques are a combination of fillers and biostimulators, a 100% initial correction is suggested. Injection trauma is very limited noside effect has been recorded.Results: After one year of treatments and patients follow up, the results are very encouraging: high efficacy, cost effectivness andgood patients compliance has been recorded.The filling is immediate and is gradually decreasing along some weeks showing a good coordination with the effect of biostimulation,arising around 40 days after injection, acting strongly and which effect is completed few months later.Very good skin texture and skin brightness and an average of correction persistance of almost one year are basis for a very goodpatients compliance.Conclusions: An innovating, unique product, very often allowing for a creative and combined approach to face rejuvenation, moretime effective and cost effective than the usual current methods.THE ASSESSMENT OF RECOVERY TIME AND IMPACT OF DERMAL FILLER SECTION: THE E-ART STUDYEVALUATION DE LA DURÉE DE RÉCUPÉRATION ET PLACE DES PRODUITS DE COMBLEMENT : L'ÉTUDE D'E-ARTNOWELL SOLISH(CANADA)Background: The use of dermal fillers which are associated with recovery times of 4-7 days are not ideal in subjects with high societaldemands or in those who wish to preserve confidentiality regarding corrections and enhancement procedures without negativelyimpacting their daily activities. While clinical experience has provided many with first-hand experience to select products that can bestmatch a patient's expectations, little has been documented scientifically on the actual recovery time and the impact of filler selection.Methods: In order to assess the recovery time and overall impact of Glymatrix collagen filler (GCF), 30 subjects were recruited throughroutine clinic visits. Each was followed prospectively over a 7-14 day period with both in-office and diary documentation of aestheticcorrection satisfaction, recovery, and adverse events.Results: Recovery following cosmetic correction with GCF was rapid and met with a high degree of subject satisfaction. Adverseevents were minimal and of short duration. Conclusions: Cosmetic correction with GCF is associated with a short recovery time,allowing patients the ability to return to their normal daily routing quickly.REMODELLING THE FACE WITH VOLUMA TMREMODELAGE DU VISAGE AVEC VOLUMA TMBERNARD HERTZOG SONIA HANNOUN(FRANCE)This work started in 2005 in collaboration with Dr. Hannoun. We included approximately 80 patients in our sample population allthrough 2006. Results including 2007.We exclusively used " Voluma " TM , a new Hyaluronic acid product marketed by Laboratoire Cornéal, which has very interestingrheological characteristics, including increased elasticity (G') and stability of viscosity (G''), which leads to a G''/G' ratio close to 0,similar to a solid.We have created a new concept of injection, based on the reinjection of fat into the face (lipofilling). We replaced injection cannula withnew blunt-tipped needles which are finer and cause less trauma due to their spatula-shaped tip. The " needle " must always be orientedin the sub-cutaneous layer above the hypodermis and perfectly controlled retro-injections must be done (injecting the product whilewithdrawing the needle).2007: improving the injection with new finest needle !We have taken a new esthetic approach to the face. We have not only worked on increasing the volume caused by " Voluma " TM , wehave also used its viscoelastic properties to try to remodel the face.44

STUDY FOR ASSESSMENT OF EFFICACY OF A NON ANIMAL STABILIZED HYALURONIC ACID (RESTYLANE ® ) ONBIOMECHANICAL PROPERTIES OF LIPS. PROSPECTIVE CLINICAL STUDYETUDE DE L'EFFICACITÉ D'UN ACIDE HYALURONIQUE STABILISÉ NON-ANIMAL (RESTYLANE ® ) SUR LES PROPRIÉTÉSBIOMÉCANIQUES DES LÈVRES. ETUDE CLINIQUE PROSPECTIVEELENA GUBANOVA(RUSSIA)Introduction: Injections of HA fillers into the lips is very popular procedure in Russia. For this type of treatment we have patients withwide range of age, because reason of this procedure is not just improvement of form and volume of lips, but also prevention of lipsaging. ?ur clinical experience shows that after lips procedure we have good clinical results for skin of perioral zone indicating adecrease of perioral wrinkles. If there are numerous papers dealing with HA injections into the face skin, but there are no papers aboutHA injections into lips and measurements of the lip functional properties.Objective: To assess the efficacy of non-animal stabilized hyaluronic acid (NASHA, Q-MED) by clinical assessment and by using noninvasivemethods.Subjects: Two groups: the first one included 27 patients (mean age 41,55±13,36 ), which were treated by Restylane, and ControlGroup, 20 persons (mean age 42,65±10,67).Study design: All patients had clinical and instrumental assessment before Restylane (D0), W2 (2 weeks after treatment), M2 (2months after treatment), M4 (4 months after treatment) and 6M (6 months after treatment).Materials and methods: Biomechanical properties were measured by means of Ballistometry (Dia-Stron UK, Ballistometer BLS 780),TEWL by Vapometer (Monaderm, Courage+Khazaka, Germany), hydratation by Corneometer (Monaderm, Courage+Khazaka,Germany) and SkinChip (L'Oreal, Paris) at each visit (D0, W2, M2, M4, M6).Results: Ballistometry data show that Restylane injection makes skin of the lips less viscous (more elastic) after 2, 4 and 6 months incomparison with the baseline and with the Control Group. Results show that hydratation of the lips increases after Restylane injectionsand that the TEWL was more controlled in the treated group.Conclusion: Our pilot study demonstrated that Restylane injection has positive influence on biomechanical parameter of the skin oflips in comparison with the baseline and Control Group. Hydratation parameters exhibit also positive results. The satisfaction levelabout Restylane procedure is maximum after 2 weeks and is maintained for 6 months according to volunteers.AESTHETIC DERMATOLOGY & SURGERYAUTOLOGOUS FIBROBLASTS GRAFTING FOR FACE REJUVENATIONGREFFE DE FIBROBLASTES AUTOLOGUES POUR LE RAJEUNISSEMENT FACIALCHRISTOPH GANSS(GERMANY)EnglishWe report our experience with 141 treatments by 92 patients over 3 yearsIndication: Textural changes of face skin due to ageing. Ideally patient between 40 to 60 without too much skin sagging.Technique: A small skin biopsy is done behind the ear, then the specialised laboratory (Ticeba, Germany) will isolate the fibroblastsand culture them. We inject a first batch of 90 million fibroblasts 3 months after biopsy and another batch of 90 million cells two monthslater. The injection technique is very specific and a particular training is needed.Ideal treatments areas: face, neck and decolleté.Results: a progressive change in the skin texture occur within 2-3 months after treatment and increases for 6 months or more. Skinthickness and skin elasticity are improved with a slight tensing effect on the whole face, thus giving a real rejuvenation effect. If a facelift is indicated this technique is not replacing it.From our collective of 92 patients, 21 asked for a second zone treatment, 25 patients are currently under the treatment procedure.The limiting factor for this treatment is the price which is high due to the sophisticated technology of the laboratory work.FrançaisLe développement des techniques d'isolement et de culture cellulaire a permis une application esthétique des greffes de fibroblastes,déjà utilisées chez les grands brûlés et dans certains cas de plaies chroniques, en association ou non avec des kératinocytes.Ce traitement se fait en trois phases :1. biopsie cutanée, isolement et culture des fibroblastes.2. (J.90) première injection sur l'ensemble du visage de 90 millions de fibroblastes.3. (J.150) seconde injection sur les mêmes zones de 90 millions de fibroblastes.Nous rapportons l'expérience de plus de 57 traitements depuis deux ans réalisés chez 48 patients.Technique : Anesthésie par blocs de la face, EMLA et O2/N2O.Injection très superficielle : à la jonction dermo-épidermiqueEffets secondaires immédiats :- Erythème et œdème pendant les premières 12 h.- Quelques rares hématomes.Effets secondaires tardifs : Aucun effet secondaire durable n'a été noté, en particulier aucune évolution chéloïde.De rares irrégularités cutanées ont été parfois visibles sur les paupières inférieures pendant quelques mois.Résultats : L'amélioration de la trophlicité et de la tonicité cutanée a été notée chez la plupart des patients, débutant deux mois aprèsle traitement et se poursuivant sur un à deux ans minimum (follow-up de 27 mois).Discussion : Bien que les résultats soient difficilement objectivables, il nous a semblé important de rapporter cette première série detraitements avec Isolagen ® en utilisant cette technique d'injection. En effet, les premières publications rapportent des résultats à courtterme avec une technique de comblement et non par des injections sur toute la surface du visage.Il serait intéressant de procéder à une étude prospective, en incluant une troisième personne neutre pour l'objectivation des résultats,45

ainsi que des biopsies pré et post traitement. Toutefois il est très difficile de réaliser ce genre d'étude avec une population de patientsayant une demande esthétique et vivant à l'étranger pour une partie d'entre eux.Pour nous, les résultats sont encourageants et malgré l'arrêt de production par le laboratoire Isolagen nous allons continuer cestraitements. En effet, le laboratoire Isolagen a cessé son activité en Europe en raison de pertes financières.Seuls quelques laboratoires en Europe sont équipés pour produire les fibroblastes. Nous travaillons actuellement avec le laboratoireTiceba en AllemagneAESTHETIC DERMATOLOGY & SURGERYSESSION 44.30 pm / 16h30THE COSMETIC CONSULTATION: "COMMON BUT COMPLEX SITUATIONS "LA CONSULTATION COSMÉTIQUE : “SITUATIONS COMMUNES MAIS COMPLEXES”CHAIR: ANTONIO PICOTO PROFESSOR OF DERMATOLOGY (LISBON, PORTUGAL)GERHARD SATTLER DERMATOLOGIST (DARMSTADT, GERMANY)HOW TO EVALUATE THE PSYCHOLOGICAL PROFILE OF A NEW PATIENT IN COSMETIC SURGERY?COMMENT ÉVALUER LE PROFIL PSYCHOLOGIQUE D’UN NOUVEAU PATIENT EN CHIRURGIE ESTHÉTIQUEJOHN COTTERILL(UK)Anxiety, depression and phobias are common in the general population and some phobias, such as body dysmorphic disorder(dermatological non-disease /dysmorphophobia) present most commonly in cosmetic clinics. It is important to identify patients withemotional and psychological problems because a purely mechanistic cosmetic surgical approach may be inappropriate and make thepsychological problems much worse.There is no substitute for a good history. Delegating data collection to a non-medical manager or a poorly trained nurse is not bestpractice and often patients with significant psychological problems will not be identified before a cosmetic procedure is carried out. Theconsequences may be a suicidal patient, or an angry patient resorting to litigation.Questionnaires exist to identify, for instance, patients with depression and body dysmorphic disorder. Patients may lie, and thesequestionnaires are no substitute for a good history carried out by a caring doctor.EVALUATION OF PATIENT'S HEALTH BEFORE COSMETIC SURGERYEVALUATION DE LA SANTÉ DU PATIENT AVANT INTERVENTION CHIRURGICALEGERHARD SATTLER(GERMANY)In cosmetic surgery with the indication for anti-aging purposes, several medically relevant aspects have to be considered. The generalcondition plays the most important role, also infectious diseases as well as preliminary accidents, injuries and surgeries. Cumulatingtrauma in a minimal period of time contributes to the increase of risk for DVT.In the same manner, the psychological evaluation and condition needs to be examined.How old is the patient who wants to undergo surgery and which kind of invasiveness this procedure will probably have?In general, in cosmetic surgery, no-downtime procedures are the most preferred and performed. But the older generation intends moreand more to ask for cosmetic surgery services. This raises the potential risk of undesired situation which can bring old healthy patientsat risk during a cosmetic surgery procedure.APPROPRIATE PLAN TO USE OR AVOID MEDICATIONS BEFORE AND AFTER MEDICO-SURGICAL PROCEDURESPLAN ADAPTÉ POUR LA PRESCRIPTION ÉVENTUELLE D’UN TRAITEMENT AVANT ET APRÈS UNE PROCÉDUREMEDICO-CHIRURGICALEANTONIO PICOTO(PORTUGAL)Very important issues about your patient:Cardiac devicesAntibiotic prophylaxisAnticoagulationHistory of Herpes infectionSmoking and alcoholic habits.Pearls: Have a complete list of the patient's current medications.Don't stop medications unless absolutely indicated.Discuss with the patient GP or Cardiologist.Find out about dietary and "natural products".Use AB only in very selected occasions.Sedation: always useful…even "talkesthesia"…ADVICES TO PATIENT ABOUT FACE ENHANCEMENT: FROM COSMETICS TO SURGERYRECOMMANDATIONS AU PATIENT POUR EMBELLIR LE VISAGE : DE LA COSMÉTIQUE À LA CHIRURGIESERGE LETESSIER(FRANCE)46

ADVICES TO PATIENT BEFORE AND AFTER LASER AND IPL TREATMENTRECOMMANDATIONS AU PATIENT AVANT ET APRÈS UN TRAITEMENT LASER OU IPLLEONARDO MARINI(FRANCE)Patient-physician relationships have quite evolved during recent years due to a constantly increasing availability of conventional andadvanced communication sources where the entire spectrum of medical-surgical knowledge as well as old and brand new technologicadvances are discussed. Patients do not "shop around" just visiting and consulting different doctors' offices but also reading on theirweb sites and on the internet before making a final decision. Informed consents are an enormous problem since they must be acceptedas legal documents and should contain an enormous quantity of information, quite similar to the informative pamphlets accompanyinga drug. Unfortunately there is no standardization and extremely simple to discouraging complicated documents are available. Patientscan be scared after reading all possible complications, side and adverse effects and may even refuse treatments. This is morecommon in cosmetic indications. The "before and after" laser and IPL treatments is an important sequence of ancillary skin careregimes which are intended as an integral part of the overall procedure. Patients should be aware of the importance of thesepreliminary and following steps that will take them along the path of a predictable clinical success. Personal adjustments are alwaysnecessary since different skin types and different patients have a different skin reactivity to laser and IPL treatments. They need to beperfectly known by physicians before choosing emission parameters during their procedures. Lasers and IPL sources are responsiblefor selected thermal wounding that follow all sequential maturation processes known as tissue healing. Preparing tissues and adoptinga proper wound healing skin care do have quite a significant impact on the final outcome of our treatments. All these information shouldbe properly printed on our informed consents.AESTHETIC DERMATOLOGY & SURGERYTATTOOING: SIGNIFICANCE, RISKS, AND REMOVING PROCEDURESTATOUAGE : IMPORTANCE, RISQUES ET TECHNIQUES D’EFFACEMENTPIERCING: SIGNIFICANCE AND RISKSPIERCING : IMPORTANCE ET RISQUESNICOLAS KLUGER(FRANCE)NICOLAS KLUGER(FRANCE)Piercing has regained popularity for the past decade. It is characterized by the introduction of a "ring" usually made of surgical steel,niobium or titanium in a wide variety of anatomic locations such as noses, ears or navel.Underlying motivations for obtaining piercing are nowadays highly variable : beauty, art and fashion; individuality; personal catharsis;physical endurance; group affiliations and commitment; resistance; spirituality and cultural tradition; addiction; sexual motivation; orsometimes no specific reason.Piercing may be performed in a wide variety of anatomic locations such as ear lobes; lips; nose; auricular helix; eyebrows; nipples; naveland genitals. In practice, any part of the skin may be pierced.Various components may be found in the rings: surgical steel, niobium, titanium. Nickel, which is highly allergenic, is sometimes found.Since 2001, nickel concentration is limited up to a maximum of 0,05% in Europe.Piercing is usually performed in a " professional " parlour. The piercier has undoubtedly acquired an experience and a technique whichmake him/her a real professional. However, their knowledge in anatomy, chemistry and in the basic rules of hygiene is often limited.Delay of healing is highly variable according to the location of the ring. It usually takes up to several months before a complete healingis acquired: 6 to 8 weeks for the ears, eyebrows and lips; 3 to 6 weeks for the tongue; 2 weeks to 9 months for genital piercing accordingto the localization; more than 9 months for a navel piercing (due to chronic traumas).Two kinds of complications are considered. The ones that are independent and the ones that are specific to a localization.Complications that are common to every piercing may include :Contact dermatitis (nickel, disinfectant…) ; bleeding ; hematoma ; keloid formation ; bacterial infections with cutaneous infections (dueto S.aureus, Streptococcus A, P.aeruginosa), tetanos, osteomyelitis, septic arthritis or endocarditis and viral infections (hepatitis B +++,hepatitis C and HIV (one plausible case reported)Complications according to the localization may includeEars- Perichondritis; abcess; ear deformation; tissue tearing; embedded earringsOral mucosa- Swelling, chewing and speech disorders; perforation; tissue tearing; jewelry inhalation or swallowing; galvanism; halitosis; gingivalrecession; dental alterations: tooth fracture or chipping; nerve damage; interference with radiographs and with airways management;Ludwig's angina; uncontrolled drooling;Nose- Jewelry swallowing or aspiration; perichondritis; necrosis of nasal wall; septal hematoma formationNipple- Breast feeding impairment;Genitals (women)- Compromise of barrier contraceptivesGenitals (men)- Frictional irritation; paraphimosis; penile engorgement; priapism; recurrent condyloma; urethral rupture; urethral stricture; urinary flowinterruption; loss of the jewelry during sexual intercourseReferences1. Wohlrab S, Stahl J, Kappeler PM. Modifying the body: motivations for getting tattooed and pierced. Body Image 200;4:87-952. Guiard-Schmid JB, Picard H, Slama L, et al. Le piercing et ses complications infectieuses. Presse Med. 2000;29:1948-56.3. Meltzer DI. Complications of body piercing. Am Fam Physician. 2005;72:2029-34.4. Lopez-Jornet P, Navarro-Guardiola C, Camacho-Alonso F, et al. Oral and facial piercings: a case series and review of the literature. Int JDermatol. 2006;45:805-9.5. Tweeten SM, Rickman LS. Infectious complications of body piercing 1998;26:735-406. Dhir S, Dhir AK. Intraoperative loss of nasal jewelry: anesthetic concerns and airway management . J Clin Anesth 2007; 19:378-38047

Friday April 11 th / Vendredi 11 AvrilAESTHETIC DERMATOLOGY & SURGERYBLUE AUDITORIUM / AMPHI BLEUAESTHETIC DERMATOLOGY & SURGERYSESSION 58.30 am / 8h30LIP ARTISTRY AND LOWER FACE REJUVENATION: MEDICAL AND SURGICAL APPROACHESEMBELLISSEMENT DES LÈVRES ET DU BAS DU VISAGE - APPROCHES MÉDICALE ET CHIRURGICALECHAIR: ANTOINE PARASKEVAS PLASTIC SURGEON (PARIS, FRANCE)MARK LUPIN DERMATOLOGIST (VICTORIA, CANADA)ANATOMY OF THE AGING LOWER FACE (FILM WITH CADAVER DISSECTION)ANATOMIE DU BAS DU VISAGE VIEILLISSANT (VIDÉO DE DISSECTION SUR CADAVRE)FABIO INGALLINA(ITALY)Beauty is individual, aging as well.However, aging of the face follows certain common and predictable patterns Genetics and environment are guiding together the agingprocess which concerns all the tissue layers from the skin to the bone.As years go by, there is a progressive descent of the soft tissues due to gravitational forces and consequently wrinkles, furrows andfolds appear.These changes generally become apparent in a woman's skin in her mid-30 s when oestrogens level start to decline.Actinic damage of the skin and photo aging result in loss of collagen and elastin fibres in the dermis and the skin becomes thinner andinelastic.Fat, unlike muscle, is supported only by the facial ligaments of the face. Progressive facial and ligamentous laxity causes fat descentand sagging.In the lower face, fat descent along with attenuation and lengthening of the orbicularis oris and depressor anguli oris muscles, createsa downward slant of the corner of the mouth and the appearance of " marionette lines ".The falling fat accumulates behind the mandibular retaining ligaments and creates " jowls "In the neck, the platysma muscle is also attenuated, there is pre platysmal and sub platysmal fat accumulation, submental and neckfolds and loss of the cervicomenal angle.Another process that contributes to facial aging is the loss of glandular tissue, much of the firmness of a youthful face is due to a highglandular concentration.At the bone level, osteoporosis results in skeletal resorption which alters soft tissue support.Overall, the volumetric distribution in the face is altered and, in facial rejuvenation surgical procedures, volumetric restoration is moreimportant than the amount of skin excess resected.ARTISTIC ANALYSIS OF THE HARMONY OF THE LIPSANALYSE ARTISTIQUE DE L’HARMONIE DES LÈVRESROBIN MOOKHERJEE(FRANCE)EnglishMedical or surgical correction of the lips cannot be done without an artistic approach.Analysing the harmony of lips is speaking of caracteristic elements like beauty and mobility and involving the different parts of the facelike nose chin, eyes.There is a very subjective aspect to this analysis as beauty varies during the different periods of life, and also with race, culture,fashion. But there are some basic facts that stay, that we should keep in mind to give our patients the best medical or surgical result.We will show how in different cases, different artistic approches are possible, concerning lip contour, cupid's bow, volume, oralcomissures, in connection with the rest of the face.FrançaisAnalyse artistique de l'harmonie des lèvresUne correction médicale ou chirurgicale des lèvres se doit d'être effectuée avec une approche artistique. Parler de l'harmonie deslèvres c'est parler de beauté et de mobilité concernant d'autres éléments du visage comme le nez, le menton, les yeux, les joues.Il y a un coté très subjectif à cette analyse, puisque par définition la beauté varie selon l'age, la race, la culture, la mode de chacun.Il reste cependant des éléments constants,que nous devons garder à l'esprit pour donner le meilleur résultat médical ou chirurgical ànos patients.Nous allons démontrer les différentes approches possibles concernant l'ourlet, l'arc de cupidon, le volume des lèvres, les commissureslabiales et ceci en connexion avec le reste du visage.48

FAT GRAFTING OF THE LIPS: WHAT TO DO ? WHAT TO AVOID ?GREFFE GRAISSEUSE DES LÈVRES: QUE FAIRE ? CE QU’IL FAUT ÉVITER ?ANTOINE PARASKEVAS (FRANCE)FAHD BENSLIMANE (MOROCCO)Fat grafting of the lips, when properly planned and performed, can have excellent and very long lasting results.An attractive upper lip has a well defined white roll and philtral columns, under these filtral columns there is a well developed centralfullness. Medially to each commissure there is an other fullness but which is significantly less protuberant than the central one.In the lower lip, the white roll is less developed than in the upper lip and the anatomy of an attractive lower lip follows the shape of theupper lip in a " reverse " pattern: in the center there is a depression (opposite to the central upper lip fullness), bordered on either sideby tubercles significantly larger than the central protuberance of the upper lip.The amount of vermilion visible on the lower lip is much greater than in the upper lip.The goal of lip augmentation is to " flip out " the vermilion to create attractive and full lips, while placing the least fat volume possible.To achieve that, almost all of the grafted fat should be infiltrated superficially, immediately deep to the mucsa. Placement opposite tothe teeth provoques a" push " of the teeth to the mucosa that leads to the desired eversion.Placement into the orbicularis oris muscle should be avoided because it makes the lip thicker and prevents eversion, creating anartificial look. Also, fat should not be placed deep to cutaneous portion of the lip for the same reason.The volumes used to enhance the white roll are about 1cc, for the body of the upper lip 2 to 4 cc and in the body of the lower lip 3 to8 cc are generally needed.We use the technique of "micro fat grafting" with infiltration cannulas less than 1mm in diameter. This allows better take of the fatgrafts with less irregularitiesAESTHETIC DERMATOLOGY & SURGERYLIPS ENHANCEMENT: HOW TO ACHIEVE A NATURAL LOOK?EMBELLISSEMENT DES LÈVRES : COMMENT OBTENIR UN ASPECT NATURELMARK LUPIN(CANADA)PERMALIP ® :A NEW METHOD FOR LIPS ENHANCEMENTPERMALIP ® : UNE NOUVELLE MÉTHODE D’EMBELLISSEMENT DES LÈVRESSERGE LETESSIER(FRANCE)Multiple procedures have been already tried for lips enhancement with satisfactory results but also sometime impredictible reactionsgoing from disappointment with injection of biodegradable products to inesthetic or ugly aspect with non resorbable products.PERMALIP is a soft solid silicone implant giving a permanent and natural esthetic aspect.The procedure under local anesthesia is easy and safe and do not require repeated treatments.Complications are possible but extremely rare.PERMALIP is approved by USA FDA and is fully CE marked.We will discuss the best indications and compare with other techniques of lips enhancement.THE AGING LIPS: A PHOTOMORPHOMETRIC AND MRI BASED STUDYLES LÈVRES VIEILLISSSANTES : UNE ÉTUDE PHOTOMORPHOMÉTRIQUE BASÉE SUR L’IRMNIKLAS IBLHER(GERMANY)Introduction: A lack of scientific data about the complex three dimensional changes is the reason for the multitude of rejuvenationapproaches to the aging upper lip. In recent years rejuvenation approaches to the upper lip mainly focused on volume substitution ofpostulated volume loss by injecting various filler materials. Although regaining (temporary) volume the hereby treated lips often acquirea certain "blown up look", suggesting that this approach is not the single right answer. In this study we scientifically investigate thecomplex three dimensional changes to the aging upper lip for the first time.Methods: To achieve reliable results we performed a study with different approaches. In the first part 182 standardized subjectphotographs proportions of the upper lip were measured, compared to facial dimensions and correlated to age. In the second partthree dimensional measurements of the upper lip complex were performed on cranial MRI scans of 30 women aged 20-35 years and30 women aged 65-80.Results: Photomorphometric data shows a significant lenghtening of the upper lip and the upper lip skin with decrease of visible lipred. This is confirmed by MRI scans which prove a redistribution of the volume. The thickness at various levels of the upper lipdecreases while the length increases. Remarkably, the volume showed no changes in the two age groups. The nasolabial angledecreased with age easily explained by the well known phenomenon of ptosis of the nose. The angle between the upper lip and thevertical did not show any changes.Conclusion: Our results demonstrate that the aging process of the upper lip consist of a redistribution of the same volume fromthickness to length, but not an absolute volume loss. This can be explained by the loss of elasticity and following ptosis of the upperlip tissues. Consequently rejuvenation techniques which address the lengthening and ptosis of the upper lip might lead to a morenatural rejuvenation result. Volume augmentation as a sole approach might not address the important changes in the aging upper lip.49

WHY SURGERY FOR LIPS IS LEGITIMATE? HISTOLOGICAL ANALYSISPOURQUOI UNE PLACE POUR LA CHIRURGIE DES LÈVRES ? ANALYSE HISTOLOGIQUEVINCENZO PENNA(GERMANY)AESTHETIC DERMATOLOGY & SURGERYIntroduction: The aging lip goes along with an apparent lengthening of the upper lip which leads to an inverted aspect of the upperlip with inadequate upper incisal display and thinning of visual lip red enforcing the senile facial expression. The often postulatedvolume loss explains the popular approach to encounter the described aspects of the aging lips by using filler injections for temporaryvolume restitution. We therefore investigated aging changes of the lip histologically. The upper lip lift as a consequence of our findingsand an adequate surgical option is described and patients who underwent this kind of surgery are presented.Method: Histology:In order to correctly evaluate histological changes in the aging lip tissue samples of upper lips from female and male, young and oldpatients were taken, analysed and compared.Surgical Technique: The incision on the upper lip skin follows the contours of the base of the nose and is always extended into bothmelolabial folds in order to get more lateral lift and to avoid downturned lip corners. The tissue resection includes skin only and istypically wedge-shaped, viewed in cross-section. Meticulous wound closure produces an almost invisible scar. The operation may beperformed as outpatient surgery using local anesthesia, with intravenous sedation if requested. Commonly the lip lift is combined withother operations such as facelift, dermabrasion, autologous volume augmentation with SMAS, dermofat grafts or autologeous fatinjections.Conclusion: Histological analysis show that with aging the thickness at various levels of the upper lip decreases while the lengthincreases. Remarkably, the volume showed no changes in the two age groups. Considering these results approaches in upper liprejuvenation have to adequatly address the correction of the lengthened upper lip.The here described upper lip lift is a safe and reliable classic surgical procedure , that provides immediate, dramatic and permanentresults and most often helps to circumvent the use of fillers.SESSION 6SKIN REJUVENATION: FROM THE SIMPLEST TO THE MOST SOPHISTICATED TREATMENTSLE RAJEUNISSEMENT DE LA PEAU : DU TRAITEMENT LE PLUS SIMPLE AU PLUS SOPHISTIQUÉCHAIR: MICHAEL KAMINER PROFESSOR OF DERMATOLOGY (BOSTON, USA)SERGE LETESSIER DERMATOLOGIST (PARIS, FRANCE)11.00 am / 11h00ABLATIVE FRACTIONAL TECHNIQUE WITH CO2TECHNIQUE ABLATIVE FRACTIONELLE AVEC CO2MICHAEL KAMINER(USA)For years ablative carbon dioxide laser resurfacing was the gold standard by which other resurfacing techniques were measured.However, ablative carbon dioxide resurfacing was fraught with some significant complications, as well as prolonged recovery andhealing periods. For this reason, recent advances in fractional resurfacing have led physicians away from traditional carbon dioxidelaser resurfacing. Carbon dioxide resurfacing has recently regained popularity with the introduction of new fractional carbon dioxideresurfacing techniques and technologies. These include the new devices from Reliant and Lumenis. Additional fractional technologiesutilizing the Erbium laser from Sciton have also become increasingly popular.The reason for the increase in popularity for these ablative fractional technologies is that they provide the advantages of rapid recoveryand safe treatment, combined with the advantages afforded by previous ablative resurfacing techniques. Many of these newtechnologies allow us to approach the results previously seen with techniques that required long healing periods, but now these resultscan be obtained with rapid 3-5 day healing periods and significantly reduced risk.This lecture will detail some of the new ablative fractional carbon dioxide technologies available, the results that can be expected withthem, as well as indications for their use.ABLATIVE FRACTIONAL TECHNIQUE WITH ERBIUMTECHNIQUE ABLATIVE FRACTIONELLE AVEC ERBIUMPIERRE ANDRÉ(FRANCE)50Erbium Yag Laser: a mandatory tool in a dermatological practiceThis is an ablative laser of 2640 nm Wlength. Target is waterThis is a tool, which permits to treat a lot of skin lesions very easily.As it vaporizes lesion, histological exam is not possible, therefore the importance to treat only benign lesions.For many superficial skin lesions as hydradenomas, seborrheic keratosis, no anesthesia is required.In cases of larger or deeper skin lesions, local anesthesia is easily performed and treatment is fast and painless. In a dermatologicalpractice we can use it every day.In aesthetic indications, fine lines and wrinkles can be removed with less redness and risk of reactional hyper-pigmentation that afterCO2 laser.First systems with only short pulses gave bloody operative fields, now we can modulate duration of pulses and then obtain somecoagulation by thermal effect.As we can get thermal effect, outcome after resurfacing is similar to resurfacing with CO2 Laser.With some new systems it is possible to do fractional resurfacing and or to do stimulation for remodeling ("Smooth mode").

For 1 year we use a new hand-piece that permits us to perform a "mini-ablative" resurfacing (Pixel technology). As most of people donot enjoy with long downtime, we can use this technique for inducing healing phase and so far collagen production and wrinklesenhancement. Several sessions are required to get a nice outcome.MEDIUM AND COMBINED PEELS: INDICATIONS AND RESULTSPEELINGS MOYENS ET COMBINÉS : INDICATIONS ET RÉSULTATSPHILIPPE EVENOU(FRANCE)Full face TCA peel, alone or combined with perioaral phenol peel, is a fast, cheap, and very effective rejuvenation technique. This peelproduces good results in the treatment of actinic damage, rhytides and pigmentary dyschromias.Disadvantages are slow and rough recovery, risks of scarring and pigmentation disorders.Neck and chest have a greater tendency to scar with medium peels, and it is generally best to use superficial agents on this skin.TCA in high concentrations (50% and above), is more unpredictable and more likely than phenol to produce scarring. It often resultsin a slight texture change or slight hypopigmentation. It is recommended to use TCA 30 to 40%, or Jessner-TCA peel.TCA peel semiology must be well-known, and a close follow up is essential.AESTHETIC DERMATOLOGY & SURGERYABLATIVE CO2 LASER RESURFACING: LOCALIZED AREA AND/OR FULL FACERESURFACING ABLATIF AU LASER CO2 : ZONE LOCALISÉE ET/OU SUR TOUT LE VISAGESERGE LETESSIER(FRANCE)Since 1982 we performed more than 15000 cases of laser resurfacing.It is obvious that it is an excellent technique for facial rejuvenation but it still very operator dependent .The best esthetic result and the most easy post-operative care can be achieve using a very high power and the shortest duration ofeach pulse.If we compare the CO2 laser to more recent machine or new technology , actually not one of them can give such effect in one sessionwith a long lasting result.Complications can occur as any sugical procedures but are very rare if the physician is well trained. The acute observation of the colourof the skin after each pass give a perfect control of the depth of the laser abrasion.If a full face laser abrasion is not necessary the best areas to be treated are the peri-orbital and the peri-oral areas.ABLATIVE ERB:YAG LASER RESURFACING: LOCALIZED AND/OR FULL FACERESURFACING ABLATIF AU LASER ERB:YAG : ZONE LOCALISÉE ET/OU SUR TOUT LE VISAGELEONARDO MARINI; ALEKSANDAR KRUNIC- ANDREA DORIA.(ITALY)Er:YAG laser technology has been quite improved recently allowing physicians to precisely modulate its photo-thermally inducedclinical effects on skin. We can now span from pure "cold" ablation to "long pulse" photocoagulation, to a combination of the twoeffects together and even count on a fractional resurfacing mode. With this extremely versatile photo-thermal treatment arrayphysicians can effectively treat a large series of superficial skin alterations either alone or as part of a regional or full faceprocedure. Lighter skin phototypes are very forgiving when spot or regional treatments are performed. Darker skin phototypesusually require a full face procedure.PHENOL BASED PEELING: PARTIAL AND FULL FACE PROCEDUREPEELING AU PHÉNOL : PROCEDURE LOCALISÉE ET/OU SUR TOUT LE VISAGEMARINA LANDAU(ISRAEL)Chemical peels are one of the most powerful non-surgical rejuvenating procedures for facial skin. Deep chemical peels are based onphenol-croton oil combination in various concentrationsIn spite the fact that deep peels are known for at least one hundred years, their popularity had been changed during the time. Recentrevival of deep chemical peels is related to disappointment from CO2 laser resurfacingDeep peels are efficient for removal of facial skin pigmentations, various types of wrinkles, premalignant lesions and improvement ofacne scars. For practicing dermatologist deep peels remain the most important rejuvenating tool. With proper selection of candidates,this procedure provides long lasting results often superior to the surgical face lift.Partial peeling procedure is indicated when a localized problem occurs. Deep perioral wrinkles used to be one of the major indicationsfor partial deep peeling during surgical face lift.This approach has been almost completely abandoned due to perioral hypopigmentation developing in the late post peel course.Today, focused periorbital deep peeling has become more popular due to its efficacy to treat wrinkles and dark circles with nosignificant hypopigmentation.During this presentation basic principles of deep chemical peel, selection of the patients, indications for the procedure will be discussedtogether with potential complications and the ways to avoid them.COMBINED TECHNIQUES: WHAT I LIKE TO DO FOR ENHANCING THE WHOLE FACETECHNIQUES COMBINÉES : CE QUE J’AIME FAIRE POUR EMBELLIR L’ENSEMBLE DU VISAGELEONARDO MARINI(ITALY)51

SESSION 7PERIORAL REJUVENATION - MEDICAL AND SURGICAL APPROCHESRAJEUNISSEMENT DU CONTOUR DES LÈVRES : APPROCHE MÉDICALE ET CHIRURGICALECHAIR: FABIO INGALLINA PLASTIC SURGEON (CATANIA, ITALY)CLAUDIO CARDOSO DE CASTRO PLASTIC SURGEON (RIO DE JANEIRO, BRAZIL)AESTHETIC DERMATOLOGY & SURGERY2.00 pm / 14h00PERIORAL REJUVENATION WITH PHENOL PEELRAJEUNISSEMENT PÉRIORAL AVEC LE PEELING AU PHÉNOLPHILIPPE EVENOU(FRANCE)Perioral phenol peel is a very effective but delicate technique. There is no systemic risk with phenol on a small surface, but theproblems are slow and rough recovery, risk of achromia and risk of scarring.To obtain a good result with a quick recovery and without complications, it is important to use a good formula, to have a good techniqueand to perform a good follow-up.The formulas recommended by Gregory Hetter, mixing phenol with 1 % or less croton oil, are safer than traditionnal Baker-Gordonformula. A mild hypopigmentation can occur, but achromia and scars are very unusual.Perioral phenol peel is a good complement to surgical face lifting.G. HETTER'S FORMULASPhenol Water Septisol Croton oilHeaviest(Baker-Gordon) 3 cc 2 cc 8 drops 3 drops (2%)Heavy 4 cc 6 cc 16 drops 3 drops (1%)Medium-heavy 4 cc 6 cc 16 drops 2 drops (0,7%)Medium-light 4 cc 6 cc 16 drops 1 drop (0,35%)Very-light Take 3 cc of medium-light and add :(eyelids, neck) - 2 cc of phénol- 5 cc of water.WHAT CAN WE EXPECT FROM LASERS IN THIS AREA?QUE PEUT-ON ATTENDRE DES LASERS SUR CETTE ZONE ?MICHAEL KAMINER(USA)Until recently, the most reliable way to obtain significant improvement in perioral wrinkling was to utilize ablative resurfacing techniquessuch as the carbon dioxide or Erbium lasers. Unfortunately, these lasers were often associated with prolonged healing periods, as wellas potential risks that included scarring and infection. Furthermore, in some cases delayed hypopigmentation was seen, particularlywith the carbon dioxide laser.Some of the available chemical peel techniques were able to somewhat improve perioral wrinkling, but unless Phenol was used, theresults were modest at best. Some of the newer non-ablative fractional technologies such as the Fraxel device have been quite usefulin improving perioral wrinkles, but there are limits to how much improvement can be obtained with a series of treatments.The recent introduction of fractional ablative technologies such as carbon dioxide and Erbium fractional lasers has significantlyimproved our ability to treat perioral wrinkling. Rejuvenation of the perioral area is paramount to improving the appearance of many ofour patients, and the ability to safely and reliably improve this area with fractional ablative technologies is a significant advance in ourfield. Recovery is relatively rapid, less than one week, and the risks are significantly reduced as compared to traditional ablativetechnologies.This lecture will review some of the available fractional technologies available to treat perioral photoaging, and review those patientsthat are good candidates, as well as techniques for providing optimal results.DENTAL AESTHETICS IN IMPLANTOLOGY: INDICATIONS, TECHNIQUES AND RESULTSESTHÉTIQUE DENTAIRE EN IMPLANTOLOGIE : INDICATIONS, TECHNIQUES ET RÉSULTATSPATRICK MISSIKA(FRANCE)Implants supported prosthesis have specific demanding requirements in aesthetics, phonetics and function. The aesthetic challengeis very acute when the implant concerns the anterior area and mainly the central incisor. The surgeon must take care of bone resorptionfollowing tooth extraction.In order to fulfil these criteria, in case of bone resorption, ridge reconstruction must be performed to achieve proper crestal volume.Intra oral bone graft is the way to treat most clinical cases prior to implant placement and obtain an optimal aesthetic result.ADJUVANT TECHNIQUES: LIPS TATOOINGTECHNIQUES ADJUVANTES : TATOUAGE DES LÈVRESBRIGITTE SITBON(FRANCE)52

HOW TO CORRECT THE AESTHETIC FAILURES OF THE LIPS AESTHETIC TREATMENTS?COMMENT CORRIGER LES ÉCHECS DES TRAITEMENTS ESTHÉTIQUES DES LÈVRES ?KOENRAAD DE BOULLE(BELGIUM)RHYTIDECTOMY OF LOWER THIRD OF THE FACE AND NECK: MY EXPERIENCERHYTIDECTOMIE DU TIERS INFÉRIEUR DU VISAGE ET DU COU : MON EXPÉRIENCESESSION 8CLAUDIO CARDOSO DE CASTRO(BRAZIL)ENHANCEMENT OF THE FACE: THE BEST FILLING TECHNIQUESEMBELLISSEMENT DU VISAGE : LES MEILLEURES TECHNIQUES DE COMBLEMENTCHAIR: PIERRE ANDRÉ DERMATOLOGIST (PARIS, FRANCE)DIMITRA DAZIOU-PLAKIDA DERMATOLOGIST (ATHÈNES, GREECE)AESTHETIC DERMATOLOGY & SURGERY4.30 pm / 16h30WHAT'S NEW IN BIOCOMPATIBLE FILLERS?QUOI DE NEUF DANS LES FILLERS BIOCOMPATIBLES ?LUITGARD WIEST(GERMANY)This presentation will focus on newer developments of the fourth generation of Hyaluronic Acid Preparations, on a new porcine derivedcross-linked collagen product and new semipermanent and permanent biocompatible fillers.Hylans: The changing generation of Hyaluronic acid based (HA) Dermal fillersDerivates of hyaluronic acid, the Hylans, are temporary tissue fillers with advantages compared to collagen, including longerpersistence in the skin and decreased incidence of delayed hypersensitivity reactions. By chemically cross-linking molecules of HA,more stable macromolecules are formed which have the same biocompatibility as native HA. Since they are water insoluble gels theyremain stable in tissue. They can be classified by their concentration, the method and degree of cross-linking, and the source of theHA., and also by the size of gel particles per mL. Hylan gels in the third generation have been developed that are processed chemicallydifferent, others contain no particles for better distribution in the upper dermal level, thus being suitable for mesotherapy. There arealmost 50 Hylans on the European market, and as more hylans become available,- there will be a greater opportunity to match specifichylan preparations to treatment areas and defects.Collagens:A new product is being discussed which is produced by polymerization of monomeric porcine collagen followed byribose glycation andwhich lasts for at least 12 months.Semipermanent, resorbable synthetic fillersPolylactic acid, Polyalkylamide and Dextran beads suspended in Hylan Gel have been used as semipermanent dermal hydrogel fillers,which are not simply fillers, but also stimulate increased dermal connective tissue regeneration.They are synthetic polymers that areresorbable, biocompatible and biodegradable. They are injected into the deep dermal tissue or subcutaneous tissue and are expectedto last between 2 and 4 years.Permanent FillersThe demand for permanent fillers to correct soft tissue defects is increasing on the European market, and has compelled theproduction of many synthetic options. They offer the advantages of lower cost, consistent formulation, longevity, and limitedhypersensitivity.Inert synthetic (alloplastic) agents may have the potential for permanent implantation. The prolonged clinical improvement followinginjection of these fillers that are permanently deposited in the tissue, is due to stimulation of fibroblasts that synthesize new collagenaround the various particlesGenerally permanent fillers are delivered into the deep dermis or below and require sometimes injections with larger bore needles.Hydrogels are polymers that draw water into the area. Out of more than 30 permanent fillers on the market the most recent FDAapprovedPMMA spheres in 3,5% bovine collagen carrier and 0.3% lidocaine are being presentedHOW DO I TREAT THE PERI-ORAL AREA?COMMENT JE TRAITE LA ZONE PÉRI-BUCCALE ?INES VERNER(ISRAEL)The perioral area is of major importance in the aesthetics of the lower face. Many changes occur in this area with aging e.g. theappearance of perioral rhytides, volume loss, lengthening of the upper lip with lateral lip drop, marionette lines etc. etc.Numerous different soft tissue fillers are available to correct these different problems but only some are suitable to address the differentindications in this area.Anatomy of the perioral area, how it changes with aging and the most suitable fillers for correction in the various locations will bediscussed.53

HOW DO I TREAT THE PERI-OCULAR AREA?COMMENT JE TRAITE LA ZONE PÉRI-ORBITALE ?BERNARD HAYOT(FRANCE)Facial grooves and wrinkles stemming from loss of fat, as well as frown lines and jowls, can be corrected with hyaluronic acidinjections. The mouth area often requires a combination treatment, using both Botox and hyaluronic acid.AESTHETIC DERMATOLOGY & SURGERYUnder-eye circles / How under-eye circles ageWhen the volumes of the young face gradually disappear, the bone structure of the eye socket becomes visible. The under-eye areasseem to separate from the rest of the face, producing what is sometimes called the "skeletal" look. Under-eye circles make the facelook old and tired.Cheeks How cheeks ageLoss of fat in the skin causes grooves to appear between the nose and the mouth because the structures that held up the skin are nolonger there.The cheekbones become prominent Loss of fat in the malar region accentuates under-eye circles, emphasizing the eye socket.The temples /How the temples ageThe eyebrow and the templeAs the fat in the temple disappears, the lateral support of the eyebrow also disappears, and the line of the eyebrow sinks progressively.The end of the eyebrow is no longer visible when looking directly at the face.But the eyebrow itself has not fallen-loss of lateral support produces an illusion.FAT GRAFTING: A LONG TERM EXPERIENCELIPOFILLING : EXPÉRIENCE À LONG TERMEDIMITRA DASIOU-PLAKIDA(GREECE)Background: Autologous adipose tissue has been proved to be an excellent soft tissue augmentation material despite the controversyon the efficacy and longevity reported in the medical literature. Fat injections can correct cosmetic defects that are caused by loss ofsubcutaneous tissue, such as atrophy of the face due to significant weight loss, wrinkles and facial involution due to aging.Objective: To evaluate the safety and long-term results of facial rejuvenation by autologous fat injections using the fine-needletechnique and frozen fat for touch-up implantation procedures.Method: Patients were evaluated clinically and photographically. Extraction, processing and implantation of fat were performed usingan anaerobic technique. The fat was harvested by tumescent liposuction, using syringes and small diameter blunt-tip cannulas (2-3mm). After washing the collected fat in normal saline it was centrifuged, transferred to small size syringes (1-2.5 mL) and then injectedin the deep subcutaneous layer using fine needles of 21-23 G. Hypercorrection was avoided. One month after the initial procedure apercentage of the implanted fat was absorbed. Therefore, a touch-up session of fat injections was necessary in order to replace theamount of the absorbed implant. In some cases a third or more sessions of fat injections were necessary in order to achieve thedesired cosmetic result. The use of frozen fat simplified the repeated fat implantations.Results: The clinical long-term follow-up of more than 2000 cases for up to 20 years showed that absorption of the injected fat wasestimated at 40-60%. The absorption rate varied a lot in each case. Final correction after two or more repetitions of frozen fat injections,persisted for many years, the longest being more than 12 years. All the advantages of the fine-needle technique for fat grafting provedto be of significant value. More accurate and refined work, less painful injections, no scars at needle puncture points, early treatmentof small defects, and the facility to treat multiple sites, even the entire face, in a single session. There were no major complications.Oedema and sometimes echymoses at the donor site for 6-10 days, as well as some slight bruising at the injected areas for 3-5 daysare the disadvantages of the procedure.Conclusions: Autologous fat transplantation can be a gratifyingly effective treatment for subcutaneous augmentation and facialenhancement, producing permanent results in the majority of cases. The technique employed in this procedure plays an important rolein providing immediate and satisfying results that are characterized by safety, long term correction and minimal downtime.HOW TO TREAT SMALL DEFECTS OF THE NOSE WITH INJECTIONS?COMMENT TRAITER LES PETITES IMPERFECTIONS DU NEZ AVEC LES INJECTIONS ?PIERRE ANDRÉ(FRANCE)Small defects of the nose are common and people who suffer from are not always inclined to perform surgery.Injections techniques may correct easily many primary or post-rhinoplasty defects.I prefer to use biodegradable products in terms of safety.Radiesse* (hydroxyapatite), Evolence* (porcine collagen), and a large range of hyaluronic acid may be used.Injections are not painful as we use a thin needle (30/27 G) and they do not require anesthesia.Results depend on physician's artistic talent. With HA it is also important to inform patient that if there is misplacement, hyaluronidasemay dissolve rapidly HA.In the nose HA longevity is high and touch-up is necessary only every 10 months.In some cases, we can combine filler and Botulinum toxin to elevate tip of the nose.FILLERS: COMPLICATIONS AND THEIR MANAGEMENTCOMBLEMENTS : LES COMPLICATIONS ET COMMENT LES GÉRER ?KOENRAAD DE BOULLE(BELGIUM)54

CUTANEOUS INFLAMMATION AFTER HYALURONIC ACID INJECTIONLES INFLAMMATIONS POST INJECTIONS D’ACIDE HYALURONIQUEHARRYONO JUDODIHARDJO(UK)Hyaluronic acid (HA) is now the most commonly used dermal fillers in aesthetic treatment. Even though HA is generally a safetreatment, unwanted cutaneous inflammation after HA injections are reported regularly to the FDA and other regulatory bodies.Our immune system normally only recognises protein and not sugars such as HA, so what cause these cutaneous inflammation?This presentation will discuss the various causes of cutaneous inflammation after HA injections. Review of published articles on thissubject will also be presented.HYALURONIDASE: A MANDATORY TOOL FOR THE COSMETIC PHYSICIANHYALURONIDASE : UN OUTIL INDISPENSABLE AU PRATICIEN ESTHÉTIQUEPIERRE ANDRÉ(FRANCE)AESTHETIC DERMATOLOGY & SURGERYHyaluronidase: a mandatory product when using HA injectionsIn aesthetic medicine, demand is growing up for ambulatory techniques. Filler became the most frequent procedure in agingtreatments.A lot of different agents may be used, but in aesthetic medicine biodegradable products must be preferred.Hyaluronic acid (HA) is for now the "gold standard". The large range of HA offers great opportunities for aging treatment with a highsafety. In very rare cases adverse reactions, or misplacement may appear and it is of great value to dissolve rapidly HA.Hyaluronidase (HAse) is a specific enzyme that hydrolyses HA. HAse is commonly animal-derived and before injecting it skin testingis required. Prick test must be preferred to IDR for eliminating immediate sensitivity.Several products are launched on the world market: Wydase*, Hydase*, Amphadase*, Vitrase*, Spreadase*…They are bovine, ovine or venom snake derived. No product is equivalent to each other and you must be prudent before use.A new HAse is now on the market and does not require skin testing: Hylenex* is a human recombinant HAse.Friday April 11 th / Vendredi 11 AvrilAESTHETIC DERMATOLOGY & SURGERYROOM/SALLE 252 ABSESSION 98.30 am / 8h30INTRODUCTION TO THE PHILOSOPHY OF THE SYMPOSIUMINTRODUCTION : PHILOSOPHIE DU SYMPOSIUMFAT SYMPOSIUM - THE BASIS ABOUT FAT (PART1)SYMPOSIUM SUR LA GRAISSE: LES FONDEMENTSCHAIR: GUSTAVO LEIBASCHOFF AESTHETIC MEDICAL DOCTOR (BUENOS AIRES, ARGENTINA)PHILIPPE BLANCHEMAISON PHLEBOLOGIST (PARIS, FRANCE)GUSTAVO LEIBASCHOFF(ARGENTINA)THE NORMAL ADIPOSE TISSUE AND ITS PHYSIOPATHOLOGYLE TISSU ADIPEUX NORMAL ET SA PHYSIOPATHOLOGIEMAX LAFONTAN(FRANCE)Most energy reserves in the human body are stored in adipose tissue (AT) as triglycerides (TG). TG may arise in the adipocyte fromtwo major routes: de novo lipogenesis from non-lipid precursors or uptake of fatty acids from the plasma. Fatty acids move throughthe endothelial lining to the adipocytes, where they are taken up; some of them escape adipocyte trapping and are transported byalbumin to other tissues. A number of enzymes are involved in TAG accumulation in adipocytes including acyl-coenzymeA:diacylglycerol transferase (DGAT) which catalyses the addition of the third fatty acyl-CoA moiety to diacylglycerol, fatty acid synthase(FAS) and lipoprotein lipase (LPL) which provide the fatty acid substrates for TG synthesis. The major route for TG deposition in humanAT is the uptake of pre-existing fatty acids from circulating TGs (existing in chylomicrons or very-low-density lipoprotein (VLDL)particles); the mechanisms will be detailed and pathological dysfunctions discussed.To use the AT energy reserves (e.g., during fasting, endurance exercise and various stressful situations), AT TG must first behydrolysed and the resultant non esterified fatty acids (i.e., NEFAs) delivered to the working muscle. This is achieved by a highly activeand regulated pathway: lipolysis, whereby TGs stored in the adipocyte are hydrolysed, and fatty acids delivered to the plasma. Therate-limiting step in AT lipolysis is the hydrolysis of TG by lipases. The hydrolysis of stored TG involves several lipases and lipid dropletassociatedproteins such as perilipins.Fat mobilization is regulated by various mechanisms in humans. It is acutely stimulated by catecholamines (adrenaline and55

AESTHETIC DERMATOLOGY & SURGERYnoradrenaline) and natriuretic peptides. Human fat cells express both beta1-2 and alpha2-adrenergic receptors. Acting through bindingto beta1-2-adrenoceptors, catecholamines stimulate adenylyl cyclase and promote cAMP production from ATP and promote hormonesensitive lipase (HSL) activation and lipolysis. Conversely, selective stimulation of fat cell alpha2-adrenergic receptors inhibits lipolysis.In fact, the final response to catecholamines is modulated according to the beta1-2-/alpha2-receptor number ratio, the affinity of bothreceptors for catecholamines, and various post-receptor coupling events. Natriuretic peptides also act on specific natriuretic peptidereceptors (NPR-A receptors). Site-related differences in the effects of catecholamines have been reported in fat cells and also in vivoin men and women. Obesity, type 2 diabetes, prolonged fasting are associated to alterations of fat cell function(1).A number of dysfunctions have been revealed in the various steps of the lipolytic cascade; they will be discussed during the talk.Finally, in addition to the metabolic disturbances attributable to lipolysis and NEFA handling by AT, it can also have a substantial impacton systemic glucose homeostasis, insulin resistance and vascular disorders through altered production and release the bioactivemolecules secreted by the adipocyte (adipokines). These molecules possess either pro-inflammatory potencies (i.e., leptin, interleukin-6, tumor necrosis factor-alpha) or various beneficial metabolic and vascular effects (adiponectin) (2). In addition, a number of factors,initially supposed to be uniquely secreted by adipocytes are also produced by other cell types contained in the stroma-vascular fractionof AT. Inflammatory cells such as monocytes, macrophages and lymphocytes infiltrate the AT of obese rodents and humans. Thedefinition of the role and the recruitment processes leading to accumulation of macrophages and lymphocytes in AT of obese patientswarrants further evaluation.References1. Langin D, Lucas S, Lafontan M 2000 Millenium fat-cell lipolysis reveals unsuspected novel tracks. Horm. Metab. Res. 32:443-4522. Lafontan M, Berlan M 2003 Do regional differences in adipocyte biology provide new pathophysiological insights? Trends Pharmacol. Sci. 24:276-283FAT TISSUE AND THE LYMPHATIC SYSTEMLE TISSU GRAISSEUX ET LE SYSTÈME LYMPHATIQUEETIENNE SOUDANT(FRANCE)It is a well known anatomical feature that lymph nodes are commonly embedded in adipose tissue. Chronic inflammation and lymphnode activation influence adipose tissue function (Iipolysis, glycerol release, …).In the skin the lymphatic vessels are also an important actor in microcirculation and have certain effects on fat tissue. When the lymphremain static (prolonged standing, cold, obesity, old age,…) fat tissue progresses (1, 2).Skin lymphatics run parallel with the blood supply and have the function of conserving plasma proteins, scavenge foreign material,antigenic substances, and local compounds which are able to affect fat tissue behavior.Blind-ended lymphatic capillaries arise within the interstitial spaces of the dermal papillae and have an open junction connected toelastic fibers.These unvalved superficial dermal vessels coated with elastic fibers drain into valved deep dermal and subdermal plexuses. Thesethen coalesce to form larger lymphatic channels, which course through numerous filtering lymph nodes on their way to join the venouscirculation near the subclavian vein-internal jugular vein junction bilaterally.Direct Injury to diffusely distributed terminal lymphatics but also to elastic tissue during liposuction are inevitable and probablycontribute to postoperative edema.In the skin the efficiency of the blind-ended lymphatics are closely dependent upon mechanical forces such as gentle massage.Consistent mechanical forces can act directly on cells (3) like adipocytes but gentle ones act on lymphatic clearance (4) and thenindirectly on fat tissue.The effects of these mechanical forces (massage for example) could be adapted following the period where it is done (5).REFERENCES1. T. Ryan. The ageing of the blood supply and the lymphatic drainage of the skin. Micron 35: 3, 161-171, 20042. T. J. Ryan DM, S. B. Curri. The development of adipose tissue and its relationship to the vascular system. Clinics in Dermatology 7: 4, 1-8, 19893. C. A. Lambert., E. Soudant., B. V. Nusgens, C. M. Lapière. Pretranslational regulation of extracellular matrix macromolecules and collagenaseexpression in fibroblasts by mechanical forces. Laboratory Investigation, 66: 4, p 444, 1992.4. P.S. Mortimer et al. The measurement of skin lymph flow by isotope clearance--reliability, reproducibility, injection dynamics, and the effect ofmassage. J Invest Dermatol. 1990; 95(6):677-825. Touitou Y., Soudant E., Koulbanis C., Reinberg A., Bazin R., Nicolaï A., Mechkouri M. Circadian rhythms in a set of biochemical and biophysical skinvariables (including transepidermal water loss) documented with non-invasive methods in healty young women. 6th Internat. Conf.Chronopharmacology. Book of abstracts. E. Haus (Ed) U. of Minnesota, St Paul, Abstract * XI-5, (1994).OVERVIEW OF THE TREATMENTS WHICH REDUCE FAT CELLS AND OTHERS THAT DESTROY ADIPOSE ONESVUE D’ENSEMBLE DES TRAITEMENTS RÉDUISANT LES CELLULES GRAISSEUSES ET CEUX DÉTRUISANT LESADIPOCYTESPHILIPPE BLANCHEMAISON(FRANCE)THE STEPS FOR A SAFE LIPOSCULPTURELES ÉTAPES DE LA LIPOSCULPTURE SANS DANGERGUSTAVO LEIBASCHOFF(ARGENTINA)The realization of the Liposculpture is not only a surgical act.There are some elements that help this surgery to be more effective and safe.These are facts accumulated through more than 25 years dedicated exclusively to lipoplasty:From the right diagnostic, the good indication, through understanding what the patients want and the relation with the aestheticpathology that they suffer.56

The help of non-invasive diagnostic tools for the preparation of a good surgical technique (videocapillaroscopy and ultrasound )The correct use of the iconography in the medical consultation and in the pre and post op. The importance of the pre-opphysiotherapeutic, cosmetic and medical preparation of the patient. The placement of the patient in the operating table. The importanceof ergonomics for the surgeon and the patient.The tumescent anesthesia technique, its proper realization. The support of the conscious sedation. The ergonomics in the realizationof the surgery. The state of the art in cannulas. Why is a good cannula so important?The various techniques for liposculpture depending on the patient's pathology.The state of art device like Ultrasonic Liposculpture Liposelection Vaseror Laserlipolysis Smartlipo ®Rules for a safe liposculpture.The immediate and mediate post-op, as important as the surgery itself.LIPOFILLING FOR THE CORRECTION OF THE BUTTOCK DEPRESSION ACCORDING TO THE " OVAL SHAPE THEORY "LIPOFILLING POUR LA CORRECTION DE LA DÉPRESSION FESSIÈRE SELON LA THÉORIE DE L’OVALAESTHETIC DERMATOLOGY & SURGERYMARC-HENRI BON(FRANCE)Subject: This conference is aimed at demonstrating the following. On the one hand that the ideal shape of the pelvis (that is thighs,hips and buttock) is an oval one : this is the so-called " oval shape theory ".And on the other hand that to obtain this ideal shape, our technique implies a lipofilling of the buttock depression.Material and method: This method does not apply to obese patients but includes all the other cases even slim patients. One mustunderstand that all women, after puberty, have their pelvis shaped as violin boxes.- in 100% of the cases, the liposculpture must include all three liposuccions of saddle bag, hips and inside of the highs.- in 95% of the cases, the only liposuccion is not enough to obtain the oval shape wanted.One must then do a liposculpture by doing a lipofilling of the buttock depression.The reinjected volume must be between 100 and 400cc for each side.The adipocit survival depends on it's harvesting and it's transfer which must be done by using a big canula (6mm diameter).Results: One obtains three different results : a rejuvenilisation of pelvis's shape, the thigh is elongated and it seems like the buttockis placed higher.From the violin box shape of the adult's pelvis, we have obtained the oval shape of the prepuberty pelvis.Conclusion: The lipofilling of the buttock depression is needed in 95% of the cases. This technique had been successfully used forthe past 14 years.This is why, it is as much important to consider the buttock depression as to consider the hips and saddle bags bumps.FAT AND VARICOSE VEINS: WHICH TREATMENT FIRST? WHYGRAISSE ET VARICOSITÉS : QUE TRAITER EN PREMIER ET POURQUOI ?CLAUDE GARDE(FRANCE)The mixture of fat with blood is potentially dangerous and can provok: fat embolism and thromboembolism .We have to remember thatthis risk is the first one during liposuction with 23.4% of the total risk(AACS 2003). During liposuction, there are large injuries of small,and medium vessels and sometimes of larges one.The venous desease is above all a weakness of the vessels that are dilated and blisteredWhat are the main areas (steatomes) involved when liposuction ?What are the main veins to fear?What is the interest and the limit of tumescent anaesthesy?Are there someelse factors contributing to increase the vascular risk?What assessement to perform before liposuction?More than 30% of women present varicose veins that increase the interface between blood and fat. So the first goal is to reduce thisinterface by treating the varicose veins. Are all the varicose veins to treat before?Is it possible to treat the VV in the same session than liposuction?What interval between the VV treatment and the liposuction ?According to our experience and the litterature we will answer these questionsThe treatment of big calves and anklesTo have big calves and ankles is a real aesthetic problem complicated to treat because there are often several intricated problems.Before to propose a treatment on the fat, it is mandatory to have a good evaluation:- to dismiss a too big muscle: the sport 's practice to reduce big legs can lead to increase the volume of muscle: Echographic fat padmeasurement.- to dismiss a lymphatic functionnal insufficiency that is quite constant: Clinical examination and isotopic lymphography .- to dismiss a capillaro-venous insufficiency because liposuction is not the treatment of edema :Clinical specialized examination anddupplex scanwhen the fat treatment is decided: What kind of treatment to choose: liposuction or lipolaser?For us, it is careful to perform a dupplex to mark the presence of perforatorsIn this area, there are a lot of vessels, nerves, and lymphatics, so we have to choose the less aggressive technicThe tumescent anaesthesy must be important in volume to increase the thickness of the lipolysis zone. The incision have to be doneall around the 1/3 inferior of the calf to allow less injuries of lymphatics, nerves and vessels as possibleIf liposuction is required, what type of liposuction cannulas to choose?When the liposuction or the lipolaser is performed, a compression is necessary, we recommand a strong one (class 3 or class 2X2)This device must be worn three monthsCould we expect a long term result of lipo at this level? The major risk is a progressive reccurrency because interaction with lymphaticsand so with macrophages and preadipocyt57

SESSION 1011.00 am / 11h00AESTHETIC WORKSHOP PROPOSED BY ALLERGANCHAIR: HERVÉ RASPLADO FACIAL PLASTIC SURGEON (CANNES, FRANCE)AESTHETIC DERMATOLOGY & SURGERYEXCEEDING PATIENT EXPECTATIONS WITH THE ALLERGAN FACIAL PORTFOLIODÉPASSER LES ATTENTES DES PATIENTS AVEC LE PORTFOLIO FACIAL ALLERGANGiuseppe Sito (Italy) - Lakhdar Belhaouari (France) - Gregor Wahl (Germany) - Phillip Levy (Switzerland)SESSION 112.00 pm / 14h00SKIN AGING AROUND THE WORLDLE VIEILLISSEMENT CUTANÉ À TRAVERS LE MONDESKIN AND HAIR DISORDERSDÉSORDRES CUTANÉS ET CAPILLAIRESCHAIR: ANDRÉAS KATSAMBAS PROFESSOR OF DERMATOLOGY (ATHÈNES, GREECE)CATHERINE OLIVERES-GHOUTI DERMATOLOGIST (PARIS, FRANCE)MICHÈLE VERSCHOORE(FRANCE)Facial skin aging has been extensively studied on Caucasian skin in the last thirty years. Wrinkling, sagging, telangiectasia, flaccidityand ptosis are typical of Caucasian skin aging. It is only recently that skin aging has been more studied in Asian an African population.Dyspigmentation is a typical symptom of aging of the face in populations with darker phototypes. We have studied various skinparameters in four different populations.In African-American, a youthful microrelief is maintained after 50 years old whereas it is several altered in Caucasian skin. Regardingdermis alteration, African-Americans maintain a better skin density and elasticity. Asians and Caucasians have a gradual decrease ofsebum excretion, starting at 30 years old whereas in Hispanic an African-American, a moderate decrease can be observed only after50 years old.All these findings are of utmost importance for the signification of facial skin aging among different populations in the world and for thedesign of skin care products adapted to each population.COSMETICS AND COSMECEUTICALSLES PRODUITS COSMÉTIQUES ET COSMÉCEUTIQUESNICOLAS BACHOT(FRANCE)PIGMENTARY DISORDERS: CLINICAL ASPECTS AND TREATMENTSLES DÉSORDRES PIGMENTAIRES : ASPECTS CLINIQUES ET TRAITEMENTSTORELLO LOTTI(ITALY)Pigmentary disorders represent a heterogeneous group of cutaneous and mucous changes. Hypomelanotic skin disorders arecutaneous pigmentary disorders characterized by a reduced melanin content in the skin that results in a lightening of the skin.Hypomelanoses can be congenital or acquired and clinicals aspects may be various. They include infectious disorders such aspityriasis versicolor; post-inflammatory disorders, such as pityriasis alba, those caused by chemical and physical agents, lupuserythematosus and scleroderma; lichen sclerosus; vitiligo; halo nevus; melanoma associated leukoderma; idiopathic guttatehypomelanosis; leukoderma punctata; and progressive macular hypomelanosis of the trunk.Hyperpigmentation disorders can be inherited or acquired, resulting from alterations occurring at any level in the melanogenesispathway. In clinical practice, acquired hyperpigmentation including melasma, post-inflammatory hyperpigmentation, solar lentiginesand dischromias of photoaged skin, represent the most common disorders of pigmentation the dermatologist has to treat.Despite the large number of treatment modalities available, management of pigmentary disorders is often unsucessful anddisappointing, and is still a challenge for dermatologists.HOW TO DEAL WITH RED FACE: CLINICAL ASPECTS AND TREATMENTSTACHES ROUGES : ASPECTS CLINIQUES ET TRAITEMENTSCATHERINE OLIVERES-GHOUTI(FRANCE)ANDROGENIC ALOPECIA IN MALE: DIAGNOSIS AND MEDICAL TREATMENTSL'ALOPÉCIE ANDROGÉNIQUE CHEZ L'HOMME : DIAGNOSTIC ET TRAITEMENTS MÉDICAUXPASCAL REYGAGNE(FRANCE)58

ANDROGENIC ALOPECIA IN FEMALE: DIAGNOSIS AND MEDICAL TREATMENTSL'ALOPÉCIE ANDROGÉNIQUE CHEZ LA FEMME : DIAGNOSTIC ET TRAITEMENTS MÉDICAUXEWA GUIGNÉ(FRANCE)Androgenetic alopecia (AGA) is the commonest cause of hair loss in women. The family history factor is less present than it is for men.Regarding physiopathology, the influence of androgens appears to be less significant. Women with AGA do not have higher levels ofcirculating androgen. However, they have been found to have higher levels of 5a-reductase (which converts testosterone todihydrotestosterone), more andogen receptors and lower level of cytochrome P450 (which converts testosterone to estrogen).Hair miniaturization through the reduction of the anagen phase is common to both sexes; however, lengthening of the latency phasehas not been proven in women. Clinically, onset occurs at any time between puberty and menopause, although it often affects menlater in life, with a peak between 40 and 50 years old. In women, abnormalities are predominantly located on the top of the skull butmay also extend to the temporal areas. Two patterns are commonly reported: central and diffuse, or with a frontal predominance("Christmas tree" pattern). The front limit does not recede although hair does become thinner and shorter there. Similarly, bitemporalhair loss is replaced by diffuse thinning. Hair miniaturization is less pronounced than in men and spares some hair, so that there areno areas completely bald. As diagnosis is clinically less obvious, a cause of associated telogen effluvium should be moresystematically looked for in women. Biopsy is indicated in case of doubt with alopecia disseminata or cicatricial alopecia (diagnosisoften difficult in Afro-American women).Most women with andogenetic alopecia have normal menses, normal fertility, and normal endocrine function, including genderappropiatelevels of circulating androgen. Therefore, an extensive hormonal work-up is unnecessary. If women have irregular menses,abrupt hair loss, hirsutism, or acne recurrence, an andocrine evaluation is appropriate. In this situation, total testosterone, freetestosterone, dehydroepiandrostone (DHEA)-sulfate, and prolactine level should be obtained. (1) Telogen effluvium may accelerateAGA, and causes, such as iron deficiency and thyroid disorder must be considered.AESTHETIC DERMATOLOGY & SURGERYTopically administered 2% minoxidil is the only one officially authorized treatment in AGA (US food and drug administration (FDA)-approved treatment and French AMM). The mechanism of action of minoxidil is unknown, but is not involve androgen pathways.Randomized, controlled, double blind clinical trials involving large group of women showed hair regrowth with 1% and 2% minoxidilsolution (2, 3). A significant increase benefit has been shown for the 5% minoxidil solution compared with the 2% solution (4). Theprimary side effect of topical minoxidil is facial hypertrichosis. The 5% minoxidil solution can be used in case of non dark- haired womenwithout hypertrichosis. Commercial preparations contain minoxidil in a propylene glycol base. In case of allergic reaction to this base,a compounding pharmacist can prepare an alternative preparation in which minoxidil is suspended in a less sensitizing agent. Topicaltretinoin is known to increase the percutaneous absorption of minoxidil and therefore, to enhance the response of AGA to minoxidil.Antiandrogen treatment may also be used in the systemic treatment of women AGA. The most potent antiandrogen is cyproteroneacetate (androcur). It is preferred in women with androgen dependent skin anomalies (seborrhoea, acne, hirsutism and androgenicalopecia). The combination of estrogen and antiandrogen is preferred in fertile women, with AGA, who request oral contraceptives. Itis possible to used a pill containing estrogen and progestin with anti androgen action, as ethynil estradiol+drospirenon (jasmine,jasminelle) and cyproterone acetate + ethynilestradiol (diane 35), or an association of cyproterone acetate (androcur) and naturalestrogen (provames). During menopause, it is possible to administer cyproterone acetate separately without estrogen. Cyproteroneacetate (androcur) is not available in US. Spironolactone (aldactone), which also have antiandrogenic action, may be used in thetreatment of AGA (5). It is a classic treatment of AGA in USA. Spironolactone should be used in combination with hormonalcontraception in order to reduce side effects especially menstrual irregularity and prevent pregnancy in child bearing women, as it mayfeminize the male foetus.Finasteride, a 5 alpha-reductase type 2 inhibitor, has demonstrated an efficacy in androgenic alopecia of young men. In women, it canbe used in post menopausal women or in association with oral contraceptive in fertile women as it can produce feminization of malefoetus. Only one large-scale controlled study was carried out, in post menopausal women, and using the doses as for men, hence1mg/day one year. It revealed no effectiveness (6). However, isolated cases or smaller series suggested that finasteride can beeffective on women when used at higher doses, 2,5 to 5mg/day. Responses have been obtained in women with or without ahyperandrogenism, whether post menopausal or not. In this latter case, finasteride was always associated with oral contraception,which makes it difficult to assess its actual effect (7).Dutasteride represent a second generation of 5 alpha-reductase inhibitor. It may be more potent as it inhibits type 1 and type 2isoenzymes. The efficacy and the tolerance of dutasterid in treatment of female AGA, is not actually well determined.Drugs containing vitamins, aminoacids and trace elements may be used as supportative therapy.In some patients psychotherapy is recommended.Micrografting may also be considered in some cases, but suitable candidates for this approach are less numerous than in menpopulation.Hairstyling, teasing, coloring, permanants, and the used of hair spray are supported, rather than prohibited. Women may shampootheir hair as frequently as they wish without fear of worsening hair loss.References1- Masmoudi A, Meziou TJ, Reygagne P. Androgenic alopecia revealing an ovarian secreting tumor. Ann Dermatol Venereol 2007; 134(2): 164-6.2-Tsuboi R, Tanaka T, Nishikawa T et al. A randomized, placebo-controlled trial of 1% topical minoxidil solution in the treatment of androgeneticalopecia in Japanese women. Eur J Dermatol 2007; 17: 37-44.3- Jacobs JP, Szpunar CA, Warner ML et al. Use of topical minoxidil therapy for androgenetic alopecia in women. Int J Dermatol 1993; 341: 964-73.4- Lucky AW, Piacquadio DJ, Ditre CM et al. A randomnized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment offemale pattern hair loss. J Am Acad Dermatol 2004; 50 (4): 541-53.5-Hodemaker C, Van Egmond S, Sinclair R. Treatment of female pattern hair loss with a combination of spironolactone and minoxidil. Australas JDermatol, 2007; 48: 43-5.6-Price VH, Roberts JL, Hordinsky M, Olsen EA et al. Lack of efficacity of finasteride in post menopausal women with androgenetic alopecia. J AmAcad Dermatol 2000 Nov; 43 (5pt 1) : 768-76.7-Iorizzo M, Vinvenzi C, Voudouris et al. Finasterid treatment of female pattern hair loss. Arch dermatol 2006 Mar; 142 (3): 298-302.59

HAIR TRANSPLANTATION: WHAT'S NEW?LA GREFFE DE CHEVEUX : QUELLES NOUVEAUTÉS ?PATRICK LAFAURIE(FRANCE)AESTHETIC DERMATOLOGY & SURGERYThe technique of hair transplantation undergo many improvements but the principle is always the same: taking hair graft in the occipitalzone and distribute in the more natural way to the bald area.There is a precise manner to utilise the donor site with less visible scar.In the recipient zone we use a microblade to insert the micrograft with the forcep's technique in a mixed and irregular way.Many technical details are explained and results are exposed.AUTOLOGOUS HAIR REGENERATION THERAPY : THE ULTIMATE SOLUTION TO BALDNESSTHÉRAPIE DE RÉGÉNÉRATION AUTOLOGUE DU CHEVEU : L’ULTIME SOLUTION À LA CALVITIEPAUL KEMP(UK)Autologous Hair Regeneration Therapy: The Ultimate Solution to Baldness Cell therapy is becoming an important new therapy for skinrejuvenation. Introduction of cultured dermal fibroblasts (both autologous and allogeneic) to augment the dermal fibroblast populationcan correspond to an increase in dermal collagen content in thin skin as well as a remodelling of the extra cellular matrix in scar tissue.It has also been known for over 40 years that particular specialised cells such as dermal papilla cells from the hair follicle are able toinduce brand new hair follicles to form by interacting with epidermal cells when transplanted into a new area. It has been a goal ofseveral laboratories to turn this scientific phenomenon into a commercial treatment for hair loss.This talk will review the current status of this challenge and the hurdles that have been overcome, and still remain to be overcome,before cell therapy becomes the "ultimate solution to baldness".SESSION 124.30 pm / 16h30FAT SYMPOSIUM - OVERVIEW OF THE SLIMMING TECHNIQUES PART 2SYMPOSIUM SUR LA GRAISSE - VUE D'ENSEMBLE DES TECHNIQUES AMINCISSANTESCHAIR: MAX LAFONTAN PROF. RESEARCH DIRECTOR (TOULOUSE, FRANCE)GUSTAVO LEIBASCHOFF AESTHETIC MEDICAL DOCTOR (BUENOS AIRES, ARGENTINA)THE IMPACT OF THE NUTRITION OVER FAT TISSUEL'INFLUENCE DE LA NUTRITION SUR LE TISSU GRAISSEUXWILMAR ACCURSIO(BRAZIL)IMPACT OF A MECHANICAL MASSAGE TECHNIQUE ON LIPID MOBILIZATION IN FEMORAL ADIPOSE TISSUE:A MICRODIALYSIS APPROACHIMPACT DU MASSAGE MÉCANIQUE SUR LA MOBILISATION LIPIDIQUE DANS LA ZONE GRAISSEUSE FÉMORALE :ÉTUDE PAR MICRODIALYSEMAX LAFONTAN(FRANCE)Background: Adipocytes from femoral adipose tissue areas are known to be metabolically "silent". Changes related to fat cellhypertrophy are often associated with veino-lymphatic stasis and fibrosis of connective tissue and may be involved in the formation ofcellulite. It is very difficult to study the impact of treatments on this tissue. Studies were carried out to study the incidence of the LPGcelluM6 ® technique on lipid mobilization in adipose tissue using an in situ microdialysis technique which has been extensively used byour group for various clinical investigations concerning adipose tissue biology (1).Patients, materials, methods: Nine healthy women volunteers with cellulite (grade>2) received 12 sessions (35 min each) of LPGcelluM6 ® technique (1-month treatment). Microdialysis probes infused with increasing concentrations of isoproterenol (beta-adrenergicagonist) were implanted in femoral adipose tissue before and one day after the end of the treatment.Results: At the end of LPG celluM6 ® treatment resting glycerol levels were lowered in the dialysate of the microdialysis probeimplanted in the femoral adipose tissue (a result which suggests local blood flow improvement). Moreover, the lipid-mobilizing effectof isoproterenol (isoproterenol-induced glycerol release) was enhanced after one month of LPG celluM6 ® treatment. In addition, amanifest improvement of cellulite was also observed after one month of treatment with a significant decrease of morphometricdeterminations (i.e. decrease in skinfold measurements and cellulite grade).Conclusion: The results suggest an increase in the lipolytic responsiveness in femoral adipose tissue in women with cellulite havingundergone the LPG celluM6 ® technique treatment during one month. It is not excluded that longer sessions or longer periods oftreatment with the LPG celluM6 ® technique could be more beneficial for a better recovery of lipolytic efficiency in fat deposits whichare known to be highly resistant to lipid mobilization. This mechanical massage facilitates mobilization of resistant fat deposits. It mustbe reminded that long lasting effects will be expected if equilibrated dieting and regular endurance exercise are maintained.Reference (1) Lafontan M, Arner P 1996 Application of in situ microdialysis to measure metabolic and vascular responses in adipose tissue. TrendsPharmacol. Sci. 17:309-31360

MESOTHERAPY: DOES IT REALLY WORK ON FAT TISSUE?LA MÉSOTHÉRAPIE FONCTIONNE-T-ELLE VRAIMENT SUR LE TISSU GRAISSEUX ?PHILIPPE PETIT(FRANCE)Is mesotherapy effective on the fatty tissue? Obviously in this way, the question can only bring a positive answer. Yes, mesotherapyis effective on the fatty tissue but with some precisions.First of all, the mesotherapy has never made nobody lose weight, thus the mesotherapy has no direct action on the generalized weightor on the obesityThe mesotherapy is effective on the localized excess loads and on the cellulite on the only condition to drive well the treatment that isto make a global coverage.The number of ways in this domain is important and it means that whatever is the used technique, it is always necessary to use theother means and it is all the interest of this Round Table there that to confront these various means and to try to use them in a additiveway and multiplicative: in this domain, 1 + 1 can make 3 or 4, it is the synergy.AESTHETIC DERMATOLOGY & SURGERYTwo close methods one of the other one are generally used to decrease the localized fatty excess loads.The first one appeals to the phosphatidylcholine (PTC) and the second in the dissolution hypoosmolaire.The PTC is although known all over the world, but its common practices received no validation in most of the countries (AMM inFrance, FDA in the USA). The mode of action lipolytic is well known. It is the natural component of the bile that has an actionémulsifiante of the dietary lipids. The constituent phospholipids of cellular membranes is destroyed by lipolytic enzymes. And on theother hand the PTC has an action on the dissolution of fibrous wefts which connect adipocytes. It is what, what improves the qualityof the skinThe mesodissolution is a technique of mesotherapy derived of the dissolution hypoosmolaire or lipotomie described in the 90s byHoefflin and Bernstein.. The theoretical principle is simple: multi injection of variable volume of solution hypoosmolaire in the fattytissue, the effect of inflation then explosion of adipocytes by difference of osmosis between the physiological tissue and the injectedmixture.The technique thus consists in mixing medicines with draining action, antiradicalaire, défifrosante diluted in some water for preparedinjection, which will give the hypoosmolarité.The cellulite, which defines itself as a hydro-lipodystrophy (infiltration of water and accumulation of fats with cellular suffering ofadipocytes), entails a thickening and a disorganization of the fibrous tissue associated to an oedema, which increases the pressure ofwater and compresses fibers, cells, blood and lymphatic vessels ending in a state of asphyxiation of this connective tissue.The role of the mesotherapy is to reactivate the micro-traffic, to improve the lymphatic drainage, to bring nourishing elements andtrophiques to restore the state of tissues.But it will be necessary to add to it the advices of dietary hygiene and life and do not to hesitate to associate to it the other effectivetechniques, which gather us around this Round Table.which gather us around this round table.PHOSPHATYDILCHOLINE VS SODIUM DEOXICHOLATELA PHOSPHATYDILCHOLINE VS SODIUM DEOXICHOLATEGIOVANNI SALTI(ITALY)The novel concept of chemical adipocitolysis through local injections has gone a widespread diffusion recently. Phosphatidylcholine isthe active drug in the commercial preparation used for this purpose, but clinical studies suggested that sodium deoxycholate, aneccipient of the preparation, could be the really active substance. We decided to investigate if phosphatidylcholine and sodiumdeoxycholate have any clinical efficacy in chemical adipocitolysis, and their respective roles. We also studied the safety and sideeffects of the treatments. 37 consecutive female patients were studied for the treatment of bilateral gynoid lipodystrophy.Each patient received injections of a phosphatidylcholine/sodium deoxycholate preparation on one side and of sodium deoxycholatealone on the controlateral side, being each single patient the control of herself. Four treatments were carried out every 8 weeks in adouble blind, randomized fashion. Clinical evaluations, photographic and ultrasonographic measurements at every time of the studyallowed for final judgement. A statistical analysis concluded our study. An overall reduction of local fat was obtained in 91.9% of thepatients without statistically significative differences between the treated sides. Reduction values on the phosphatidylcholine/sodiumdeoxycholate treated sides are in the order of 6.46% clinically and 36.87% ultrasonographically, while on the deoxycholate treatedsides they are in the order of 6.77% clinically and 36.06% ultrasonographically. Both treatments, at the dose used in the study, resultedsafe in the short term. The most common side effects are local and few. In summary, both treatments have shown moderate andequivalent efficacy in treating local fat, with sodium deoxycholate having a slower post-operative resolution, suggesting that sodiumdeoxycholate could be sufficient by itself to determine a fat cell destruction and that phosphatidylcholine could be useful to obtain alater emulsification of the fat or to attenuate the strength of sodium deoxycholate.ULTRASOUNDS: ARE THEY ALL EQUIVALENT?ULTRASONS : SONT-ILS TOUS LES MÊMES ?PHILIPPE BLANCHEMAISON(FRANCE)61

LASERLIPOLYSISLA LIPOLYSE AU LASERNICOLA ZERBINATI(ITALY)AESTHETIC DERMATOLOGY & SURGERYCARBOXITHERAPY: DOES IT REALLY WORK ON FAT TISSUE?LA CARBOXITHÉRAPIE FONCTIONNE-T-ELLE VRAIMENT SUR LE TISSU GRAISSEUX ?GUSTAVO LEIBASCHOFF(ARGENTINA)HOW DOES RADIOFREQUENCY CAUSE LIPOLYSIS? AN IN VIVO TISSUE TEMPERATURE STUDY SHOWING TIME IS CRUCIALCOMMENT LA RADIOFRÉQUENCE ENTRAÎNE-T-ELLE LA LIPOLYSE? UNE ÉTUDE IN VIVO DE LA TEMPÉRATUREDES TISSUS MONTRANT L'IMPORTANCE DU TEMPSCLAUDIA VAN DER LUGT(NETHERLANDS)HYDROLIPOCLASIA USING GREATER VOLUMES: THE BRAZILIAN EXPERIENCEL'HYDROLIPOCLASIE AVEC DE GROS VOLUMES : L'EXPÉRIENCE BRÉSILIENNEWILMAR ACCURSIO(BRAZIL)The hydrolipoclasia is a very well known method for the reduction of localized fat where we inject saline solution in the fatty tissue andsubmit it to the action of ultrasound energy, working with a high frequency and potency. These ultrasound parameters associated withthe presence of liquid in the fatty tissue, produce the cavitation phenomenon that leads to the mechanical rupture of fat. The higherthe injected volume and the bigger the exposition of the tissue to the ultrasound waves the greater the rupture produced by theultrasound. Initially small volumes were used, between 20 and 30 ml, in each area of approximately 10 to 15 cm in diameter.Experience has shown that greater volumes produce a higher reduction in body measurements.In Brazil, in the last years, volumes up to 500 ml have been used for the same area driving to an improvement in results. The quantityof liquid that can be injected depends on the cohesion of fat tissue and of the tension of the upper skin layer. The technique is to injectas much as volume possible, respecting the individual characteristics of each patient. After the infiltration, ultrasound energy is usedwith the following parameters: frequency 3 MHz, potency 3 Watts/cm2 (total potency 45 watts), making slow circular movements inorder to enhance the cavitation potential of the technique. The results depend on the correct application of the method and the choiceof areas with evident accumulation of fat to be treated, because small increases of thickness of fatty tissue spread in extensive, nonlocalized areas won't respond well to this treatment. Better results are achieved in thighs, supratrocanteric, supra pubic and abdominalfat.In our trials in the Clinical Research Center of the Brazilian Society of Aesthetic medicine we have been getting good and better resultswith greater volumes than we had before with small volumes and we will show them in our presentation.BLOOD LOSS EVALUATION IN LASER-ASSISTED LIPOSUCTIONL’ÉVALUATION DE LA PERTE DE SANG DANS LA LIPOSUCCION ASSITÉE AU LASERKARIM MASSOUD(EGYPT)The use of interstitial Nd:YAG laser on adipose tissues leads to destruction of adipocytes, coagulation of blood vessels, and stimulationcollagen deposition in the subdermal layer. The potential clinical effects are lipolysis, reduction in the blood loss and bruising, as wellas skin tightening. In order to measure the percent of blood loss reduction with laser-assisted liposuction, 14 volunteer females wereincluded in the study. All cases suffered from symmetrical localized fat deposits in the trochanteric and/or the gluteal regions. Epiduralanesthesia was used in all cases. Infiltration of diluted epinephrine solutions was performed using equal volumes to both sides of thebody. Interstitial Nd:YAG laser was applied to the right side using a 600 Um. fiber and 14 W. of power. Both sides were suctioned bythe same surgeon using the same cannula and the syringe technique. The same volume of total suction was collected from each side.The amount of Hemoglobin was calculated in the diluted infranatant fluid of each side. An average of 30% blood loss reduction wasnoted in the laser-assisted liposuction side.LOW FREQUENCY ULTRASOUNDS FOR THE TREATMENT OF LOCALIZED LIPODYSTROPHIESLES ULTRASONS À BASSE FRÉQUENCE POUR LE TRAITEMENT DES LIPODYSTROPHIES LOCALISÉESFULVIO VANNINI- ANNA MARIA FORENZA(ITALY)PROSLIMELT: low frequency ultrasound for the treatment of localized lipodistrophyesDr.Fulvio Vannini, presents the results of a clinical study conducted on 40 patients after 10 months of treatment using Proslimelt, aspecial device that uses specific ocalized low frequency ultrasound waves (working within a range of 30 to 70 Khz).This clinical evaluation is based on plicometric, perimetric measurements, blood sample analysis, echograhic and termographicpictures and histological exams.62

Proslimelt is an apparatus, that uses specific focalized low frequency ultrasound waves that produces a breakage of the cellularmembrane of the treated tissue and the exiting of the adipocytes from the cells, leaving the surrounding areas undamaged, with atermo-mechanical effect, in a comfortable, fast, safe and non invasive way.Dr.Vannini will show that the results reached by using this device have been encouraging in the consideration of stable and long lastingeffects with low frequency ultrasound waves are used for eliminating excess of localized fat.Based on these results, the author believes that this type of treatment could be an excellent alternative or complement to traditionalsurgery.SKIN LAXITY IMPROVEMENT AND BODY CONTOURING, USING A COMBINATION OF BI-POLAR RADIOFREQUENCY,INFRARED LIGHT AND TISSUE MANIPULATIONCOMBINAISON RADIOFRÉQUENCE BIPOLAIRE, LUMIÈRE INFRAROUGE ET MANIPILATION MÉCANIQUEFRANCESCA DE ANGELIS(ITALY)AESTHETIC DERMATOLOGY & SURGERYBack ground: In response to the global rise in non-surgical body contouring treatments, we studied the effects of a new platform,based on elos combination of bi-polar radiofrequency and infrared light energies, combined with negative pressure and tissuemanipulation.Methods: Ten subjects affected by cellulite of the thighs and/or buttocks underwent treatment to reduce both cellulite andcircumferences of the treated areas. Ten additional subjects with sagging skin on their abdomen, waist or thighs following liposuctionin these areas within 9 to 24 months were also treated. All subjects were treated once a week for a total number of four treatments.Subjects were evaluated using standardized photographs and by having the investigator and an independent evaluator grade visualimprovement. Measurements of body weight and circumferences of the treated areas were performed at baseline, several times duringthe treatment course and four weeks after the last treatment.Results: Preliminary results indicate a rapid reduction in the circumference of the treated areas and a smoother appearance of theskin's surface in almost 85% of the areas treated. Based on treatments conducted so far, we report circumferences reduction of atleast 1cm (and up to 5.2cm at the end of the treatment series). We also observed a reshaping effect, manifested mainly by lifting ofsagging skin and improvement of skin texture, in those patients previously treated with liposuction. Side effects were limited to transienterythema in most patients; bruising was observed in two patients after the first couple of treatment sessions, but not as the treatmentseries progressed. High patient satisfaction rates were noted during and after the treatment course.Conclusions: This device demonstrated to be effective and safe for body contouring and improvement of skin laxity, with no downtime or side effects.Saturday April 12 th / Samedi 12 AvrilAESTHETIC DERMATOLOGY & SURGERYBLUE AUDITORIUM / AMPHI BLEUSESSION 13REJUVENATION OF THE EYES: MEDICAL AND SURGICAL APPROACHES PART 1LE RAJEUNISSEMENT DE LA ZONE PÉRI-ORBITALE : APPROCHES MÉDICALE ET CHIRURGICALECHAIR: CÉDRIC KRON PLASTIC SURGEON (PARIS, FRANCE)ROBERT PETERSON PLASTIC SURGEON (HONOLULU, USA)8.30 am / 8h30PARTICULARITIES OF PERI-ORBITAL ANATOMYPARTICULARITÉS ANATOMIQUES DE LA ZONE PÉRI-ORBITALEJACQUES LAGIER(FRANCE)This lecture deals with corpse anatomic dissection performed in the anatomic laboratory of the faculty of Medecine in Nice.The Human anatomy forms the basis of all medical and surgical procedures .Firstly, the eyelid skin is the thinnest and the most mobile part of the body.With time, sun exposure and smoking, a lot of changes occur, namely a misposition of the eyebrows, dermatochaliasis, fat bag, lines,and rings .These changes are accounted for by the gravity forces and thus result in facial fat drop and muscular weakening .Secondly, I would like to point out the "SMAS" and its continuity with the orbicularis muscle .You can see how to use the fasciasuperficialis flap in oculoplastic surgery .Thirdly, the anatomy of the glabellar area shows you how to treat glabellar lines with botulic toxin. Moreover, the anatomy of thesuperior and inferior orbital rim shows you how to perform the lipostructure graft.Lastly, deeper, under the orbicularis muscle, you can see the levator eyelid system.To conclude, I will show you an example of surgical procedure directly applied from anatomy.63

“FRESH-EYE-LOOK” WITH BOTOX AND FILLERSRAJEUNISSEMENT PÉRI-ORBITAL GRÂCE À LA TOXINE BOTULIQUE ET AUX FILLERSSAID HILTON(GERMANY)AESTHETIC DERMATOLOGY & SURGERYThe expression of the eye is essential for the assessment of age and beauty of a person. Therefore the aesthetic orbital reshaping isone of the most important procedures in cosmetic medicine. Depending on indication and patient's choice we offer and combinedifferent tools: surgery, ablation, implants, fillers and botulinum toxin (Btx). During this presentation will be shown the current standardin technique and injection points for the combination of Btx and fillers for periorbital nonsurgical rejuvenation as well as possible sideeffects and their treatment.TEMPORAL LIFT BY GALEAPEXYLE LIFTING TEMPORAL PAR GALÉAPEXIEALAIN FOGLI(FRANCE)When performing a full face-lift, one can very often notice an unsufficient improvement at the level of the temporal and malar regions.They represent a transitory zone between foreheads and face. The purpose of this article is to describe a technique with an intracapillarytemporal approach giving us an elevation of the tail of brow, an improvement of crow's feet and of the malar area. We willalso discuss an associated skin resection of the lower lid. We accomplish a temporal lift by anchoring the upper edge of the incisedto the temporal fascia.PLACE OF CANTHOPEXY/ CANTHOPLASTY IN THE REJUVENATION OF THE REGARDPLACE DE LA CANTHOPEXIE / CANTHOPLASTIE DANS LE RAJEUNISSEMENT DU REGARDROBERT PETERSON(USA)Loss of lower lid support is a common sequel of aging, and this loss of eyelid support can lead to lower eyelid ptosis, scleral show,and a prominent lid/cheek junction with festooning. Rejuvenation of the lower lid and upper cheek depends upon this lid support, andwhen absent, it is vital to restore good support prior to removal of skin, muscle or fat. In this lecture we will show the importance oflower lid support, and discuss technical options for achieving it:1. The importance of location of suture placement for support sutures2. How to avoid lid pulling away from the globe and resulting conjunctival edema3. Decision whether to release the lateral septum to get more lid elevation4. Suture options and selection5. To split or not split the orbicularis muscle?6. Post-op ancillary measures7. When to shorten the lid, and how to do it8. Lid support to help with the lid/cheek junction9. Should you ever do a lower blepharoplasty without canthopexy?UPPERFACE REJUVENATIONRAJEUNISSEMENT DU HAUT DU VISAGEROBERT PETERSON(USA)The eyes are the key to the upper face, and attention to the periorbital area yields the most benefit for the upper face. Properpositioning of the brow gives an adequate space between the lashes and the brow to provide space to create a visible lid crease andto apply makeup that will not get caught up in cascading lid skin. Elevation of the ptotic brow provides multiple benefits: giving a wider,more open eye, tightening the skin of the lateral orbit (lateral lid hooding and "crow's feet"), elevating the cheek skin and helping tosupport the lower lid, and helping to smooth the lid/cheek junction. Various techniques for brow elevation are discussed and compared.Other techniques to achieve these goals are also discussed and contrasted.Midface lifting and smoothing of the lid/cheek junction is the next important topic for upper face rejuvenation. This lift gives excellentsupport to the lower lid, and allows removal of skin from the lid without sclera show or ectropion. It gives fullness to the cheeks overthe malar area, and decreases the sagging of the tissues in the lower face. Different closed and open techniques are discussed, asare other techniques to achieve these goals.Ancillary procedures and techniques complete this discussion of upper face rejuvenation: Botox, fillers, laser, fat grafting, skintightening procedures, skin resurfacing and skin care and their place in the set of available options are discussed.PERIORBITAL REJUVENATION BY CO 2 INFUSIONRAJEUNISSEMENT PÉRI-ORBITAL PAR L’INFUSION DE CO 2CARLOS ANTONIO ABRAMO(BRAZIL)Background: Carbon dioxide as medical therapy was firstly employed through CO2-enriched water baths, in France at the Thermesde Royat, during the 50's. Afterward, several devices were created for practical use of the carbon dioxide allowing the transdermal orsubcutaneous application of the gas. Recently, an advanced device, the Rioblush ® machine, was developed adding a warm unit to theframework of the device. This unit heats the gas toward a temperature next to the body temperature reducing painful during the carbondioxide infusion, also enhancing vasodilatation of the peripheral blood vessels at the level of the puncture. In addition, a control unit64

for the carbon dioxide infusion pressure was added to the advanced device regulating the flow velocity. It is provided with manual andautomatic programs that increase linearly or gradually the carbon dioxide flow during the infusion, expanding the tissues according toits resistance.To proper application of carbon dioxide is necessary to take into account the skin and fat characteristics at the periorbital area, and itsresponse to the aging process. The skin of the upper eyelid is usually thin composed by epidermis and dermis without subcutaneoustissue. In the lower eyelid the skin at the ciliary margin is similar to that of the upper eyelid. However, from the ciliary margin towardthe arcus marginalis the subcutaneous tissue gradually increases, achieving the same thickness of the subcutaneous tissue of theupper middle third of the face. The aging effects over the skin of the periorbital area are responsible by the flaccidity of the upper andlower eyelids; wrinkles at the lateral canthus and lower eyelid; and darkening with compromise the upper and lower eyelids partially,at the ciliary margin or entirely, involving the eyelid as a whole.The aging effect over the skin and fat at the arcus marginalis produces a bulge on the boundary of the periorbital area with the upperportion of the middle third of the face named malar fat bag.Periorbital Rejuvenation through Carbon Dioxide InfusionAESTHETIC DERMATOLOGY & SURGERYRecovery of the skin deformities on upper and lower eyelids by using a Rioblush ® machine for carbon dioxide infusion is accomplishedthrough punctures employing a 30 Gfi needle. Carbon dioxide infusion is performed either with 1 puncture at the level of the lateralcanthus for both upper and lower eyelids, or with 2 punctures, one over the lateral portion of each eyelid.The punctures are located 1.0 cm distant from the lateral canthus. Improvement of the malar fat bag is performed by 1 puncture at thearcus marginalis with the needle toward inferiorly. For safety the depth of the punctures for upper and lower eyelids must be superficial,more precisely within the dermis. It is accomplished only introducing the hole of the needle into the skin. A deep infusion in the upperand lower eyelids is not safe, being able to cause disruption of the orbicularis oculi muscle and orbital septum, also may compromisethe eyeball and optical nerve. Unlikely, at the malar fat bag the puncture is deep, inside the subcutaneous tissue.The bone projection of the arcus marginalis underneath the subcutaneous tissue shields the orbital contents of the carbon dioxideinfusion. In our point of view, to improve the skin deformities of the eyelids the linear flow of the gas provided by the manual programis more effective than the gradually increased flow provided by the automatic program. Also, the manual program appears moreeffective than the automatic program in the treatment of fat excess of the malar fat bag, reducing the bulge at the arcus marginalis.The infusion pressure to treatment of the skin deformities and fat excess can be 60 or 80 ml of carbon dioxide per minute, inaccordance with the opposition provided by the tissue.The length or duration of the carbon dioxide infusion is not determined by time, merely by the degree of skin expansion or eyelidprojection. Eyelid projection disappears until 5 minutes after the infusion.The number of applications for session depends on the improvement achieved, ranging from 5 to 10 applications, with interval of 3days between each one. For moderate to expressive deformities the sessions can be repeated 1, 3 or 6 months after the firstapplication.TREATMENT OF UNAESTHETIC VEINS IN THE PERIORBITAL AREATRAITEMENT DES VEINES INESTHÉTIQUES DE LA ZONE PÉRI-ORBITALEALBERT ADRIEN RAMELET(SWITZERLAND)Dilated veins of the face may be a real cosmetic burden. Treatment modalities include- sclerotherapy, which may be risky (persistent facial edema, risks of extension of the sclerosing agent to the orbit),- laser, which may be problematic when performed close to the eye,- phlebectomy, according to the Muller's technique, which is as safe alternative in experienced hands. This technique will be describedand discussed.SESSION 14REJUVENATION OF THE EYES: MEDICAL AND SURGICAL APPROACHES PART 2LE RAJEUNISSEMENT DE LA ZONE PÉRI-ORBITALE : APPROCHES MÉDICALE ET CHIRURGICALECHAIR: CÉDRIC KRON PLASTIC SURGEON (PARIS, FRANCE)11.00 PM / 11H00 SAID HILTON AESTHETIC DERMATOLOGIST (DUSSELDORF, GERMANY)TRICKS FOR ASIAN UPPER BLEPHAROPLASTIESASTUCES POUR LES BLÉPHAROPLASTIES CHEZ LE SUJET ASIATIQUEROBERT PETERSON(USA)To understand Asian upper blepharoplasty, it is necessary to understand the anatomic relationships of the levator muscle, theorbicularis muscle, and the tarsus. The orbicularis muscle is a sphincter, and acts to close the eyelid by pulling the tarsus down. Theantagonist muscle is the levator, which opens the lid by pulling up on the tarsus. The orbicularis overlies the levator aponeurosis: thesetwo structures glide against each other during eyelid motion in the pretarsal area. They form a Y-shaped relationship with the lower legof the Y corresponding to the area where they are in contact. The upper left arm of the Y corresponds to the orbicularis, and the rightarm the levator: the gap between them contains the orbital septal fat.This anatomic basis is used to examine the various techniques for creation of the lid fold:1. Suture techniques - most popular in Japan/Korea/Taiwan2. Remove pretarsal tissue - popular in China3. Levator sling - most common in US4. RF5. Laser65

AESTHETIC DERMATOLOGY & SURGERYWe will also use this discuss and explain:1. Ptosis due to levator dehiscence2. Hollow upper eye configuration, with a high crease3. Brow position at rest, in animation, and compensated ptosis4. Pretarsal skin wrinkling5. Lash ptosis and elevation with blepharoplasty6. Epicanthal fold treatments7. Dealing with fat and why removal of fat can elevate the creaseDOUBLE FOLD UPPER BLEPHAROPLASTY: "SURGICAL TRICKS"BLÉPHAROPLASTIE DES PAUPIÈRES SUPÉRIEURES : "ASTUCES CHIRURGICALES”CEDRIC KRON(FRANCE)PERIORBITAL REJUVENATION BY HARAJEUNISSEMENT PÉRI-ORBITAL PAR L’ACIDE HYALURONIQUENADINE POMAREDE(FRANCE)TEAR TROUGH REJUVENATION BY LIPOSTRUCTURERAJEUNISSEMENT DE LA VALLÉE DES LARMES PAR LIPOSTRUCTURESEBASTIANO MONTONERI(ITALY & FRANCE)TEAR TROUGH REJUVENATION WITH LUNCH TIME LIFTINGRAJEUNISSEMENT DE LA VALLÉE DES LARMES AVEC LE LIFT “LUNCH TIME”MARCO GALLUCCI(ITALY)PERIORBITAL REJUVENATION BY LASERSRAJEUNISSEMENT PÉRI-ORBITAL GRÂCE AU LASERCHEMICAL BLEPHAROPLASTYBLÉPHAROPLASTIE CHIMIQUEJEAN-LUC LEVY(FRANCE)PHILIPPE DEPREZ(SPAIN)Il est actuellement possible, sans chirurgie, d'améliorer l'esthétique des paupières supérieures et / ou inférieures. Le traitement utiliseune huile de phénol et est indiqué en cas de flétrissure cutanée sans excès graisseux chez les patients de phototype 1 à 4.La technique est simple : après dégraissage et désinfection mais sans anesthésie, on applique l'huile de phénol "Lip & eyelid" à l'aided'un coton-tige sur les paupières. Une anesthésie locale apparaît en même temps qu'un blanchiment uniforme. Le traitement desquatre paupières dure de 15 à 30 minutes. Aucune occlusion n'est nécessaire mais le traitement des paupières au phénol doit êtreassocié à un peeling d'uniformisation sur le reste du visage. Ce peeling d'uniformisation, en fonction de l'intensité duphotovieillissement, peut être limité à la basale de l'épiderme ou atteindre le derme papillaire.Au premier jour, une poudre cicatrisante spécifique ou un onguent antibiotique est appliqué. A partir du 10 ème jour et si la peau dela patiente le tolère, une crème "bleaching-blending" est appliquée 2 fois par jour durant les quelques mois suivants pour éviterd'éventuels rebonds pigmentaires. Le prix de la simplicité du traitement est un érythème qui peut durer plusieurs mois. L'oedème estrapidement résolutif, en quelques jours.Les résultats définitifs se lisent à trois mois. Une éventuelle retouche peut s'effectuer un à deux mois après le premier traitementQuoique la chirurgie reste d'une efficacité supérieure dans certains cas et notamment en cas d'excès graisseux, ce traitement simplepermet souvent d'effacer définitivement le chiffonnage des paupières inférieures et de remettre la peau de la paupière supérieure entension, sans modifier le regard du patient et sans imposer au médecin d'importants investissements en matériel.Les doses totales de phénol utilisées permettent de rester toujours loin de la limite de toxicité.SESSION 152.00 pm / 14h00INTRODUCTIONIDEAS AND INNOVATIONS: "THINK DIFFERENT"IDÉES ET INNOVATIONS : PENSER AUTREMENTCHAIR: FRANÇOIS PETIT PLASTIC SURGEON (PARIS, FRANCE)OLIVIER CLAUDE PLASTIC SURGEON (PARIS, FRANCE)FRANÇOIS PETIT (FRANCE)66

PURE BUSINESSHOW TO SET UP A SUCCESSFULL MEDISPA ?COMMENT MONTER UNE CLINIQUE MEDISPA QUI RÉUSSIT ?PAKPILAI THAVISIN(THAILAND)To set up a successful MediSpa business you have to be well prepared. These 8 steps will help you think more thoroughly.1. Identify your strength and weakness2. Secure a solid concept.3. Create your business plan.4. Find the right location.5. Create services and product selection.6. Organize staff team.7. Medical insurance.8. Marketing strategy.AESTHETIC DERMATOLOGY & SURGERYThink more like a business man with the basic 4 P (Product, Price, Place and Promotion) and put in the spirit of medical doctors.COSMETIC MEDICINE AND SURGERY: SHOULD WE TEAM UP A COMPANY OR REMAIN INDEPENDENT ?MÉDECINE COSMÉTIQUE ET CHIRURGIE : TRAVAILLER POUR UNE SOCIÉTÉ OU RESTER INDÉPENDANT ?CAROLE AZZAM(SPAIN)Today the practice of cosmetic surgery has become extremely competitive and surgical skills are not the only skills required to run asuccessful practice.The market has been invaded by companies offering cheap cosmetic surgery. The plastic surgeon, once self-employed or working aspart of a professional association, is now recruited as an employee and paid according to workload and marketing skills. The currenttrend is turning plastic surgery into a consumer-oriented business employing aggressive marketing techniques that dictates profoundchanges in the way the plastic surgery specialty is perceived by the general public.Is this the "modern era" of plastic surgery? Some second thoughts are mandatory.General market trends point to a worldwide increase in demand for cosmetic surgery for both sexes and for all procedures on offer.Statistics, regional differences, legal issues and possible long-term outcomes are reviewed.Three aspects will be analyzed further: low cost surgery, touristic cosmetic surgery and permissive marketing. As a general economicrule, resource allocation will find its way to the cheapest market and transnational travel for cosmetic surgery has now become a solidreality.Furthermore the Internet is now the vehicle of these supermarkets of cosmetic surgery, blurring the perception of surgery as a choicewithout relevant risks and turning plastic surgeons into risk-averse service providers.In the long term this is going to affect not only the public chasing unreasonable results or the professional image of plastic surgeonsnow turned into greedy marionnettes but it will erode the very meaning of cosmetic surgery as a way to enhance ones defective selfand substitute it with the idea of a disposable one.SCARLOCK SYSTEM: THE IDEAL DEVICE TO PREVENT “BAD PAYERS” IN COSMETIC SURGERYLE SYSTÈME SCARLOCK : IDAL POUR PRÉVENIR LES “MAUVAIS PAYEURS” EN CHIRURGIE ESTHÉTIQUEFRANÇOIS PETIT(FRANCE)PURE PRACTICEMACROLANE INJECTIONS: THE ULTIMATE TOOL FOR SILHOUETTE RESHAPING?INJECTIONS DE MACROLANE : L’OUTIL ULTIME POUR LE MODELAGE DE LA SILHOUETTE ?PATRICK TRÉVIDIC(FRANCE)Macrolane from Q MED is a pure HA product with NASHA technology.This product received the CE mark in September 2007.The first indications of this product were body concave deformities but now the main indications are the reshaping of the silhouettemainly buttocks and breasts.The author shows the technique on video under local anaesthesia and clinical cases with radiological images.The patient selection is discussed.This product needs more datas for breasts and the author will summarize the current surveys.LASER-ASSISTED LIPOLYSIS: TECHNIQUES AND RESULTSLIPOLYSE ASSISTÉE PAR LASER : TECHNIQUES ET RÉSULTATSERIC PLOT - ARMAND PARANQUE(FRANCE)EnglishWhy a plastic surgeon interested in laser assisted lipolysis?Liposuction is a wonderful technique of removing fat overload; the results are excellent when the skin retraction occurs secondarily.67

But we all know its limitations on flaccid areas and in some difficult areas where skin retraction is often disappointing: localized fat inthe face, back, upper umbilical region, internal side of the thigh in particular.We seemed worthwhile to test a new technique (laser assisted lipolysis) whose thermal effect should cause destruction of fat cells(lipolysis) and promotes tissue retraction.So after a reminder of the principle of operation, we propose to evaluate the preliminary results of this technique, the lack of side effects(in particular the absence of skin burns), and its limitsAESTHETIC DERMATOLOGY & SURGERYFrançaisPourquoi un chirurgien plasticien s'intéresserait il à la lipolyse par laser ?La liposuccion est une technique merveilleuse de suppression des surcharges graisseuses, les résultats sont excellents lorsque larétraction cutanée survient secondairement.Néanmoins nous connaissons tous ses limites lorsqu'il existe un relâchement cutané préexistant ou dans certaines zones ou larétraction cutanée est souvent décevante : graisse localisée du visage, dos, bourrelet sus ombilical, face interne des cuisses enparticulier.Il nous est paru intéressant de tester une nouvelle technique qui par ses effets thermiques permettrait outre une destruction descellules adipeuses, l'obtention d'une rétraction tissulaire.Ainsi après un rappel du principe de fonctionnement, nous nous proposons d'évaluer les résultats préliminaires de cette technique,l'absence d'effet secondaire (en particulier l'absence de brûlure cutanée) et ses limites.CARBOXYTHERAPYCARBOXYTHÉRAPIESEBASTIANO MONTONERI(ITALY & FRANCE)HYALURONIDASE: AN EFFICIENT TREATMENT FOR UNAESTHETIC HYALURONIC ACID OVER CORRECTIONHYALURONIDASE : UN TRAITEMENT EFFICACE POUR LES SURCORRECTIONS INESTHÉTIQUES PAR ACIDE HYALURONIQUEPIERRE ANDRÉ(FRANCE)PURE SCIENCEADIPOSE-DERIVED STEM CELL IN COSMETIC MEDICINE AND SURGERYLES CELLULES SOUCHES DÉRIVÉES DU TISSU ADIPEUX EN MÉDECINE COSMÉTIQUE ET EN CHIRURGIEFLORENCIO Q. LUCERO(PHILIPPINES)Stem cell therapies hold great promise for anti-aging benefits as they are regenerative in nature. Autologous adipose-derived stemcell transplants hold even more potential as they have no ethical barriers and require no out-of-surgery culture requirements. We havedevised a method that entails the isolation of stem cells from fat derived from a mini-liposuction procedure, their activation from aquiescent stage to an active stage, and their reintroduction back into the patient via intravenous mode.This method has now been performed on 167 subjects over a two year period with no adverse effect. The anti-aging benefits that havebeen observed and reported include increased energy level, vigor, stamina and desire for physical activity, improved short-termmemory and powers of attention and concentration, better moods, improvement in sleeping patterns, enhanced sexual function andpotency, better appetite and improved digestion, improved hearing and eyesight, improved skin vitality, hair thickness and blackening.Benefits were also observed on a variety of degenerative disease types; however, they were on a small sample number.Improvement was observed in diabetic patients which prompted us to do a clinical trial to assess the efficacy of the therapy on 37patients with type II diabetes mellitus.An initial follow up of these patients after three months post-operation has shown a significant and sustained reduction in fastingglucose levels (from 10.36+4.39 mmol/l to 7.11+2.07 mmol/l; p=0.005), and glycosylated haemoglobin (from 9.12+1.90% to7.55+0.91% ; p=0.0003), and triglycerides (from 2.09+0.87 to 1.43+0.81 ; p=0.0003).There was no change in C-peptide levels, total cholesterols and other CBC, LFT and KFT values. The results of the trial to date suggestthat the autologous adipose derived stem cell therapy appears to help type II diabetes patients by decreasing their resistance to insulinand decreasing their overall cardiovascular risk factors. We believe that the stem cell transplant is probably acting by positivelyaffecting the autonomic nervous system in these subjects but this is yet to be proven. Most patients noticed the anti-aging benefitsreported above and an improvement in their neuropathy.FROM FAT TRANSFERT TO STEM CELL TRANSPLANTATION: NEW METHODS IN AESTHETIC BODYFORMINGDE LA GREFFE GRAISSEUSE À LA TRANSPLANTATION DE CELLULE SOUCHE : NOUVELLES MÉTHODES DEREMODELAGE CORPORELKARL-GEORG HEINRICH(AUSTRIA)Fat transfer has been widely used as means of body contouring and soft tissue augmentation. Results being reported by the physiciansperforming the procedure variied between complete disappointment and complete satisfaction with the outcome in terms of cosmeticresults and stability.As has been shown before fatty tissue contains stemcells, pre-adipocytes and other precursor cells.Some of the known effects of fat transfer on the treated tissue may be directly related to stemcell-activity.Protocols to enriche transplanted fat with vital stemcells and precursor cells may be the way to achieve longlasting stable results intissue augmentation. In our clinic in Vienna we are performing Stemcell assisted Fat transfer for body contouring and breastaugmentation with promissing results68

SESSION 164.30 pm / 16h30THE ANTERIOR THIGHLA CUISSE ANTÉRIEUREFAT SYMPOSIUM - PRACTICAL ROUND TABLE: HOW DO I TREAT THE DIFFICULT AREAS? PART 3FAT SYMPOSIUM - TABLE RONDE PRATIQUE : COMMENT TRAITER LES ZONES DIFFICILES ?CHAIR: PHILIPPE BLANCHEMAISON PHLEBOLOGIST (PARIS, FRANCE)GUSTAVO LEIBASCHOFF AESTHETIC MEDICAL DOCTOR (BUENOS AIRES, ARGENTINA)WILMAR ACCURSO(BRAZIL)Carboxitherapy in the treatment of cellulites and flaccidity of the lower bodyAESTHETIC DERMATOLOGY & SURGERYCarbon dioxide therapy has been used since 1930 and consists in the administration of CO2 subcutaneously. This method has manypharmacological effects that will be described as following. The first effect is an improvement of microcirculation and the enhancementof the dissociation curve of hemoglobin (Bohr Effect), with marked elevation of oxygen concentration in the tissues immediately afterthe treatment.The second effect is the fracture of adipose tissue with release of triglycerides and glycerol by not well known mechanisms. Thislipolytic activity could be a consequence of a mechanical action or due to local biochemical alterations secondary to the changes inCO2 and O2 tension just after the infusion of CO2. The third effect is an improvement in skin elasticity by the stimulus to the productionof collagen. After the treatment we can see a thicker dermis with more collagen fibers distributed more homogeneously and diffuselycompared with pre treated skin. As in the process of cellulites we have microcirculatory changes in both arterial and venous circulationbesides the primary or secondary alteration of lymphatic drainage, and pathological modifications in the fat tissue volume andarchitecture, we can expect a good response in the treatment of cellulites with carboxytherapy. Frequently we have also skin flaccidityassociated with cellulites, which adds one more indication for using carboxytherapy in the treatment of unaesthetic problems of thelower part of the body.We have been using this method since 2003 and have been searching the best parameters to have better results. We will show ourpresent experience on using this technique in the Clinical Research Center of the Brazilian Society of Aesthetic Medicine (São Paulo)for the treatment of cellulites and flaccidity of lower part of the body, showing the best flux, volume of CO2 and the puncture techniqueto achieve the best clinical effect. Improvement of skin elasticity, reduction of body measures and a better appearance of the cellulitesprocess are the final results achieved.THE INTERNAL SIDE OF THE THIGHLA ZONE INTERNE DE LA CUISSEANKLE AND CALFCHEVILLE ET MOLLETTHE BACK OF THE ARMSL'ARRIÈRE DES BRASLIPOSUCTION OF THE BREASTLIPOSUCCION DES SEINSLOCALIZED FATTY AREAS OF THE BACKZONES GRAISSEUSES LOCALISÉES DU DOSSADDLEBAGSCULOTTE DE CHEVALPHILIPPE BLANCHEMAISON(FRANCE)CLAUDE GARDE(FRANCE)CLAUDIA VAN DER LUGT(NETHERLANDS)FRANÇOIS PETIT(FRANCE)NICOLA ZERBINATI(ITALY)GERHARD SATTLER(GERMANY)How to I treat the difficult areas: SaddlebagThe outer upper thighs are probably the most common area of the female body to treat by liposuction. Although seen as a very goodarea for beginners in liposuction, the saddlebag deformity shows a number of pitfalls possibilities which can limit the excitement of thepatient.The individual variety of influencing factors include the thickness of the fat layer, the shape and volume of the buttocks, the kind ofbuttocks' crease, the extend of the individual case, the position and the shape of the trochanter and the communicating areas of theresidual parts of the thigh.Surgical strategies and maneuvers can avoid in all cases a disappointing result. These aspects will be presented and discussed.In this respect, fat removal in this area is most rewarding, excessive fat removal leads to the opinion that in a lot of cases a rule hasto be accepted: Less is more.69

LOWER ABDOMEN WITH FLACIDITYRELÂCHEMENT DU BAS-VENTREANTOINE PARASKEVAS(FRANCE)AESTHETIC DERMATOLOGY & SURGERYLIPOSUCTION OF THE NECK AND JOWLSLIPPOSUCCION DU COU ET DES BAJOUESGIOVANNI SALTI(ITALY)Aging of the neck is synchronous with aging of the face. Aging in the neck is mostly gravitational and volumetric, and occurs togetherwith jowls fat pad sagging. These changes are evident in both obese and nonobese individuals.A review of the different indications, techniques and results will be presented. A special attention is drawn on particular indications,alternative techniques and clinical results.LOCALIZED FAT ON THE FACELA GRAISSE LOCALISÉE DU VISAGETHIERRY MARÉCHAL(FRANCE)Treatment of localized fat on the face is considered as a more difficult area to treat due to its morphology and anatomy. Face hasseldom very thick fatty deposits, except in Asian patients or baby face syndrome. Besides, we have to consider during all treatmentprocedure the mouth cavity in the back and the framework of nerves passing all throughout. When coming to the neck, we have toconsider the localization of lymph knots, of vascular networks and vicinity of glands thyroid, parathyroid and parotid deeper. Obviously,the treatment can't be too invasive in this area.Focus on a technique will be established in regards of the following factors :- the precise localization of fat: cheeks, jaws, lower eye bulges, naso-labial fold and mount, sub-mental area, neck;- the thickness of localized fatty tissue and its tension or on the contrary its laxity;- face general laxity, especially when treating neck and jaws;- the patient's age, baring in mind that over treating fat localized on face can make one look older.Each fat treatment technique has advantages and drawbacks depending of the patient's specific case and condition. Sometimes,combined therapies will be more helpful than a single choice. The aim is always to have the higher possible results with patient'ssatisfaction and to lessen the risks.Treatment by Injection Lipolysis: Injecting a combination of phosphatidylcholine and deoxycholate according to Network-Lipolysiswell established protocol is a very easy-to-do treatment of fat localized on the face. The proper dosage has to be injected to the areaat 6mm deep every 1,5cm. With this technique all face and neck areas can be successfully treated. Often one sometimes two sessionsis necessary for obtaining a complete lysis of exceeding fat and a dramatic skin retraction.These adipocytolysing injections are definitively, from my experience, the non-invasive treatment giving the best results. Nevertheless,special care and know-how is essential for treating lower eye bulges, even if records of positive treatment exist it is still only to beperformed by specialized physician due to the risk of swelling of the orbicular cavity.Patients have anyway to be duly informed of the swelling of their face afterwards an Injection Lipolysis session, be it jaws, neck, submentalor cheeks area, lasting for 72 hours. Besides, no pain, no haematomas, compared to body treatments.Treatment by Laser Lipolysis: My experience of Laser Lipolysis treatments is based on the use of Osyris Pharaon 980 device, alaser developed in cooperation with Lille university (department medical lasers applications) and patented for its lipolytic and skinretraction action.Treating fat localized on face with an endo-laser is a delicate procedure due to the difficulty of reaching all areas with a canula withouttoo many cuts and no cuts at all on the face itself. Nevertheless, the company has now patented new extra thin, short canulas with asoft end enabling a better manipulation of the laser. These are considerably making the treatment of sub-mental area, jaws, neck ornaso-labial mount and fold around easier as canula can penetrate as far as the level of the nose with real comfort.A special care for these face areas is regarding temperature as it grows high very quickly due to the small surface, which is a risk ofburning the patient. Therefore, power is to be lessen on the face and not more than 9-10 watts. As well, we need to care about placingcuts for the optic fiber and canula penetration when treating a face. Even if cuts are extremely thin, one has to always try to place themunder the jaws or sub-mental area.Adjuvant techniquesResults will show after 2 up to 4 months. Improving this time as well as the discomfort of side effects inherent to each procedure ispossible with a combination of 4 other techniques:- a/ Low frequency ultrasounds efficiently draining micro particles of melted fat (Osmolipocel TM);- b/ Tri-polar radio frequencies for a deeper skin retraction effect (Regen TM);- c/ Carboxytherapy for its action on microcirculation, can be also applied before a lipolytic procedure for softening fatty tissues(Rioblush TM);- d/ Lymph manual drainage of face and neck for a quicker normalization of the tissues and oedema.Conclusion: Considering treatment of fat localized on the face, most important is the proper evaluation of the importance of fattydeposits and of the degree of skin laxity before choosing which technique to undergo. Up to my opinion and experience, I would chooselipolysis by laser for treating sub-mental area alone with a permanent focus on temperature, power and deepness of penetration of thelaser in order to avoid any risk of skin burn, especially when finishing the procedure with more superficial moves inducing andenhancing skin retraction in the following 6 months.Besides, I would choose lipolysis by injection for all other parts of the face, jaws and sub-orbital areas for the easiness, precision ofthe procedure. Only the swelling lasting for about 3 days is a necessity of warning the patient in case of an active social life. In allcases, application of adjuvant techniques enables quicker results in fat melting away, skin retraction and patient's comfort for a highersatisfaction.70

Saturday April 12 th / Samedi 12 AvrilSESSION 17AESTHETIC DERMATOLOGY & SURGERYROOM / SALLE 252 ABHAND REJUVENATION: AN INCREASING DEMAND FROM THE PATIENTSLE RAJEUNISSEMENT DES MAINS : UNE DEMANDE CROISSANTE DE LA PART DES PATIENTESCHAIR: MARC LEFEBVRE-VILARDEBO VASCULAR SURGEON (PARIS, FRANCE)TORELLO LOTTI PROFESSOR OF DERMATOLOGY (FLORENCE, ITALY)AESTHETIC DERMATOLOGY & SURGERY8.30 am / 8h30THE HAND: WHAT IS THE REQUEST FOR AESTHETIC TREATMENTS? RESULTS OF OUR SURVEYLA MAIN : QUELLES DEMANDES DE TRAITEMENTS ESTHÉTIQUES ? LES RÉSULTATS DE NOTRE ENQUÊTEMATTHIEU BEUSTES-STEFANELLI(FRANCE)Introduction: The hand, along with the face, is the only constantly exposed part of the body, and its appearance therefore plays animportant social role. Nevertheless aesthetic treatments of the hand are still little known and poorly developed. We performed a surveyin a French population to study the aesthetic importance of the hand and the main aesthetic requests which are made.Methods: A questionnaire relating to the hand and its aesthetics was sent by e-mail to a wide population. There were 200 respondents.A statistical analysis was performed by a single observer.Results: The mean grade of importance for hands aesthetics is 3 on a scale of 4. The hand appears in 4th position from an aestheticpoint of view, after the face, the general figure and the skin. The general shape, the quality of the skin, the dorsal aspect of the handand the nails are the most important aesthetic elements. Brown spots, unaesthetic nails, very visible tendons and veins, very thin andwrinkled skin, presence of pathologies or injuries and heavy palmar sweating are the unaesthetic elements which stand out most.Conclusion: This survey confirms the aesthetic importance of the hand in the general population and demonstrates that numerouselements are accessible to corrective treatments which concern various specialities, and which require therefore a multidisciplinaryapproach.SCLEROTHERAPY OF HAND VEINSLA SCLÉROTHÉRAPIE DES VEINES DE LA MAINMARIO VALSAMIS(GREECE)Intention: Injection sclerotherapy is a well known and widely used method of treatment for the varicose veins of the legs and can giveexcellent aesthetic results. The same principles of sclerotherapy have been applied for the aesthetic improvement of the dilated veinsof the hand.Methods: In this non randomized prospective study, 13 women with dilated veins of the dorsum of the hand were treated for anaesthetic improvement of their hands. All the patients were informed, that an overall aesthetic amelioration by the diminution of thevery dilated veins was the goal of the treatment. No vein was to be eradicated. Polidocanol 0.5-0.75%, Sodium Tetradecyl Sulfate 0.25-0.5% and Scleremo 70%, all of them in their liquid form, were the sclerotherapeutic agents that were used. Various quantities wereinjected in each hand (max: 2,5cc), depending on the size and the number of the veins we wanted to treat. Both hands were injectedin each session. No bandaging, elastic or not, was applied after the treatment. No precautions and no restrictions were implied afterthe treatment. The achievement of a spasm immediately after the veins have been injected was a good prognostic factor for theresponse of the veins to the treatment. The result of the previous session implied our treatment tactics for the following session. Thetotal result was regarded as satisfactory, when the diameter of the treated veins was such that the patient was overall satisfied.Results: Minimum 1 and maximum 4 sessions were needed for an overall satisfactory result. The age of the patient and the diameterof the veins were two good prognostic factors for the total number of the sessions that were needed and the concentrations and thequantities of the drugs that were used for a good result. In younger patients and in larger venous diameters, we needed more sessionsfor a good result and we used more important concentrations and quantities per session. All our patients supported the injections verywell. There were no complaints during or after the treatment and no oedemas were noted by us or mentioned by the patient.Coclusion: Injection sclerotherapy treatment of hand veins can give good aesthetic results with safety and relative ease.PHLEBECTOMY OF HAND VEINSLA PHLÉBECTOMIE DES VEINES DE LA MAINMARC LEFEBVRE-VILARDEBO(FRANCE)Because of the aging-induced phenomena, hands become commonly thinner and even skinny in elderly people. Dorsal veins candilate or look dilated in contrast. Such aspects can be anatomical for young and slim women. Some feel uncomfortable with such handsin their social life and ask strongly for their unaesthetic veins to be "erased". The easiest solution is the destruction of the veins.The first principle of treatments is to refuse to destroy all dorsal veins even if dilated, for two reasons. Firstly, aging leads to increasingindications for medical perfusions, and hands are usually the initial level of vein punctures. To loose a distal level may lead long lasting71

AESTHETIC DERMATOLOGY & SURGERYperfusions to induce major complications more rapidly. Secondly, superficial dorsal veins are the main channels of venous drainageof the hand. To destroy too many veins may induce a secondary and undesirable dilation of residual veins.The second principle is to give a very selective result. A pretherapeutic agreement decides the veins to be treated and those to bekept in place.Sclerotherapy and phlebectomy are the two possible methods. Injection of sclerosing agents is the less aggressive method. But it ispoorly selective as sclerosis may spread too widely. And results frequently include unaesthetic sub-cutaneously visible cord as residueof the fibrosed vein. The method of our choice is phlebectomy. Performed under local anesthesia, procedure can be precisely tailoredto the initial venous anatomy and keep the chosen veins. Veins are removed with sharp hooks through 1-3 mm incisions, whichbecome invisible 1 to 3 months later. From a series of 45 consecutive patients, all procedures but one have been technicallysuccessfull. No complications or side effects have been noted. The aesthetic satisfaction rate is 97.8 % for both patient and physician.Conclusion: Aging induced hands dilated veins are no more answerless unaesthetic troubles. A meticulous but simple surgicalprocedure may give smile back to our patients.FAT GRAFTING OF THE HANDLA GREFFE GRAISSEUSE DE LA MAINRENÉ-FRANÇOIS NIFOROS(FRANCE)INDICATIONS FOR DYSTROPHIC HAND VEINS : DICUSSION FROM CLINICAL CASESINDICATIONS POUR LA DYSTROPHIE DES VEINES DE LA MAIN : DISCUSSION SUR DES CAS CLINIQUESPANEL SPEAKERSTREATMENT OF HAND PIGMENTARY DISORDERS (BROWN SPOTS)LE TRAITEMENT DES TROUBLES PIGMENTAIRES DE LA MAIN (TACHES BRUNES)TORELLO LOTTI(ITALY)Smaller darkened patches can occur usually on photoexposed skin of older adults who have been exposed to the sun for many years.These spots can be seen on the face, forearms and backs of hands. Brown marks may fade with careful sun protection, broadspectrum sunscreen applied daily for 9 months of the year. Regular applications of anti-aging or fading creams may also help. Thesemay contain hydroquinone, or antioxidants such as: alpha hydroxy acids, vitamin-C, retinoids, azelaic acid. However, brown marksmay be removed more rapidly and effectively by chemical peels, cryotherapy or certain pigment lasers that target melanin in the skin.Multiple treatments may be necessary. Suitable green-light devices include: Flashlamp-pulsed tunable dye laser and Frequencydoubled Q-switched Nd:YAG laser (neodynium:yttrium-aluminium-garnet), while suitable red light devices include: Q-switchedAlexandrite and Q-switched Ruby Intense pulsed light has a similar effect. Ablative lasers (carbon dioxide and Erbium:YAG lasers)vaporise the surface skin thus removing the pigmented lesions. A fractional laser may also have some efficacy. Results are variablebut sometimes very impressive with minimal risk of scarring.HAND REJUVENATION WITH CHEMICAL PEELS AND FILLERSLE RAJEUNISSEMENT DE LA MAIN AVEC LES PEELINGS CHIMIQUES ET LES PRODUITS DE COMBLEMENTSOHAIL MANSOOR(UK)AGING NAILSLE VIEILLISSEMENT DES ONGLESECKART HANEKE(GERMANY)SESSION 1811.00 am / 11h00BREASTS IN ARTLES SEINS DANS L'ARTBREAST REJUVENATIONRAJEUNISSEMENT DES SEINSCHAIR: JEAN-CHRISTOPHE BICHET PLASTIC SURGEON (PARIS, FRANCE)MICHAEL SCHEFLAN PLASTIC SURGEON (TEL AVIV, ISRAEL)PHILIPPE COMAR(FRANCE)WHAT NEEDS TO BE CONSIDERED IN THE AGING PROCESS ON THE BREASTCE QU'IL FAUT PRENDRE EN COMPTE DANS LE PROCESSUS DE VIEILLISSEMENT DES SEINSJAVIER DE BENITO(SPAIN)72

AESTHETIC LIPOMODELING OF THE BREAST: ASSESSMENT AND PRECAUTIONSLE LIPOMODELAGE DES SEINS: INDICATIONS ET PRÉCAUTIONSEMMANUEL DELAY(FRANCE)EVOLUTION OF MACROLANE ®L'ÉVOLUTION DE MACROLANE ®SATORU YAMAGUCHI (JAPAN)PER HEDEN (SWEDEN)AESTHETIC SURGICAL MANAGEMENT OF THE AGING BREAST WITH OR WITHOUT IMPLANTSLA GESTION DE LA CHIRURGIE ESTHÉTIQUE DU VIEILLISSEMENT DES SEINS AVEC OU SANS IMPLANTMICHAEL SCHEFLAN(ISRAEL)AESTHETIC DERMATOLOGY & SURGERYMAMMARY PROSTHESIS WITH LOW PROJECTION: FRENCH SURVEY INDICATIONS AND PROBLEMSPROTHÈSES MAMMAIRES DE BAS PROFIL : ÉTUDE FRANÇAISE, INDICATIONS ET PROBLÈMESJEAN C. BICHET(FRANCE)Mentor launched on the French market a new type of mammary prosthesis with a low projection in 2006.The authors will present the results of a prospective French survey on 60 cases followed up during one year.The main indication and contraindication will be discussedSESSION 192.00 pm / 14h00THE AGING SKIN: EVALUATION AND POSSIBLE TREATMENTSLE VIEILLISSEMENT DE LA PEAU : EVALUATION ET TRAITEMENTS POSSIBLESCHAIR: PHILIPPE HUMBERT PROFESSOR OF DERMATOLOGY (BESANÇON, FRANCE)ECKART HANEKE PROFESSOR OF DERMATOLOGY (FRIBURG, GERMANY)CLINICAL SIGNS OF AGING SKINLES SIGNES CLINIQUES DU VIEILLISSEMENT DE LA PEAUNICHOLAS BACHOT(FRANCE)EVALUATION OF AGING FACE: CLINICAL SCALES AND LAB'S TECHNOLOGIESL'ÉVALUATION DU VIEILLISSEMENT CUTANÉ : ÉCHELLES CLINIQUES ET TECHNOLOGIES DE LABORATOIREPHILIPPE HUMBERT(FRANCE)Facing the increasing importance to appearance, the consumers wish to send back the picture of an interior well-being. It passesnotably by the fact to have a beautiful skin, a good mine and an appropriate face aging.Aging face is one of the most usual evaluated pattern. The aging mode depends on different parameters and conditions. It isgenetically determined, but can also be influenced by the mode of live.Before considering a treatment or a cosmetic proposition, the dermatologist as a skin expert, may add scientific value to this cosmeticdermatological practice by a clear characterization and classification of aging. For that, it may be helped by different scales,considering either the face morphology, or the wrinkle pattern, or color, radiance …Thus esthetic dermatology may nowadays rely on a Evidence Based Medecine approach and a reinforced doctor-patient relationship.It's why new technologies allow to quantitatively measure some skin parameters, and provide a useful tool for the practitioner. Thetendency is nowadays to dispose a gold standard biometrological device for an objective analysis with standardized and reproducibleresults.It will help dermatologists demonstrate the effectiveness of cosmetic procedures and treatments, to improve the reliability of theirdiagnosis thanks to instant analysis of the benefits for the patientExpected new tool would evaluate different skin characteristics (wrinkles, spots, pores, sebum), the efficacy of dermo-cosmeticprocedures, the efficacy of treatments and might represent a break-through innovation for the daily practiceNEW TECHNOLOGIES: THE NANO-PARTICLES AND THE SKINLES NOUVELLES TECHNOLOGIES : LES NANO-PARTICULES ET LA PEAUPIERRE ANDRÉ(FRANCE)ONYCHOCOSMECEUTICALSLA COSMÉTIQUE DES ONGLESECKART HANEKE(GERMANY)73

HYPERSENSITIVE SKIN, A COMMON COMPLAINTLA PEAU HYPERSENSIBLE, UNE PLAINTE COMMUNEMARIE-LAURE FLECHET(FRANCE)AESTHETIC DERMATOLOGY & SURGERYThe term "sensitive skin" commonly refers to an exaggerated and unpleasant sensitivity of the skin to frequent or prolonged use ofevery day products such as cosmetics or toiletries (Synonyms : reactive, hyper-reactive, intolerant or irritable)Instead, the term "reactive" should be preferably used, since "sensitive" could be confused with immunological hyper sensitivity, whichis a very different phenomenon, leading to eczema or urticaria. In addition, the word "sensitive" could suggest the expression of anemotional feeling. Stress and emotions are, indeed, triggering factors of sentivity but only two of many.Sensitive skin is defined by subjective complaints of discomfort and is triggered by various factors, including physical, chemical,psychological or hormonal factors. Erythema is frequent but not necessary. Tests, like the stinging test, the thermal sensitivity test orthe capsaïcin test can help diagnosis .The prevalence is very high. 60% of women and 40% of men are affected. It is more common during summer but doesn't vary withethnic or socio-cultural group.Sensitive skin is more frequent on fair, dry or blushing skin but can occur on hyperseborrheic skin too.The clinical signs are almost exclusively subjective: stinging, pricking, burning sensations; pain or pruritus are possible; erythema,desquamation, papules, wheals, scaling and erythrosis are the only visible signs: invisible dermatosis for KligmannSensitive skin is caused by several combined factors: Physical (UV, heat, cold, wind….), Chemical (cosmetics, soaps, water,pollution….), Food, Psychological, Hormonal, Preexisting facial dermatosis (Atopic Dermatitis, Seborrheic Dermatosis, Rosacea,Psoriasis).Its physiopathogenesis is poorly understood: there are no immune or allergic disorders.Evidences of sensitive skins include a change in the barrier function of the skin and an insensitive water loss increase which could inturn augments exposure to irritants.More recently, the capsaicin test results on sensitive skin have suggested the involvement of the nervous system: neurogenicinflammation seems to result from neuromediators such as substance P, CGRP and VIP, leading to vasodilatation and mast celldegranulation.O. de La Charriere classifies sensitive skin in three categories: sensitive skin and environment, sensitive skin and cosmetics, verysensitive skinSensitive skin is different from irritable and allergic skin. Patch tests, stinging test, capsaicin test can help to diagnose.Finally, treatment is difficult: it is important to first assess the complaints and avoid exposure to the triggering factors and then use alimited number of ingredients and prescribe soothing and moisturizing cosmetics. It is essential to keep in mind that these sensitiveskins pave the way for irritative and allergic skins.NUTRITIONAL SUPPLEMENTATION AND MATURE SKINSUPPLÉMENTATION NUTRITIONNELLE ET PEAU MATUREPATRICIA MANISSIER(FRANCE)With ageing and especially after menopause the skin is the organ in which the changes are the most visible. Most women noticed asudden onset of the signs of skin ageing such as skin dryness, loss of suppleness, wrinkles and pruritus. A specific nutritionalsupplement containing blackcurrant seed and fish oils, rich in omega-3 and -6 fatty acids, vitamins E and C and lycopene wasdeveloped to improve skin condition of mature skin. The purpose of this presentation is to summarize studies that support the efficacyof this nutritional supplement.A first study was a 3 month double-blind, randomised, versus control trial, performed in winter. A total of 80 women, aged 64 ± 7, wereincluded in this study. Clinical examinations and self-evaluation questionnaires allowed assessing skin conditions on face, forearm,hands and legs. Among the 80 volunteers, 40 had further examinations to measure skin hydration (Corneometer ® ), wettability (bycontact angle), relief and scaling (Visioscan ® ). Stratum corneum ceramides content was analysed using HPTLC. Results showed thatafter 3 months, the supplementation improved significantly the clinical scores on the legs for dryness (-7%, p

SESSION 204.00 pm / 16h00DARK CIRCLES: A NEW APPROACHLES CERNES NOIRS : NOUVELLE APPROCHECONTRIBUTING LECTURES IN AESTHETIC DERMATOLOGY AND SURGERYCONFÉRENCES PARTICIPATIVES EN DERMATOLOGIE ET CHIRURGIE ESTHÉTIQUECHAIR: PHILIPPE DEPREZ AETHETIC MEDICAL DOCTOR (EMPURIABRAVA, SPAIN)ALAIN MICHEL PLASTIC SURGEON (MONTBÉLIARD, FRANCE)JEAN-LUC LEVY(FRANCE)AESTHETIC DERMATOLOGY & SURGERYTUMESCENT ANAESTHESIA FOR THE COSMETIC VARICECTOMYL'ANESTHÉSIE TUMESCENTE POUR LA VARICECTOMIE COSMÉTIQUEECKART HANEKE(GERMANY)FEMALE SEXUAL REJUVENATION: NYMPHOPLASTY OR AESTHETICAL LABIAPLASTYRAJEUNISSEMENT SEXUEL FÉMININ : NYMPHOPLASTIE OU LABIAPLASTIE ESTHÉTIQUELAURENT BENADIBA(FRANCE)EnglishThe reduction of the labia minora lips (Labiaplastie or nymphoplasty) the request most frequent in the consultations of plastic surgeryand aesthetic bus for the majority of the patients the embarrassment is primarily aesthetic. This frequent intervention in the extreme-East, or of many techniques are used, has still bad reputation in France. However, in this intimate surgery, it is necessary to be awareof the handicap which exists in many patients who very often do not dare in speaking to their spouse but also to their gynaecologist.The use of techniques of plastic surgery (V Plasties) makes it possible to make importants resection of cutanéo-mucous labia bykeeping the shape and the functional aspect of the labia minora lip fully giving satisfaction to the patients. This intimate surgery istechnically simple and give excellent result bringing to the patients a true physical and psychological relief. On the other hand, it isimportant that this intervention which presents risks is carried out by experts accustomed in surgical (operating room).FrançaisIntroduction: Il y a une dizaine d'années, les interventions sur le sexe féminin ne se concevaient que dans des cas pathologiques.La chirurgie intime regroupe les interventions ayant pour but d'améliorer la région vulvaire féminine. Il ne s'agit pas d'interventionsvisant à recréer une virginité mais d'interventions de chirurgie réparatrice ou esthétique des petites et grandes lèvres, du clitoris etparfois du vagin. Aujourd'hui, des femmes demandent qu'on leur redessine la vulve, qu'on resserre le diamètre de leur vagin. Plusieursinterventions sont possibles. Certaines sont purement gynécologiques, d'autres purement esthétiques mais la demande s'exprime plusfacilement auprès des chirurgiens plasticiens habitués à traiter " ceux qui ne sont pas malades ".Résumé: La réduction des petites lèvres génitales (Labiaplastie ou nymphoplastie) la demande la plus fréquentes dans lesconsultations de chirurgie plastique et esthétique car pour la majorité des patientes la gêne est essentiellement esthétique. Cetteintervention fréquente en extreme-orient, ou de nombreuses techniques sont utilisées, a encore mauvaise réputation en France.Pourtant, dans cette chirurgie intime, il faut avoir conscience du handicap qui existe chez de nombreuses patientes qui bien souventn'osent pas en parler à leur conjoint mais aussi à leur gynécologue.La médiatisation, l'échange d'informations sur des sites internets médicaux de ce type de problème emmène de nombreuses patientesà consulter. Ces patientes expriment une gêne d'ordre esthétique et fonctionnel accentué par l'évolution des modes vestimentaires(jeans très serrés…) et des dessous (string) mais aussi la comparaison avec les actrices de film X ayant des vulves " juvéniles ". Cespatientes, de plus en plus jeunes, vivent un véritable complexe, parfois depuis l'adolescence troublant leur vie amoureuse.Sur le plan chirurgical, il existe de nombreuses techniques plus ou moins complexes mais aux suites opératoires très variables.En France, cette intervention a encore mauvaise réputation, elle est parfois même déconseillée par certains médecins, en particulier,à cause des suites difficiles de la technique la plus courante. L'utilisation de techniques de chirurgie plastique (Plasties en V) permetde faire des résections cutanéo-muqueuses importantes en gardant la forme et l'aspect fonctionnel de la petite lèvre donnantpleinement satisfaction aux patientes.Conclusion: La nymphoplastie ou la réduction des petites lèvres n'est plus un tabou dans notre société. Cette chirurgie intime estsimple techniquement et présente d'excellents résultats apportant aux patientes un véritable soulagement physique et psychologique.En revanche, il est important que cette intervention qui présente des risques soit réalisée par des praticiens habitués en milieuchirurgical (bloc opératoire).OWN EXPERIENCE IN CARRYING OUT REJUVENATING OPERATIONS IN THE MIDDLE FACEEXPÉRIENCE PERSONNELLE DU RAJEUNISSEMENT DU MILIEU DU VISAGEPETER HAJDUK - MARLEN SULAMANIDZE(CZECH REPUBLIC - RUSSIA)Patients are especially concerned about aesthetic manifestations of the ageing process in the area of the cheekbone, cheeks andsuborbital zones, therefore, rejuvenating interventions in these areas are mostly demanding.Aim: To represent experience of the TOTAL CHARM Clinic gained in carrying out aesthetic operations and manipulations in the middleface area by both classical and original techniques.75

AESTHETIC DERMATOLOGY & SURGERYMethods: Amongst surgical interventions which we have used were as follows: face lift, methods of thread-mediated lifting (Aptosthread, Aptos thread 2G, Aptos needle, Aptos needle 2G) in a combination with inferior blepharoplasty and without it, lipofilling, skinpeeling, as well as a combination of these techniques. In so doing, special attention was paid to the individual approach, aiming tominimize the invasion and, more importantly, trying to achieve the effect of moving the subcutaneous soft tissue to a new, aestheticallymore advantageous, higher position with fixation of tissues to hard structures. It was not uncommon that we used the methods aimedat increasing the volume by means of various fillers.Results: We have studied the outcomes following application of the above-mentioned methods of lifting the bucco-zygomatic andsuborbital regions and a combination thereof over the period from 2003 to 2006 in more than 450 patients. In the overwhelmingmajority of the cases, the obtained outcomes proved to satisfy both the surgeons and patients involved.Conclusion: The methods of lifting soft tissues of the middle face and their combinations which we used proved rather efficient inrejuvenating a flabby, aging face.NEW APPROACHES TO THE TREATMENT OF THE AGING FACE WITH THREADLIFT: COMPLETE, EFFECTIVE AND QUICKRESULTNOUVELLES APPROCHES DU TRAITEMENT DU VIEILLISSEMENT FACIAL AVEC THREADLIFT POUR DES RÉSULTATSCOMPLETS, EFFICACES ET RAPIDESCIRO ACCARDO(ITALY)A beautiful face has in itself some characteristics that are expression of balanced and symmetrical proportions of the facial diametersand of the "stereotassic" geometries of the face. Such mathematical proportions manifest themselves at an aesthetical level though aplastic-geometric harmony, that attracts and captures the visual and emotional attention of each of us, inducing prolonged admiration,a positive compulsive evaluation and an universal appreciation.The technique of the "face lifting" is part of the technological evolutions of the last developed surgical techniques, with the purpose toresolve or to attenuate the signs of the ageing on the face.To such purpose, I am lined up with those surgeons firmly convinced that every surgical action is however a demolition of thestructures, of the mechanical dynamics and functional characteristics of the living tissues. Insofar we establish to propose techniquesthat are less invasive or that "are not invasive at all" to resolve the problem of the aging of the face and more in general of the wholeorganism. This atavistic problem will see its definitive solution only when we will be able to check each single phase of the phenotypicalexpression of our genome but above all if we will ever know, in the next future, how to modify it or to stabilize it in a static state "ofeternal youth."The signals of ageing of the face are known to everybody: cutaneous lapsity, cutaneous redundance, atrophy of the adipose tissue,progressive reduction of the tonicity of the muscle-aponeurotic subcutaneous system, degeneration and bony remodelation, etc..These changes produce alterations of the slowness of the mental cervic angle, the onset of the platismatic folds, the appearance andthe fall of the jaw, with loss of the definition of the mandible border, the atrophy of the grease of the malar eminence and of the adiposepad of the Bichat, the close examination of the nose-buccal and bucco-mandibular furrow, the ptosis of the middle bystander of theface for the action of the gravitational vectors, the fall of the side and central portion of the eyebrow, hypotonia of the skin of the eyelid,the appearance of the plasmatic folds, etc...All these dimorphisms - say "functional" - due to the ageing, must be carefully examined on our patient. This in order to plan the mostcorrect and specific surgical techniques to carry on the specific patient, with the aim to restore in him/her a plastically and aestheticallypleasant look meant to conceal or to reduce or even to eliminate the signs of the ageing, thus realizing a "Natural" rejuvenation of theface.The Happy Lift Revitalizing Double Needle is a new method created to carry out a simple, mini-invasive and effective treatment ofthe human face, in an early phase of the ageing.This new medical device allows the operator to introduce a converging bidirectional barbed thread into the hypoderma with no needto use a cannula needle. This way the procedure of implant of threads becomes faster and simplier to perform, with a significantreduction of the operation time and a better post-op recovery for the patient. Moreover the particolar structure of the device allows torealize pathways till now not possible with the cannula needle. Semi-circular or loop paths with more effective gathering andcompacting of the tissue, with consequent enhancement of volume.Particularly, the treatment of the Eyebrow becomes much easier to perform and the performed cases witness very promising results.We recommend to practise the Happy Lift Revitalizing Double Needle precociously in order to avoid the necessity to subsequentlyrecur to more binding face-liftings. The traditional lifting has prolonged recovery time, changes the plastic harmony of the face, alteringits natural geometric proportions; the patients have the so-called "lifting face."The author proposes new ideas to use correctly this method, and particularly sets his attention on the correct clinical staging of thepatient, on whom to apply the new surgical technique. Keeping in mind all the above, it is fundamental the correct patient age, from27 to 45 years, to apply the new method of lift, above all for the aesthetic surgery result. The Happy Lift Revitalizing Double Needlesoft fast lift is not yet well performed by some surgeons colleagues.In the recent past and still in the present, these applied and today still apply the technique as substitution technique to the traditionallifting. This is absolutely not correct, also because such indication has never been proposed, nor suggested by the inventor of thistechnique but has been an arbitrary initiative of some surgeons.Surgery taught us that the ungluing, the lifting and the stretching of the tissue, as well as the direct action on the deep muscle-facialstructures are techniques guaranteeing the best results with rhytidectomy treatment in older age, that is after 45. It is on this that wehave to focus attention: the two plans to work on out of which we can get the maximum improvement in terms of stretching of the tissueand, consequently, of rejuvenation are sub-cutis and the superficial muscle-aponeurotic system. Therefore it is too much idealistic tothink that after 45, but some exceptions, less invasive techniques acting or, worse, not even acting on the same levels, can have similarresults. Insofar:I confirm that the Happy Lift Revitalizing Double Needle is not a technique able to replace the "orthodox" lifting.Such new technique - for aesthetic surgery indications - could be practiced as much precociously as possible, once the first signs ofcutaneous aging of the soft tissues of the face starts to reveal. With the application of the Happy Lift Revitalizing Double Needlethreads, the tissues are located back to their original place, where laying gravity effected them downwards. No exeresis of the skin nor76

of the subcutaneous tissue is performed, no suspending folds of the SMAS are effected, no rigid suspensions with maintenanceanchored sutures are applied. Such anchored and rigid maintenance sutures - this must be clearly stated - are not respecting,integrating nor participating to the movements of the facial mimic and mastication, thus often creating serious collateral effects.Absorbable Happy Lift Revitalizing Double Needle threads, when anchored are functionally integrated to the soft tissues and it favourtheirs inner mechanical and dynamic characteristics; they induce an immunitary reaction of generic type, like any stranger body,without inducing intolerance nor allergy.Insofar if correctly applied, in respect of the above mentioned age the "Happy Lift Revitalizing Double Needle" can slow down andin some cases even stop, for a quite long time, the "dermatocalasis" of the midface and of the up-mandible region.Happy Lift Ancorage Face LiftAging of the face and neck results in ptosis of soft tissues and the appearance of more prominent facial lines.For correction of these changes, surgeons are increasingly reporting procedures with fewer incisions and shorter postoperativerecovery periods. 1Many of these procedures utilize absorbable sutures in the subcutis to lift lax skin.Limitations of these implants have included the protrusion of sutures through the skin, asymmetry of cosmetic effect requiringcorrection with additional sutures,3 and limited durability of effects.2A new very special modified PDO suture marketed as Happy Lift Ancorage was approved in 2003 by the CE for lifting ptotic skin offace and neck. This medical device is supplied as a 31,6 cm PDO suture with a barbed middle portion. It is attached to a 152 mmstraight needle distally and a 31.1 mm 1/2 circle taper needle proximally.There are several potential advantages of this new medical device. It is designed to tie with a paired suture and be anchored tounderlying fascia or periosteum, theoretically reducing the likelihood of migration and loss of cosmetic effect.The barbs along this suture are oriented in only one direction. These unidirectional barbs when combined with more secure anchoringideally limit and lock motion into one well-controlled vector.This also allows for postoperative correction of asymmetry of tightening. Finally, the suture material is clear, making it impossible tovisualize under thin or transparent skin.Placement of Happy Lift Ancorage to reduce ptosis of the brow,6 neck, middle4-5 and lower face may be performed in an outpatientsetting under local anaesthesia. The surgeon first establishes the degree and direction of the desired tightening. This determines thecourse and number of sutures that will be placed. Infiltration of local anaesthesia is limited to these lines and the insertion points ofthe straight needle.AESTHETIC DERMATOLOGY & SURGERYMovement of the needle and suture through the deep hypoderma is generally well tolerated by patients. If the straight needle movessuperficially to this plane it is immediately apparent as linear dimpling of the overlying skin. If the needle enters the deep hypodermaor approaches the muscle fascia or periosteum, the patient will report the sensation of pain or pressure. At any point, the straightneedle may be partially or completely removed and repositioned.Translocation of the skin along the suture causes the lax skin of the face and neck to accumulate at the hairline and lateral neck.The resulting folds of skin are quickly and almost completely re-modelled or redistributed to the scalp and neck in several days toweeks, even in older patients with relatively inelastic skin.Mild complications such as swelling, bruising and subjective feelings of "tightness" usually resolve within 1-3 weeks.Transient neuropathy of the greater auricular nerve has occurred in several patients when using the sternocleidomastoid muscle fasciaas an anchoring point on the lateral neck.Leaving the knotted proximal ends of the paired sutures unanchored in the deep hypoderma is a cosmetically acceptable alternativein this location.It is not clear if this will reduce the incidence of mononeuropathy or be as stable as an anchoring point, although preliminary resultssuggest that the incidence of neuropathy drops significantly with this technique modification.After the resolution of initial postoperative swelling, any subjective discomfort from tightening or perceived asymmetry of tighteningmay be addressed without inserting more sutures or creating new incisions.Carefully applied firm retrograde pressure along a suture will result in the focal release of several underlying barbs from theirattachment to fibrous septae.This release can be appreciated as a subtle clicking sensation under the surgeon's finger. Threads have been successfully releasedup to 9 weeks postoperatively.The use of barbed sutures appears to be a viable strategy for lifting and repositioning of facial tissue.In conclusion the CE approved Happy Lift Ancorage,7 provides advantages to the surgeon and patient that other thread systems donot. Longer follow-up studies are essential, and final judgments as to the utility of these threads cannot be made in the absence oflonger term (i.e., greater than 6 months) data.References1) Silva-Siwady JG, Diaz-Garza C, Ocampo-Candiani J. A case of Aptos thread migration and partial expulsion. Dermatol Surg 31(3):356-8 (2005 Mar).2) Lycka B, Bazan C, Poletti E, Treen B. The emerging technique of antiptosis subdermal suspension thread. Dermatol Surg 30(1):41-4 (2004 Jan).3) Sasaki GH, Cohen AT. Meloplication of the malar fat pads by percutaneous cable-suture technique for midface rejuvenation: outcome study (392cases, 6 years' experience). Plast Reconstr Surg 110(2):635-54 (2002 Aug).4) Khawaja HA, Hernandez-Perez E. Transcutaneous face-lift. Dermatol Surg 31(4):453-8 (2005 Apr).5) Vazquez GD. Facial percutaneous suspension. Plast Reconstr Surg 116(2):656-60 (2005 Aug).6) Hernandez-Perez E, Khawaja HA. A percutaneous approach to eyebrow lift: the Salvadorean option. Dermatol Surg 29(8):852-5 (2003 Aug).Ancorage Happy Lift monograph Accardo C. - Medicine in formFACE VOLUMETRIC RE-HARMONIZATION UTILIZING CROSSLINKED HA WITH COESIX TECHNOLOGY AT DIFFERENT VISCOSITYRÉHARMONISATION VOLUMÉTRIQUE DU VISAGE AVEC UN ACIDE HYALURONIQUE RÉTICULÉ PAR LA TECHNOLOGIE COESIXANNA MARIA FORENZA(ITALY)People have always displayed a strong desire to keep a young-looking facial features.Features that are distinguished by firm, volume full and wrinkle-free skin. When these features change for several reasons (such asadvanced aging, life style, pollution, the sun, etc) most peoples desire the need for an improvement of their appearance.All of these factors are tied to the natural process of aging (called the "Catabolic Phase") which affects our body's tissues. During this77

AESTHETIC DERMATOLOGY & SURGERYstage of lifetime our skin loses its glow, shade, volume, tone and thins out leading to dry, sagging and wrinkly skin.To face this big challenge the most popular and widely used answer is: Filler.Hyaluronic acid based fillers are the most commonly effective products used at the moment.Hyaluronic acid is a natural polysaccharide that forms an essential part of the intercellular matrix in all human tissues, including thedermal matrix area that has undergone a constant and substantial decline due to the skin's natural aging process.Due the complete biocompatibility of this particular molecule, hyaluronic acid based fillers do not require a prior allergy test to beeffectuated.If this substance has a weak point, like all the absorbable fillers, it lies solely during the short process of infiltration, being that, in itsnatural form hyaluronic acid is rapidly degraded in hyaluronidase.For many years now, researchers have been seeking to improve its performance by increasing its molecular weight or even in linkingit with other substances aiming to extend its lifespan. This product is still considered by doctors in being among the safest.I used a brand new product that is a new hyaluronic acid based filler that demonstrated excellent results in terms the percentage ofimperfections corrected and long-term effectiveness in wrinkle and volume loss correction.The exceptionally long-lasting effects of this product are likely to be attributed to its high molecular weight that is included in itsformulation and by an innovatibe procedure that is employed in the last stage of its production with the purpose of obtaining andincreasing the quantity crosslinks found between the molecules which add to the crosslink process polarised magnetic field.This process causes an increment in surface electric charges which induces coagulation - COHESION - of the product. These are thefundaments of the new and revolutionary Coesix patented Technology, which besides protecting Hyaluronic Acid from hydroxyl radicalsand making cell degeneration very slow, gives both durability to filler implants and a filling-up effect.CARBOXYTHERAPY IN THE TREATMENT OF SCARSLA CARBOXYTHÉRAPIE POUR LE TRAITEMENT DES CICATRICESNINA KOUTNA(CZECH REPUBLIC)Background: Carboxytherapy (CO2 gas injections) is a non-invasive method, used in aesthetic medicine and dermatology for morethan 10 years. Besides the treatment of cellulite, alopecias, wounds and sclerodermias, the method is a safe and relativelly very naturaltool for gentle skin rejuvenation, hence also for the treatment of scars.Method: During my practical work with carboxytherapy (till now 246 patients) a small group of 35 persons came out, wishing also thetreatment of scars. The types of scars were: post-acné on 12 patients (8 persons with mainly saucer shape, 4 with mainly ice-pickscars), 6 patients with post-surgical or post-traumatic atrophic scars, 11 patients with "normal" scars (in the level of surrounding skin,but disturbing by colour or wideness), 3 patients with hypertrophic scars, 3 with keloids.Carboxytherapy was applied once in 2-4 weeks, if no improvement was reached during 2-3 sessions, the therapy was stopped. Finalnumber of treatments was from 2 to 11 (and some patients wish to continue further on) according to the state and interest of thepatients.Results: Nice improvement was reached especially in post-acné scars, both saucer shape and ice-pick. Saucer shape scars tend tobe smoother, ice pick ones tend to shrink.Post-surgical & post-traumatic tougher hypertrophic scars, narrow atrophic and narrow normal scars responded also very nicely.However, wide normal or atrophic scars, and especially soft ones responded poorly.Keloids usually reacted, but not very much.Conclusion: Carboxytherapy is good non-invasive and non-risky method for the treatment of both saucer shape and ice-pick postacnéscars, also for post-surgical & post-traumatic hypertrophic and narrow atrophic or normal scars.However, for wide and soft normal or atrophic scars and for keloids the method seems to be not effective enough as a sole technique.This is just a preliminary work aimed to inform about this therapeutical possibility, which has advatages of good effect in not manysessions, no risk of post-treatment pigmentary changes and no invasiveness.ADVANCED AND SAFE PEELING METHOD OF DEEP SKIN REJUVENATION: PDSR (PYUN'S DEEP SKIN REJUVENATION)MÉTHODE DE PEELING PERFECTIONNÉE ET SÛRE DE RAJEUNISSEMENT DE L'ÉPIDERME PROFOND : PDSRINSOO SHIM(S. KOREA)Deep Skin Rejuvenation is medical term of deep chemical peeling using phenol-based formula. There are many different methodsavailable for undertaking an anesthetically rejuvenating peel, practically affecting a chemical lift in patients.However these formulas itself are insufficient in the treatment of pigmentary disorder, wrinkle, scars and permanent and transientcomplications were frequently seen. Deeper peels are necessary to reach and correct deeper diseased lesions but it was difficult toreach deeper dermis and was not indicated to Asians. In 2002, Dr. Pyun developed a new Timepeel formula which is a deep chemical,phenol based peeling solution that compares favorably with other solution as a matter of fact rare arrhythmia, short duration oferythema, mild pain, rare hypopigmentation, no demarcation line and wide safety margin.Timepeel is a special solution saves skin as it only penetrates and restores skin originally. The ingredients, methods of preparationand application, as well as postpeel occlusion techniques are modified and advanced in PDSR. Acne, smallpox scar, keloid, burn scarand traumatic scar are kinds of incurable by chemical peeling or laser therapy alone and it has limitation and doesn't have enoughsatisfaction. Generally, there are highly risks of complications with combined operation of deep peeling and laser therapy, however,PDSR (Pyun's Deep Skin Rejuvenation) using Timepeel formula is the best route to make skin rejuvenation and it is new, safer, andmore predictable deep chemical peeling method. It is a safe and cost effective method with a high degree of patient satisfaction andexcellent results. Indications for PDSR include wrinkled skin, cutaneous pigmentation (such as freckles, solar lentigo and melasma),acne scar, burn scar, traumatic scar, deep dermal pits, and precancerous lesion (such as actinic keratosis and early phase of basalcell carcinoma). In order to maximize the positive cosmetic results and to enjoy the great reliability that the PDSR offers, the peelingmust be executed exactly according to the PDSR guidelines.78

Item Existing Formula TIMEPEELArrhythmia 10~30% < 0.5 %Risk of ScarFormation High Almost noneHypopigmentation Frequent NoneDuration of Erythema 6 month ~ 1 year over Mostly 2 ~ 3 monthsPain Severe MildDemarcation Line Marked (occasionally permanent) Temporary & FaintSafety margin Narrow WideFRACTIONAL CO2 RESURFACING: OUR EXPERIENCE WITH ULTRAPULSE ENCORETRAITEMENT SUPERFICIEL AU CO2 FRACTIONNÉ : NOTRE EXPERIENCE À L'ULTRAPULSE ENCOREMARIA BROZMANOVA(SLOVAK REPUBLIC)AESTHETIC DERMATOLOGY & SURGERYThe benefit of fractional resurfacing technologies is to reach almost the same effect as we can achieve with classic laser resurfacingbut with minimal healing downtime.One of such devices is UltraPulse Encore with Active Fx technology which we have been using since March 2006. It is fractionalCO2 laser, size of spot is 1,3 mm with possibility to cover more than 70% treated area.In fact, it is a modification of a single pass CO2 resurfacing. It can be safely used on face and also other parts of the human body. Asingle treatment lasts for 20-45 minutes, posttreatmenterythema and desquamation lasts up to 10 days (face up to 4-5 days, neckand dekolt up to 10days).We already treated about 350 clients.Pretreatment (about 90 minutes before precedure) consists of applying local anesthetic crème, per os we use NSAD, virostatics andsometimes also sedatives and opioid.Indications for this procedure treatment are skin ptosis, wrinkles, pigmentations, acne scars or other atatrophic scars, stretch marks.We would like to present our experience with this treatment and to show some before and after photos.Side effects are rare, for example acneiform leasions, activations of herpetic infection, bacterial infection or hzperpigmentation.We obtained Acneiform leasions in 7% of treated person , each of them has acne in medical history or had acneiform reaction onsunscreen in the past.Bacterial infection occurred in 1% of treated person, mostly cultivated bacteria was Staphylococcus aures. Face hyperpigmentationsoccurred only after 2 passes treatments (on nasolabial folds, glabelar wrinkles, etc.) and only to those with skin type IV. Theyoccurred on the neck and dekolt in 5% and in 15% of treated patients with stretch marks (mostly on abdomen).The effect of treatment was assessed based on subjective rating of clients.50% of clients is very satisfied with the treatment, 45% issatisfied (or the treatment fulfilled their expectations) and 5% of client did not notice any positive changes.UltraPulse Encore Active Fx can be considered as effective device also for nonfacial treatments. Treatment has good effect on fineto moderate lines, dyschromias and strengthening of textures. The treatment has to be repeated min 2-3 times in case of scars,stretch marks and deep wrinkles.THE IMMEDIATE EFFECT OF A NEW MONOPOLAR RADIOFREQUENCY TREATMENTLES EFFETS IMMÉDIATS DU NOUVEAU TRAITEMENT À RADIOFRÉQUENCE MONOPOLAIRESOFIA RUBBANI(USA)To determine the effectiveness of non-invasive monopolar radiofrequency for reducing celluliteA randomized before and after study with 12 patients between the ages of 29 and 45 was conducted to measure the effectiveness ofmonopolar radiofrequency energy on patients effected by cellulite. Patients were all within healthy body weight range. Each patienthad moderate to severe appearance of cellulite and skin laxity in the anterior and posterior thigh, abdomen, arms and/or buttocksregions and were treated with one Thermage procedure per region using a new shallow 3.0cm STC treatment tip. A topical cellulitecream was not applied to the areas treated or used in conjunction with the radiofrequency treatment for this study.Monopolar RF energy applied to the anterior/posterior thigh and buttocks to smooth and retexture areas affected by cellulite hasproven to be an effective non-invasive treatment among patients. When used as a monotherapy, the Thermage treatment is a welltoleratedand safe procedure that produces moderate reduction in the appearance of cellulite while tightening the skin. Furtherinvestigation utilizing a quantitative measurement tool should be utilized in the future to more accurately assess level of cellulitereduction. Follow-up evaluation is necessary to understand the longevity of this effect.EFFECTS OF NON-INVASIVE MONOPOLAR RADIOFREQUENCY AS A SINGLE-PROCEDURE,SINGLE-MODALITY FOR FACIAL REJUVENATIONLES EFFETS DE LA RADIOFRÉQUENCE MONOPOLAIRE UTILISÉE SEULE POUR LE RAJEUNISSEMENT DU VISAGEMARIA MAVRIDOU(GREECE)Objective: To demonstrate single-treatment results in facial rejuvenation using monopolar radiofreqency.Background: The aging face has multiple components: sagging, volume loss and changes in the superficial skin seen as dynamic lines,wrinkles, pigmentation, and vascular changes. One must take a comprehensive approach and correct or address all of these areasusing the best technologies available. The challenges that many clinicians face is choosing which approach will produce the greatest79

AESTHETIC DERMATOLOGY & SURGERYresults most efficiently for both the patient and clinician. While there are several treatments available, many do not offer desired resultsin a single treatment.Research Design / Patient Selection: 169 patients (157 female and 12 male) between the ages of 35-78 years old were treated withmonopolar radiofrequency over a period of 2 years.We included patients that had mild to moderate skin laxity, crepy and/or wrinkled skin and desired smoother, thicker skin as well as anoverall enhancement of skin texture and appearance. We excluded patients who had photo damage, severe elastosis, poor fibroblastresponse and elastin production.Measurement: Each patient was evaluated prior to treatment. During the evaluation, skin texture, laxity and thickness was reviewed.Succeeding evaluations were performed during post-treatment sessions to measure the degree of skin tightening, amount of wrinklereduction and skin texture enhancement from the treated area.Treatment area was evaluated and marked with grid marking paper and vectors were drawn as a guide. Treatment settings, numberof pulses and passes were determined by the degree of skin laxity, wrinkles and crepiness and were adjusted to meet patients'tolerance.Results: The results of this study revealed subtle to moderate wrinkle reduction that was seen to appear immediately in many patientsand continued to improve over time for up to 6-8 months. Procedure time averaged 75 minutes.Patients experienced little to no down time and did not exhibit any serious adverse effects. On some occasions, patients experiencedtemporary redness which disappeared within a few minutes.Conclusions: Monopolar RF energy applied to the face to tighten and texturize the skin as well as reduce and refine lines has provento be an effective and time efficient non-invasive single-treatment among patients. The procedure is well-tolerated and producesoptimal cosmetic results that are satisfying to both patients and clinicians, without surgery, injections or downtime.A NON INVASIVE APPROACH TO TISSUE TIGHTENING USING NON ABLATIVE RADIOFREQUENCYAPPROCHE NON INVASIVE DU RAFFERMISSEMENT CUTANÉ PAR RADIOFRÉQUENCE NON ABLATIVEMARIO GOISIS(ITALY)Purpose: To describe a new non invasive treatment to correct skin laxity. METHODS: 71 patients were included in this study. TheRadiage Dual Frequenc RF (Radiowave technology, Ellman International) was applied to correct skin laxity. The patient's pretretmentstatus and post-treatment status were compared.Results: In 49 cases the immediate and long-term aesthetic results very classified as very good, in 8 as good, in 2 as fairly good andin 2 as inadequate.Conclusions: The application of high frequency radiowave technology provides a efficient non-invasive correction of skin aging.80

ANTI-AGING MEDICINEABSTRACTSThursday April 10 / Jeudi 10 AvrilANTI-AGING MEDICINEROOM / SALLE MAILLOTSESSION 1AA2.00 pm / 14h00GENETIC TYPING: THE LATEST ADVANCE IN ANTI-AGING AND PREVENTIVE MEDICINE: EASY LEARNING FOR ALLLE GÉNOTYPE : LA DERNIÈRE AVANCÉE DANS LA MÉDECINE ANTI-AGE ET PRÉVENTIVE : UNE APPROCHE FACILE POUR TOUSCHAIR: DAVID LAI - ANTI-AGING MD (HONG-KONG, CHINA)ANDRÉS KANSKI - CLINICAL IMMUNOLOGY AND PREVENTIVE MEDICINE (CARACAS, VENEZUELA)THE FUTURE DIRECTION OF PREVENTIVE GENETIC DIAGNOSIS IN THE NEW MILLENIUML'ORIENTATION DES DIAGNOSTICS GÉNÉTIQUES PRÉVENTIFS DANS LE NOUVEAU MILLÉNAIREJOHANNES HUBER(AUSTRIA)Neurodegeneration becomes a challenge for the next years and prevention is mandatory.Apo-E Epsilon 4 is a high risk factor for Alzheimer disease. Cox-2-Inhibitors, Statine and NSAID have a preventive power againstneurodegeneration. Age related Macula degeneration is another overcoming problem in the over aged population. Complement factorH polymorphism announces the risk constellation for this disease and makes preventive procedures possible.Glutathione S-transferase gen polymorphism is another genetic variation, associated with a higher risk for lung and bladder cancer.Last year, the Welcome Trust Foundation identified in a genome wide association studies polymorphisms for seven common diseasessuch as diabetes, multiple sclerosis and bipolar disorders. Another paper in "Lancet" identified four Snips associated with breastcancer. Many polymorphism described at the moment have functional consequences, reducing or stimulating gen activity. This is truefor COMT, for Methylentetrahydrofolatreduktase and for CYP enzymes allowing an individual pharmacogenomic procedure.THE ABC BASICS OF ANTI-AGING GENETICS: EASY LEARNING FOR BEGINNERSLES BASES DE LA GÉNÉTIQUE ANTI-ÂGE POUR LES DÉBUTANTSCHRISTIAN SCHNEEBERGER(AUSTRIA)ANTI-AGING MEDICINEThe Construction Plan of Life - Genes and DNAThese days the human genome is almost completely decoded and the knowledge of the structure of the genome is constantlyincreasing. Furthermore, the knowledge of the segmentation of genetic information in coding and non-coding regions as well as thequantity, formation and structure of genes is steadily advancing. The scripture which describes the construction plan of life is calledthe DNA-sequence. DNA consists of a succession of small building blocks (nucleotides) each with one of four possible components,so called bases, Adenine (A), Guanine (G), Cytosine (C) or Thymine (T)."Genes are recipes": The human genome contains approx. 3 billion base pairs in form of 46 chromosomes and genes are defined bysegments on the chromosomes. Within a gene the sequence of bases along a DNA strand defines the construction plan for a protein.The genetic information is memorized in the succession of bases. A "word" of this code is always generated by three bases (the codon)and stands for a specific component (one of 20 possible amino acids) of the coded protein - the gene product.An essential and indeed unexpected scientific finding concerns the variability of the genome within the human population: The genomecontains about every 1,000 bases a variable nucleotide, a so called "single nucleotide polymorphism", short SNP. Variable informationin the human genome affects not only singular nucleotides, more rare insertions or deletions of short as well as of long DNA segmentsand also variants of numerous repetitive DNA segments are described.This natural variation of the human genome is jointly responsible for the individuality of every human being. In humans, up to 99.9%of the genome is identical; the remaining fraction of 0.1% is variable. This small share contributes to our individuality and can explainindividual reactions to the same environmental influences. The insight into genetic individuality and with it insight into the geneticpredisposition of a patient is of prime importance for modern anti-aging and preventive medicine.This presentation will focus on the scientific basis of genetic variation. Thereby, the molecular nature of DNA, genes and geneticvariation will be explained.81

PERSONALIZED MEDICINE: INTEGRATING PREVENTIVE GENETICS INTO CLINICAL PRACTICE. THE CANADIAN EXPERIENCEMÉDECINE PERSONNALISÉE : LA GÉNÉTIQUE PRÉVENTIVE INTEGRÉE À LA PRATIQUE CLINIQUE. L'EXPÉRIENCE CANADIENNEELAINE CHIN(CANADA)Our traditional western medical practice model is failing us, as evidenced in:- Incidence of chronic illnesses such as cardiovascular disease, cancer and diabetes rising at an alarming rate;- Costs running out of control, particularly in North America, where the burden of aging "baby-boomers" has yet to be felt;- The growing gap between science and medical practice.Why? It is because we have a "disease care" model rather than a true "health care" approach. Traditionally, physicians have beentrained to diagnose symptoms and treat disease. Consequently, the cost of treatment is higher and the probability of reversing or curingdisease is lower than had it been prevented or diagnosed before symptom manifestation. Yes, we keep people alive longer but at whatcost financially and in quality of life? This problem is exacerbated, certainly in North America, by the way health care gets funded andby the tendency of most of the population to wait until they experience symptoms before taking action.A true "health care" model is about early detection of health risk and preventing disease before damage begins. Science now gives uspotent diagnostic tools to accomplish this, with preventive genetics playing a crucial and growing role.However, a transition from "disease care" to "health care" requires a fundamental paradigm shift for both physician and patient. Whatare the tenets of this new paradigm?- Keeping the individual symptom-free - we need to accept this as the standard.- Proactive screening - we should deploy the best and latest science to identify risk and increase the probability of very early diseasedetection.- An integrative approach - collaboration across health disciplines, coordinated by the primary physician, applying medical science anddrawing on a range of skills to deliver a "total solution" to the individual, must replace traditional silo's.- One size does not fit all - we are each different in important ways that are fundamental to achieving and sustaining health. Geneticscience enables us to deliver true individualized health care.- Empowering individuals to "own" their health is essential for prevention to work - they must be responsible and informed.Scienta Health, a pioneer in individualized preventive medicine, has operated a Toronto-based clinic founded on these principles since2004. Genetic testing forms a core part of the multi-faceted Scienta protocols. The presentation to the Conference will highlight fourexamples of how powerful the integrative diagnostic protocols have been in delivering results that otherwise would have been unlikely.Examples will cover:1. Vascular Risk - Factor V - implications for lifestyle, air travel and recreation2. Nutrigenomics - Vitamin D - implications for bone health, cancer3. Pharmacogenetics - prescribe the "right" drug safely and effectively4. Diabetes Risk and Weight Loss - interaction: genetics, hormones and dietScienta Health is currently modelling these protocols in a portal-accessible, web-based format for use by clinicians in Europe, Asiaand North America.HOW DOES GENETIC TYPING HELP REDUCE THE RISK OF DIABETES AND METABOLIC SYNDROME?COMMENT LE GÉNOTYPE AIDE-T-IL À RÉDUIRE LES RISQUES DE DIABÈTE ET DE SYNDROME MÉTABOLIQUE?KÀROLY NAGY(HUNGARY)ANTI-AGING MEDICINEMetabolic syndrome (MS) is characterized by insulin resistance, abdominal obesity, dyslipidemia, raised fasting glucose andhypertension. The prevalence of MS and its individual components is steadily growing reaching "epidemic level" at several continent,its major clinical consequence being the dramatic increase in new onset non-insulin dependent diabetes and subsequentcardiovascular morbidity and mortality. Efficient diagnosis and treatment needs a holistic approach where testing of geneticpolymorphism - e.g. single nucleotide polymorphism (SNP) - is a new powerful method providing new dimensions for additional riskstratification and more efficient preventive and curative interventions.The results of candidate SNPs - according to main etiological factors - and genome-wide scanning can be divided into two basic groupsaccording to gene-gene and gene-enviroment interactions : the first is the "Non-Responsive", while the second being "Responsive"type. We give an overview of the present situation including advantages and shortcomings of some of these "Rersponsive" SNP testshighlighting possibilities for non-pharmacological interventions - e.g. modulation of eating habits, exercise planning - as well as for drugtreatment in the prevention and treatment of pre-Metabolic Syndrome and its fully developed clinical picture.We draw the attention to the importance of integrating genetic test results with data of traditional medicine and of enviromental effectsachieving a balanced summary.Examples of SNPs include genes as: TCF7L2; KCNJ11; FTO; G-protein beta3-subunit; Adiponectin; Peroxisome proliferator-activatedreceptor-gamma2 ; Interleukin-6 and Interleukin-10; Fatty acid amide hydroxylase ; Ghrelin receptor ; pancreatic Glucokinase ; Insulininducedgene2 ; APOA5, FABP4.The aim of these new genetic tests is to individualize metabolic and cardiovascular risk stratification of patients and offer them tailoredpreventive and curative therapy.INDIVIDUALIZED NUTRITIONAL PROGRAM OF GREAT ANTI-AGING VALUE: THE ROLE OF GENETIC TYPINGPROGRAMME NUTRITIONNEL INDIVIDUALISÉ À HAUTE VALEUR ANTI-ÂGE : LE RÔLE DU GÉNOTYPEJOHANNES WESSOLLY(GERMANY)On the topic of genes and nutrition, nowadays the question is not so much what diet fits best with our genes and how can we positivelyinfluence our genes through our diet, but more how many toxins do we ingest with our food and how well does our genetic82

detoxification work. Therefore we always test the genes that are responsible for the detoxification of the toxins in our foods or areactivated by these toxins (Cyp 1A1, Cyp 1B1, COMT, SOD2, GST´s) just to name a few of the most important ones.These genes are involved not only in the breakdown of heavy metals, pesticides, fungicides, herbicides (so-called xenooestrogens),but also in the breakdown of the free radicals induced by these substances.Polymorphisms in these genes can severely complicate the metabolism of these environmental toxins and can thereby cause asignificant risk of disease. The functioning of these genes can be positively influenced with the correct diet or the correct micronutrients.Information concerning these polymorphisms allows us to implement preventive nutritional medicine measures.A practical example:A healthy 29 year old male with the following family history:Grandfather (father's family)Prostatic carcinoma, heart attackGrandmother (father's family)Mammary carcinomaFatherProstatic carcinomaMotherDepressionGrandmother (mother's family)Mammary carcinomaGrandfather (mother's family)Heart attack, prostatic carcinomaThe man is an investment banker and due to be transferred to an Asian city notorious for its environmental pollution.He has the following gene polymorphisms, COMT, SOD, GST´s, Cyp 1A1, Cyp 1B1 which indicate a deficiency in the detoxificationcapacity and thereby an increased risk of various chronic diseases including cancer.The following was recommended as a preventive measure: Nutritional supplement with high dosed vitamin C, Q10, Vitamin D3, aminoacids, selenium, zinc, phytooestrogens, brocolli extract and omega-3 fatty acids. And of course: organic food.CONCEPTION IN THE MIDDLE AGE: HOW TO USE GENETIC TYPING TO SAFEGARD THE HEALTH OF AGING PREGNANT MOM?LA GROSSESSE À LA CINQUANTAINE : COMMENT UTILISER LE GÉNOTYPE POUR LA PROTECTION DE LA FEMME ENCEINTE ?BERNHARD POETSCH(AUSTRIA)How old is too old ?The past decade has seen a remarkable shift in the demographics of childbearing around the western countries. The number of firstbirths per 1000 women 35 to 39 years of age increased by 36 percent between 1991 and 2001, and the rate among women 40 to 44years of age leaped by a remarkable 70 percent. In 2002, in USA 263 birth were reported in women between 50 and 54 years of age.The effect of maternal age on the outcome of pregnancy may be best assessed by examining five specific factors that can negativelyaffect the desired outcome of a pregnancy- namely,A healthy mother and a healty baby: declining fertility,fetal abnormalities, premature birth (miscarriage),and impaired placentation(hypertensive complications and stillbirth. Maternal death,the risk of which also increases with age, is fortunately so rare that it doesnot factor into this discussion.Fetal abnormalities, premature birth and impaired plazentation account for more than 90% of perinatal deaths.These problems are ascommon today as they were more than 30 years ago and our failure to reduce their prevalence is essentially the consequence ofinadequate methods of screening and lack of effective strategies for their prevention.For example premature birth: Interventions to reduce the morbidity and mortality of preterm birth can be primary (directed to allwomen), secondary (aimed at eliminating or reducing existing risk), or tertiary (intended to improve outcomes for preterm infants).Nowadays most efforts so far have been tertiary interventions, such as regionalised care, and treatment with antenatal corticosteroids,tocolytic agents, and antibiotics. These measures have reduced perinatal morbidity and mortality, but the incidence of preterm birth isincreasing.Extensive research in the last 20 years has now established that ULTRASONOGRAPHY can identify the majority of affected fetusesand women at high risk for these problems. The new scientific flield GENETIC TYPING stats now to support the existind strategies butfurther studies are needed to make clear how many genes are involved. Latest research found a strong genetic component- maternal,paternal, and fetal genes are involved. Ineritance patternwas also described. A meta-analysis identified the followingPOLYMORPHISMS as candidate genes: FACTOR V LEIDEN; PROTHROMBIN (Factor II), PAI I (Plasminogenactivatorinhibitor),MTHFR (Methylenetetrahydrofolate reductase, Angiotensinogen and Endothelial NO-Synthase (NOS)3). PROGESTERON RECEPTOR is in discussion.ANTI-AGING MEDICINEThe remaining challenge is to ensure that this knowledge finds a practical application in a service for the benefit of middle age pregnantwomen and forms the basis for further research to develop effective therapeutic interventions.The American Society for Reproductive Medicine has begun a concerted effort to make the public more aware of the risks of delayingchildbearing.So how should we counselour young business-school student when she asks about her choises? Generally speaking, the decadebetween 25 and 35 years of age would seem to be ideal. For women between 35 and 45 years of age for whom earlier childbearingis not an option, this decade remains safe enough that maternal age alone should not be a contraindication to childbearing. However,women do face decreasing fertility and a moderate increase in the risks of chromosomal abnormalities and premature birth(miscarriage) as the pass 40 years of age.Perimenopausal and postmenopausal pregnancy remains an option for those women who are lucky enough to find themselves healthyand sufficiently wealthy to pursue it.HOW TO USE GENETIC TYPING TO LOWER THE RISK OF GYNECOLOGICAL CANCERS: PRACTICAL POINTSCOMMENT UTILISER LE GÉNOTYPE POUR DIMINUER LE RISQUE DE CANCERS GYNÉCOLOGIQUES : ASPECTS PRATIQUESCLEMENS TEMPFER(AUSTRIA)The number of reports investigating disease susceptibility based on the carriage of low-penetrance, high-frequency polymorphismshas steadily increased over the last years.83

Evidence based on meta-analyses of individual case-control studies is accumulating defining specific individual variations in diseasesusceptibility. Genetic variations of the estradiol metabolism have been described as significant contributors to disease susceptibilitywith variations depending on ethnic background.In the field of Obstetrics and Gynecology, the genetic contribution of polymorphic markers to a series of disorders has so far beencharacterized, among them pregnancy loss, preeclampsia, endometriosis, breast cancer, and hormone replacement therapy (HRT)-related complications such as thrombosis. Among others, thrombophilic genetic variants such as factor V Leiden, factor II prothrombinG20210A as wells as genetic variants of cytochrome P450 (CYP) enzymes, such as CYP19 and CYP1B1, have been established asgenetic risk markers and disease modifiers of recurrent and sporadic pregnancy loss and HRT-independent and HRT-dependentbreast cancer, respectively.In addition, meta-analysis of data in the literature established the TGFBR1*6A, the GSTP Ile105Val, the GSTM1 gene deletion, andthe TP53 Arg72Pro polymorphisms as low-penetrance genetic risk factors of sporadic breast cancer.With respect to genetic modulation of therapy effects, beneficial effects of ERT/HRT are also modulated by the carriage of SNPs, e.g.osteoprotection and blood lipid changes by the estrogen receptor alpha (ER-) Pvu II polymorphism.Polymorphisms of the COMT, ER-alpha, IL-1RA, and factor V genes have been demonstrated to modulate the timing of naturalmenopause. Lastly, a strong genetic contribution of polymorphisms to the development and the clinical course of endometriosis hasbeen established with data pointing to the COMT, GST, NAT-2, and ER-alpha genes as susceptibility markers.In summary, the available evidence points to a number of polymorphisms of a wide variety of genes as strong hereditary determinantsof the susceptibility to benign and malignant gynecologic and obstetric conditions.YOUR PARENT SUFFERED FROM STROKE AND HEART ATTACK: HOW TO USE GENETIC TYPING TO LOWER YOUR OWN RISK?ANTÉCÉDENTS FAMILIAUX D'AVC ET DE CRISE CARDIAQUE : COMMENT UTILISER LE GÉNOTYPE POUR RÉDUIRE VOSPROPRES RISQUES ?ANDRÉS KANSKI(VENEZUELA)We present a conventional cardiovascular evaluation of a patient, and show that with genetic testing the management can becompletely different.A) The Lipid evaluation using ApoA1 determines that this patient should not be using a rich PUFA diet (even with high TG). ApoEgenotyping shows that this patient has an A4 allele present.This makes him prone to cardiovascular disease (42%) and increase his risk to Alzheimer Disease up to four times. As ApoE4 patientsdo not respond to statins, is relevant to define CYP 3A5*3 to define the magnitude of possible muscle damage in the presence of nonfunctional alleles (poor metabolizers).B) The coagulation profile showed an ITGB3 with a PIA2 allele.These patients are less sensitive to the action of aspirin on platelet aggregation. These patients might benefit from Clopidogrel insteadof aspirin.IIn order to have additional alternatives we also performed CYP2C9 *2*3 and VKORC1 to evaluate eventual warfarin requirements.C) In the absence of a well defined metabolic syndrome several markers showed and evident increased risk. At this stage we are quiteinterested in the performance of an important susceptibily gene for T2DM: TCF7L2. Contrary to many SNPs this one has beensimultaneously detected in patients from European descent, African Americans, Asians and Hispanic population.D) Although there was no evidence of hypertension. The presence of an AGT genotype (Thr/Thr) increases the possibility of smallvessel disease, hypertension and good response to ACE inhibitors necessary in this patient.Tailored preventive medicine is here to stay.SAFER HORMONE REPLACEMENT THERAPY GUIDED BY GENETIC TYPINGLE TRAITEMENT HORMONAL SUBSTITUTIF PLUS SÛR GRÂCE AU GÉNOTYPEDAVID LAI(CHINA)ANTI-AGING MEDICINEHRT is important in perimenopause to early post menopause to improve quality of life, and is indicated primarily for symptoms that arerelated to estrogen deficiency. Although re-analysis of WHI data suggested that there is no extra risk of breast cancer during the firstseven years' use of standard doses of CEE+ MPA and for as much as 15 years of CEE-alone therapy, the French E3N cohort study(1) on the risk of breast cancer among 80,377 postmenopausal subjects during a mean follow-up of 8.1 years revealed that estrogenalone arm was associated with a 1.29-fold increased risk. This risk became not significantly increased when progesterone ordydrogesterone were added to estrogens, but remains a concern for estrogen combined with other progestins.Further, the WHI data now show that, in younger postmenopausal women within 10 years of menopause, HRT was associated with areduction of coronary heart disease risk; after which, the excess risk starts to rise.However, the stroke risk is more elevated in HRT-treated women and the hazard ratio does not change according to age; but seemsto be correlated with the dose of HRT(2). Recently, it has been reported that HRT in low dose may be safe in older women and stillimprove cardiovascular profile (3,4,5).The role of genetic typing in preventive medicine practice were recently reported (6). Screening for single nucleotide polymorphismmay identify individual at increased risk of breast cancer upon HRT and those who might benefit the most from it. The personalizedHRT management based on genetic typing will be presented through case discussion.References:1. Fournier et al, Breast Cancer Res. Treat. 2008.2. Grodstein et al, Ann Intern Med 2000; 133: 933-941.3. Nick P, Inter. Congress Breast Dev., Funct. Disease, Turin, Italy 2007.4. Stevenson J, Gyn. Endocrin. Journal 2008; 24, supple. no.1: 59.5. Mueck et al, Gyn. Endocrin. Journal 2008; 24, supple. no.1: 141.6. Lai DYC, Journal Fur Menopause 2004; 4: 22-24.84

SESSION 2AAMEETING WITH THE LEADERS OF THE ANTI-AGING MEDICINE: INTERNATIONAL RENOWNED ANTI-AGING EXPERTSFROM AROUND THE WORLD SPEAK ABOUT THE BEST ANTI-AGING MEDICINE AND WHAT THE FUTURE LOOKS LIKERENCONTREZ LES LEADERS DE LA MÉDECINE ANTI-AGE : DES EXPERTS MONDIALEMENT RECONNUS PRÉSENTENT LE MEILLEUR DE LA MÉDECINEANTI-ÂGE ET LEUR VISION DU FUTUR DANS LA LUTTE CONTRE LE VIEILLISSEMENT4.30 pm / 16h30CHAIR: THIERRY HERTOGHE ANTI-AGING MEDICAL DOCTOR (BRUSSELS, BELGIUM)JORGE FLECHAS ANTI-AGING MEDICAL DOCTOR (HENDERSONVILLE, USA)PROSPECTS FOR DEFEATING AGING ALTOGETHERPERSPECTIVES D’AVENIR POUR COMBATTRE LE VIEILLISSEMENT TOUS ENSEMBLEAUBREY DE GREY(UK)It may seem premature to be discussing approaches to the effective elimination of human aging as a cause of death at a time whenessentially no progress has yet been made in even postponing it. However, two aspects of human aging combine to undermine thisassessment.The first is that aging is happening to us throughout our lives but only results in appreciable functional decline after four or moredecades of life : this shows that we can postpone the functional decline caused by aging arbitrarily well without knowing how to preventaging completely, but instead by increasingly thorough molecular and cellular repair.The second is that the typical rate of refinement of dramatic technological breakthroughs is rather reliable (so long as publicenthusiasm for them is abundant) and is fast enough to change such technologies (be they in medicine, transport, or computing)almost beyond recognition within a natural human lifespan.In this talk I will explain, first, why (presuming adequate funding for the initial preclinical work) therapies that can add 30 healthy yearsto the remaining lifespan of healthy 55-year-olds may arrive within the next few decades, and, second, why those who benefit fromthose therapies will very probably continue to benefit from progressively improved therapies indefinitely and thus avoid debilitation ordeath from age-related causes at any age.HOW LONGEVITY MEDICINE MAY PROGRESSCOMMNET FAIRE PROGRESSER LA LONGÉVITÉETIENNE-EMILE BAULIEU(FRANCE)AGE-RELATED REDUCTION OF ENDOGENOUS MELATONIN: IMPLICATIONS FOR DECLINING HEALTHRÉDUCTION DE LA MÉLATONINE ENDOGÈNE LIÉE AU VIEILLISSEMENT : LES IMPLICATIONS SUR LE DÉCLIN DE LA SANTÉRUSSEL REITER(USA)Melatonin is an uncommonly beneficial agent which is endogenously produced but the production of which diminishes with increasedaging. The gradual, but substantial, loss of melatonin in the aged is often considered as being consequential in the onset and progressionof a number of age-related diseases, the most important of which may be neurodegenerative conditions and the increasedfrequency of cancer.Melatonin achieves its protective effects in the central nervous system due to its, a), rapid entrance into the brain from the circulationdue to its ability to readily pass through the blood-brain barrier, b), its ability to scavenge a wide variety of highly toxic reactants (e.g.,peroxynitrite anion, hydroxyl radical, hydrogen peroxide, etc.)that are normally generated in and destructive to the brain, c), its membrane-mediatedfunctions which allows it to upregulate the activities of several antioxidative enzymes (e.g., superoxide dismutases,glutathione peroxidase, glutathione reductase, catalase,etc.), d), its stimulation of the synthesis of glutathione, another inmportantintracellular antioxidant, and, e), its ability to reduce electron leakage and, therefore, limit free radical generation (this process has beenreferred to as radical avoidance), by increasing the efficiency of electron transport through the respiratory chain.Via these combined actions melatonin reduces the activation of apoptotic pathways that normally lead to cell death. It is now alsoknown that melatonin's high potential as an antioxidant not only relates to melatonin itself, but also to its metabolites that are formedwhen melatonin scavenges reactive oxygen and reactive nitrogen species.These important metabolites include cyclic 3-hydroxymelatonin, N1-acetyl-N2-formyl-5-methoxykynuramine, N1-acetyl-5-methoxykynuramine and possibly others. The new information on the antioxidant and anti-inflammatory potential of melatonin hasbeen exploited in models of age-related neurodegenerative diseases, especially Alzheimer's disease, Parkinsonism andischemia/reperfusion injury (stroke).In each of these experimental situations melatonin has been found to be highly beneficial in reducing brain damage and the severityof these debilitating conditions. In addition to its antioxidant activity, melatonin has a variety of oncostatic actions. The findings to datehave clear implications for reducing the health deterioration that occurs with aging, especially since endogenous melatonin levels dropas humans age.Melatonin is available in many countries as an essentially toxicity-free supplement and is taken by many individuals on a daily basis.ANTI-AGING MEDICINE85

SEXUALITY AND LIFESPANSEXUALITÉ ET LONGÉVITÉGORM WAGNER(DENMARK)Ten years after the introduction of the first phosphodiesterase inhibitor 5, one of the major sexual dysfunctions - erectile dysfunction(ED) - has now been well researched.The etiologies and the risk factors for developing ED shall be discussed and new findings related to obesity shall be presented.The male and female sexual dysfunctions will be critically analysed in relation to age.Thursday April 10 / Jeudi 10 AvrilANTI-AGING MEDICINEROOM / SALLE PASSYSESSION 3AAANTI AGING WORKSHOP 1 ABC OF ANTI-AGING HORMONE THERAPYABC DES TRAITEMENTS HORMONAUXCLAUDE DALLE (FRANCE)GÉRARD PASCAL (FRANCE)2.00 pm / 14h00BASIC HORMONE THERAPYBASES DE LA THÉRAPIE HORMONALEThe anti aging medecine begins to be called a global aging management, because it needs to work and be effective to have asynergistic approach between many sides.It is a holistic medicine, holding all organs and functional points of view.it is also a preventive medicine, and this is one of the main aim of this medicine. You will learn how check many disease's risk.So to practice it, you need to change your approach and your point of view,In using all your ancient ways, you can regenerate and rejuvenate your patients, first by the internal improvements, using :- Nutrients & micronutrition,- hormones,- sleep conditions,- pollution risk,- genetic risk,and in a second way, by external improvements, linked to the aesthetic medicine and surgery.This workshop will show you;- What ask to your patient, from personal & familial antecedents to today's status- How to examine the body and to extract important news rapidly- What kind of blood & urines tests to do- What kinds of treatment- What is a global follow up.You will gather in this short and condensed hour already enough informations to have a comprehensive point of view, to go further byadditional courses, and enrich by this way your practice in an original and essential way.ANTI-AGING MEDICINEANTI AGING WORKSHOP 2 NUTRIENTS AND ANTI-AGING - EFFICIENT NUTRIENTS FOR A HEALTHY AGING3.00 pm / 15h00NUTRIMENTS ET MÉDECINE ANTI-AGE - LES NUTRIMENTS EFFICACES POUR VIEILLIR EN BONNE SANTÉHOKAN CEDERBERG (SWEDEN)ERIC ALEXANDER RICHTER (THE NETHERLANDS)Alkylglycerols! What Vikings, Astronauts - and you - have in common!In fact Vikings and Astronauts have a lot in common: they are real explorers, brave and curious: travel in un-traveled Territory, neverknowing what lies ahead. Their mission depend on the functionality of each member of the crew - losing one man to (unnecessary)disease, also in a length of time and severity aspect, seriously sets back their whole mission and can be detrimental to its survival.Like a soldier who gets injured - not only is the Army then one man down, other soldiers will also have to attend to the injured! So theregimen has to be very strict diet-wise and lifestyle- wise for these Pioneers.Scandinavian fishermen took shark liver oil, containing high levels of Alkylglycerols, as a treatment for gastrointestinal problems, slowhealing wounds and for improved health in general (the immune system concept was not invented then!) already several hundredyears ago - in fact it is believed that even the Vikings, a thousand years ago, knew this secret.Today research has proven that Alkylglycerols also protect the human body from damaging radiation which has led to research andclinical tests in many different fields of radiation and how the body can be protected from this damaging radiation:1. Medical research in conjunction with radiation therapy for the treatment of Cancer.86

2. Research in regards to cellular phone radiation and radiation from electric power lines.3. Military research for protecting its personal from all types of radiation including cosmic radiation, which Astronauts and Pilots areseverally exposed to, as well as other - "intended and un-intended" - military types of radiations.Alkylglycerols are also "scavengers", very effectively removing heavy metals (including mercury continuously leaking from dentalamalgam/silver fillings).Removal of heavy metals as found in amalgam/silver fillings and other sources of heavy metals are crucial for good general health.However, when removed, extra precautions have to be taken as the body - and the blood streams - then will be exposed to a cascadeof damaging heavy metals, which all have to be removed effectively not to cause irreversible damage on many organs, specifically thebrain. Heavy metals are known to be instrumental in the development of Alzheimer's Disease, probably Parkinson's Disease and manyother brain and organ disorders.Alkylglycerols also play an important role in reproductive health, promoting fertility, protecting the egg and the sperm and facilitatingfertilization. Interestingly enough mothers' milk contains the highest level of Alkylglycerols in the human, while there is also some inthe bone marrow and in the spleen!Alkylglycerols taken systemically also have specific positive effects on the aging process of the skin, being building blocks for a healthyskin structure. By taking Alkylglycerols the skin gets fuel to maintain its health and youth and they are an integral part of the "Beautyfrom Within"-concept.Alkylglycerols are corner stones for a Healthy Aging process in general. Working on the immune system they have a similar structureto beneficial Plasmalogens. The similarity chemically between Alkylglycerols, Plasmalogens and PAF antagonists is more thanobvious. Alkylglycerols cross the blood-brain barrier and have been tested as a carrier of life saving drugs into the brain. Research hasbeen made on Alkylglycerols as a Histone Deacetylase Inhibitors (HDI) and compared in studies to sodium phenyl butyrate(triButyrate ® ) which is a confirmed and effective HDI.Finally, recent studies indicate that the activation of Protein Kinase C, an essential step in cell proliferation, can be inhibited byAlkylglycerols. This action suggests a competitive inhibition of 1.2-diacylglycerol by Alkylglycerols. Further studies on theimmunostimulatory action of Alkylglycerols suggest a primary action on the Macrophage. The process of Macrophage activation hasbeen demonstrated with both synthetic and natural Alkylglycerols. While the exact mechanism has not been found, both an autocrineand paracrine system have been suggested.Vital Corner stones for Healthy Prostate functionsEarly detection is crucial for all disease states, not the least Cancer. For Prostate Cancer the PSA test has proven not to besatisfactorily accurate, many men have low PSA readings, but can still have a developed Prostate Cancer, even in late stages. Andover one million men in the US only have unnecessarily a biopsy, with "negative" results (NO Cancer!). Conversely, many men havea developed Prostate Cancer in different stages, but it is in a "disease control"/stabilized state and the disease is NOT progressing.Diet (red meat - black men in the US) is an important factor, so is heritage and sexual and urinary behavior ("make love often and sitdown and urinate"!). All men develop Prostate problems/Cancer if they live long enough", someone postulated.One can do a lot to promote a healthy prostate gland - preventatively, as a complement to traditional treatment or as the primetreatment in case of disease, using natural and alternative treatments.Recently a "concoction" of four different existing regimens was developed in Sweden, in several test cases proven to be very effectiveand totally without side effects - negative medical or psychological consequences (regular pilot and clinical studies of this combinationare currently being designed):1. 2+2 capsules highly purified Shark Liver Oil capsules containing Alkylglycerols for strengthening the immune system and to protectthe body against the damaging effects of radiation treatment or chemotherapy;2. 2+2 capsules ProstaHealth containing no less than 13 ingredients, all with established positive effects on the prostate, that all workin synergy (it has been referred to as the "most comprehensive Prostate Formula" containing saw palmetto, pygeum africanum,pumpkin seed, urtica, beta-sitosterol, lycopene, quercitin, selenium, zinc, copper, magnesium, vitamins-D3/E);3. 2.5 mg Sublingual Melatonin.. Recent research shows that people with Prostate Cancer have an abnormally low level of Melatoninin the blood.4. Sodium phenyl butyrate/triButyrate ® (dosage to vary with disease state). From the 350+ long Reference List found onwww.tributyrate.com, some examples of the usage in conjunction with Prostate Cancer will be shown/discussed.Many men with confirmed advanced Prostate Cancers in different stages and after having gone through all the traditional regimens,including hormone treatment, radical surgery, etc. often after having spread to the skeleton, have as a last resort turned to alternativetreatments and this regimen has so far shown "shockingly" positive results ("The Captain Roy's case" will be discussed/shown).New Usage and Formulations of Key Aging HormonesTypical bio-identical hormones, commonly used in Aging Medicine, have been controversial from "Day One", largely due to the factthat they are cheap, safe and non-patentable in comparison to synthetically produced patented expensive hormones, typically heavilyladen with severe side effects. The usage of these key bio-identical Healthy Aging Hormones in the US, and worldwide, is growingtremendously and patients are at large extremely satisfied. However, they all have to be treated with respect and can in certain casesbe overdosed. More is not always better! Recent research and clinical observations have brought about complementary ranges ofDHEA and Melatonin Formulations based on scientific findings in collaboration with the World's foremost Hormone Experts. DHEA isnow also available also in 5, 20, 35mg versions (and as 25mg 7-keto-DHEA) complementing the since long generally available 10, 25and 50 mg versions, to ensure optimal dosage for each usage/patient, efficacy- and safety-wise.Because of new findings in the area of tinnitus ("ringing in the ears"), periodontal disease (where the correlation between patients withperiodontal disease and abnormally low levels, correlated for age, of Melatonin in the blood, is almost total) and for treatment ofprostate problemsand electric allergies new versions of Melatonin - 0.2, 0.5 and 2.5 mg sublingual and 20 mg regular tablets -complementing the traditional generally available formulations of 1 and 3 mg tablets, have been developed, to accommodate everyneed for all types of patients. On recommendation, slow release Melatonin formulations are avoided because of their common residualserious drowsiness effects.Pregnenolone is generally taken in larger dosages and therefore the availability of the since long established potencies of 10, 25 and50 mg capsules is deemed to suffice for most usages and indications.Sodium Phenyl Butyrate/triButyrate ® - a "Miracle molecule", or what?!Developed in the mid-1980's, originally for Johns Hopkins Hospital as a treatment for Urea Cycle Disorder, a metabolic childrendisease (today over 1.500 children, some aged 20+, are alive because of triButyrate) this compound has today been used in over 20different indications - including over 20 types of Cancer - ranging from Ornithine Transcarbamylase Deficiency, Cystic Fibrosis ("CF"),Thalassemia, Sickle Cell Anemia, Adreno Leuco Dystrophy ("ALD"), Spinal Muscular Atrophy ("SMA"), Multiple Sclerosis ("MS"),ANTI-AGING MEDICINE87

Amyotrophic lateral Sclerosis ("ALS"), Huntington's Disease, Hunter's disease, Benign Prostate Hyperplasia, "BPH" andKidney/Brain/Liver/Eye disorders.In Cancer, the most researched types are Breast, Brain, Colon, Prostate, Liver and Skin Cancers, but also Leukemia, Hodgkin'sDisease, Bone, Cervical, Gastric, Head&Neck, Intestinal, Lung, Nervous System, Ovarian, Pancreatic, Renal and Thyroid Cancershave been researched and used clinically.Lately, scientific studies also show a general positive effect on the aging body, including the aging skin.The working mechanisms are at large unknown , for all/most indications for which it has been tried, different working mechanisms havebeen postulated starting from "the back" = the known biochemistry paths of the disease itself, and surely all these are VERY differentin their nature (based on the very different nature of all the listed deceases).OR, which is, according to some, the most likely scenario, they are for all these diseases "very basic" and " in common" workingmechanisms and at large "the same", addressing health/disease at its "basic roots" (admittedly a very "unscientific" - or maybe rathera very "un-pharmaceutical /commercial" - approach!!).Over 350 References/Publications are available (www.tributyrate.com), conducted at the World's most prestigious Research Institutesand Hospitals, e.g. Karolinska Institute, Johns Hopkins, M.D. Andersen, Mayo Clinic, Memorial Sloan-Kettering, Mount Sinai, NCI(National Cancer Institute), of which the majority are published in peer-reviewed Journals e.g. The Lancet, New England Journal ofMedicine and many other International leading medical Journals."The A's to Z's for Healthy Aging"A Aging; Alkylglycerols; Antioxidants; ArthritisB Brain; Bones; Breast; BabyC Cancer; Cellular phones; Curious; Chemicals; Carbohydrates; Coke, Cigarettes; CycleD Dental (Natural) Health; Dietary Supplements; Diet; DHEAE (Mother) Earth; Environment; Exercise; Education; Energy; ElectricityF Fruit; Flowers; Fossile Fuels, FatG Growth Hormones; Growth, Genes (Parents!); Global WarmingH Hormones; Heart; Health; Healthy Aging; Hair; Hydro PowerI Intelligence; Infants; Immune System; Impotence; InformedJ Job; JuicesK KnowledgeL Liver, Love; Light/Dark; LiveM Melatonin; Minerals; Meditation; Memory; Mental Health; MassageN Nutrients; Nutrition; NewsO Omega3; OsteoporosisP Prostatic Health; Pharmaceuticals, Politics; Poison, Pregnenolone; Power; Pleasure; People; (No)Plaque; ProteinsQ Q-10; QuestR Radiation; Religion; RelaxS Smoking; Softener; Skin; Sun; Sex; Stomach; Survival; Saliva; Solar Power; Sugar/s; SwimT triButyrate; Trust; ToxicU Unethical; U are responsible for your own life ("Take charge!")V Vegetables; VitaminsW Wine (Alcohol); Water; World; Washing/Drying; Wind Power; WalkX Xerostomia; X-rayY Yougurt; Ying and Yang; YogaZ Zero, Zink, ZoneANTI-AGING MEDICINESESSION 4AA4.00 pm / 16h00HEAVY METALS AND CHELATION TECHNIQUESMETAUX LOURDS ET TECHNIQUES DE CHELATIONCHAIR: CHRISTOPHE DE JAEGER GERIATRIST, GERONTOLOGIST (PARIS, FRANCE)VERA STEJSKAL, PROFESSOR OF IMMUNOLOGY (DANDERYD, SWEDEN)METABOLISM OF HEAVY METALSMÉTABOLISME DES MÉTAUX TRACE TOXIQUESANDRÉ PICOT(FRANCE)Metabolisation of toxic trace metals can be explained through toxicochemistry, at the interface of chemistry and biology(cf. diagram 1).88

As a lot of data is available for Mercury (Hg), it will be taken as a reference.As molecular mechanisms are involved in toxic processes, a good approach to the metabolism of toxic trace elements must take theirphysical state into account, as well as their physicochemical and chemical properties (cf. diagram 2).The diagram 3 sums up the state of the knowledge about the biotransformation of Mercury in the human organism and the steps willbe developed during the oral presentation.Diagram 2: Diagram 3:Main properties of chemicals involved in toxic processes Metabolism and targets of MercurySuch a metabolism probably concerns other toxic trace metals like Lead (Pb) and Cadmium (Cd), as well as Thallium (Tl), Silver (Ag),Bismuth (Bi) and Tin (Sn).A good knowledge of the metabolism pathways of toxic trace metals should help to understand the molecular mechanisms involved incellular aging process, in particular in the central nervous system.References1. Picot A., Proust N. Speciation and toxicity: mercury and associated compounds. Trace Microprobe Tech 2000;18: 182-92.2. Picot A., Proust N. Toxicochimie des xénobiotiques minéraux et organominéraux : importance de la spéciation. EMC (Elsevier Masson SAS, Paris)Toxicologie - Pathologie professionnelle., 16-001-R-10, 2007.3. Grosman M., Picot A. Le mercure des amalgames dentaires, l'un des principaux facteurs étiologiques de la maladie d'Alzheimer ?http://atctoxicologie.free.frEVALUATION TECHNIQUES OF THE POISONING BY HEAVY METALSTECHNIQUES D'ÉVALUATION DE L'INTOXICATION PAR LES MÉTAUX LOURDSVERA STEJSKAL(SWEDEN)ANTI-AGING MEDICINEAlthough acute metal poisoning in an occupational setting is easily diagnosed by measurement of metal concentration in the blood orurine, the same is not true for chronic metal poisoning which might develop following chronic low-dose exposure. The situation iscomplicated by the fact that under those circumstances, the health of exposed subjects is affected differently. Depending on thehereditary susceptibility, some people are relatively resistant to low dose effects while others, the susceptible ones, might developvarious forms of health problems ranging from skin diseases to chronic fatigue or serious autoimmune diseases. Let's take the exampleof mercury, a ubiquitous poisonous metal continuously released from the dental amalgam. Despite of the well-known fact that mercuryis one of the most toxic substances on the earth, only Scandinavian countries have followed the precaution "better safe than sorry"and either banned amalgam already (Norway) or will do so later this year (Sweden and Denmark).It is well established that measurement of mercury concentration in the blood, urine or hair will not be help to distinguish amongpatients with toxic or allergic reactions to mercury. The markers of susceptibility which allow for the detection of susceptible subjectsare determination of the polymorphism in certain important genes such as those for coproporphyrinogen oxidase (CPOX4) or genesinvolved in the production and metabolism of glutathione. Another way is to measure the inflammatory potential of mercury whichvaries among the individuals. The susceptible groups reacting to mercury in an inflammatory way are patients with abnormal immunereactivity, such as allergy and autoimmunity.Metals such as mercury behave as haptens and induce the so called cellular type of hypersensitivity. This reaction is easily measuredby blood test, a lymphocyte transformation test (LTT-MELISA ® , www.melisa.org).BREAST TUMOURS STRONGLY ACCUMULATE TRANSITION METALS: NEW THERAPEUTICAL IMPLICATIONSLES TUMEURS DU SEIN ACCUMULENT FORTEMENT LES MÉTAUX DE TRANSITION : NOUVELLES CONSÉQUENCESTHÉRAPEUTIQUESJOHN IONESCU(GERMANY)Increased levels of transition metals like iron, nickel, chromium, copper and lead are closely related to free radical generation, lipid89

peroxidation, formation of DNA-strand breaks and tumour growth in cellular systems. In order to determine the correlation to malignantgrowth in humans, we investigated the accumulation of heavy metals in 8 healthy and 20 breast cancer biopsies by means of astandardized Atomic Absorption Spectrophotometry (AAS) methodology.A highly significant accumulation of iron (p < 0.0001), nickel (p < 0.00005), chromium (p < 0.00005), zinc (p < 0.00001), cadmium (p< 0.005), mercury (p < 0.005) and lead (p < 0.05) was recorded in the cancer samples when compared to the control group. Copperand silver showed no significant differences to the control group whereas tin, gold and palladium were not detectable in any biopsies.As previously reported by us, the higher heavy metal concentration encountered in various tumours may be used for therapeuticalintervention with ascorbic acid or substituted phenolic mixtures.The autoxidation of Vitamin C and phenolic compounds in the presence of heavy metals strongly increase the superoxide and H2O2- generation at the tumour site resulting in a fast depletion of the malignant cell reducing equivalents with oxidosis shift and apoptosisinduction.Our results suggest that the use of the above mentioned redox-active compounds devoided of side-effects should be seriouslyconsidered in the treatment of different malignancies and infections.REVERSE PREMATURE AGING CAUSED BY HEAVY METALS: MOST RECENT DATA ON HEAVY METAL DETOXIFICATION TOREVERSE PREMATURE AGINGINVERSER LE VIEILLISSEMENT PRÉMATURÉ INDUIT PAR LES MÉTAUX LOURDS : LES DERNIÈRES DONNÉESSUR LA DÉSINTOXICATION DES MÉTAUX LOURDS POUR CONTRER LE VIEILLISSEMENT PRÉMATURÉVERA STEJSKAL(SWEDEN)Although acute metal poisoning in an occupational setting is easily diagnosed by measurement of metal concentration in the blood orurine, the same is not true for chronic metal poisoning which might develop following chronic low-dose exposure. The situation iscomplicated by the fact that under those circumstances, the health of exposed subjects is affected differently. Depending on thehereditary susceptibility, some people are relatively resistant to low dose effects while others, the susceptible ones, might developvarious forms of health problems ranging from skin diseases to chronic fatigue or serious autoimmune diseases. Let's take the exampleof mercury, a ubiquitous poisonous metal continuously released from the dental amalgam. Despite of the well-known fact that mercuryis one of the most toxic substances on the earth, only Scandinavian countries have followed the precaution "better safe than sorry"and either banned amalgam already (Norway) or will do so later this year (Sweden and Denmark).It is well established that measurement of mercury concentration in the blood, urine or hair will not be help to distinguish amongpatients with toxic or allergic reactions to mercury. The markers of susceptibility which allow for the detection of susceptible subjectsare determination of the polymorphism in certain important genes such as those for coproporphyrinogen oxidase (CPOX4) or genesinvolved in the production and metabolism of glutathione. Another way is to measure the inflammatory potential of mercury whichvaries among the individuals.The susceptible groups reacting to mercury in an inflammatory way are patients with abnormal immune reactivity, such as allergy andautoimmunity.Metals such as mercury behave as haptens and induce the so called cellular type of hypersensitivity. This reaction is easily measuredby blood test, a lymphocyte transformation test (LTT-MELISA ® , www.melisa.org).TEETH AND HEAVY METALS: DIAGNOSIS AND TREATMENTSDENTS ET MÉTAUX LOURDS : DIAGNOSTIC ET TRAITEMENTSERIC OQUINARENA(FRANCE)INTEREST OF LOCAL TECHNIQUES OF CHELATIONL'INTÉRÊT DES TECHNIQUES LOCALES DE CHÉLATIONSAMI SANDHAUS(SWITZERLAND)ANTI-AGING MEDICINEEnglishSome of the alloys inside of the body can slow down the achievement of an anti-aging therapy.Endo-oral acidity (saliva e.g.) increases the oxidative risk making impossible the achievement of an anti-aging therapy value.The capital of the hyaluronic acid will be observed chemically reduced and by reducing a hypodermic elasticity of the treatment.The preparation of the contaminated ground will be done by demounting of considered materials. A technique of new local quellationwill be presented during this conference.FrançaisCertains alliages endo-corporels peuvent freiner l'accomplissement d'une thérapie anti-aging.L'acidité endobuccale (salive par ex.) augmente le risque oxydatif ne permettant pas d'accomplir une thérapie anti-aging de valeur.Le capital de l'acide hyaluronique se verra réduite chimiquement et en réduisant une élasticité hypodermique du traitement.La préparation du terrain contaminé se fera par des déposes des matériaux incriminés. Une technique de chélation locale inédite seraprésentée lors de cette conférence.INTEREST OF ORAL AND INTRAVEINOUS TECHNIQUES OF CHELATIONL'INTÉRÊT DES TECHNIQUES LOCALES ET INTRAVEINEUSES DE CHÉLATIONPHILIPPE TOURNESAC(FRANCE)Chelation is the binding or complexation of a bi- or multidentate ligand. These ligands, which are often organic compounds, are calledchelants, chelators, chelating agents, or sequestering agent. The ligand forms a chelate complex with the substrate. The term isreserved for complexes in which the metal ion is bound to two or more atoms of the chelating agent, although the bonds may be any90

combination of coordination or ionic bonds.Virtually all biochemicals exhibit the ability to dissolve metal cations. Thus proteins, polysaccharides, and polynucleic acids areexcellent polydentate ligands for many of the metal ions.Chelation therapy describes the use of chelating agents to detoxify poisonous metal agents such as mercury, arsenic, and lead byconverting them to a chemically inert form that can be excreted without further interaction with the body. Very often, there is confusionbetween detoxification and chelation. Detoxification should be used to describe techniques used to help the body eliminate a toxic.Testing of homocystein, antioxidant (selenium, vitamine C and B, SOD, glutathion peroxydase), and magnesium is absolutelynecessary before practicing any chelation.The use of chelation in case of acute metal intoxication or high chronic metal intoxication is medically well understood and accepted.In case of slight environmental intoxication the problem is different; the presence of mercury in the hair of in the urine is not the proofof a metal intoxication. As many chelating treatments have proven or potential side effects, especially because there are not specificof a metal, it is important to prove the intoxication. The Melisa test ® is actually the best biological test for metal intoxication.It is also important to follow the metal intoxication through a Melisa ® test or urine dosage before and after chelation. If the metal intakeis stopped the intoxication will disappear spontaneously in a few months. If it is not possible to stop the metal intake the chelationshould theoretically be continued over a long period but the innocuousness of such a treatment has not be proven.Oral chelation is only efficient on the intestine content.The chelator ties to metals present in the intestine. As it is not a specific reaction it can tie to any metals from magnesium or calciumto mercury. If the heavy metal is regularly absorbed as it is the case for teeth fillings or if the food is polluted with toxic metals this kindof chelation could be prescribed. This kind of chelation may also interfere with the reabsorption of toxic metals eliminated through theliver into the bile.Oral DMSA speeds the elimination of mercury, lead, and arsenic, antimony, bismuth, and gold it is considered as the safest and mostscientifically studied.Chlorella is a genus of single-celled green algae. In vitro Chlorella is capable of absorbing a great quantity of metals. It has proven itsefficiency when absorbed with the metal in mice. The few data we have from case reports demonstrate that the increase of metalexcretion is only in feces and not in urine. This should stop all the literature about the action of chlorella in side the vessels or theneurological system. There are no serious medical studies proving efficacy in case of intoxication in human beings. This is verysurprising because the claims for mobilization of mercury from tissues or facilitation of mercury excretion are not scientifically proven.Cilantro, a particular form of coriander, is in the same scientific situation as chlorella.D-penicillamine is used in Wilson's disease to chelate copper.Other molecules like glutathione and lipoic acid have shown a slight in vitro chelation capacity. Their efficacy is probably more tied toa positive reinforcement of the body's detoxification capacity than a chelating effect. Many so called "chelating food complements" arein this situationIV chelation is usually practiced with EDTAEDTA is the abbreviation for ethylenediaminetetraacetic acid. This amino acid is widely used to sequester di- and trivalent metal ions.EDTA binds to metals via four carboxylate and two amine groups. EDTA forms especially strong complexes with Mn, Pb Cu, Fe, andCo. It also ties to Calcium, magnesium and many heavy metals. It has very few effects on mercury intoxication. Doctor Wittel anAmerican MD practicing a lot of EDTA chelation in the USA estimates that approximately 500 000 American take this treatment everyyear. The main use seems to be for arteriosclerosis with the aim to take away the calcium from the arteries. It is also used in manyother indication such metabolic disturbances (cholesterol excess, diabetes), bone and muscle pain, antiaging (skin, Alzheimer, hair,eyes) and chronic fatigue syndrome. The positive impact on cardiovascular disease has not been scientifically proven in any doubleblind test but a very big trials is being conducted at the moment to prove or infirm the benefit for post cardiac infarctus patient(http://nccam.nih.gov/chelation). The positive impact on lead intoxication is not to be discussed. But we are lacking studies on humansfor other heavy metals intoxication. It is always associated with minerals and vitamins supplementation because of its chelating effects.ANTI-AGING MEDICINEDMPS is potentially too toxic to use and no longer has place in the practice of medicine. Some continue to use it for acute mercuryintoxication, but it may not be safe.Déféroxamine is used for iron or aluminium acute intoxicationConclusion: Chelation seems to be therapeutically interesting. A number of case reports are in favor of this kind of treatment. We needmore scientific experimentation on humans to validate the technique and have a better estimation of the risks. It should never beisolated from estimation and treatment of the body capacity of desintoxication.Chelators as antidotes of metal toxicity: therapeutic and experimental aspects. Blanusa M, Varnai VM, Piasek M, Kostial K. Curr MedChem. 2005;12(23):2771-94.Cilantro, Chlorella and Heavy metals. John Millet Medical Herbalism Vol 14 n°4:17-20Treatment of Mercury and Lead Poisonings with Dimercaptosuccinic Acid (DMSA) and Sodium Dimercaptopropanesulfonate (DMPS)Jan Aaseth, Dag Jacobsen, Ole Andersen, Elsa WickstrØm Analyst 1995 Mar; Vol 120, page 853ff91

Friday April 11 / Vendredi 11 AvrilANTI-AGING MEDICINEROOM / SALLE MAILLOTSESSION 5AASEXOLOGY AND SEXUAL ENDOCRINOLOGY: OXYTOCIN, THE SEXIEST HORMONE EVER? RELAXIN, THE FORGOTTEN HORMONE?SEXOLOGIE ET ENDOCRINOLOGIE SEXUELLE : OCYTOCINE, LA PLUS ATTIRANTE DES HORMONES ? RELAXINE, L'HORMONE OUBLIÉE ?CHAIR: RONALD VIRAG VASCULAR SURGEON, SEXOLOGIST (PARIS, FRANCE)GORM WAGNER ANTI-AGING MEDICAL DOCTOR (COPENHAGEN, DENMARK)8.30 am / 8h00OXYTOCIN CAN PROVIDE WOMEN WITH MULTIPLE ORGASML'OCYTOCINE PEUT DONNER AUX FEMMES DE MULTIPLES ORGASMESJORGE FLECHAS(USA)OXYTOCIN FOR MEN TOO?L'OCYTOCINE AUSSI POUR LES HOMMES ?CLAUDE DALLE(FRANCE)Oxytocin (OT) in not only a female hormone ; men have it and it acts like a neurotransmitter in the brain, but like an hormone in theblood.In the brain, it activates the liberation of acetylcholine, dopamine and noradrenaline alphareceptors.It can be counteract by GABA, and noradrenaline betareceptors. We can stimulate the OT by the serotonine, so important for the brainpeace.Oxytocin does not need a feedback, but its half life is very fast, only 5 to 10 mn.It seems nearly like ADH, and works a little bit like it.OT acts on the seminiferous tubules by contracting muscles to push out spermatozoa, and OT participates strongly to the prostatecontraction during orgasm, so is helpful for fertility.Like for women, OT creates attachment between people, particularly during arousal and orgasm.It is certainly one of its main action. Only a physical contact stimulates the OT secretion !During orgasm, we can observe an increase in the level of OT just before the conclusion:The level of OT seems correlated to the orgasm intensity.The penis has many OT receptors. The ventral prostate also.We restore male ejaculation with OT, but, because of its short half life, we need for men to take it during arousal or erection time.But we know now that at low level we can have and increase a penile erection, but at high level, we have inversely a detumescence.OT is decreasing the stress, and cortisol; its also an anxiolytic hormone, a relaxing hormone.By this way it helps to sexual receptivity and counteracts impotence.We will see the dose during the lecture.ANTI-AGING MEDICINEOXYTOCIN AND FIBROMYALGIAOCYTOCINE ET FRIBROMYALGIEJORGE FLECHAS(USA)RELAXIN: ITS ROLE IN THE PATHOGENESIS OF FIBROMYALGIARELAXINE : SON ROLE DANS LA PATHOGÉNÈSE DE LA FIBROMYALGIESAMUEL YUE(USA)POLYHORMONAL AND METABOLIC INFLUENCES IN MALE SEXUAL DYSFUNCTIONINFLUENCES POLYHORMONALES ET MÉTABOLIQUES DANS LA DYSFONCTION SEXUELLE CHEZ L’HOMMERONALD VIRAG - VÉRONIQUE HASTERT(FRANCE)CHANGES IN THE PHYSIOLOGICAL RESPONSES TO SEXUAL STIMULATION DURING LIFESPANCHANGEMENTS DES RÉPONSES PHYSIOLOGIQUES À LA STIMULATION SEXUELLE AU COURS DE LA VIEGORM WAGNER(DENMARK)The basic physiological mechanisms in response to sexual stimulation in both women and men shall be presented.The psychological and somatic changes in sexual response will be discussed in relation to aging.92

SESSION 6AAOPTIMAL NEUROLOGY IN 15 YEARS FROM NOWNEUROLOGIE OPTIMALE DANS LES 15 PROCHAINES ANNÉESCHAIR: MONIKA GOLKOVA NEUROLOGIST (PRAGUE, CZECH REPUBLIC)LUIZA SPIRU PROF. OF GERONTOLOGY AND GERONTOPSYCHIATRY (BUCHAREST, ROMANIA)11.00 am / 11h00NEUROENDOCRINOLOGY OF BRAIN AGINGNEUROENDOCRINOLOGIE DU VIEILLISSEMENT DU CERVEAULUIZA SPIRU(ROMANIA)BRAIN BUILDING: ANTIOXIDANTS, NEUROTRANSMITTERS, AND FOOD WHICH IMPROVE YOUR BRAIN PRIMDÉVELOPPEMENT CÉRÉBRAL : ANTIOXIDANTS, NEUROTRANSMETTEURS ET ALIMENTS AMÉLIORANTVOS CAPACITÉS CÉRÉBRALESMONIKA GOLKOVA(CZECH REPUBLIC)The Brain Controls the Body. Each biochemicals controls the related main age accelerators.For example, dopamin controls the brains voltage, or power. When our dopamin levels fall, we can become overweight, our digestivesystem becomes stressed, leading to diabetes, our immune system becomes compromised…When optimally functioning, the same four neurotransmitters are also the great age decelerators. By boosting each of them, you canbuild up your brain power, speed, synchrony, and rhythm.About 95 % of cellular energy production occurs in the mitochondria and many diseases of aging are increasingly being referred to as"mitochondrial disorders ". Brain cells require a hight level of energy metabolism to properly function. This lecture will show some of themost potent mitochondrial energizers and building blocks of our brain.AGING BRAIN: HOW TO AVOID DEMENTIA?VIEILLISSEMENT CÉRÉBRAL : COMMENT ÉVITER LA DÉMENCE ?PASQUALE CALABRESE(GERMANY)CUTTING-EDGE DIAGNOSIS IN BRAIN AGING PREVENTIONLE DIAGNOSTIC DE POINTE POUR LA PRÉVENTION DU VEILLISSEMENT DU CERVEAULUIZA SPIRU (ROMANIA)CRITICAL CONTROVERSIES IN BRAIN ANTI-AGING THERAPYLES CONTROVERSES SUR LES TRAITEMENTS DU VIEILLISSEMENT CÉRÉBRALAMOS KORCZYN(ISRAEL)ANTI-AGING MEDICINESESSION 7AASTEM CELLS FOR A LONGER AND BETTER LIFESPANLES CELLULES SOUCHES POUR UNE ESPERANCE DE VIE PLUS LONGUE ET MEILLEURECHAIR: MICHAEL E. MOLNAR PROF. BIO-CELLULAR RESEARCHER (NEWARK, USA)THIERRY HERTOGHE PRESIDENT Wosaam (BRUSSELS, BELGIUM)2.00 pm / 14h00TREATMENT OF AGING DISEASE BY STEM CELL TRANSPLANTATIONLES TRAITEMENTS DES MALADIES LIÉES AU VIEILLISSEMENT PAR LA TRANSPLANTATION DE CELLULES SOUCHESMICHAEL E. MOLNAR(USA)School medicine has declared aging a natural inevitable process : There is no 'aging disease', and thereby no reason for any R&D, sincethere is nothing that you can do against 'Mother Nature'.The goal of medicine has been to learn the cause of disease(s), including of aging disease, and to find treatment for disease(s), e.g. forpreservation of the vitality of aging organism until the alleged genetic limit of our life at 120 years.Vitality measures the ability of one's organism to realize all vital functions, physical, mental and spiritual.Vitality is an optimal performance of capacities existing in an individual. 'Devitalization' means loss of vitality due to aging disease, andaging-related diseases. 'Revitalization' means re-establishment of lost vitality.Treatments of 'aging disease' have been based on various theories, none of them able to explain all causes of aging, whetherenvironmental or genetic.There are two major types of 'aging disease': accidental, or random, and programmed,because we age 'by accident' and 'by design'.The latest "Merck Manual of Geriatrics" defines 'usual aging' as 'changes due to the combined effects of the aging process and ofdisease and adverse environmental and lifestyle factors', while 'successful aging' as 'changes due solely to the aging process,93

uncomplicated by damage from environment, lifestyle, or disease'. 'Usual aging' should be defined as 'aging disease'.Succesful aging process leading to our demise at 120 years, is disrupted by three factors: severe illness, severe trauma, or 'usualaging', i.e. 'aging disease'.Characteristics of 'aging disease':1/ The rate of age-related decline of the function of every organ varies greatly, so that people become less alike as they age;2/ Within any organism the functions of various organs decline at different rates;3/ Each human being has at least one malfunctioning organ or organ system;4/ Different people age at different rates, and the pattern of their aging varies, too.Medicine cannot treat successfully aging related diseases, or other diseases in an aging patient, without treatment of aging disease.The earlier in life the revitalization therapy program begins, the better are the results. The best time to start is between 40 and 50 yearsof age.The later the revitalization program commences, the more aggressive has to be the therapy.Experts always believed in a complex approach to the treatment of aging disease, i.e. stem cell transplantation alone is not sufficient.The foundation of the treatment of 'aging disease' consists of lifestyle adjustments, correct nutrition, regular active exercise, properhandling of stress, spiritual immersion.Functional normalization of all organ systems by all means of orthodox and alternative medicine, and detoxification, is the key task ofmedical profession in treating 'aging disease'.1/ Patient with 'aging disease' needs an improvement of biological functions in their entirety (i.e. 'vitality'): physical, mental and spiritual;2/ Follow-up examinations require measurement of parameters described in therapeutic protocol, but also an evaluation of the 'vitality',which to some degree is a matter of the patient's personal judgment;3/ The more advanced are the symptoms and signs of aging disease the more thorough must be the diagnosis of all diseases andmalfunctions of all organ systems, and clinical use of comprehensive therapeutic protocol, not only SCT, mandatory;4/ The regenerative ability of an organism is diminishing with age, thus the 'aging disease' should be treated early, and repeatedly.The older is the patient at the time of the first treatment, the more frequent should be the SCT treatment. As long as there is someregeneration potential left, and the patient is not in the terminal stage of some disease(s), stem cell transplantation should not bedenied.Treatment is not so much a targeted stimulation of specific organs, and but rather a general improvement of elementary functions ofthe entire organism, and of vitality.Biological age refers to functional capacities of an organism corresponding to the respective stage of individual's lifespan. Discrepancybetween the chronological age and biological age is therapeutically correctible.Female patients should receive as a minimum stem cell transplants of ovaries, placenta, adrenal cortex, hypothalamus, liver, whilemale patients should receive at least stem cell transplants of testes, placenta, adrenal cortex, hypothalamus, liver, as treatment ofaging disease.PLACENTAL GROWTH FACTOR IN ANTI-AGING THERAPYLE FACTEUR DE CROISSANCE PLACENTAIRE DANS LA THÉRAPIE ANTI-ÂGESAWAKO HIBINO(JAPAN)ANTI-AGING MEDICINEThe use of placental extract for medication is not new. Traditional Chinese medicine saw its use around 4,000 years ago, and evennowadays in some tribal communities women use placental extract as a health-booster after childbirth. In mainstream medicine,placental extract made its debut in the 1950s. From 1959 onwards, Laennec ® , a medication produced by the purification of humanplacental extract, has been used in Japan as a treatment for chronic hepatic injuries and menopausal disorder, its use pioneered byDr. Kentaro Hieda. Today, Laennec ® is produced by Japan Bioproducts Industry Co. Ltd. (Tokyo, Japan).Total placenta extracts are heterogeneous in their cellular components, as they contain material of both fetal and maternal origin.Recently, there has been a renewed focus on human placenta extract (HPE) as a medication for pain reduction in conditions such asrheumatoid arthritis, atopic dermatitis, and neuralgia. HPE are widely used in clinical and fundamental research, particularly to studythe hormonal and exchange functions of the placenta.HPE has been used also for skin care as cosmetics, being expected to have an inhibitory effect, such as vitamin C or Vitamin E mightprovide, on cutaneous oxidative stress. Moreover, cosmetic and dietary supplements that include placental extract recently came ontothe market and have been widely noticed in the anti-aging field. HPE is also known to have activity in anti-inflammation, anti-sunburn,anti-pigmentation, anti-mutagenesis and anti-anaphylaxis. Other reports previously demonstrated that HPE exhibited potent in vitroand in vivo anti-oxidative activities, namely scavenging one of the oxygen-free radicals and one of the fatty acid peroxyl radicals andsuppressing ethanol-induced hepatic oxidative stress. HPE is widely marketed in Japan for immunotropic and anti-inflammatoryactivities, wound healing and in the anti-aging field.Our studies have indicated that supplementation of placenta extracts leads to skin rejuvenation. More recent investigations have alsoshown that the topical application of Laennec has similar beneficial effects. We have shown in case studies that Laennec affects thewater retentive properties of the skin and the efficacy for pigment and acne vulgari after its injection.94

SESSION 8AA3.00 pm / 15h00BORDERLINE ENDOCRINOLOGYAUX FRONTIÈRES DE L'ENDOCRINOLOGIECHAIR: TULLIO SIMONCINI ONCOLOGIST, ENDOCRINOLOGIST (ROMA, ITALY)SERGE JURASUNAS ANTI-AGING MEDICAL DOCTOR (LISBON, PORTUGAL)TREATING WITH HUMAN GROWTH HORMONE GROWTH - HORMONE DEFICIENT ADULTS WITH LAB TESTS WITHREFERENCE RANGESTRAITEMENT DES PATIENTS ADULTES DÉFICIENTS EN HORMONE DE CROISSANCE AVEC DES TESTS DANS LES LIMITESDE RÉFÉRENCETHIERRY HERTOGHE(BELGIUM)Presentation-Description: The main difference between conservative and advanced endocrinology is that in conservativeendocrinology only patients with hormone levels under the lower reference limit of the patient's age category are considered to havea deficiency and may get treated, while in advanced endocrinology also patients with hormone tests within reference ranges may gettreated.Reference ranges are not healthy ranges, but mere statistical ranges that help us know what hormone levels other people in thepopulation have. 95 % of a population will statistically have a hormone level within the reference range, while 2.5 % will have a levelunder the lower reference, and 2.5 % above the upper limit. It remains also so even if a whole population is deficient in the hormone(postmenopausal women for estradiol for example), or whether 10, 30, 50, or 70 % of the population would be sufficient in it.Here, with the example of serum IGF-1 levels, which reflect growth hormone activity, data are shown that support the view that lowerhormone levels within the reference range may be associated with disease and therefore not sufficient and in fact reflect a growthhormone deficiency.There is no or poor scientific backing to support the claim that only patients with serum IGF-1 levels under the lower reference of aperson's age category would be growth hormone deficient, and above that level growth hormone sufficient. On the other hand, thereis an important amount of scientific data that shows that being in the lower forth, third, half, two thirds or even lower three quarters ofthe reference range for serum IGF-1 is associated with an increased risk of disease or disease markers such as increased risks ofhigher body mass index, highervisceral fat mass, obesity, more metabolic syndrome features, low mini-mental state examinationscores, high serum triglycerides, higher CRP, increased intima media thickness of carotid arteries and atherosclerotic plaques in them,increased systolic and diastolic blood pressure, arterial hypertension, history of angina pectoris or of myocardial infarction,cardiovascular disease, including ischemic hear disease and heart failure, stroke, cervical cancer including intraepithelial neoplasia,endometrial, pancreatic, rectal cancers, glioma, increased tumor-node-metastasis stage in breast cancer patients, prostate cancer,acute lymphoblastic leukaemia, and, last but not least increased mortality.Increased risks of breast, prostate and colon cancers have also been reported at higher levels of serum IGF-1, but this may not bedue to an excess growth hormone production, but to other causes such as a production of serum IGF-1 by tumour tissue. A higherserum level of IGF-1 is a consequence and not a cause of the cancer. Supports for this view is found in studies that show thatreductions of IGF-2 precede the appearance of cancer (in liver cancer for example), increases of IGF-1 during time in progressiveprostate cancer, etc.ANTI-AGING MEDICINEIncreased mortality in people with lower serum IGF-1 levels within reference range1. Rasmuson T, Grankvist K, Jacobsen J, Olsson T, Ljungberg B. Serum insulin-like growth factor-1 is an independent predictor of prognosis in patientswith renal cell carcinoma. Acta Oncol. 2004;43(8):744-8.2. Vasan RS, Sullivan LM, D'Agostino RB, Roubenoff R, Harris T, Sawyer DB, Levy D, Wilson PW. Serum insulin-like growth factor I and risk for heartfailure in elderly individuals without a previous myocardial infarction: the Framingham Heart Study. Ann Intern Med. 2003 Oct 21;139(8):642-8.3. Jankowska EA, Biel B, Majda J, Szklarska A, Lopuszanska M, Medras M, Anker SD, Banasiak W, Poole-Wilson PA, Ponikowski P. Anabolic deficiencyin men with chronic heart failure: prevalence and detrimental impact on survival. Circulation. 2006 Oct 24;114(17):1829-37. Cardiology Department,Military Hospital, ul. Weigla 5, 50-9814. Denti L, Annoni V, Cattadori E, Salvagnini MA, Visioli S, Merli MF, Corradi F, Ceresini G, Valenti G, Hoffman AR, Ceda GP. Insulin-like growth factor1 as a predictor of ischemic stroke outcome in the elderly. Am J Med. 2004 Sep 1;117(5):312-7.5. Roubenoff R, Parise H, Payette HA, Abad LW, D'Agostino R, Jacques PF, Wilson PW, Dinarello CA, Harris TB. Cytokines, insulin-like growth factor1, sarcopenia, and mortality in very old community-dwelling men and women: the Framingham Heart Study. Am J Med. 2003 Oct 15;115(6):429-35.Increased cardiovascular disease and disease markers in people with lower serum IGF-1 levels within reference range6. Janssen JA, Stolk RP, Pols HA, Grobbee DE, Lamberts SW. Serum total IGF-I, free IGF-I, and IGFB-1 levels in an elderly population: relation tocardiovascular risk factors and disease. Arterioscler Thromb Vasc Biol. 1998 Feb;18(2):277-827. Efstratiadis G, Tsiaousis G, Athyros VG, Karagianni D, Pavlitou-Tsiontsi A, Giannakou-Darda A, Manes C. Total serum insulin-like growth factor-1and C-reactive protein in metabolic syndrome with or without diabetes. Angiology. 2006 May-Jun;57(3):303-11.8. Leonsson M, Hulthe J, Johannsson G, Wiklund O, Wikstrand J, Bengtsson BA, Oscarsson J. Increased Interleukin-6 levels in pituitary-deficientpatients are independently related to their carotid intima-media thickness. Clin Endocrinol (Oxf). 2003 Aug;59(2):242-50.9. Juul A, Scheike T, Davidsen M, Gyllenborg J, Jørgensen T. Low serum insulin-like growth factor I is associated with increased risk of ischemic heartdisease: a population-based case-control study. Circulation. 2002 Aug 20;106(8):939-44.10. Laughlin GA, Barrett-Connor E, Criqui MH, Kritz-Silverstein D. The prospective association of serum insulin-like growth factor I (IGF-I) and IGFbindingprotein-1 levels with all cause and cardiovascular disease mortality in older adults: the Rancho Bernardo Study. J Clin Endocrinol Metab. 2004Jan;89(1):114-20.11. Aitman TJ, Palmer RG, Loftus J, Ansell BM, Royston JP, Teale JD, Clayton RN. Serum IGF-I levels and growth failure in juvenile chronic arthritis.Clin Exp Rheumatol. 1989 Sep-Oct;7(5):557-61.12. Hunt KJ, Lukanova A, Rinaldi S, Lundin E, Norat T, Palmqvist R, Stattin P, Riboli E, Hallmans G, Kaaks R. A potential inverse association betweeninsulin-like growth factor I and hypertension in a cross-sectional study. Ann Epidemiol. 2006 Jul;16(7):563-71.13. Vasan RS, Sullivan LM, D'Agostino RB, Roubenoff R, Harris T, Sawyer DB, Levy D, Wilson PW. Serum insulin-like growth factor I and risk for heart95

failure in elderly individuals without a previous myocardial infarction: the Framingham Heart Study. Ann Intern Med. 2003 Oct 21;139(8):642-8.14. Jankowska EA, Biel B, Majda J, Szklarska A, Lopuszanska M, Medras M, Anker SD, Banasiak W, Poole-Wilson PA, Ponikowski P. Anabolicdeficiency in men with chronic heart failure: prevalence and detrimental impact on survival. Circulation. 2006 Oct 24;114(17):1829-37.15. Denti L, Annoni V, Cattadori E, Salvagnini MA, Visioli S, Merli MF, Corradi F, Ceresini G, Valenti G, Hoffman AR, Ceda GP. Insulin-like growth factor1 as a predictor of ischemic stroke outcome in the elderly. Am J Med. 2004 Sep 1;117(5):312-7.Increased risk of cancer in people with lower serum IGF-1 levels within reference range16. Lönn S, Inskip PD, Pollak MN, Weinstein SJ, Virtamo J, Albanes D. Glioma risk in relation to serum levels of insulin-like growth factors. CancerEpidemiol Biomarkers Prev. 2007 Apr;16(4):844-6. Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National CancerInstitute, Room 7053, 6120 Executive Boulevard, Bethesda, MD 20892-7238, USA. Lstefan@mail.nih.gov17. Agurs-Collins T, Adams-Campbell LL, Kim KS, Cullen KJ.Ins ulin-like growth factor-1 and breast cancer risk in postmenopausal African-Americanwomen. Cancer Detect Prev. 2000;24(3):199-206.18. Fuhrman B, Barba M, Schünemann HJ, Hurd T, Quattrin T, Cartagena R, Carruba G, Muti P. Basal growth hormone concentrations in blood andthe risk for prostate cancer: a case-control study. Prostate. 2005 Jul 1;64(2):109-15.19. Woodson K, Tangrea JA, Pollak M, Copeland TD, Taylor PR, Virtamo J, Albanes D. Serum insulin-like growth factor I: tumor marker or etiologicfactor? A prospective study of prostate cancer among Finnish men. Cancer Res. 2003 Jul 15;63(14):3991-4.20. Palmqvist R, Hallmans G, Rinaldi S, Biessy C, Stenling R, Riboli E, Kaaks R. Plasma insulin-like growth factor 1, insulin-like growth factor bindingprotein 3, and risk of colorectal cancer: a prospective study in northern Sweden. Gut. 2002 May;50(5):642-6.21. Lönn S, Inskip PD, Pollak MN, Weinstein SJ, Virtamo J, Albanes D. Glioma risk in relation to serum levels of insulin-like growth factors. CancerEpidemiol Biomarkers Prev. 2007 Apr;16(4):844-6.22. Stolzenberg-Solomon RZ, Limburg P, Pollak M, Taylor PR, Virtamo J, Albanes D. Insulin-like growth factor (IGF)-1, IGF-binding protein-3, andpancreatic cancer in male smokers. Cancer Epidemiol Biomarkers Prev. 2004 Mar;13(3):438-44.23. Schaffer A, Koushik A, Trottier H, Duarte-Franco E, Mansour N, Arseneau J, Provencher D, Gilbert L, Gotlieb W, Ferenczy A, Coutlée F, PollakMN, Franco EL; Biomarkers of Cervical Cancer Risk Study Team . Insulin-like growth factor-I and risk of high-grade cervical intraepithelial neoplasia.Cancer Epidemiol Biomarkers Prev. 2007 Apr;16(4):716-22.24. Serrano ML, Romero A, Cendales R, Sánchez-GÃ∆mez M, Bravo MM. Serum levels of insulin-like growth factor-I and -II and insulin-like growthfactor binding protein 3 in women with squamous intraepithelial lesions and cervical cancer. Biomedica. 2006 Jun;26(2):258-6825. Chen C, Lewis SK, Voigt L, Fitzpatrick A, Plymate SR, Weiss NS. Prostate carcinoma incidence in relation to prediagnostic circulating levels ofinsulin-like growth factor I, insulin-like growth factor binding protein 3, and insulin. Cancer. 2005 Jan 1;103(1):76-84.Increased risk of overweight and obesity in people with lower serum IGF-1 levels within reference range26. Martha PM, Gorman KM, Blizzard RM, Rogol AD, Veldhuis JD. Endogenous growth hormone secretion and clearance rates in normal boys, asdetermined by deconvolution analysis: relationship to age, pubertal status, and body mass. J Clin Endocrinol Metab. 1992 Feb;74(2):336-44.27. Henderson KD, Goran MI, Kolonel LN, Henderson BE, Le Marchand L. Ethnic disparity in the relationship between obesity and plasma insulin-likegrowth factors: the multiethnic cohort. Cancer Epidemiol Biomarkers Prev. 2006 Nov;15(11):2298-302.28. Tong PC, Ho CS, Yeung VT, Ng MC, So WY, Ozaki R, Ko GT, Ma RC, Poon E, Chan NN, Lam CW, Chan JC. Association of testosterone, insulinlikegrowth factor-I, and C-reactive protein with metabolic syndrome in Chinese middle-aged men with a family history of type 2 diabetes. J ClinEndocrinol Metab. 2005 Dec;90(12):6418-23.TREATING TESTOSTERONE DEFICIENT MEN WITH TESTOSTERONE LEVELS WITHIN REFERENCE RANGESTRAITEMENT DES HOMMES DÉFICIENTS EN TESTOSTERONE AVEC DES NIVEAUX DE TESTOSTERONEDANS LES LIMITES DE RÉFÉRENCEANNA MODELSKA ZOLKIEWICZ(POLAND)ANTI-AGING MEDICINEPatients examined for PADAM presented main complains including psychological symptoms, somatovegetative and sexual symptoms,accounting for 51%, 36% and 13% respectively.Depressed mood, hot flashes, sweating and erectile dysfunction were dominant. Depending on the criteria of androgen deficiency, notall patients had low total testosterone (TT) and free testosterone (FT) levels.Lab tests of serum testosterone (T) show reference ranges, that also decline with age. The reference ranges are pure statistical values.95% of the patients are within reference ranges, only 2.5% of them have lower level and 2.5 % have level above the reference range.Scientific studies are reporting the effects of T levels on the risk of diseases in tertiles, quartiles, quintiles of serum T level within thereference ranges. Several studies show pathology for patients inside the serum T reference ranges. Diseases related to cardiovascularsystem or presence of cancer, obesity, diabetes and many others are often found more frequent in patients with serum T located inthe lower 3/4, 2/3, 1/2, 1/3, 1/4 or 1/5 lowest values of the reference range.The healthy range of serum T is probably located in the upper half of the reference range or in the upper tertile or upper quartile of thereference range. There is proposal that patients with serum T within the reference range, but in the lower half of it and suffering froma clinical T deficiency syndrome may need T treatment.Older men with higher serum FT are associated with better cognitive function. There are data demonstrating that lower serum TT andFT levels are associated with increased plasma amyloid beta peptide 40 in older men with memory loss or dementia, suggesting thatsubclinical androgen deficiency enhances the expression of Alzheimer's disease-related peptides in vivo.FT concentrations were lower in men who developed Alzheimer disease and this difference occurred before diagnosis. Increases inFT levels were associated with reduction of risk of Alzheimer's disease.Hypogonadal men with serum T concentration less than 300 ng/dl have higher risk of having overt depression.Studies showed positive correlation of serum T level in hypogonadal men with muscle mass and exercise functional capacity.There is a significant influence of T level on cardiovascular markers. Low serum T concentration associates with lower extremityperipheral arterial disease in elderly men. The inverse correlations were found between higher level of FT and decreased arterialstiffness in men with type 2 diabetes mellitus. Middle-aged men with symptoms of PADAM with T deficiency, show increased intimamediathickness of common carotid artery. These data suggest that higher T levels may offer protection against the development ofartherosclerosis in middle-aged men.TT and FT levels of the male patients with coronary artery disease were significantly lower than those of controls. Study analysisrevealed that FT levels, hyperlipidemia and smoking were independent predictors of premature coronary artery disease. There wasnegative association between serum T level and serum TG, TC, LDL-C, PAI as well as positive association between serum T level andHDL-C. A negative correlation was observed between TT, FT and blood pressure, especially diastolic pressure. It was demonstratedthat low levels of FT were characteristic for patients with low ejection fraction.96

Cross-sectional studies indicated that T level was significantly lower in men with type 2 diabetes. Men with higher T levels withinreference range had 42% of lower risk for type 2 DM.The inverse correlation was found between serum T level and BMI, visceral obesity and prevalence of metabolic syndrome. Men inthe upper tertile of serum T have lower risk of having 3 or more features of the metabolic syndrome independently of age. Higher Tlevels within reference range of older men are associated with better insulin sensitivity and reduced risk of the metabolic syndrome.There are valuable studies concerning influence of serum T levels on the range of mortality. It was found, that in men endogenous Tconcentrations were inversely related to mortality due to cardiovascular disease and other causes.The optimal situation is observed when serum T level is in the higher quartile of the reference range. The progressive prevalence inmortality may be noticed at lower quartiles of the reference range. This is suspected that the lowest quartile of serum T level may beconnected with the highest risk of mortality.Osteoporosis is a significant problem in older men. In the study 52% of elderly with low bioavailable T levels had BMD levels belowthe young adult normal range.Based on clinical studies it was established that elevation in the serum level of T was related to decrease in prostate cancer risk.Conclusion: There is a strong support to treat serum testosterone levels within the reference range in men with clinical symptoms oftestosterone deficiency.Khaw KT, Dowsett M, Folkerd E, Bingham S, Wareham N, Luben R, Welch A, Day N. Endogenous testosterone and mortality due to all causes,cardiovascular disease, and cancer in men: European prospective investigation into cancer in Norfolk (EPIC-Norfolk) Prospective Population Study.Circulation 2007 Dec 4;116(23):2694-701 Clinical Gerontology Unit box 251, Addenbrooke's Hospital CambridgevbCB2 2QQ, UK.Blouin K, Despres JP, Couillard C, Tremblay A, Prud'homme D, Bouchard C, Tchernof A. Contribution of age and declining androgen levels to featuresof the metabolic syndrome in men. Metabolism. 2005 Aug;54(8):1034-40. Molecular Endocrinology and Oncology Research Center, Laval UniversityMedical Research Center, Quebec, CanadaMohr BA, Guay AT, O'Donnell AB, McKinlay JB. Normal bound and nonbound testosterone levels in normally ageing men: results from theMassachusetts Male Ageing Study. Clin. Endocrinol. 9Oxf). 2005 Jan;62(1):64-73Zitzmann M, Faber S, Nieschlag E. Association of specific symptoms and metabolic risks with serum testosterone in older men. J Clin EndocrinolMetab. 2006 Nov;91(11): 4335-43 Institute of Reproductive Medicine of the University, Domagkstr. 11, Munster, GermanyYeap BB, almeida OP, Hyde Z, Chubb SA, Hankey GJ, Jamrozik K, Flicker L. Higher serum free testosterone is associated with better cognitive functionin older men, while total testosterone is not. The Health In Men Study.: Clin Endocrinol (Oxf). 2007 Sep 20. School of Medicine and Pharmacology,University of Western Australia, FreemantleHospital, Freemantle, Western AustraliaGillett MJ, Martins RN, Clarnette RM, Chubb SA, Bruce DG, Yeap BB. Relationship between testosterone, sex hormone binding globulin and plasmaamyloid beta peptide 40 in older men with subjective memory loss or dementia. J Alzheimers Dis. 2003 Aug;5(4): 267-9. Department of Endocrinologyand Diabetes, Freemantle hospital, Western AustraliaMoffat SD, Zonderman AB, Metter EJ, Kawas C, Blackman MR, Harman SM, Resnick SM. Free testosterone and risk for Alzheimer disease in oldermen. Neurology. 2004 Jan 27;62(2):188-93. Laboratory of Personality and cognition, National Institute on Aging, Intramular Research Program,Baltimore, USAMakhlouf AA, Mohamed MA, Seftel AD, Neiderberger C. Hypogonadism is associated with overt depression symptoms in men with erectile dysfunction.Int J Impot Res. 2007 Aug 16. Department of Urologic Surgery, University of Minnesota, Minneapolis, USATivesten A, Mellstrom D, Jutberger H, Fagerberg B, Orwoll E, Karlsson MK, Ljunggren O, Ohlsson C. Low serum testosterone and high serum estradiolassociate with lower extremity peripheral arterial disease in elderly men. The mrOS Study in Sweden. J Am Coll Cardiol. 2007 Sep 11;50(11): 1070-6.The Wallenberg Laboratory for Cardiovascular Research, Goteborg University, SwedenFukui M, Ose H, Kitagawa Y, Yamazaki M, Hasegawa G, Yoshikawa T, Nakamura N. Relationship between low serum endogenous androgenconcentrations and arterial stiffness in men with type 2 diabetes mellitus. Metabolism. 2007 Sep;56(9):1167-73 Department of Endocrinology andMetabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, JapanTurhan S, Tulunay C, Gulec S, Ozdol C, Kilickap M, Altin T, Gerede M, Erol C. The association between androgen levels and premature coronary arterydisease in men. Coron Artery Dis. 2007 May; 18(3):159-62. Department of Cardiology, Ankara University School of Medicine, Ankara, TurkeyYP Teoh, AM Wallace. Population reference ranges for plasma testosterone and calculated free testosterone in older men. Endocrine Abstracts(2006)12 P104. Department of Clinical Biochemistry, Glasgow royal Infirmary, Glasgow, United KingdomSvartberg J, von Muhlen D, Mathiesen E, Joakimsen O, Bonaa KH, Stensland-Bugge E. Low testosterone levels are associated with carotidatherosclerosis in men. J Intern Med. 2006 Jun;259(6):576-82.Department of Medicine, University Hospital of North NorwayDobrzycki S, Serwatka W, Nadlewski S, Korecki J, Jackowski R, Paruk J, Ladny JR, Himle T. Assessment of correlations between endogenous sexhormone levels and the extensiveness of coronary hart disease and the ejection fraction of the left ventricle In males. J Med Invest. 2003 Aug; 50(3-4):162-9. Department of Invasive Cardiology, Bialystok University Medical Center, PolandDing EL, Song Y, Malik VS, Liu S. Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta-analysis.JAMA 2006 Mar 15;295(11):1288-99.Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard MedicalSchool, boston, Mass, USASelvin E, Feinleib M, Zhang L, Rohmann S, Rifai N, Nelson WG, Dobs A, Basaria S, Golden SH, Platz EA. Androgens and diabetes in men: resultsfrom the Third National Health and Nutrition Examination Survey (NHANES III). Diabetes Care. 2007 Feb;30(2):234-8. Department of Epidemiology,Johns Hopkins Bloomberg School of Public Health, Baltimore, USAChen RY, Wittert GA, Andrews GR. Relative androgen deficiency in relation to obesity and metabolic ststus in older men. Diabetes Obes Metab. 2006Jul;8(4): 429-35. Department of Medicine, University of Adelaide. AustraliaMuller M, Grobbee DE, den Tonkelaar I, Lamberts SW, van der Schouw YT. Endogenous sex hormones and metabolic syndromein aging men. J ClinEndocrinol Metab. 2005 Aug; 90(8):4979, 2005 May;90(5):2618-23. Julius Center for Health Sciences and Primary Care, University Medical CenterUtrecht. The Netherlands.ANTI-AGING MEDICINEHYPOTHYROID PATIENTS WITH LABORATORY TESTS WITHIN REFERENCE RANGESPATIENTS HYPOTHYROÏDIENS AVEC DES TESTS THYROÏDIQUES DANS LES LIMITES DE RÉFÉRENCETHIERRY HERTOGHE(BELGIUM)In many countries, the majority of physicians only treat patients for hypothyroidism when a patient's lab tests are clearly below thelower limit of the reference range for serum free T4 and the serum TSH level clearly above the upper limit .Only a small group of individuals get thyroid treatment, while more may need treatment. Indeed, much often recent data is found thatprofoundly question the adequateness of treating with thyroid supplements only patients whose lab tests clearly outside of thereference ranges.Reference ranges are only statistical ranges that show between what levels the thyroid hormones or TSH of 95% of a population aresituated. They do not and never have been meant to become barriers that sharply delimit thyroid health and illness.The typical thyroid laboratory tests only check part of the thyroid axis, and in particular not the distal end of the thyroid axis that deals97

with thyroid function in the target cells other than the pituitary gland that is different than any other thyroid target tissue. Serum levelsof thyroid hormones and TSH may look acceptable for a patient, while the thyroid status in the cells that need thyroid hormones, maybe deficient. Over the 60 studies show that patients with laboratory tests within reference range but situated in the lower 4/5 ths , 2/3 rds ,fi, 1/3 rd , 1/4 th or 1/5 th , or 1/10 th of the thyroid hormones reference range have increased risk of mortality and disease includedcardiovascular disease, obesity, diabetes, etc. How is this possible? Many reasons can be given. The optimal ranges of a patient aregenerally much narrower than the population reference ranges. For example, the individual optimal serum TSH range may be 0.2-0.8and not the 0.2-4.5 mIU/ml shown by the laboratory. This means that whenever the patient's TSH level climbs up to 1.5 mIU/l, he islikely to be hypothyroid.Another reason for "normal lab tests in patients with cellular hypothyroidism may be a decrease in thyroid hormone receptors in thethyroid target cells such as occurs in diabetes, obesity, cortisol deficiency or with age: from 31 years on.SESSION 9AAANTI-AGING GASTROENTEROLOGY: CAN WE HEAL THE BODY BY IMPROVING THE GASTROINTESTINAL TRACT?GASTRO-ENTEROLOGIE ANTI-AGE : PEUT-ON GUÉRIR LE CORPS EN AMELIORANT LE SYSTEME DIGESTIF ?CHAIR: GEORGES MOUTON SPORTS & FUNCTIONAL MEDICINE (LIÈGE, BELGIUM)MARCEL ROBERFROID PROFESSOR, PHARMACY SCHOOL (LOUVAIN, BELGIUM)4.30 pm / 16h30INTRODUCTION TO THE MUCOSAL IMMUNE SYSTEM AND TO THE GUT MICROBIAL ECOSYSTEM,FOR A BETTER UNDERSTANDING OF THE INTESTINAL ECOSYSTEMPRÉSENTATION DU SYSTÈME IMMUNITAIRE MUQUEUX ET DE LA FLORE MICROBIENNE INTESTINALE,POUR UNE MEILLEURE COMPRÉHENSION DE L’ÉCOSYSTÈME INTESTINALFRANCISCO GUARNER(SPAIN)The term "microflora" or "microbiota" refers to the community of living micro-organisms assembled in a particular ecological niche ofa host individual. The human gut is the natural habitat for a large, diverse and dynamic population of micro-organisms which overmillennia have adapted to live on the mucosal surfaces or in the lumen (1).Our current knowledge about the microbial composition of the intestinal ecosystem in health and disease is still very limited. Studiesusing classical techniques of microbiological culture can only recover a minor fraction of faecal bacteria. Over 50% of bacteria cellsthat are observed by microscopic examination of faecal specimens cannot be grown in culture (2).Molecular biological techniques based on the sequence diversity of the bacterial genome are being used to characterize non-cultivablebacteria (3).Molecular studies on the faecal microbiota have highlighted that only 7 of the 55 known divisions or superkingdoms of the domain'bacteria' are detected in the human gut ecosystem, and of these, 3 bacterial divisions dominate, i.e. Bacteroidetes, Firmicutes andActinobacteria (4).However, at species and strain level, microbial diversity between individuals is highly remarkable up to the point that each individualharbours his or her own distinctive pattern of bacterial composition (3).ANTI-AGING MEDICINEOn the other hand, studies comparing animals bred under germ-free conditions with their conventionally raised counterparts haveclearly demonstrated the important impact of resident bacteria on host physiology. The interaction between gut bacteria and their hostis a symbiotic relationship mutually beneficial for both partners. The host provides a nutrient-rich habitat and the bacteria conferimportant benefits to the host (1).Functions of the microbiota include nutrition (fermentation of nondigestible substrates that results in production of short chain fattyacids, absorption of ions, production of aminoacids and vitamins), protection (the barrier effect that prevents invasion by alienmicrobes), and trophic effects on the intestinal epithelium and the immune system (development and homeostasis of local andsystemic immunity).Animals bred in a germ-free environment show low densities of lymphoid cells in the gut mucosa and low levels of serumimmunoglobulins. Exposure to commensal microbes rapidly expands the number of mucosal lymphocytes and increases the size ofgerminal centres in lymphoid follicles. Immunoglobulin producing cells appear in the lamina propria, and there is a significant increasein serum immunoglobulin levels (5).Most interestingly, recent findings suggest that some commensals play a mayor role in the induction of regulatory T cells in gutlymphoid follicles (6).Regulatory pathways mediated by regulatory T cells are essential homeostatic mechanisms by which the host can tolerate the massiveburden of innocuous antigens within the gut or on other body surfaces without responding through inflammation.1. Guarner F, Malagelada JR. Gut flora in health and disease. Lancet 2003; 361:512-519.2. Suau A, Bonnet R, Sutren M, Godon JJ, Gibson G, Collins MD, Dore J. Direct rDNA community analysis reveals a myriad of novel bacteriallineages within the human gut. Appl Environ Microbiol 1999; 65: 4.799-4.807.3. Ley RE, Peterson DA, Gordon JI. Ecological and evolutionary forces shaping microbial diversity in the human intestine. Cell 2006; 124: 837-848.4. Eckburg PB, Bik EM, Bernstein CN, Purdom E, Dethlefsen L, Sargent M, Gill SR, Nelson KE, Relman DA. Diversity of the human intestinalmicrobial flora. Science 2005; 308: 1635-1638.5. Yamanaka T, Helgeland L, Farstad IN, Fukushima H, Midtvedt T, Brandtzaeg P. Microbial colonization drives lymphocyte accumulation anddifferentiation in the follicle-associated epithelium of Peyer's patches. J Immunol 2003; 170: 816-822.6. Guarner F, Bourdet-Sicard R, Brandtzaeg P, Gill HS, McGuirk P, van Eden W, Versalovic J, Weinstock JV, Rook GA. Mechanisms of Disease: thehygiene hypothesis revisited. Nat Clin Pract Gastroenterol Hepatol 2006; 3: 275-284.98

INCREASE OF INTESTINAL PERMEABILITY LEADING TO IMMUNE DYSFUNCTION: AUTOIMMUNITY PREVALENCE AND AGINGAUGMENTATION DE LA PERMÉABILITÉ INTESTINALE ENTRAÎNANT UN DYSFONCTIONNEMENT IMMUNITAIRE:AUTO-IMMUNITÉ ET VIEILLISSEMENTMICHAEL CULP(UK)PREBIOTICS, GUT MICROBIOTA, GASTROINTESTINAL PEPTIDES AND METABOLIC ENDOTOXEMIA:ROLES IN APPETITE CONTROL, TYPE II DIABETES AND OBESITYLES PRÉBIOTIQUES, LA FLORE MICROBIENNE INTESTINALE, LES PEPTIDES GASTROINTESTINAUXET L'ENDOTOXÉMIE MÉTABOLIQUE : RÔLES DANS LE CONTRÔLE DE L'APPÉTIT, LE DIABÈTE DE TYPE II ET L'OBÉSITÉMARCEL ROBERFROID(BELGIUM)Over the last decades, knowledge of the physiology of the colon and, in particular, of the roles and functions of the colonic microbialflora have progressed considerably. It is now well established that the composition of that flora is complex and largely individual in termof genera, species, and even strains. Its multiple roles depend, at the same time, on that complexity, on the balance of its compositionand on the interactions / co-operations between genera, species and even bacterial strains but also on the exchanges /communications between the prokaryotic and the colonic eucaryotic cells to control metabolic activities, gene expression and/or celldifferentiation. As a consequence, the colon, this so particular organ of the gastrointestinal tract, must be fed, i.e. must receive specificfoods : the colonic foods.Only one category of colonic food is well documented today i.e. the prebiotics and in particular the inulin-type fructans, which have thecapacity of modulating the composition of the colonic microflora to reinforce its balance and exert / modulate, indirectly, physiologicaleffects such as mineral absorption, endocrine functions, immune activities but also to reduce the risk of major diseases such asobesity, diabetes, inflammatory bowel diseases, colon cancer…The term inulin-type fructans covers all ß(2 1) linear fructans, that are extracted from chicory roots, including native inulin (DP 2 to 60- DPav=12), oligofructose or fructooligosaccharides (DP 2 to 8 - DPav= 4), and inulin HP (DP 10 to 60 - DPav= 25) as well as Synergy1,a specific combination of oligofructose and inulin HP. These food ingredients resist digestion and classify as dietary fibre improvingbowel habits. But, unlike most dietary fibres, their colonic fermentation is selective thus causing significant changes in the compositionof the gut microflora with increased and reduced numbers of potentially health-promoting bacteria (especially Bifidobacterium-spp) andpotentially harmful species (eg some Costridia) respectively. All inulin-type fructans do so and thus are prebiotic that further inducechanges in the colonic epithelium and in miscellaneous colonic functions.More recently, inulin-type fructans have been tested for their capacity to modulate lipid and glucose metabolism in several animalmodels. They decrease food intake and fat mass development, and reduce the risk of hepatic steatosis in normal and in obese rats;moreover, they exert an anti-diabetic effect in streptozotocin- treated rats and in high-fat fed mice. These beneficial effects of inulintypefructans are linked to an increase in Glucagon-Like Peptide-one (GLP-1) level in the portal vein, and in GLP-1 and proglucagonmRNA in the proximal colon due to an increase in the number of GLP-1-positive L cells resulting from an increase production ofNeurogenin 3 and NeuroD, 2 factors known to be involved in the differentiation of stem cells into L cells. The chronic administration ofthe GLP-1 receptor antagonist exendin 9-39 (Ex-9) totally prevented the beneficial effects of inulin-type fructans (improved glucosetolerance, fasting blood glucose, glucose-stimulated insulin secretion, insulin-sensitive hepatic glucose production, and reduced bodyweight gain).Furthermore GLP-1 receptor knock out mice (GLP-1R-/-) were completely resistant to the anti-diabetic actions of inulin-type fructans.These findings highlight the potential interest of enhancing endogenous GLP-1 secretion by inulin type fructans for theprevention/treatment of obesity and type 2 diabetes. If diabetes and obesity are two metabolic diseases characterized by insulinresistance, recent data also support the hypothesis of a role of low-grade inflammation. Seeking an inflammatory factor that might becausative for the onset of insulin resistance, obesity, and diabetes, bacterial lipopolysaccharide (LPS) has been identified as atriggering factor. Indeed a 4-week high-fat diet that causes both insulin resistance and obesity also increases plasma LPSconcentration by 2 to 3 fold reaching a threshold level that has been defined as metabolic endotoxemia. Importantly, such a high-fatdiet also increased the proportion of LPS producing microflora (especially a lower Bifidobacterium-spp. caecal content) in the gut.Moreover when metabolic endotoxemia was induced through continuous subcutaneous infusion of LPS, fasted glycemia andinsulinemia and whole-body, liver, and adipose tissue weights were increased to a similar extent as in high fat-fed mice. In addition,adipose tissue F4/80-positive cells and markers of inflammation as well as liver triglycerides content, were increased as well as liver,but not whole body, insulin resistance. Adding inulin-type fructans to the high fat diet totally restored numbers of bifidobacteria andcompletely normalized endotoxemia.Multiple-correlation analyses showed that endotoxemia significantly and negatively correlated with faecal Bifidobacterium-spp that,furthermore, significantly but positively correlated with improved glucose-tolerance, glucose-induced insulin-secretion, and normalizedinflammatory tone as shown by a decreased endotoxemia, plasma and adipose tissue proinflammatory cytokines levels. Together,these findings suggest that the composition of the gut microbiota is a potential key factor in the patho-physiological regulation ofendotoxemia, that furthermore controls an inflammatory process that might play a role in diabetes and obesity. Restoring a 'healthy'composition of the gut microflora by prebiotics and especially inulin-type fructans appears thus as a promising strategy to reduce therisk of these major pathologies.As research continues in this area, the available data already support the hypothesis that prebiotics and especially inulin-type fructansare likely to become good candidates for inclusion in the arsenal of an anti-aging medicine.ANTI-AGING MEDICINE99

REVOLUTIONARY APPROACH TO INFLAMMATORY BOWEL DISEASES: BENEFITS FROM PROBIOTICSAND PREBIOTICS INTAKEAPPROCHE RÉVOLUTIONNAIRE DES MALADIES INFLAMMATOIRES DE L'INTESTIN : LES AVANTAGES DES PROBIOTIQUESET PRÉBIOTIQUESFRANCISCO GUARNER(SPAIN)The inflammatory bowel diseases (IBD), Crohn's disease, ulcerative colitis and pouchitis, are chronic conditions of unknown aetiologycharacterized by persistent mucosal inflammation at different levels of the gastrointestinal tract. Typically, these diseases exhibitundulating activity with bouts of uncontrolled, chronic mucosal inflammation, followed by remodelling processes that occur duringperiods of remission (1).The precise aetiologies of these chronic inflammatory conditions remain to be elucidated and therefore, the available medical therapiescan only control up to some extent the eruptions of disease activity, but fail completely regarding to the eradication or permanent cureof such diseases. However, the pathophysiological mechanisms that lead to the mucosal inflammatory lesions have been unveiled atleast in part during the past few years. These mechanisms result from complex interaction of environmental, genetic andimmunoregulatory factors. Two broad hypotheses have arisen regarding the fundamental nature of the pathogenesis of IBD (2).The first argues that primary dysregulation of the mucosal immune system leads to excessive immunologic responses to normalmicrobiota. The second suggests that changes in the composition of gut microbiota and/or deranged epithelial barrier function elicitpathologic responses from the normal mucosal immune system. In either case, abnormal communication between gut microbialcommunities and the mucosal immune system is being incriminated as the core defect leading to IBD in genetically susceptibleindividuals.Evidence accumulated during the past few years clearly indicates that induction and regulation of the immune system occurs primarilyin gut-associated lymphoid tissues and the gut-draining mesenteric lymph nodes. Recent findings suggest that some commensals playa mayor role in the induction of regulatory T cells in gut lymphoid follicles (3).The gut may be the major site for induction of regulatory T cells, which secrete immuno-regulatory cytokines such as IL-10 and TGFbetaand can regulate both Th1 and Th2 responses. Regulatory pathways mediated by regulatory T cells are essential homeostaticmechanisms by which the host can tolerate the massive burden of innocuous antigens within the gut without responding throughinflammation.Prebiotics such as inulin and oligofructose improve composition and biochemical activities of the microbial communities within the gut.Numerous studies have shown that both inulin and oligofructose selectively stimulate the growth of bifidobacteria and lactobacilli bothin the gut lumen and in mucosa-associated microbial communities. These changes have an important impact on immune homeostasis(4).Studies with infants suggest that supplementation with these prebiotics positively affects postnatal immune development and increasesproduction of secretory IgA. Several studies using different animal models have confirmed this observation (increased production ofsecretory IgA) and have also demonstrated that oral administration of inulin-oligofructose mixture increases production ofimmunoregulatory cytokines by Peyer's patch lymphocytes, such as IL-10 (4).These mechanistic studies suggest a role of inulin and oligofructose in the prevention of immunoinflammatory disorders. Oraladministration of inulin and oligofructose has been consistently associated with reduced mucosal inflammation in various animalmodels of intestinal inflammation (IBD), including TNBS, DSS and HLA-B27 transgenic rodents (5). Clinical trials in human Crohn'sdisease, ulcerative colitis, and pouchitis confirm the ability of inulin and oligofructose to mitigate mucosal inflammation in these chronicconditions (6, 7).ANTI-AGING MEDICINE1.O'Hara AM, Shanahan F. Gut microbiota: mining for therapeutic potential. Clin Gastroenterol Hepatol 2007; 5: 274-84.2.Strober W, Fuss I, Mannon P. The fundamental basis of inflammatory bowel disease. J Clin Invest 2007; 117: 514-21.3.Mazmanian SK, Kasper DL. The love-hate relationship between bacterial polysaccharides and the host immune system. Nat Rev Immunol 2006; 6:849-58.4.Seifert S, Watzl B. Inulin and oligofructose: review of experimental data on immune modulation. J Nutr 2007; 137: 1S-5S.5.Guarner F. Prebiotics in Inflammatory Bowel Diseases. Br J Nutr 2007; 98: S85-S89.6.Furrie E, Macfarlane S, Kennedy A, Cummings JH, Walsh SV, O'Neil DA, Macfarlane GT. Synbiotic therapy (Bifidobacterium longum/Synergy 1) initiatesresolution of inflammation in patients with active ulcerative colitis: a randomized controlled pilot trial. Gut 2005; 54: 242-249.7.Casellas F, Borruel N, Torrejon A, Varela E, Antolin M, Guarner F, Malagelada JR. Oral oligofructose-enriched inulin supplementation in acute ulcerativecolitis is well tolerated and associated with lowered faecal calprotectin. Aliment Pharmacol Ther 2007; 25:1061-1067.GUT SWEET TASTE RECEPTORS: HOW SWEETENERS CONTRIBUTE TO OBESITYLES RÉCEPTEURS DE GOUT SUCRÉ INTESTINAUX : COMMENT LES ÉDULCORANTS CONTRIBUENT À L'OBÉSITÉGEORGES MOUTON(BELGIUM)The gastrointestinal tract represents a sensory organ that responds to a large array of signals originating in the lumen. Molecularsensing by specific gastrointestinal cells plays a crucial role in the control of multiple fundamental functions including digestion,regulation of caloric intake, pancreatic insulin secretion, metabolism, as well as protection from ingested harmful drugs and toxins.However, despite the fact that these fundamental properties of the gastrointestinal tract have been recognized for a considerableamount of time, the initial molecular recognition events that sense the chemical composition of the luminal contents of the GI tract haveremained elusive until very recently.However, as it has now been understood, the chemosensory machinery discovered in specialized neuroepithelial taste receptor cellsof the lingual epithelium appears as well operational in different clusters of intestinal cells that sense the chemical composition of theluminal content of the gut.A novel family of mammalian taste receptors has been identified in 2000, consisting in about 40 different G protein-coupled receptors(GPCRs) expressed in taste receptor cells of the tongue and palate. The GPCR superfamily results from the expression of about 1000genes known to code mostly for sensory receptors involved in vision (rhodopsin) and in olfaction (hundreds of odorants with specific100

GPCRs). Still in 2000, bitter taste receptors were discovered: they are exclusively expressed in taste receptor cells that contain therare G protein -subunit gustducin, identified and cloned in 1992 from taste buds of tongue taste papillae.The same team reported in 2001 the characterization of sweet taste receptors, which also express gustducin.Five years before, a German team had already addressed the question of whether the epithelium of the gut might also express -gustducin. They have shown that this specific G protein subunit is expressed in the epithelium of the gut where it is associated with aspecialized cell type that was long known under the name of tuft cell.The function of this cell type, widespread in the digestive and respiratory tracts from simple vertebrates to humans, had always beenenigmatic. However, the discovery of the presence of -gustducin has provided a clue to the long-sought function of tuft cells, whichappear to possess the cellular and molecular basis for chemoreception.Besides, -gustducin is expressed in different subsets of enteroendocrine cells such as intestinal L-cells that secrete peptide YY andGLP-1, two gastrointestinal peptides involved in satiety signaling. In August 2007, an article published in the PNAS showed that humanL-cells express sweet taste receptors and taste G protein subunit -gustducin. This protein has also been found recently (articlepublished in November 2007) in another cluster of enteroendocrine cells, the stomach cells secreting ghrelin, a satiety promoting(orexigenic) peptide.It appears that both natural sugars and artificial sweeteners are sensed by sweet taste receptors. Thus, sweeteners are nutritionallyactive and their intake may have an impact on the carbohydrate metabolism despite their lack of calories. The composition of theintestinal luminal content varies considerably with the diet. It is therefore important that the intestinal lumen "senses" and responds toany significant change by regulating its function accordingly.A prototype example of this process is the modulation in the capacity of the gut to absorb monosaccharides via the intestinal luminalmembrane glucose transporter SGLT1. Located in the brush border within the apical membrane, it transports glucose and galactosefrom the intestinal lumen to the cytoplasm.Sugar consumption is known to regulate the expression of genes involved in intestinal sugar absorption. Therefore, it is logical toconsider that sugar-sensing receptors in membranes facing the intestinal lumen can also modulate intestinal sugar absorption. In2003, a team from the University of Liverpool used sheep intestine as a model to show that luminal monosaccharides, bothmetabolisable (i.e. simple sugars) and non metabolisable (i.e. sweeteners), regulate the expression of SGLT1. Introduction of D-glucose and of some D-glucose analogues into ruminant sheep intestine resulted in more than 50-fold enhancement of SGLT1expression.The authors concluded that luminal glucose is sensed by a glucose sensor - distinct from SGLT1 - located on the luminal membraneof the gut epithelium and linked to a G protein-coupled receptor, resulting ultimately in the modulation of intestinal monosaccharideabsorption. The sweet taste receptor and the taste G protein subunit -gustducin, expressed in enteroendocrine cells, underlie intestinalsugar sensing and regulate the expression of SGLT1. Indeed, dietary sugars as well as artificial sweeteners increase SGLT1expression together with glucose absorptive capacity in wild-type mice, but not in knockout mice lacking the sweet taste receptor or -gustducin.In an extensive interview realized by Health Orbit on the 21st of August 2007, the leading author declared that: "Surprisingly we alsofound that the receptor was able to detect artificial sweeteners in foods and drinks resulting in increased capacity of the intestine toabsorb dietary sugars, which would explain why these sweeteners are unsuccessful at helping people lose weight". Interestingly,Professor Soraya SHIRAZI-BEECHEY belongs to the University of Liverpool Faculty of Veterinary Science and she will research howto activate the receptor through dietary supplements, before and during horse races, in order to increase intestinal absorption ofglucose among horses, as they need high levels of glucose to sustain them in long races.Friday April 11 / Vendredi 11 AvrilANTI-AGING MEDICINEROOM / SALLE PASSYANTI-AGING MEDICINESESSION 10AAANTI AGING WORKSHOP 3 SKIN DISORDERSTROUBLES CUTANÉS8.30 am / 8h30TREATMENT OF CHRONIC DERMATOSES AND SKIN AGINGLE TRAITEMENT DES DERMATOSES CHRONIQUES, ET DU VIEILLISSEMENT CUTANÉJOHN IONESCU(GERMANY)Previous research indicates that the intrinsic (genetically determined) and the extrinsic (UV- and toxic exposure mediated) skin agingprocesses are overlapped and strongly related to an increased generation of free radicals. In turn, the intrinsic skin aging process ismediated by decreased energy levels and anabolic processes in the skin cells, deficient antioxidant defence mechanisms, deficientmelanin synthesis, deficient detox capacity (genetic polymorphisms) as well as decreased sexual hormones supply (age related) andwater retention.Biomarkers of the intrinsic aging include hyaluronic acid depolimerisation, a reduced melanogenesis and oestrogen dependentcollagen synthesis, lowered ATP generation and wound repair capabilities, an impaired antioxidant defence and an increasedlipofuscin generation (age spots). Besides, inflammatory and proliferating skin conditions like acne and psoriasis are also associatedwith decreased ATP and cyclic nucleotides (cAMP) in blood and epidermal cells.In the late 80's we noticed that psoriatic skin lesions significantly respond to supplementation with energy generating compounds andmelanin promoters. In clinical studies, topically applied energy generating compounds like AMP, ADP and NAD (CELL ENERGY ® )normalized the cell replication rate in psoriatic skin, diminished the acne pustulae and induced a significant improvement of skin101

structure and wrinkles (anti-aging-effect).On the other side, the photoaging process of the human skin in the presence of natural sunlight or artificial UV-sources happenscontinuously and leads in time to dryness, deep wrinkles, sagging, lost of elasticity, mottled pigmentation and skin telangiectasia.Typical biomarkers include a strong generation of free radicals, lipid peroxidation, collagenase activation, glycation / oxidation ofproteins (AGE products), activation of p53 transcription factors, low DNA repair capacity and cumulative DNA mutations.Clinically, the adverse effects of natural sunlight and other UV-sources on normal human skin may vary from sunburn with erythema,oedema and DNA damage (12-24 hrs. after UV-exposure) to polymorphic light reaction (eczema solare), solar actinic elastosis andactinic hyperkeratosis (as common precancerous condition), up to different skin cancer forms like basal cell carcinoma (BCC),squamous cell carcinoma (SCC) or malignant melanoma (MM).The study of the lipid, protein and DNA oxidative damage triggered by the free radical attack subsequent to sunlight exposure hasconducted to appropriate strategies to slow down or block these reactions making possible the design of innovative skin careformulations.In this respect, a new German photoaging defence formula (SOLARIS ® ) combines for the first time the double UVA + UVB protection(SPF 25) with melanin promoting aminoacids directly enhancing the natural tanning process. Free radical blocking agents like Vit. Eand carrot oil, are preventing the sun exposure side-effects together with immune stimulating plant extracts ( -glucans) with antiherpesvirus activity.To slow down the photoaging related wrinkle formation efficiently, a new collagen synthase stimulating formula (ENERGO RepairComplex ® ) offers a synergistic anti-aging combination of UV-light blockers, free radical quenchers (Vit. E, Coenzyme Q10) andcollagen/ elastin synthesis promoters like hydroxyprolin and plant bioflavonoids. The active ingredients are incorporated in liposomescontaining skin identical phospholipids and ceramides by means of the patented DMS ® nanoparticle technology. A rapid uptake in theepidermis cells is thus granted.The use of the described hypoallergenic topical products results in a significant improvement of the skin structure and appearancewithin 30 days, as documented with the standardized Surface Evaluation of Living Skin (SELS) methodology in a group of 35 womenaged 40 to 63 years.Goals & Objectives- Understanding the role of cellular energetics in chronic inflammatory skin diseases (psoriasis, acne, eczema) and aging- Explaining the biomarkers of the skin aging process as background for specific anti-aging treatments- Describing innovative procedures and formulas to counteract the described chronic dermatoses and wrinkle formation- Monitoring the anti-aging therapy results by means of the standardized Surface Evaluation of Living Skin (SELS) methodologySESSION 11AAJAPAN ANTI-AGING MEDICINELA MEDECINE ANTI-AGE AU JAPONCHAIR: YOSHIKAZU YONEI PROFESSOR OF GASTROENTEROLOGY (KYOTO, JAPAN)9.30 am / 9h30ANTI-AGING SECRETS OF JAPANESE CENTENARIANS AND ELDERLY PEOPLELE SECRET ANTI-ÂGE DES CENTENAIRES JAPONAISTAKUJI SHIRASAWA(JAPAN)ANTI-AGING MEDICINEThe life expectancies of Japanese male and female are 78.32 and 85.23 years in 2003, respectively, which showed that Japanrepresents one of the most remarkable countries for the logevity over the world.The life expectancies in Japan dramatically extended during last 100 years, by 30 years from around 50 years to over 80 years.Molecular analyses of the model system such as C. elegans or Drosophila melanogaster suggested that there are several dozens ofgenes that regulate the lifespan of animals. Some germline mutations in such model organisms etend the lifespan of model organismsas long as 2-6 times. Moreover, molecular analyses of human premature aging syndromes such as Werner syndrome or Hutchinson-Gilford syndrome suggest that genes encoding DNA repair enzymes are responsible for the development of ageing phynotypes inhuman. In addition to the genetic factors, environmental factors such as diet and physical exercises as well as the wellness of mentalstate also play an important role in the determination of lifespan in individuals.Japanese centenarian studies suggest that independency, daily diet, daily physical exercises,and the motivation for life, and thepositive way of thinking are the pivotal factors influencing the QOL of Japanese centenarians.The frailty of elderly people becomesone of the important social issues in Japan, which would be further improved by the alterations of lifestyles such as dietary interventionor physical exercises. I will present the secrets of longevity from Japanese centenarian studies in the lecture.GLOBAL NETWORK OF ANTI-AGING ACTIVITIY FROM JAPANLE RÉSEAU GLOBAL ANTI-ÂGE AU JAPONYOSHIKAZU YONEI(JAPAN)Anti-Aging Medical Research Center, Doshisha University has a global project on which it works in cooperation with Japanese Societyof Anti-Aging Medicine. It is to publish an international medical journal, to promote the network software using an Anti-Aging QOLCommon Questionnaire, and finally to establish the common data bases. The piling of medical evidence is basic for the developmentof anti-aging medicine.The journal "Anti-Aging Medicine" (ISSN 1882-2762) that valued the transparency and neutrality was published for this end. Originalarticles are in English, with the advantage of the internet, also translation forms of Japanese or other language are postedsimultaneously (http://www.anti-aging.gr.jp/webjournal/index.html). The policy of this journal avoids choosing only convenient data, andnegative data or data with controversy are also welcomed. The valuable information is often included in these raw data."Aging Check" is network software that supports facilities in which it engages it in the anti-aging medicine. It collates with Japanese102

population information when the examination data of the aging level and the aging risk factor are input , and calculates the functionage such as muscle age, blood vessels age, neurological age, hormone age and bone age. It is used in not only Japan but also Taiwanand South Korea. An English version and a French version are being made now. The Anti-Aging QOL Common Questionnaire is builtinto this software. It is used for not only the Anti-Aging clinics but also a medical check up in companies and a regional medicalexamination. In the near future, it aims the establishment of a common data base.What aims the Japanese Society of Anti-Aging Medicine.The concept of the anti-aging medicine started at the early 1990's in US and Europe, and was introduced into Japan in around 2000.In contrast to US, the Japanese are all covered by the insurance system and eyes to the medical treatment are severe. Even if theanti-aging medicine is introduced with commercial principle, it is not accepted by the Japanese. The academic society that was ableto participate the doctor and dentist's, without uneasiness, who belonged to existing Medical Societies was necessary.The number of members exceeded 6,000 now after Japanese Society of Anti-Aging Medicine had been established in 2001. Theirspecial areas include many medical departments, and form a global network with the physicians, surgeons, and dentists in our society.Our common goal is, by daily health promotion and improving QOL, to achieve a healthy long life. For that, the matter on which oursociety is working is as follows; to establish of the method of evaluating the aging levels and risk factors for aging, to promote an Anti-Aging QOL Common Questionnaire, to establish of a common data base, to publish an international medical journal (Anti-AgingMedicine), and making of the network software for the anti-aging clinics. It introduces these activities this time.FUNCTIONAL FOODS FACTOR:FOSU (FOOD OF SPECIFIED SPECIAL USELE FACTEUR D’ALIMENTATION FONCTIONNELLE : FOSU (NOURRITURE D’EMPLOI SPÉCIAL PRÉDÉFINI)SHAW WATANABE(JAPAN)Functional food system has been employed by the Japanese Government in 1990. The foods have two categories: food with nutritionclaims and food for specified health uses (FOSHU). Five categories of foods for special dietary uses are (i) foods for the ill, (ii) milkpowder for pregnant and lactating women, (iii) formulated milk powder for infants, (iv) foods for the aged, and FOSHU. Vitamins,minerals, herbs, proteins, fatty acids and dietary fibers are regarded as components of foods with nutrient function claims. FoodSanitation Law and Health Promotion Law cover the standardization and safety of FOSHU. More than 600 foods are approved asFOSHU.Non-nutrient food chemicals (factors) are recently noticed due to various possibilities of health promotion and disease prevention.Japanese consume a lot of soy bean products containing isoflavones, which may lead to the low incidence of estrogen-related cancers,cardiac infarction and osteoporosis. More than 600 food factors in vegetables and fruits are considered to influence the variousmetabolic stages in the body. Each phytochemical, however, failed to show their effects by the previous human intervention study.A breakthrough is necessary for proper evaluation of FFF. We started to make a database of non-nutrient functional food factors (FFF).By using the FFF database we can estimate the total intake of phytochemicals from dietary records, and evaluate the most effectivecombination of FFF for human health by epidemiological studies. So far, flavonoids, terpenoids and carotenoids, sulfur compoundsand functional peptides are included. We try to apply this FFF database to the on-going population based cohort study (JHPS).AGING CHECK SYSTEM IN JAPANLE BILAN MÉDICAL ANTI-ÂGE AU JAPONMASASHI UWABU(JAPAN)The number of specialized anti-aging medical clinics is increasing in Japan gradually.Five years ago these types of clinics were non-existent .Today the momentum is building and the future in this area looks promisingin Japan .The focus of clinics in Japan today evaluate bone density, muscular volume, hormone level, vascular age, and the functionof the nervous system, etc .These are the methods used in measuring the biological age of a patient.Treatment is based on these findings.In my presentation I will discuss the various biological aging check systems.ANTI-AGING MEDICINESESSION 12AAANTI AGING WORKSHOP 4THE FOOD AND THE SKINLA NOURRITURE ET LA PEAUCHAIR: CHRISTINE LAFFORGUE (PH.D.),UNIT OF DERMOPHARMACOLOGY AND COSMETOLOGY (CHÂTENAY-MALABRY, FRANCE)11.00 am / 12h00PRACTICAL TIPS TO IMPROVE THE SKIN NUTRIENTSCONSEILS PRATIQUES POUR AMÉLIORER LA PEAU AVEC DES NUTRIMENTSNADINE POMAREDE(FRANCE)EnglishThe skin is an organ located at the interface with the outside who interacts with the environment inside and that feeds nutrientsprovided by food. Comprehensive care of the patient cannot be reduced to acts on the surface of the skin, now the care of the skinconsists in the application of appropriate topical, but also advice on nutrition and supplements targeted. Studies show that therelationship between diet and skin exist, but are still poorly defined. However, channels have been opened that may have direct103

implications for direct questioning of patients. Apply on the skin of topical to treat diseases, correct flaws or simply maintain it remainsindispensable. Now we realise that food can act in synergy with the topical treatment and / or cosmetics.BibliographyPurba MB, Kouris-Blazos A, Wattanapenpaiboon N, Lukito W, Rothenberg EM, Steen BC, Wahlqvist ML Skin wrinkling. Can food make a difference?.J AmColl Nutr. 2001 Feb;20(1):71-80.Kohen. Skin anti-oxydants: their role in aging and evaluation in oxydative stress- New approaches for their evaluation. Biomed and pharmacother. 1999;53:181-92Pomarède N. Alimentation and skin : psoriasis, atopic dermatitis, dryness, photoprotection, acne and skin-aging . Nouv Dermat ;25 :Suppl.10 :12-16.FrançaisConseils pratiques pour améliorer la peau avec des nutrimentsLa peau est un organe situé à l'interface avec l'extérieur qui interagit avec le milieu intérieur et qui se nourrit des nutriments apportéspar l'alimentation.La prise en charge globale du patient ne peut se réduire à des actes à la surface de la peau, désormais la prise en charge de la peauconsiste à l'application de topiques adaptés, mais aussi de conseils nutritionnels et d'une supplémentation ciblée. Des études montrentque les rapports entre l'alimentation et la peau existent mais sont encore mal définis. Néanmoins, des voies ont été ouvertes quipeuvent avoir des implications directes pour orienter le questionnement des patients. Appliquer sur la peau des topiques pour traiterdes pathologies, en corriger les défauts ou tout simplement l'entretenir reste indispensable. Désormais nous prenons conscience quel'alimentation peut agir en synergie avec les traitements topiques et/ou les cosmétiques.BibliographiePurba MB, Kouris-Blazos A, Wattanapenpaiboon N, Lukito W, Rothenberg EM, Steen BC, Wahlqvist ML Skin wrinkling. Can food make a difference?.J AmColl Nutr. 2001 Feb;20(1):71-80.Kohen. Skin anti-oxydants: their role in aging and evaluation in oxydative stress- New approaches for their evaluation.. Biomed and pharmacother.1999; 53:181-92Pomarède N. L'alimentation et la peau : psoriasis, dermatite atopique, sécheresse cutanée, photoprotection, acné et vieillissement cutané. NouvDermat ;25 :Suppl.10 :12-16.ANTIOXYDANTS: LATEST SCIENTIFIC EVIDENCESANTIOXYDANTS : DERNIÈRES AVANCÉES ET NOUVELLES PERSPECTIVESMARVIN EDEAS(MALTE)WHICH FOOD AND COSMETICS TO IMPROVE THE SKIN ?QUELS INGRÉDIENTS ALIMENTATAIRES ET COSMÉTIQUES POUR LA PEAU ?MARVIN EDEAS(MALTE)SESSION 13AAANTI AGING WORKSHOP 5 CANCER TREATMENTLE TRAITEMENT DU CANCERANTI-AGING MEDICINE10412.00 am / 12h00HOW TO USE EFFICIENTLY AN IMPORTANT OVERLOOKED TREATMENT?COMMENT UTILISER EFFICACEMENT UN TRAITEMENT GÉNÉRALISÉ ?TULLIO SIMONICI(ITALY)From about 100 years the theory on cancer is based on the hypothesis that there is a malfunctioning of the genes.This point of view implies that the cancer is an intracellular fact. On the contrary, my point of view is that cancer is an infection, a fungalinfection, that is an extracellular phenomenon.As in the world of the plants, where the cancer is due to a fungal invasion, it is possible to argue the same thing for the human beings.Fungi are always involved in the cancer and they are found in vivo and in the post-mortem examination, but scientists think that theycome on just after the illness. My opinion is that they come before, produce the cancer, blunt the immune system then invadecompletely the organism. Every kind of cancer is caused by candida species fungi and the histology configuration is the defencereaction of a tissue against their invasion.By the time, the tissue gets exhausted and produces only undifferentiated cells.The cancer could be named a "solid abscess" where the colonies are inside and host cellular reaction is all around.Usual antifungal drugs are ineffective in the tumours because the solid colonies can be attacked only on the surface of their volume,and after the first administrations they becomes resistant.A solid infection is much more powerful than a bacterial one, that's why simple fungal infections can last forever.At the moment the only substance that I found, able to penetrate the volumetric infections is the sodium bicarbonate for the cancer ofinternal organs; for skin cancer the iodine tincture (peculiarly spread on) is the best substance to eliminate them.There are many works that show the effectiveness of sodium bicarbonate on cancer, but their conclusion are wrong because theyassume an intracellular action, instead of an antifungal one. It takes more than 20 years that I cured people with my method and manypatients healed completely from cancer even in the cases the official oncology gave up. Many videos in my websitewww.cancerfungus.com show many patients that are testimonial of the effectiveness of my therapy.The best way to try to eliminate a tumour is to put it in contact with sodium bicarbonate as close as possible, with oral administrationfor the digestive tract, with enema for the rectum, with washing out for the vagina and uterus; intravenously for the lung and the brain,with inhalation for the upper airways. Breast, lymph nodes and under skin lumps can be treated with local perfusions.

The internal organs can be treated with sodium bicarbonate by locating suitable catheters in their arteries (liver, pancreas, prostate,limbs) or in the cavities (pleura, peritoneum).It is important to treat every kind of cancer with the right dosage, 500 cc 5% or 8,4% for the administrations in vein, artery and in thecavities.Every treatment has to consider that tumour colonies regress from the 3dh to the 4th day and collapse from the 4th to the 5th day, sothat a 6 day administration is enough.A complete effective cycle is made of 6 days on 6 days off treatment, repeated 4 times.The most important side effects of this care system are thirst and tiredness.In conclusion, sodium bicarbonate is really effective against the tumours and harmless as well, it should always administered to everycancer patient.MORE NATURAL APPROACHES TO CANCER TREATMENTDES APPROCHES PLUS NATURELLES DU TRAITEMENT DU CANCERSERGE JURASUNAS(PORTUGAL)SESSION 14AACONTRIBUTING LECTURES IN ANTI-AGING MEDICINECONFERENCES PARTICIPATIVES EN MEDECINE ANTI-AGECHAIR: ASCANIO POLIMENI ANTI-AGING MEDICAL DOCTOR (ROMA, ITALY)JOSÉ MARQUEZ-SERRES ANTI-AGING MEDICAL DOCTOR (SEVILLE, SPAIN)2.00 pm / 14h00CARNOSINE AND SKIN AGINGLA CARNOSINE ET LE VIEILLISEMENT DE LA PEAUDAMIANO GALIMBERTI(ITALY)Connective tissue cells, called fibroblasts, play the leading role in the ongoing regeneration of the dermis. In order to function properly,fibroblasts must strike a delicate balance between destruction of extracellular protein and synthesis of new protein. Normally fibroblastsare quiescent, dividing at a low rate. They produce only small amounts of the matrix metalloproteinase enzymes (collagenase andstromelysin) that break down the surrounding extracellular matrix, and large amounts of matrix metalloproteinase inhibitors (TIMP-1and TIMP-2). But in response to various stimuli including wounding and inflammation, they undergo a drastic transformation intoactivated fibroblasts. They then secrete large amounts of enzymes that break down collagen and destroy the extracellular matrix.Cellular senescence locks fibroblasts and keratinocytes into an approximation of this activated state (West MD, 1994). They switchfrom a matrix-producing to a matrix-degrading mode, secreting more matrix metalloproteinases and less matrix metalloproteinaseinhibitors. Senescent fibroblasts and keratinocytes are known to accumulate in aging skin, as demonstrated by a biomarker of skin cellsenescence (Dimri GP et al., 1995). In addition to breaking down the extracellular matrix, they secrete proinflammatory mediators suchas interleukin-1 alpha and growth factors such as heregulin (regulator of breast and epithelial cell growth) whose influence extends farbeyond the cell secreting them (Campisi J, 1998; Campisi J, 1997).Proteasome activity declines in keratinocytes and epidermal cells with age. At the same time, protein carbonyl levels are rising andthe increasing numbers of senescent cells are secreting more proteolytic enzymes.Carnosine has been shown to rejuvenate cells displaying the senescent phenotype, quickly restoring the juvenile phenotype(McFarland GA et al., 1999; McFarland GA et al., 1994). Elderly cells rejuvenated by carnosine lived 3 times longer than cells withoutcarnosine. When the rejuvenated cells were removed from the carnosine rich environment,they assumed appereance and behavior ofaging cells. Carnosine stimulates a factor called vimentin that promotes robustness in cultured fibroblasts (Ikeda D et al., 1999).Vimentin is a structural protein that imparts strength and stability to fibroblasts and endothelial cells. Carnosine preserves the integrityof rat fibroblasts in a nutritionally deficient culture medium (Kantha SS et al., 1996). Carnosine significantly reduced 8-hydroxydeoxyguanosine levels in fibroblasts after four weeks of continuous culture. DNA oxidation is thought to contribute importantlynot only to cellular senescence. The natural dipeptide carnosine offers a superior efficacy and toxicity profile compared toaminoguanidine (Munch G et al., 1997; Preston JE et al., 1998; Burcham PC, 2000). Carnosine rejuvenates senescent fibroblasts.Carnosine helps reverse proteasomal decline. Carnosine addresses the major pathways through which proteins become carbonylatedthrough its antioxidant and anti-glycation actions, its ability to quench reactive aldehydes and chelate metals, and its effectivenessagainst lipid peroxidation.Now that many are cutting down on meat-the main dietary source of carnosine-supplementation becomes especially important.Carnosine is safe, with no toxicity even at dosages above 500 mg per kilogram of body weight in animal studies (Quinn PJ et al., 1992).The enzyme carnosinase breaks down carnosine into aminoacides.It must be saturated with more carnosine than it is able to neutralizein order to make free carnosine available to the rest of the body. An effective dosage of carnosine is 1000mg x day (500 mgx2).ANTI-AGING MEDICINECOMPLEMENTARY ANTIOXYDANT FUNCTION OF CAFFEINE AND GREEN TEA POLYPHENOLS FOR THE SKINEFFET ANTI-OXYDANT COMPLÉMENTAIRE DE LA CAFÉINE ET DES POLYPHÉNOLS DU THÉ VERT SUR LA PEAUJARED JAGDEO(USA)The study of free radicals is particularly relevant in the context of human skin carcinogenesis and photoaging because of their abilityto induce DNA mutations and damaging lipid peroxidation byproducts, including 4-hydroxy-2-nonenal (HNE). Therefore, it is importantto identify and evaluate agents with the ability to modulate intracellular free radicals and HNE.The purpose of this research is to investigate the ability of anti-oxidants green tea polyphenols (GTPs) and caffeine, alone and incombination, to modulate the hydrogen peroxide (H2O2)-induced upregulation of reactive oxygen species (ROS) free radicals andHNE in normal human skin fibroblast WS-1 cells in vitro. GTPs and caffeine were selected for evaluation because in clinical and animal105

studies they demonstrate anti-oxidant properties in skin tissue. Furthermore, GTPs and caffeine share a close natural botanicalassociation as components of green tea leaves. H2O2 is a well known generator of free radicals that occurs during endogenous andUV-induced oxidation processes in the human skin and was used to upregulate ROS and HNE in normal human fibroblast WS-1 cells.Using a flow cytometry-based assay, the results demonstrate that at 0.001% concentration, green tea polyphenols alone, and incombination with 0.1 mM caffeine, inhibited the upregulation of H2O2-generated free radicals and HNE in human skin fibroblasts in vitro.THE INCREASING TIME-LAG BETWEEN SCIENTIFICALLY BASED PROOF AND CLINICAL PRACTICE:DEFINING THE CAUSES IN RELATION TO ANTI-AGING MEDICINELE DÉCALAGE CROISSANT ENTRE LES PREUVES SCIENTIFIQUES ET LA PRATIQUE MÉDICALE :DÉTERMINATION DES CAUSES LIÉES À LA MÉDECINE ANTI-ÂGEJEFF HOEYBERGHS(BELGIUM)Background: The time that lapses between the application of certain scientific progress and the application there of into medicalpractice, appears to be on the increase. This is particularly true for preventive medicine and the management of age related risks. Lackof public funding, the evolution of medicine towards super specialization and the very rapidity of scientific and technical progress itself,are all contributing to this. The authors examine these various factorsThey also give clear recommendations towards filling the need for the modernization of medical training and practice in this respect.Methods: We use the Belgian Public Health system as a comparable model for most western medical systems.1. We studied -with relevant examples- how scientific breakthroughs translate into industrial availability or not.2. We qualified the trend to medical super specialization over the past 2 decades by analyzing the medical training system, the trendsin hospital vacancies and the available figures from the government regarding reimbursement of ratified diagnoses and treatments.3. We study the link between super specialization and the increase of the discrepancy between the best possible health care and thecare available - both privately and publically funded - over the last 20 years by means of some common treatment examples relating tothe assessment and treatment of age-related health risks.4. Likewise, we studied the link between the amount of scientific breakthroughs and their general implantation ratio after five years, bya review of the national statistics.Results1. Industrial implementation of scientific research appears to be driven by sales figures and patent rights, rather than biological insights.2. The fragmentation of medical specialization remains steadily on the increase. Clinical judgment is increasingly replaced by technicaltreatments and investigations.3. The discrepancy between medical science and medical practice has grown substantially over the last 20 years.4. There is a gradual increase of the ratio between the best possible care and the available public health care, particularly for theindividual who suffers from premature aging symptoms.Conclusions1. The clinical science of aging comprises many different specialties of medicine i.e. cardiology, endocrinology, allergology, rheumatology,pharmacology, neurology, psychology, gastro-enterology, urology, gynecology, andrology, clinical biology, pathology, etc... There is anapparent lack of up-to-date medical specialists who can integrate all the knowledge necessary for optimal anti-aging care.2. Scientific progress is overwhelmingly rapid for the average, single handed, medical practitioner. This keeps most of them out of date.3. A comprehensive modern clinical approach to age related risk management is complicated because of its multidisciplinary nature andits dependency on expensive investigations.4. Treatments that restore natural biochemistry provide the most secure handle on the optimization of the aging process with a view todisease prevention. This contrasts with the activity and productivity of the pharmacological research. They rarely pursue this path as itis impossible to patent.5. The Belgian governments can no longer afford healthcare that is both optimal and freely available. This is particularly the case forpreventive medicine. This is reflected in the situation for the western health care systems in general.ANTI-AGING MEDICINEIn Summary, the scientific treatment of age related risks is the Cinderella of current medicine. Premature onset aging disorders can, andshould, now be effectively treated, both from a preventative and a curative point of view. Compared to the scientifically proven treatmentoptions for the most common age-related disorders, mainstream medical practice hobbles increasingly further behind scientific reality.Authors' recommendations: The authors believe that the recognition of a new medical specialty that comprehensively covers this fieldof indication is now urgently due. In this paper they give a description of the technological basis that would have to underlie acomprehensive anti-aging medical discipline. Until a systematic, up-to-date, approach to age-related risks permeates the medicalcommunity as a whole, both the aging individual and the societies in general will undeservedly loose out on acceptable quality ofpreventative aging-related health care, both in the public and the private setting.HOW THE BEST ANTI-AGING PHYSICIANS OF SPAIN WORKMÉTHODES DE TRAVAIL DES MEILLEURS MÉDECINS ANTI-ÂGE EN ESPAGNEJOSÉ MARQUEZ-SERRES(SPAIN)FOOD, INFLAMMATION AND THE AGING PROCESSNOURRITURE, INFLAMMATION ET PROCESSUS DE VIEILLISSEMENTROGER DEUTSCH(USA)The chemical composition of foods can, by virtue of activation of various receptors, such as PPAR receptors and STAMP 2 (sixtransmembrane protein of prostate - 2) activate either inflammatory or anti-inflammatory pathways in cells. Activation of the former leadsto the generation of toxic mediators and free radicals. Oxidative stress has been liked to many degenerative diseases of aging including106

cardiovascular disease, dementia and insulin resistance; as well as inflammatory processes, such as asthma, RA (rheumatoid arthritis)urticaria, and inflammatory bowel diseases. Upregulation of the inflammatory process further impacts aging by increasing cortisollevels, to the suppression of sex hormones, and the shortening of telemeres.Attempts have made to devise methods to determine the individual food intolerances or sensitivities that, in part, underlie theseprocesses. The problem in testing is that there is no single clear-cut biological pathway underlying such reactivity as exists in Gell andCombs type I reactivity that mediates "true" food allergy. Several pathogenic mechanisms are involved in delayed reactions to foodsthat are both immune and non-immune. Hence, a non-mechanism dependant approach that can indicate that effects of food on variouspathways is desirable. The extant methods of testing with highlighting of a new cellular approach that is not mechanism dependent willbe reviewed.METABOLIC SYNDROME AND INSULIN RESISTANCE IN MIDDLE-AGED WOMEN WITH SUBCLINICAL HYPOTHYROIDISMLE SYNDROME MÉTABOLIQUE ET LA RÉSISTANCE À L'INSULINE CHEZ LES FEMMES SOUFFRANTD'HYPOTHYROÏDIE SUBCLINIQUE À LA CINQUANTAINEAVRAHAM ISHAY(ISRAEL)Background: Overt hypothyroidism may result in accelerated atherosclerosis and coronary heart disease (CHD) presumably becauseof the associated hypertension, hypercholesterolemia, and hyperhomocysteinemia. As many as 10%-15% of older women havesubclinical hypothyroidism (SH) and thyroid autoimmunity. Whether SH is associated with risk for CHD is controversial. As metabolicsyndrome (MS) and insulin résistance (IR) are major risk factors of atherosclerotic vascular disease, we investigated SH women forpresence of these metabolic disturbances.Patients, material, methods: Forty three women (aged 56.4±7.6) with SH and 49 age-matched healthy female controls with normalthyroid function were evaluated. SH was defined as an elevated (>4.5 mU/L) thyrotropin (TSH) along with normal free thyroxin (FT4)levels (8.7-22.6 nmol/L). None of the patients had been previously treated with thyroxin.We determined fasting blood levels of FT4, TSH, insulin, glucose (G), total cholesterol, high-density lipoprotein- cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG). Body mass index (BMI), waist and hip circumferences, bloodpressure, HOMA 2-Insulin resistance index (HOMA-IR) and the presence of metabolic syndrome (MS) were obtained in all participants.MS was diagnosed when 3 or more of the followings were present: waist circumference> 88 cm, hypertension (blood pressure values>130/85 mm Hg), TG >150 mg/dl, G >110 mg/dl, and HDL < 50 mg/dl. Normal HOMA-IR value was < 1.7.Results: The SH and control groups did not differ in their total cholesterol, LDL-C and HDL-C means values. Mean TG levels weresignificantly higher in SH group than in controls (130.8 vs. 112 mg/dL p

Serum calcium (mmol/L) 11.0±1.4 10.3±0.6 9.6±0.4Serum phosphate (mmol/L) 2.8±0.5 3.2±0.6 3.5±0.5PTH (pmol/L) 190.3±40.1 136.4±96.5 47.9±5.0Glucose ((mg/dl) 107.8±37.5 99.4±20.3 92.1±13.5Insulin (uU/L) 11.6±7.8 10.5±6.1 8.7±5.6CLEANSING OF THE MUCOID PLAQUE BY NATURAL MEANSNETTOYAGE DE LA PLAQUE MUCOÏDE PAR DES MOYENS NATURELSELEONORA LUKA PILLA(SWITZERLAND)OXYDIZING STRESS - THE NECESSARY EVALUATIONLE STRESS OXYDANT - LA NÉCESSAIRE ÉVALUATIONROBERT NATAF(FRANCE)Le stress oxydant est impliqué de façon croissante dans la pathogénie de nombreuses maladies liées à l'age, dont les maladies cardiovasculairesde nature athéroscléreuse.Encouragés par le succès des modèles animaux, les essais cliniques à grande échelle de supplémentation en antioxydants, vitaminesE et C le plus souvent, chez des cardio-vasculaires, ont été pour la plupart décevants.Or la majorité des études destinées à réduire le stress oxydant se sont illustrées, entre autres insuffisances sur le choix, la forme, ladose des antioxydants, par l'absence totale d'indicateurs biologiques tant au niveau des déchets oxydatifs que du statut antioxydant.D'autant que d'autres études ont montré, sur la base de marqueurs biologiques et de protocoles expérimentaux minutieux, que chezle sujet sain, exempt de stress oxydant, les antioxydants étaient inopérants.Or, nous disposons actuellement d'indicateurs biologiques, sensibles, spécifiques, mesurés par une technologie de pointe, capablesde préciser l'intensité d'un processus oxydant et souvent d'en évoquer le siège au niveau de l'organe ou de la cellule.S'il est vrai que notre panoplie d'antioxydants appelle sans tarder un important développement, il est actuellement possible de freinerl'évolution de certaines affections à composant oxydative avec une supplémentation en antioxydants, à condition de sélectionner parces indicateurs biologiques rigoureux, reconnus par la communauté scientifique, les sujets soumis à un processus oxydant accru.MITOCHONDRIAL MEDICINE UNDERSTANDING AND TREATING AGING AT A MOLECULAR LEVELCOMPRENDRE LA MÉDECINE MITOCHONDRIALE ET TRAITER LE VIEILLISSEMENT AU NIVEAU MOLÉCULAIREBERND KLEINE-GUNK(GERMANY)ANTI-AGING MEDICINEOne of the oldest and most important concepts of aging is Denham Harman´s Free-Radical-Theory. Meanwhile it is well establishedthat aggressive molecules that are lacking one electrone on their orbit (Reactive Oxygen Species, ROS) play a decisive role in theaging process. ROS occur e.g. as a consequence of UV radiation, smoking, enviromental toxins, etc. However, more than 80 % of allROS do not result from external factors but are created internally as a by-product of our energy production.Thus, those organells, that are responsible for our energy production come into the focus of anti-aging science: the mitochondria.Mitochondria are supposed to have been solitary primitive organisms before they were incorporated into the body cell during evolution.One proof of this theory is the fact, that mitochondria still possess a DNA of their own which no other cell organell has. The main taskof mitochondria is the production of energy, mainly in the form of ATP. During this process ROS can be emitted through protone leaks.Recent science has shown that mitchondria, too, undergo an aging process. This is mainly due to damages to the mitochondrial DNAand their membranes. The results of this aging process are twofold: On the one hand the production of ATP decreases, on the otherhand the emittance of ROS increases. Thus, the aging of the cell is more and more understood as a result of mitochondrial dysfunction.Nevertheless - this dysfunction can be treated. A key role in the energy production process is played by the coenzyme NADH. Alsonamed coenzyme 1, NADH mainly serves as an electrone transport system. It helps producing ATP and is a highly efficient free radicalscavanger. By this it is supporting mitochondria in their role of energy production while at the same time protecting them againstoxidative stress. Supplementation of NADH is therefore applied mitochondrial medicine.However, there are a few factors that make things complicated. NADH is a short-lived, very reactive substance that quickly loses itseffects when exposed to light, oxygen, etc. Furthermore it is destroyed by the gastric acids when taken orally.The task is therefore to develop a form of stabilized NADH and to make it resistant against gastric acids. An alternative would be thesublingual application of NADH. In any case, NADH supplements offer a big chance to treat the aging process at its molecular level.But of course, they have to prove their bioavailability.EFFECTS OF OBESITY ON COGNITIVE FUNCTION IN OTHERWISE HEALTHY INDIVIDUALSLES CONSÉQUENCES DE L'OBÉSITÉ SUR LES FONCTIONS COGNITIVES CHEZ LES INDIVIDUS SAINS PAR AILLEURSTOM RICHART(BELGIUM)Aim: To summarize the pleiotropic effects of obesity on cognitive performance and affective status in otherwise healthy individuals, inthe light of improving personalized treatment plans on evidence-based findings.Methods: We searched the recent literature focused on the interactions between obesity, hypertension, insulin resistance, cognitiveand affective status. We paid specific attention to gene-environment interaction studies at the level of the general population.Results: The presence of obesity in otherwise healthy individuals is associated with a significant decline in mental performance andoverall welllness as assessed by validated tests of executive function, mental stress tolerance and depression scales. At all ages,obesity is associated with established biomarkers of aging: arterial stiffening, insulin resistance and an accelerated loss of mental108

performance.Outcome studies of anti-obesity drugs indicate a lack of efficacy in achieving weight loss. Population studies indicate that geneticvariance in genes encoding cellular metabolism and uncoupling proteins might attenuate energy homeostasis. Other population-basedreports stress the importance of behavioural therapy in the treatment of overweight patients.Conclusions: We conclude that obesity is a pathophysiological sign of a gene/behaviour/environment mismatch. For the effectivetreatment of the individual obese patient, all of the confounding variables (genetic layout, environment and psychological profile)should be assessed according to the current standards.NATURE'S ANSWER TO SEXUAL HYPOFUNCTION: THE HORMONOMIMETIC AND ANTIOXIDANT PROPERTIES OFICARIIN IN RELATION WITH MALE AND FEMALE SEXUAL WELLBEINGLA RÉPONSE DE LA NATURE À L'HYPOFONCTIONNEMENT SEXUEL : L'HORMONOMIMÉTISME ET LES PROPRIÉTÉSANTIOXYDANTES DE L'ICARIINE ASSOCIÉS AU BIEN-ÊTRE SEXUEL MASCULIN ET FÉMININROCK R. GOERDIN(BELGIUM)Background: Icariin, a flavonol glycoside found in Herba Epimedii is purported to enhance sexual wellbeing in both males and females.Epimedium is a Chinese herb used in traditional medicine to treat fatigue, arthritic and nerve pain, and sexual dysfunction. Use ofEpimedium is thought to attenuate levels and actions of several sex hormones.Several animal experiments suggest an attenuation of sexual desire and erectile function by epimedium extracts. Furthermore, these arereflected in the anecdotal positive effects on sexual experience of patients with over the counter (OTC) preparations containing Icariin.Purpose: To further clarify the actions of Epimedium extract on erectile dysfunction and attenuation of tumescence and sexual desirein both males and females.To highlight, in particular, the clinical potential of Icariin - as a standardized Epimedium component- in the treatment of age-relatedsexual hypofunction.Methods: The authors searched the scientific literature for documentation and clarification of the subject.Results:In vitro studies: In in-vitro studies of smooth muscle cells lining the corpus cavernosum of the penis, icariin blocks the degradativeaction of PDE5 on cGMP. Results of in vitro studies suggest that components of Epimedium, especially icariin, exhibit neuroprotective,immunomodulatory and anticancer effects. Epimedium grandiflorum was reported to have anti-HIV activity in vitro.Animal models: Animal studies confirm these findings and suggest attenuation of sexual desire and increased tumescence in severalanimal models.Icariin also stimulates the differentiation of osteoblasts and increases the activity of alkaline phosphatase (ALP) and the expression ofI-collagen protein in Sprague-Dawley rats, hereby promoting bone formation. Serum testosterone concentration is also significantlyelevated compared with the control group.Icariin improved the condition of reproductive organs and increases the circulating levels of testosterone. In animal models, it increasesthe sexual desire in both males and females. Therefore, Icariin may be of benefit in the management of partial androgen deficiency inthe aging male.Human trials: The findings in relation with osteoporosis were replicated in a randomized placebo-controlled trial, where Icariinprevented bone loss in postmenopausal women. Icariin treatment improved the steady-state serum osteocalcin. This indicatesosteogenesis by increased oseoblastic activity.Discussion: Icariin is a new kind of biological modifier and differential agent with possible anticancer effects. It also acts as aprotective agent for postmenopausal osteoporosis.Icariin acts as a cyclic Guanosine Mono Phosphate (cGMP)-specific Phosphodiesterase (PDE5) type 5 inhibitor. This facilitates therelease of nitric oxide (NO), which is part of the physiological process resulting in penile erection and clitoral tumescence as a resultof sexual stimulation. This attributes to Icariin a clear-cut potential for treating erectile dysfunction(ED).The testosterone mimetic properties may also be beneficial in females to enhance both sexual tumescence and desire.Conclusions: Icariin carries significant testosterone mimetic properties. No major side effects have been reported.These findings make epimedium herb extracts a potential candidate for use in the treatment of age-related sexual dysfunction,particularly when attributable to hormonal deficits.In females, it is potentially beneficial as a sexual enforcer, boosting desire and wellbeing. In males, it can increase sexual desire anderectile function in an explicit way.On the scientific and anecdotal basis currently available, Icariin can be safely recommended as the best documented substance forincreased sexual wellbeing that occurs in nature.More randomized prospective trials, in particular with standardized compositions, are required both to quantify the dose-effectrelationship in the enhancement of sexual function as well as to define the possible subgroups for specific indications.ANTI-AGING MEDICINETHE ADDED VALUE OF EXTENSIVE PRELIMINARY LABORATORY SCREENING TO VERY LOW CALORIC DIETSWITH HIGH PROTEIN CONTENTLA VALEUR AJOUTÉE DES LARGES EXAMENS DE LABORATOIRE PRÉLIMINAIRES DANS LES RÉGIMES BASSESCALORIES HYPERPROTÉINÉSFRANCINE TEMPELS(BELGIUM)Background: To date, the worldwide ratio of overweight to underweight individuals has reached unity. This number remains steadilyon the increase. Several pharmacological interventions and dietary approaches have been proven to be largely ineffective, both interms of sustained weight loss as well as improvement of cardiovascular risk factors. Due to the multifactorial etiology of obesity, clearcut management has remained elusive.To date, the use of very low caloric diets with high protein content (VLC-HP) in the treatment of obesity has proven to be both safeand effective. Considerable improvement in biomarkers of cardiovascular risk and insulin resistance is seen in the majority of patientsthat are compliant with the dietary plan.Materials and Methods: We reviewed the current literature on pharmacological and dietary treatments of overweight and obesity andthe impact on the individual changes in cardiovascular and metabolic risk factors. We included studies that addressed the influence of109

food allergies and/or intolerance in the light of the reduced number of possible food allergens presented to the patient during the VLC-HP diet. Additionally, we looked into the evidence from genetic cohort studies of overweight and diabetic populations.Results: Cardiovascular risk factors (blood lipids, insulin resistance and hypertension) improve significantly more in HP diets,especially as compared to current pharmacological-only treatments and/or general dietary advice. A significant number of patientsexperiences resistance to weight loss from their genetic background, endocrine imbalances or intolerance of food components asassessed by IgG/IgE micro-array. Individual adjustment of the composition of the diet is mandatory according to these preliminaryfindings.Discussion: In our experience, high-protein (HP) diets are well tolerated and induce rapid and sustained loss of weight over andbeyond low caloric carbohydrate-based alternatives. Their added benefit centres primarily around their improved adherence. That isattributable to the prolonged HP-induced satiety and the lower incidence of gastro-intestinal intolerance. In the light of preliminary IgGdetermination, it is also very likely due to the low content and low variety of allergens.Conclusions: Maximally effective treatment of overweight and/or obesity should be tailor-made. It depends on the findings fromgenetic profiling, the comprehensive assessment of dietary habits, IgG-mediated food intolerances, endocrine screening, physicalactivity and psychological assessment. When planning a specific individualized treatment system in order to maximize outcome, thesemultiple etiological factors all need to be taken into account. In combination with behavioural guidance, VLC-HP diets are probably themost effective tool currently available. Their outcome can be further improved by adapting their detailed composition in accordancewith the results of extensive preliminary laboratory screening.SALIVARY HORMONE TESTING: DO’S AND DON’TSTESTS HORMONAUX SALIVAIRES : QUE FAIRE ET NE PAS FAIREWOLFGANG ZIEMANN(GERMANY)The HERS studies I and II as well as the WHI/NIH study have shown that HRT might result in elevated health risks for postmenopausalwomen. Therefore compounding pharmacies now are offering individualized HRT based on natural hormones and on the results ofsalivary hormone analysis. A recent publication has shown that the results of some commercial saliva labs are not reproducible.Therefore these results cannot be the basis of an individualized HRT.The main problem in salivary testing seem to be the pre-analytical procedures. Chewing and other pressure on the teeth will increasethe interference with plasma components and will result in elevated salivary hormone measurements. Visible blood contamination willdo the same and therefore must be avoided.The collection device must be free of adsorption effects. This especially is important for progesterone analysis.Therefore polypropylene is the best material for collection. Polyethylene should not be used at all. As meat and dairy products maycontain significant hormone concentrations such foods should not be consumed during the collection day.The main problem seems to be the significant biological CV of hormone secretion. The episodic secretion pattern does not allowreproducible results if saliva analysis is done just from one single sample. In order to reduce the biological variation of testing resultsany salivary measurement should be based on a mixture of 5 samples collected during a period of 2 to 3 hours.In order to catch the morning peak of Cortisol secretion the samples have to be collected during the first 2 hours after the usual wakeuptime.The maximum value usually will appear 1 hour after the usual awakening.In general salivary testing reflects the free hormone fraction and therefore the hormone activity. In contrast to this serum analysis onlycan give a result for the total hormone concentration which represents mainly (>95%) the inactive bound hormone fraction.Therefore salivary hormone testing is much superior to serum testing provided the correct pre-analytical procedures are carefullyfollowed.SESSION 15AAANTI AGING WORKSHOP 6 GENETIC TYPINGLE GÉNOTYPEANTI-AGING MEDICINE4.30 pm / 16h30MEN AND WOMEN: HOW TO WORK WITH THE MOST IMPORTANT GENETIC TYPING TESTS?HOMMES ET FEMMES : COMMENT TRAVAILLER AVEC LES MEILLEURS TESTS GÉNOTYPIQUES ?JOHANNES HUBER (AUSTRIA)ANDRES KANSKI (VENEZUELA)5-alpha reductase polymorphism is important for men and women in a different way. 5-alpha dehydrotestosteron protect the femalebreast, whereas it is a burden for the male prostate gland. Progesterone is converted in 2 metabolic high ways in the femaleorganism: In 3 pregnane and in 5 alpha-pregnene. The later one is associated with strong proliferation in the female breast andshould be avoided in the menopausal area.Aromatase gen display also different SNP, with higher enzyme activity, producing more estrogens from androgens. This is importantfor the female breast as also for pars medialis in the prostatic tissue.Catechol-O-Methyltransferase gen and methylen tetrahydrofolat-reductase gen have a faster and a slower working genetic variation,this important for cardiovascular system, for the mood and for the intestinal tract. Glucose metabolism and inflammation areconnected with aging process and display also a genetic variation in the competent genes, which becomes more and more importantfor preventive medicine.110

Saturday April 12 / Samedi 12 AvrilANTI-AGING MEDICINEROOM / SALLE MAILLOTSESSION 16AAANTI AGING WORKSHOP 7 ANTI-AGING THROUGH SPA THERAPYANTI-AGE ET SPA5.30 pm / 17h30COMPLEMENTARY TREATMENT FOR HOLISTIC ANTI-AGING PROGRAM: HOW ALTERNATIVE MEDICINE ASSISTS ONANTI-AGING- ALL THESE SUBJECTS WILL HELP THE DOCTORS UNDERSTAND WHAT ARE SPA TREATMENTS,ALTERNATIVE MEDICINE INCLUDING MASSAGE, AROMATHERAPY, HYDROTHERAPY, CHROMOTHERAPY, CHINESETRADITIONAL MEDICINE, ACUPUNCTURE... ALL FOR MORE BODY AND MIND, NOT JUST HORMONE AND MEDICINETRAITEMENT COMPLÉMENTAIRE POUR UN PROGRAMME ANTI-ÂGE HOLISTIQUE : COMMENT LES MÉDECINES DOUCESASSISTENT LA MÉDECINE ANTI-ÂGE (SPA, MASSAGES, AROMATHÉRAPIE, HYDROTHÉRAPIE, CHROMOTHÉRAPIE,MÉDECINE TRADITIONNELLE CHINOISE, ACUPUNCTURE...)PAKPILAI THAVISIN(THAILAND)SPA = Solus per Aqua = Health through WaterSpa - To devote enhancing overall well-being through a variety of professional services that encourage the renewal and spirit.(definition by The International Spa association - ISPA)For thousands years since Roman Empire, Spa therapy has been used by highly developed ancient civilizations for treatment diseaseand purify body and spirit. Nowsaday spa treatments include variety of therapeutic programs to enhance total body health and promotevitality such as hydrotherapy, therapeutic massage, aromatherapy, chromotherapy, colon cleansing, acupressure, acupuncture,traditional medicine, Bio-energy medicine, homeopathy, etc.Spa treatments are not just experience based. There are more and more scientific studies proved that they have some measurablehealth benefits. For example; massage is not just for relaxation but can help improve blood circulation and oxygenation of organs,muscles and joints, can safe lots of knees from invasive surgical procedure.Aromatherapy massage can significantly lower the post test Fatique score on Breast cancer patients after mastectomy &chemotherapy.Colon hydrotherapy can help detoxify yeast overgrowth in the bowel, improve immunity and cure allergic reactions. While Musictherapy and Chromo (color) therapy can relieve stress, reduce blood pressure and enhance deep sleep.Meditation regulates memory and attention. Brain scans of experienced meditators showed thickening in the insula area of the braincortex which involves in the integration of emotion with thought. Meditation can help slow down the brain atrophy that typically occurswith age.Most Spa treatments can reduce stress which is the truly killer that cause impairment of immune system, unbalance hormone, andhigher cortisol that promote degeneration.To integrate Spa therapy into conventional Anti-Aging medicine will help us achieve the total body & mind Rejuvenation.ANTI-AGING MEDICINESESSION 17AACOMMUNICATIONS IN FOREFRONT ANTI-AGING MEDICINECOMMUNICATIONS DE PREMIER PLAN EN MEDECINE ANTI-AGEChair: DAMIANO GALIMBERTI PRESIDENT OF ITALIAN ASSOCIATION OF ANTI-AGING PHYSICIANS (MILANO, ITALY)JOHN IONESCU PROFESSOR OF BIOCHEMISTRY AND IMMUNOLOGY (NEUKIRCHEN, GERMANY)8.30 pm / 8h30WHAT'S THE FUTURE OF DHEA'S REPLACEMENT THERAPY?QUEL AVENIR POUR LA THÉRAPIE DE REMPLACEMENT DE LA DHEA ?ASCANIO POLIMENI(ITALY)Future perspectives of dhea therapy used alone and in combination with other therapies in HRT of menopause, in chronic inflammatoryand autoimmune diseases, in immunedeficiency-immunesenescence and in the prevention of cardiovascular death.Estrogen therapy (oral estrogen specially) alone or combined with synthetic progesterone can promote breast cancer in users of HRTfor menopause's complaints. Tamoxifen and other SERM (selective estrogen receptor modulators) are the most effective treatmentsfor breast cancer through its ability to antagonize estrogen-dependent growth by binding estrogen receptors (ERs) and inhibitingproliferation of breast epithelial cells.In a series of animal models, androgens and DHEA have been found to inhibit breast cancer development and growth and to stimulatebone formation. In clinical studies, DHEA has been found to increase bone mineral density and to stimulate vaginal maturation withoutaffecting the endometrium, while improving well-being and libido with no significant side effects. To avoid the concerns about the useof traditional hormone replacement therapy, dhea (a tissue-targeted precursor of sex steroid formation) offers hope of a physiologicaltissue-targeted hormone replacement that, combined with a SERM, would simultaneously prevent breast and uterine cancer.The natural concomitant secretion of DHEA with glucocorticoid (GC) probably enables the latter to protect the body from ill-effects ofstress without exerting their deleterious potency. GC are widely used as key therapy in chronic inflammatory and autommune disease.Long-term GC administration may result in some deleterious side-effects, such as muscular weakness, atrophy and necrosis, diabetes,111

fattiness, osteopenia, osteoporosis and avascular necrosis and susceptibility to infections. DHEA ameliorates some deleterious effectsof GC, such as diabetes, amino acid deamination, fattiness, hypertension and susceptibility to viraemia. By its anabolic effects inmuscles, bones and endothelium, DHEA may diminish the severity of GC-induced catabolic effects like myopathy, osteopenia,osteoporosis and avascular necrosis.On the other hand, administration of GC inhibits ACTH secretion, involutes the adrenal cortex and results in further DHEA deficiency,particularly harmful in chronic autoimmune diseases (i.e. RA, SLE). Therefore, the deleterious side-effects of chronic administration ofGC emerges from both their direct catabolic activity and the suppression of DHEA production. The viewpoint presented in an Italianstudy claims that under chronic GC supplementation, DHEA replacement therapy may reduce damage caused by GC administration.The progression of HIV infection is accompanied by complex alterations in the production of adrenal steroids. Cortisol levels areincreased in HIV infection whereas those of dehydroepiandrosterone (DHEA), a physiologic antagonist of the immunoregulatoryactivities of cortisol, decrease. The progression of HIV infection to AIDS is also characterised by a shift from a type 1 to type 2 cytokineproduction. The type 1 to type 2 shift and the altered Dhea/Cortisol ratio are negatively correlated with the in vivo CD4 T-cell counts,with the malnutrition markers, such as body-cell mass and fat mass, and with the increased circulating lipids (cholesterol, triglycerides,and apolipoprotein B) associated to the lipodystrophy syndrome. The observations of an Italian research group, show that thecortisol/DHEA ratio is dramatically altered in HIV-infected men, particularly during the syndromes of malnutrition and lipodystrophy, andthis ratio remains elevated whatever the antiretroviral treatment, including HAART. These findings have practical clinical implications,since manipulation of this ratio could prevent metabolic (protein and lipid) perturbations and improve nutritional and immunologicalstatus as shown by an Italian research group.The dampening of cortisol and DHEA circadian fluctuation and the progressive decrease of DHEA/cortisol ratio are at the basis ofmultiple clinical implications of immunesenescence: the shift from anabolic to catabolic status, the activation of atherosclerosisprogression, the deterioration of immune competence, the impairment of cognitive and affective performances and the glico- andlipometabolic disorders. The hypothesis of a DHEA supplementation strategy comes out from these premises,as shown in some Italianstudies.Several epidemiological studies indicate an inverse correlation between DHEA/DHEAS plasma concentration and mortality, particularlydue to cardiovascular disease. The analysis of the Rancho Bernardo population was the first to correlate DHEAS levels withcardiovascular risk in males over 50 yr of age. Afterward, a number of studies extended this observation to young men as well as topremenopausal and postmenopausal women. Low DHEAS levels have been also associated with cardiovascular events, with theextent of angiographic coronary stenosis, as well as with allograft vasculopathy, suggesting a role for DHEAS in delaying coronarydisease.However, other studies have questioned the association between DHEA/DHEAS and cardiovascular disease, and a later reanalysisof the Rancho Bernardo cohort showed a much weaker correlation. The prospective PAQUID study has recently renewed the interestin this issue, showing higher mortality in male patients with lower DHEAS concentrations.Animal studies indicate a protective role of DHEA for atherosclerotic disease in primates and rabbits, but in vitro studies explaining themechanisms are largely missing.Steroid hormones regulate vascular function in part through general metabolic modifications, but mostly through actions exerteddirectly on the vessel wall. Endothelial cells are primary targets of steroids that regulate endothelial function through transcriptional aswell as rapid nontranscriptional mechanisms. For instance, estradiol stimulates nitric oxide (NO) synthesis via the induction ofendothelial NO synthase (eNOS) expression as well as through nongenomic enhancement of its activity .The mechanisms of action of DHEA are not clear. Part of the effects of DHEA depends on the conversion to estrogens and androgensand on the recruitment of the respective receptors. However, there is suggestive evidence that DHEA may have a dedicated receptor.In a new italian study was shown that DHEA directly regulates human endothelial cells, activating eNOS through both genomic andnongenomic mechanisms.To conclude we can claim that, endothelial NO induction by DHEA provides a rationale for some of the vascular protective effects ofthis steroid.ANTI-AGING MEDICINESODIUM PHENYLBUTYRATE/TRIBUTYRATE ® : 350+ PUBLICATIONS LATER, SAFE, EFFECTIVE AND "CHEAP",WILL IT EVER SEE DAYLIGHT AS A TREATMENT?SODIUM PHENYLBUTYRATE/TRIBUTYRATE ® : SÛR, EFFICACE ET BON-MARCHÉ, APRÈS PLUS DE 350 PUBLICATIONS,VERRA-T-IL LA LUMIÈRE DU JOUR ?HOKAN CEDERBERG(SWEDEN)Developed in the mid-1980's, by triple crown america, inc. originally for Johns Hopkins Hospital as a treatmernt for Urea CycleDisorder, a metabolic children disease (today over 1.500 children, some now aged 20+, are alive because of SPB/triButyrate) thiscompound has been used in over 20 different indications for research, pilot and clinical studies and for treatment - including over 20types of Cancer - ranging from Cystic Fibrosis, Thalassemia/Sickle Cell Anemia, Adreno Leuco Dystrophy (ALD), Spinal MuscularAtrophy (SMA), Amyotrohpic Lateral Sclerorosis (ALS), Multiple Sclerosis (MS), Huntington's Disease, Hunter's disease, BenignProstate Hyperplasia (BPH) and Kidney/Brain/ Liver/Eye disorders and more.In Cancer, the most researced/treated types are Breast, Brain, Colon, Prostate, Liver and Skin Cancers as well as Leukemia andHodgkin's disease, however, it has also several studies on Bone, Cervical, Gastric, Head&Neck, Intestinal, Lung, Nervous System,Ovarian, Pancreatic, Renal and Thyroid Cancers .Lately, scientific studies also show a general positive effect on the aging body, including the aging skin. Several studiers are underwayboth for oral and topical formulations.The working mechanisms are at large unknown for many of the very different indications, and either they are in the end very differentin their nature OR they will prove to be "very basic", addressing health/disease at its "basic roots" being largely one and the samemechanism - this being a very "unscientific" approach!! In this case it can be compared to aspirin and similar compounds, where theworking mechanisms at large are still undefined and the compound having effects on many disease states.The dosage historically was very high compared to traditional corresponding drugs (500 mg - 1 gram/kg body weight up to 20 gramsa day, although up to 35 grams a day have been tried without severe side effects) but our own, as well as others', research shows thatif the administration is as constant as possible over the 24 hours it can be cut down drastically. For prostate disease as little as 2 gramsa day have been found effective.It is strongly believed that triButyrate also possesses preventative functions, then at relatively low dosages. Side effects at high112

dosages range from tiredness, dizziness to an upset stomach. At lower dosage triButyrate can be claimed to be virtually side effectfree.As it is by many postulated that all Cancers have, if they are not the same disease, a lot of common denominators and are possiblyall similar infections of the body, it is only logical to postulate accordingly that one and the same medicine/molecule can be a "cure-all"for all the different types of Cancers and all the different indications, surely proven by the over 350 References/Publications that areavailable (www.tributyrate.com), work conducted at the World's most prestigious Research Institutes and Hospitals, e.g. KarolinskaInstitute, Johns Hopkins, M.D.Andersen, Mayo, Sloan-Kettering, Mount Sinai, NCI and many more, published in peer-reviewedJournals e.g. The Lancet, New England Journal of Medicine, Nature and many other International Journals specialized on respectivetopics.But, the key questions remains: who wants a treatment for so many diseases including for all/most types of Cancer, which is: 1) naturalby definition, although the compound used is synthetically made, 2) has no serious side effects in most dosages and 3) cost basicallynothing compared to traditional cancer treatment/chemo theraphy and 4)which above all cannot be patented? Maybe the samegroupings that also have made sure that alternative energy sources and alternatively propelled cars and airplanes are virtually nonexistent.SodiumPhenylButyrate/triButyrate ® - a "Miracle molecule"?!Developed in the mid-1980's, by triple crown america, inc. originally for Johns Hopkins Hospital as a treatmernt for Urea CycleDisorder, a metabolic children disease (today over 1.500 children, some aged 20+, are alive because of triButyrate) this compoundhas been used in over 20 different indications - including over 20 types of Cancer - ranging from Cystic Fibrosis, Thalassemia/SickleCell Anemia, ALD, Spinal Muscular Atrophy (SMA), MS, Huntington's Disease, Hunter's disease, "BPH" and Kidney/Brain/Liver/Eyedisorders. In Cancer, the most researced types are Breast, Brain, Colon, Prostate, Liver and Skin Cancers. Lately, scientific studiesalso show a general positive effect on the aging body, including the aging skin. The working mechanisms are at large unknown andeither very different in their nature OR "very basic", addressing health/disease at its "basic roots" being largely one and the samemechanism (a very "unscientific" approach!!). Over 350 References/Publications are available (www.tributyrate.com), conducted at theWorld's most prestigious Research Institutes and Hospitals, e.g. Karolinska Institute, Johns Hopkins, M.D.Andersen, Mayo, Sloan-Kettering, Mount Sinai, NCI, published in peer-reviewed Journals e.g. The Lancet, New England Journal of Medicine and many otherInternational Journals.AGING AND ANTI-AGING MEDICINE IN THE MIDDLE-EASTVIEILLISSEMENT ET MÉDECINE ANTI-AGE DANS LE MOYEN ORIENTABDULRAZAK ABYAD(LEBANON)Middle Eastern countries have certain cultural, social and economic characteristics in common with similar aspiration. The percentageof elderly in the Middle East is expected to increase with improvement of the health care delivery in the area. The region, like otherdeveloping countries, needs to define the policies and programs that will reduce the burden of aging populations on the society andits economy. There is a need to ensure the availability of comprehensive health services for the elderly. A rising geriatric population,with increasingly unmet health care needs, strongly suggest the necessity for a better educational preparation of those healthprofessions actually or potentially serving them. The absence of sufficient numbers of trained geriatricians and gerontologists, amonghealth professionals, seriously undermines the ability of the country's health care system to adequately assess, treat, and rehabilitatethe growing aging population. This shortage leads to inappropriate care, higher costs, and poorer patient outcomes.Anti Aging medicine movement is still in its early phase in the region. Although it is practised by many health professional but there islack of adequate training in the field and lack of regulations.ANTI-AGING MEDICINESESSION 18AA2.00 pm / 14h00CUTTING EDGE GENETICSLA GÉNÉTIQUE D'AVANT-GARDECUTTING-EDGE ANTI-AGING MEDICINE: THE MOST RECENT SCIENTIFIC STUDIESMÉDECINE ANTI-AGE DE POINTE : LES DERNIÈRES ÉTUDES SCIENTIFIQUESCHAIR: CLAUDE DALLE ANTI-AGING MEDICAL DOCTOR (PARIS, FRANCE)YOSHIKAZU YONEI PROFESSOR GASTROENTEROLOGY (KYOTO, JAPAN)BERNARD WEBER(LUXEMBOURG)The development of preventive strategies for major age related diseases has changed the nature of genetics. Assessment of geneticrisks is getting more and more the basis for preventive biomedicine and offers the chance for effective prevention and treatment ofchronic diseases.In the last years, high-throughput genotyping technologies have been developed that analyze thousands of markers from a singlesample at once. Genetic tests play an important role in predictive medicine since they permit to adapt the expression of the genes totheir environment. The interpretation of genetic tests needs to consider the gene-gene interactions and the impact of environment onthe estimation of the relative risk (RR). The RR related to deleterious polymorphisms may reach a factor of 15 and can be increasedup to more than 80 fold by one or several negative environmental factors. Prediction of a relative risk for major age related diseasesand individualized counseling are already possible today by assessment of single nucleotide polymorphisms (SNPs) that have beencharacterized so far for cardiovascular diseases, osteoporosis, breast cancer and more recently prostate cancer.A Swedish-American study found that patients whose genes contained four of the five common variants, found to be associated withprostate cancer in 2006 and 2007, had a 400% to 500% increased RR of developing the disease.That risk shot up to over 900% in patients who had the genetic variants and a family history of prostate cancer. The tendencies for theresponses to nutritional and pharmacological interventions are also for a large extent genotype dependent, enabling and individualizedcounseling of the patients on the basis of their genetic background.113

The efficacy of applying nutrigenetics to long term weight management has been demonstrated by a recent study in which a significantimprovement in long term (more than 300 days) weight management for individuals whose nutrient requirements were tailored toindividual variations in the genes known to affect nutrient metabolism and transport was observed. The selection of polymorphismsthat are used for genotyping should be made very carefully and based when available on meat-analyses or replicative studies thatconfirm the initially observed phenotype-genotype association and the impact on the RR for disease. With the growing number ofgenetic markers, the interpretation of results is getting more and more complicated, and the interaction between genes need tothoroughly investigated, since there may be additive, multiplying or competing effects.Only expert based systems for interpretation of genetic profiles and individualized prevention and treatment can evaluate the complexinteractions involved in etiological pathways.THE PROPER WAY TO SUCCESSFUL AGINGLA BONNE VOIE POUR BIEN VIEILLIRYOSHIKAZU YONEI(JAPAN)The concept of the anti-aging medicine started at the early 1990's in US and Europe, and was introduced into Japan in around 2000.In contrast to US, the Japanese are all covered by the insurance system and eyes to the medical treatment are severe. Even if theanti-aging medicine is introduced with commercial principle, it is not accepted by the Japanese. The academic society that was ableto participate the doctor and dentist's, without uneasiness, who belonged to existing Medical Societies was necessary. The number ofmembers exceeded 6,000 now after Japanese Society of Anti-Aging Medicine had been established in 2001.Their special areas include many medical departments, and form a global network with the physicians, surgeons, and dentists in oursociety. Our common goal is, by daily health promotion and improving QOL, to achieve a healthy long life. For that, the matter on whichour society is working is as follows; to establish of the method of evaluating the aging levels and risk factors for aging, to promote anAnti-Aging QOL Common Questionnaire, to establish of a common data base, to publish an international medical journal (Anti-AgingMedicine), and making of the network software for the anti-aging clinics. Our society believes these activities are on the proper way tosuccessful aging.CUTTING EDGE HORMONE TREATMENTS: DHEA AND GHLES TRAITEMENTS HORMONAUX DE POINTE : DHEA ET HORMONE DE CROISSANCECLAUDE DALLE(FRANCE)Dhea is a very amazing and powerful hormone and each year brings us new precisions on it. Where is the best absorption?Does dhea fight insulinoresistance ? can it decrease inflammation really ? answers to these questions exist already.Dhea is secreted mainly in the morning, like testosterone.Do you know that dhea can decrease appetite ? and is also an androgenic hormone ?But we know now that dhea is linked to testosterone and mortality & cancer rates in men !In post menopausal women, dhea increases with exercise, and by the way modifies many other parameters like estradiol, estrone andgrowth hormone.At this age of women's life, it helps also greatly to improve bone mineral density.Dhea appears now like a robust biomarker of health status in older people.Dhea is proven to be inversely associated with ovarian cancer risk,This hormone also copes with stress more than we thought, and, not surprisingly, is correlated with pain.So we must inform our patients of the efficacity of dhea, but always be careful before prescription by doing a blood test.ANTI-AGING MEDICINEConcerning growth hormone, we know its protective effect against cervical neoplasia, particularly in young women.But we have learnt also that in case of smoking pregnant women, the infant will be with a real lower Igf1 level.Igf1 appears more and more like a stimulator of immunity, and also a regulator of homeostasis for T cells.Unfortunately, Igf1 is correlated to obesity, and for the treatment of diabetes, like a good new way, but here it requires the presence ofa balance between Igf1 and its binding protein; igf1/igfbp3 is biologically active on the carbohydrate metabolism.This lecture will learn to you more on these two hormones, to improve your practice, already after the end of the slides !.CUTTING EDGE INFORMATION ON TESTOSTERONE IN AGING MEN AND WOMENLES DERNIÈRES INFORMATIONS SUR LES TRAITEMENTS PAR TESTOSTERONE CHEZ L’HOMME ET LA FEMME VIEILLISSANTSJEAN-CLAUDE EMPERAIRE(FRANCE)The age related decline in androgen production is much similar in both sexes, and may finally induce a Partial Androgen Deficiency inAging Males (PADAM) a swell as a Female Androgen Deficiency Syndrome (FADS); the latter is not influenced by the onset of naturalmenopause, but is hastened by bilateral oophorectomy.PADAM and FADS share most of their characteristics:1° - main clinical symptoms (diminished well-being or dysphoric mood, persistent unexplained fatigue, sexual dysfunction with loss oflibido) are multi-factorial and non specific, and quite all the proposed Evaluation Charts or questionnaires have their pitfalls.2° - Biological data are also questionable. Total plasma testosterone is not contributive and its biologically active fractions must beindividualized. Direct determination of free testosterone is usually not valid through the available commercial kits, and is bettercalculated from the levels of total testosterone and Sex Hormone Binding Globulin (SHBG).Biovailable testosterone may finally represent the best approximation of the individual androgenic status provide the ammoniumprecipitation technique is issued. Another difficulty is the determination of the physiological values: although this remains a matter of114

debate, the normal ranges for the reproductive age (20-40 years) is usually taken as references because the data in healthy individualin each category of age scarce.3° - Both clinical symptoms and biological evidence should be present to validate the diagnosis of and androgen deficiency; insituations where doubt remains, and in the absence of contra indications, a trial for 3 to 6 months with testosterone may be initiated.Prospective studies are now available that show benefits of testosterone treatment despite a strong placebo effect.Testosterone therapy showed significant progress in the last few years: subcutaneous pellets, intramuscular injections and even oraladministration are being replaced by transdermal forms, especially patches that ensure stable testosterone levels within thephysiological limits.Long terms are still lacking, however, to assess the safety and adverse effects of testosterone administration, especially in women.SESSION 19AAGLOBAL WARMING AND RISKY ENVIRONMENT: HOW TO AVOID THE PREMATURE AGING?RÉCHAUFFEMENT CLIMATIQUE ET ENVIRONNEMENT À RISQUES: COMMENT EMPÊCHER LE VIEILLISSEMENT PRÉMATURÉ ?CHAIR: MARIO KRAUSE ANTI-AGING MEDICAL DOCTOR (HANNOVER, GERMANY)THIERRY HERTOGHE ANTI-AGING MEDICAL DOCTOR (BRUSSELS, BELGIUM)2.00 pm / 14h00EFFECT OF CELL PHONES ON THE BRAIN: A PROTECTIVE DEVICEEFFETS DU TÉLÉPHONE CELLULAIRE SUR LE CERVEAU : UN DISPOSITIF PROTECTEURCAREEN SCHROETER(THE NETHERLANDS)Introduction: There is increased interest in the use of cell phones and its effect on the human brain. The brain is a sensitive organand highly susceptible to the electromagnetic field. There is public concern that using mobile phones with a latency period of morethan 10 years could increase the risk of brain tumours.Aim: In this preliminary study, brain mapping technology was applied in order to investigate the effects of mobile phones on the electroencephalographicactivity in humans with and without a protective device.Method: Thirty patients, twenty-one females and nine males, were randomly selected in the Medical Center Maastricht, theNetherlands. Quantitative EEG (QEEG) was applied, using multichannel measurements which can better determine spatial structuresand localize areas with brain activity or abnormality.Results: Our study shows generally high electromagnetic frequency alpha values with eyes closed compared to eyes open. With eyesclosed, the baseline value of the absolute power of the alpha frequency is 51+/- 3.1 µV≈, using mobile phones the absolute power ofthe alpha frequency decreases to 43+/-3.1 µV≈, applying the protective chip the alpha frequency returns back ( 51.9+/-0.4 µV≈ ).As illustrated in Figure 3a an increased delta activity was demonstrated within the left hemisphere and in F4/F8 site without theprotective system. In Figure 3b a significant reduction of the delta activity could be demonstrated with the protective chipFigure 3aFigure 3bANTI-AGING MEDICINEGLOBAL WARMING AND HEALTH: THE EVIDENCESRÉCHAUFFEMENT CLIMATIQUE ET SANTÉ : ÉTAT DES LIEUXBETTINA MENNE(ITALY)ENVIRONMENT ILLNESS: LATEST DATAMALADIES ENVIRONNEMENTALES : LES DERNIERS CHIFFRESMARIO KRAUSE(GERMANY)XENOHORMONES: HOW TO DEAL WITH?XÉNOHORMONES : COMMENT AGIR ?LENNART HARDELL(SWEDEN)Xenohormones or endocrine disrupters are exogenous substances that cause adverse health effects in an intact organisms.These chemicals are man made and released to the environment. Most of them are liophilic, they enter the ecological system and arestored in the body in adipose tissue. Examples of such environmental contaminants are dioxins, PCBs, DDT and pentachlorophenol.Also other chemicals are of concern such as bisphenol A and polybrominated flame retardants (PBDE). Xenohormones may interferewith the normal hormone regulation resulting in diminshed fertility, altered sex differentiation, changes in behavior and altered celldifferentiation leading to increased occurrence of cancer. The testicular dysgenesis syndrome includes birth defects such as115

hypospadia and cryptorchidism, reduced sperm quality and increased risk of testicular cancer. Results supporting the testiculardysgenesis syndrome will be presented from a study on concentrations of certain xenohormones in mothers to young men withtesticular cancer. Other hormone dependant malignancies that have been associated with xenohormones include breast, uterine andprostate cancer. Certain xenohormones such as dioxins and PCBs may also impair the immune system and have been associatedwith an increased risk of non-Hodgkin lymphoma (NHL).An increased risk of NHL has been found in patients on immunosuppressive drugs. Also these results will be presented in more detail.HUMAN BEING, ENDANGERED SPECIES: THE EFFECTS OF ENDOCRINE DISRUPTORS ON FERTILITYLA RACE HUMAINE EN DANGER : LES EFFETS DES BLOCAGES ENDOCRINIENS SUR LA FERTILITÉMARIO KRAUSE(GERMANY)INFLAMMATION AND TOXICITY DUE TO METALS : AN IMPORTANT FACTOR OF PREMATURE AGINGINFLAMMATION ET TOXICITÉ DÛES AUX MÉTAUX : UN FACTEUR IMPORTANT DU VIEILLISSEMENT PRÉMATURÉVERA STEJSKAL(SWEDEN)The pollution of the human body with metals is external (through the environment) and internal (through dental fillings, orthopaedicimplants and mercury and aluminium-containing vaccines and pharmaceutical preparations).Cigarette smoke contains many metals, such as mercury, cadmium, lead, arsenic and nickel and this is one of the reasons whysmoking habits are correlated to many degenerative diseases and cancer. Metals affect the body in two ways, as toxins and asinducers of inflammation. The first mechanism operates in all exposed individuals and as an example serves binding of heavy andtransitional metals to energy fabric of the body-mitochondria thus upsetting energy of the cell. Inflammatory potential of metals is morespecific, it operates only in certain genetically vulnerable individuals.Usually these patients do not tolerate skin contact with nickel-containing items such as cheap earrings and jeans buttons. The basisof inflammation is so called cellular type of hypersensitivity, a type of allergy. Allergy to metals is not only a local phenomenon (suchas swelling of earlobes upon contact with cheap earrings or eczema under the jeans buttons, but it is systemic, and it can be expressedin all parts of the body. Metal-induced inflammation may be involved in the pathology of allergic and autoimmune diseases (such aspsoriasis, eczema), neurological diseases such as multiple sclerosis, collagen diseases (rheumatoid arthritis, systemic lupuserythematosus, Sjögren's disease) and psychiatric diseases (depression, epilepsy). Metal-induced pathology is also indicated incardiovascular diseases and as a cofactor behind so called aseptic loosening of metal hip and knee implants. Metal allergy can bemeasured in vivo by skin test (patch test) and /or by blood test (LTT-MELISA ® ) test.When the presence of allergy is demonstrated, the removal of allergy-causing substances is indicated, such as avoidance of nickelcontainingearrings, and in the case of dental materials, replacement of amalgam or metal crows with non metallic restorations.This procedure combined with other anti-inflammatory treatments such as supplementation with anti-oxidants and omega 3 fatty acidsand the application of progesterone cream will result in decreased inflammation and better health.SESSION 20AANUTRIENTS IN THE SERVICE OF AGE AND SKIN: LATEST SCIENTIFIC EVIDENCELES NUTRIMENTS AU SERVICE DE L’AGE ET DE LA PEAU : LES DERNIÈRES DONNÉES SCIENTIFIQUESCHAIR: JEAN-PAUL MARTY UNIT OF DERMOPHARMACOLOGY AND COSMETOLOGY,FACULTY OF PHARMACY (CHÂTENAY-MALABRY, FRANCE)2.00 pm / 14h00ANTI-AGING MEDICINEPOLY UNSATURED FATTY ACIDS (PUFA) AND THE SKINACIDES GRAS POLYINSATURÉS ET PEAUTONY RAWLINGS(UK)Nutrients are obviously vital for dermatological functioning and polyunsaturated fatty acids (PUFAs) are no different to any othernutrient in this respect. However, they do are some important actions that are essential for skin functioning. For instance, crosssectional studies have shown that higher intakes of linoleic acid are associated with a lower likelihood of senile xerosis and skinatrophy. Nevertheless, both omega-3 and omega-6 fatty acids are important.The omega-6 classes are vitally important for skin barrier function and linoleic acid, especially, plays a key structural role in theacylceramides of the stratum corneum barrier lipids regulating the water permeability barrier characteristics. Age-related (and diseaserelated)reductions in the linoleate content of acylceramides are known resulting in impaired barrier characteristics.Moreover, as keratinocytes lack the delta-5 and delta-6 desaturase enzymes, gamma-linolenic acid is also vital for epidermaldifferentiation.FUNCTIONAL FOODS AND DERMONUTRITION: ESSENSIS ®ALIMENTS FONCTIONNELS ET DERMONUTRITION : ESSENSIS ®TAOUS LASSEL(FRANCE)The skin is an outward sign of inner health and well being. Providing protection is certainly one of the most important function of theskin functions. As a protective barrier, the skin must prevent water loss and protect against pathogen and foreign substances enteringthe body. One of the primary layers that provide this protection is the stratum corneum (SC). Lifestyle changes such as ageing, andenvironmental factors, in particular cold weather, can impair the functioning of this barrier through alterations to the composition of the116

lipids which make up the SC.Under such circumstances, transepidermal water loss levels may be elevated and the natural moisture barrier may be moresusceptible to irritation or to the development of dry skin. It is now well established that good skin condition is dependent upon nutrientsin the diet. Interestingly some nutritional factors could help to improve skin barrier such as fatty components (fatty acids, vitamin E)that helps to improve the natural moisture barrier of the skin and or keratinocyte cellular differentiation which in vitro improve SC barrierfunction. Essensis is a fermented dairy product specifically formulated with borage oil, green tea extract and vitamin E to improve skinbarrier function as part of a healthy diet. Essensis addresses the healthy population -globally and from a dermatological perspective.More precisely this product is the global population.A MOISTURIZING / ANTI-AGINGACTIVITY OF LUTEIN: RESULTS FROM A DOUBLE-BLIND CLINICAL STUDYEFFETS HYDRATANT ET ANTI-AGE DE LA LUTEINE : RÉSULTATS D’UNE ÉTUDE CLINIQUE EN DOUBLE AVEUGLEPIERFRANCESCO MORGANTI(ITALY)The introduction of a new generation of cosmetic and dietary products that can truly prevent or reverse signs of photoaging, anddirectly modify the metabolic activity of the skin, and the speed of its extracellular renewal, are growing year by year. These productsblend the visual improvement of skin appearance generated by a cosmetic or a diet supplement with the treatment function of a drughencethe name of Cosmeceutical and Nutriceutical .Moreover demand is growing for multifunctional products that offer excellent efficacy, but that can reduce the time spent on groomingto a few minutes per day. In addition, consumers still ask for safe and natural ingredients in their products, but want also both cosmeticand diet supplement that have an image based on scientific soundness and pure ingredients.For these reasons, customers want also to know more about products-how they are made, what they contain, the constitution of thepackaging, and the integrity and reputation of the manufacturing companies themselves.However, both ingredients and products, whatever natural or chemical-must be rigorously controlled with respect to both safety andefficacy. At this purpose, recently new cosmeceutical ingredients have been developed and studied. They include lutein, because ofits high water binding and antioxidant capacity, and the biopolymer chitin nanofibri, which can easily deliver the active compounds tothe epidermis and/or dermis.The quality and, therefore, the efficacy of today's natural lutein, is, in fact, much improved due to more sophisticated harvesting,purification, processing, and quality control methods. For the same reasons, the chitin'nanofibril, for its high purity, may be used ascosmetic / drug carrier to speed up the rate of penetration of active molecula, but may be also useful as cell recovery nutrient thatenhances the rate of DNA repair following sun exposure, or as moisturizing agent for its water retention capacity.Results: the results obtained indicate that the combined oral and topical administered lutein provides the highest degree on antioxidantand moisturizing protection. However, both the separate oral and topical administration of this oxycarotenoid also provide significantactivity in the skin.Additionally the use of chitin nanofibrils as carrier ameliorates the transcutaneous skin penetration, meanwhile the antiaging activity oflutein is synergized by the use of melatonin and hyddrolized collagen (gelatine).This and other obtained results will be reported and discussed.REFERENCESMorganti P. (2007) Where nutriceuticals meet cosmecuticals, J. Appl. Cosmetol., 25:111-120Mattioli-Belmonte M, Zizzi A, Lucarini G, Giantomassi F, Biagini G, Tucci G, Orlando F, Provinciali M, Carezzi F, and Morganti P. (2007) Chitosan-linkedto chitosan glycolate as Spray, Gel, and Gauze Preparations for Wound Repair, J . Bioactive and Compatible Polymers, 22: 525-538Morganti P, Sousa Martins D, and Morganti G. (2007) Luteina. Un nutriente cutaneo, Integr Nutr, 10 (3): 15-21; Cosm. Technology, 10(5): 11-16Morganti P. (2007) Beauty from inside out , Nutracos, VI (4): 5-8Muzzarelli R.A.A. Morganti P. Morganti G. Palombo P. Palombo M. Biagini G. Mattioli Belmonte M. Giantomassi F. Orlandi F. and Muzzarelli C. (2007)Chitin nanofibrils/chitosan composites as wound medicaments, Carbohydrate Polymers 70: 274-284Morganti P, and Morganti G. (2007) Fotoprotezione e Luce Blu, Cosmetic News, anno XXX n. 175:225-228Morganti P, and Morganti G. (2007) Cosmeceutical and Nutraceuticals to age well, Eurocosmetics, 15 (6): 6-10Morganti P. and Morganti G. (2007) Nanotechnology and Wellness , SOFW-Journal 133(5): 22-26Morganti P, Morganti G, Muzzarelli R.A.A and Muzzarelli C. (2007) Chitin nanofibrils: a natural compound for innovative cosmeceuticals, C&T USA, vol122, No4 : 81-88Morganti P, and Morganti G. (2007) Carotenoids and vitamins to prevent photodamage and skin aging, Eurocosmetics, 15 (3): 10-17Palombo P, Fabrizi G, Ruocco V, Ruocco, Flühr J, Roberts R, and Morganti P. (2007) Beneficial long-term effects of combined oral/topical antioxidanttreatment with carotenoids lutein and zeaxanthin on human skin: A double-blinded, placebo-controlled study in humans, Skin Pharmacol & Physiol,20:199-210ANTI-AGING MEDICINESESSION 21AAFITNESS MEDICINE: HOW TO INCREASE ENERGY AND QUALITY OF LIFE?MÉDECINE PHYSIQUE : COMMENT AMÉLIORER SA QUALITÉ DE VIE ET ÊTRE EN PLEINE FORME ?CHAIR: CLAUDE DALLE ANTI-AGING MEDICAL DOCTOR (PARIS, FRANCE)ADRIAN SLEE NUTRITIONAL MEDICINE DOCTOR (LONDON, UK) MALABRY, FRANCE)3.00 pm / 15h00MINERAL AND MULTINUTRIENT SUPPLEMENTS THAT IMPROVE FITNESSLES SUPPLÉMENTS MINÉRAUX ET MULTINUTRITIONNELS QUI AMÉLIORENT LA FORMEERIK-ALEXANDER RICHTER(THE NETHERLANDS)117

THE AGE-RELATED LOSS OF MUSCLE MASS AND POTENTIAL THERAPEUTIC DIETARY INTERVENTIONSPERTE DE MASSE MUSCULAIREAVEC L’ÂGE ET INTERVENTIONS DIÉTÉIQUES THÉRAPEUTIQUESADRIAN SLEE(UK)The Age-Related Loss of Muscle Mass and Potential Therapeutic Dietary InterventionsAging is associated with a progressive loss of neuromuscular function which may lead further to physical impairment and disability.Studies indicate that there is a characteristic loss of skeletal muscle mass (atrophy) and strength in both men and women, associatedwith aging, termed 'sarcopenia'. In addition, both aging and sarcopenia may directly and indirectly increase the potential for thedevelopment of obesity and type 2 diabetes.The potential mechanisms leading to the development of sarcopenia are complex, multi-factorial and currently being elucidated.A reduction and/or deficiency in physical activity, calorie and protein intake and the altered production of anabolic and catabolicmediators and hormones have been suggested. Potential factors implicated include the age-associated reduction in sex steroids(androgens and estrogens), growth hormone (GH), insulin-like growth factor (IGF) -1 and loss of motor units, with a concomitant risein catabolic and inflammatory-immunologic factors (including pro-inflammatory cytokines). Other correlations recently describedinclude IGF-2 genotype polymorphisms, low vitamin D status and high parathyroid hormone.Studies further indicate that molecular and cellular pathways which regulate muscle protein turnover are less responsive in aging.However, specific nutritional (including essential amino acids), hormonal (including testosterone and GH) and exercise (resistancetraining) interventions may positively alter skeletal muscle protein turnover potentially in a synergistic manner favouring an increaseand/or partial restoration in muscle mass and function.Nutritional interventions may include those which potentiate the endogenous production of anabolic mediators and reduce theproduction of catabolic and inflammatory types and oxidative stress. High protein and 'paleolithic-type' dietary interventions designedto increase intake of natural foods high in essential and sulphur-containing amino acids, anti-oxidants (in vegetation), immunemodulating fatty acids (omega-3/fish oils), creatine (in meat and fish) and micronutrients (including vitamin D, zinc) may providetherapeutic benefits.ACID BASE MEDICINE FOR BETTER ENERGY AND ENDURANCEPLUS D'ÉNERGIE ET D'ENDURANCE EN RÉTABLISSANT L'ÉQUILIBRE ACIDE-BASEJOHN van LIMBURG STIRUM(SWITZERLAND)Physical activities can range from ballet, sprinting, marathon to weight lifting. Each situation demands on our corporal resources in aunique manor. The delivery of energy must adapt accordingly.The prime differentiation lies in the utilization of oxygen in the delivery of sufficient ATP, the energy currency of our body.Anaerobic ExerciseHigh impactShort termMore muscle massAerobic ExerciseLow impactLong termLess muscle massFor these diverse types of work outs our body possesses three sources of energyATP-PCr Energy SystemLactic Acid Energy SystemOxygen Energy SystemANTI-AGING MEDICINEThese systems will be utilized depending on the type of sports activity involved:Anaerobic training without lactate productionAnaerobic training with lactate productionAerobic training with lactate productionAerobic training without lactate productionAnaerobic training without lactate production: ATP is stored in creatine as creatine phosphate. Creatine can be regarded as thecellular ATP buffer. When suddenly a great deal of energy is necessary, creatinine phosphate will rapidly regenerate ADP to ATP. Theby product of ADP is H2PO4. This compound can accumulate and cause local acidification. The systemic bicarbonate will not berelevantly challenged. This type of exercise has a usual duration up to 30 seconds.Anaerobic training with lactate production: If exercising lasts up to 2 - 6 Minutes the creatinine phosphate reserves will be depleted.The cells start to metabolize glucose to form pyruvate that in turn will be further transformed to lactate. This reaction will deliver anadditional two ATP per molecule of glucose. Lactate diffuses readily out of the cell into the blood stream and the bicarbonate levelswill decrease. In these cases an alkalization can be useful in improving performance.Aerobic training with lactate production: In endurance sports lasting longer than 6 minutes aerobic and anaerobic energy systemsare usually combined.Aerobic training without lactate production: In this case pyruvate enters the mitochondria and is transformed to Acetyl CoA whichenters the cyclic acid cycle in order to deliver energy (NADH) for the proton motor force and ATP synthesis. CO2 leaves the cell andby its hydration to H2CO3 and dissociation to HCO3 the bicarbonate levels usually are not significantly affected or may even rise.Sufficient supply of acidic protons in the intermembrane space is crucial for the mitochondrial ATP production as well as the thyroid118

hormone T2 and calcium. Because the bicarbonate levels are usually not lowered, alkalization will not improve performance underthese circumstances.Supplements to enhance energy and enduranceCoenzyme Q10Iron (Ferritin > 100ug/L)B1,2,3PhosphateMagnesiumManganeseLipoic acidSodium bicarbonate: This supplement is appropriate in short and intensive training ranging from 30 seconds up to 6 minutes. Thiswould be the equivalent of a 400 - 800m run or body building with a high volume and low weights. The application is about 200 - 300mg/ Kg, 120 - 30 minutes before training onset. When it comes to aerobic energy production never forget that alkalization can move theoxygen dissociation curve to the left, leading to poorer oxygen delivery and inefficient lactate ATP production pathway.Potassium phosphate: Phosphates are widely engaged in metabolism: ATP-Production, creatine phosphate, oxydativephosphorylation, glycogen breakdown, as well as lactate buffering. Therefore this supplement is useful for all types of sports: 1'000mg- 4'000mg before training.Water: With the loss of sweat the blood osmolarity may rise and develop a hypertonic dehydration. This in turn will lead to contractionalkalosis. It is therefore crucial to supply sufficient isotonic or hypotonic solution not only to replenish the fluid balance but also toneutralize (acidify) the alkalisation that in turn can inhibit efficient mitochondrial ATP production.Plasma Bicarbonate and Age: According to Frassetto L and Sebastian A, bicarbonate levels start to decline beyond the age of 50.That means that our buffering capacity will shrink accordingly. Mitochondrial support is therefore increasingly essential. A regularbedtime dose of an alkalizing agent may be helpful as well. But most of all, remind the elderly to drink sufficient and clean water, asthirst becomes rare as we age. Also keep in mind that seniors usually consume numerous allopathic medications. These canpotentially influence the acid base household:Causes for Metabolic AcidosisAntiepilepticsCarboanhydrase-inhibitorsKClMethioninPhenformin,SalicylatesTricyclic antidepressantsCauses for Metabolic AlkalosisLaxativesAntacidsCalcium antagonistsPotassium saving diureticsLithiumNSAID'SMetforminSRIDiureticsSteroidsThe best way to reliably evaluate the acid base household in clinical practice is the Venous Blood Titration Assessment. Moreinformation on this method can be found on www.komstar.chSESSION 22AAONCOLOGY: HOW TO LIVE LONGER DESPITE CANCER?ONCOLOGIE : COMMENT VIVRE PLUS LONGTEMPS MALGRÉ UN CANCER ?Chair: LEV BERSTEIN PROFESSOR OF ONCOENDOCRINOLOGY (ST PETERSBURG, RUSSIA)PETER LIM PROFESSOR OF UROLOGY AND ANDROLOGY (SINGAPORE)ANTI-AGING MEDICINE4.30 pm / 16h30OXIDATIVE STRESS AND CANCER – ANTIOXIDANT THERAPYSTRESS OXYDATIF ET CANCER - TRAITEMENTS ANTIOXYDANTSSERGE JURASUNAS(PORTUGAL)Introduction: Today considerable evidence supports the contention that excessive oxidative stress interfere with the cytotoxicity ofantineoplasic agents and cancer cells that also induce middle to intolerable side effects. Oxidative stress increases with theadministration of antineoplasic agents, a large body of preclinical and clinical evidence suggest that dietary antioxidantssupplementation can influence the response to chemotherapy, reducing side effects, increasing Quality of Life and overall increasingthe percentage of effectiveness.Chemotherapy induces oxidative stress often mediated by increasing ROS activity (and the cancer itself) that may interfere with theeffectiveness of antineoplasic agents. Chemotherapy may influence the cell's progression of the membrane (lipid peroxidation) incancer cells that prolong the GI phase and therefore decrease the proliferation rate which cause failure in the treatment. Inhibition ofcaspases due to oxidation can also impair apoptosis and increase tumor resistance while antioxidants modulate ROS activity andtherefore protect membrane structure and gene expression.Oxidative stress may also activate inflammatory mediators such as cyclooxygenase 2 (COX 2) overexpressed in many cancer that inturn induce angiogenesis, MMP's down-regulate apoptosis impair immune defense and increase tumor resistance to chemotherapy.Cyclooxygenase 2 (COX 2) become a new target in the treatment of cancer and inhibitors of COX2 a new class of anticancer agents.Antioxidants have potential to improve the efficacy of chemotherapy and prevent adverse effects through the following mechanisms.Oxidative stress status assessment3 methods:119

Peripheral blood assessmentOxidative urine test (oxidata)Free Oxygen Radical Monitor Test (FORM)- Reduce or prevent from excessive ROS activity, minimize adverse effects- Reduce or prevent lipid peroxidation, thereby increasing the proliferation rate of cancer cells to improve the efficacy of chemotherapy- Selectively induce apoptosis over necroses- Inhibit cyclooxygenase 2 (COX2) activity inhibit angiogenesis- Stimulate or restore the immune systemThe antioxidant treatment: For over 15 years we use a new low molecular antioxidant compound 100% natural, as dieteticsupplementation, made from active small molecules extract from modified vegetables herbs and seed under an innovative processthat are rich in antioxidant but poorly absorbed by the body before the procedure. The antioxidant compound presented in sachet ofgranule for oral intake contain vitamin A, C, E, beta-carotene, catalase, glutathione, catechin, tannin highly effective against ROSactivity and with pharmalogical effects. The antioxidant compound (Anoxe) demonstrates in vitro, in vivo strong property to neutralizeROS activity. Strong anti-inflammatory property, inhibit COX 1, COX 2 activities.Furthermore the antioxidant compound prevents or eliminates lipid peroxidation, platelets aggregation in blood circulation which isobserved through peripheral blood analysis.Conclusion with 2 examplesReferences:1 - Shacter E. Williams - J.A., Hunson et al: Oxidative stress interfere with cancer chemotherapy: Inhibition of lymphoma cell apoptosis andphagocytosis.Blood - July 1 - 96 (1) 307-313.2 - Conklin K.A. - Chemotherapy associated oxidative stress.Int.Cancer Thu 2004 (4) 294-299.3 - Brown NS and Bickwell R. - Hypoxia and oxidative stress in breast cancer: oxidative stress its effects on the growth, metastasic potential andresponse to therapy of breast cancer .Breast Cancer Res. 3 - 2001 - 323-327.4 - Gasparini G. , Logo R., Sarmento R. and Mariboto A. - COX2 inhibitiors in câncer therapy.Lancet Oncol. 2002 - vol.4 - 606-607.5 - Conklin K.A. - Dietary antioxidants during cancer chemotherapy: impact on chemotherapy effectivenessand development of side effects.Nutr. Cancer 2000 - 317-318.www.sergejurasunas.comANTI-AGING MEDICINEENDOCRINOLOGY OF AGING AND CANCER: ROLE OF ENDOCRINE-GENOTOXIC SWITCHES; PREVENTIVE POTENTIALENDOCRINOLOGIE DU VIEILLISSEMENT ET CANCER : RÔLE DES CHANGEMENTS ENDOCRINO-GÉNOTOXIQUES ;POTENTIEL PRÉVENTIFLEV BERSTEIN(RUSSIA)Aging is considered as a factor leading to the increase in incidence of cancer as well as several other main non-communicablediseases (NCD's). The apparent paradox of simultaneous increase with aging of NCD's connected with estrogen deficiency as well aswith estrogenic excess can be explained by the existence of the phenomenon of the switching of estrogen effects. The increase ingenotoxic action of estrogens (an isolated or combined with the weakening of their hormonal effect) can modify the course of ageassociatedpathology. Aforementioned changes in estrogen effect may alter the biology of tumors to make them less favorable/moreaggressive. Two other endocrine-genotoxic switchings (EGS) involving phenomena of dual function of glucose and adipogenotoxicosismay produce similar influences on tumor and other NCD's biology. Mentioned three phenomena forming a 'basic triad' can actindependently of each other or in concert. EGS and their inductors may serve as targets for prevention and, probably, treatment ofage-associated non-communicable diseases.The preventive measures has to be aimed to optimally orchestrate the balance between endocrine and DNA-damaging effects ofestrogens, glucose and adipose tissue-related factors (in general population and in carriers of some germ-line mutations as well), andinclude among other approaches stimulators of AMP-kinase, inhibitors of fatty acid synthase, certain antigenotoxicants and stimulatorsof DNA repair.This study was supported in part by RFBR grants 06-04-48159 and 07-04-00732.120

NEW CANCER POLYMORPHISM TO SPOT AND IMPROVE ANTI-AGING THERAPIESLE NOUVEAU POLYMORPHISME DU CANCER POUR DÉCOUVRIR ET AMÉLIORER LES THÉRAPIES ANTI-ÂGEHELENA BARANOVA(FRANCE)Recent progress in genetics and genomics opens new opportunities for clinical usage of genetic data. However, despite tremendousnumber of studies and publications only around 4 % of all obtained results can be considered as clinically reliable and possible totransfer to practice.This presentation is focused on the recent achievements in relation to genetics of cancer, the necessity of EBM (evidence basedmedicine) usage and possible practical outcome. Special attention is paid to understanding of deference and management strategiesfor inherited and environmentally induced cancers. Prostate cancer example will be demonstrated.Furthermore, epigenetics and epigenomics impacts in cancer development and management are particularly highlighted.New possibilities for personalized prevention approaches based on recent genomics achievements are especially discussed.Finally, modern vision of aging through genomics will be presented, including the new therapeutic opportunities for anti-aging medicine.THE CANCER IS A FUNGUSLE CANCER EST UN CHAMPIGNONTULLIO SIMONCINI(ITALY)From about 100 years the theory on cancer is based on the hypothesis that there is a malfunctioning of the genes. This point of viewimplies that the cancer is an intracellular fact.On the contrary, my point of view is that cancer is an infection, a fungal infection, that is an extracellular phenomenon.As in the world of the plants, where the cancer is due to a fungal invasion, it is possible to argue the same thing for the human beings.Fungi are always involved in the cancer and they are found in vivo and in the post-mortem examination, but scientists think that theycome on just after the illness. My opinion is that they come before, produce the cancer, blunt the immune system then invadecompletely the organism.Every kind of cancer is caused by candida species fungi and the histology configuration is the defence reaction of a tissue againsttheir invasion. By the time, the tissue gets exhausted and produces only undifferentiated cells.The cancer could be named a "solid abscess" where the colonies are inside and host cellular reaction is all around.Usual antifungal drugs are ineffective in the tumours because the solid colonies can be attacked only on the surface of their volume,and after the first administrations they become resistant.A solid infection is much more powerful than a bacterial one, that's why simple fungal infections can last forever.At the moment the only substance that I found, able to penetrate the volumetric infections is the sodium bicarbonate for the cancer ofinternal organs; for skin cancer the iodine tincture (peculiarly spread on) is the best substance to eliminate themThere are many works that show the effectiveness of sodium bicarbonate on cancer, but their conclusion are wrong because theyassume an intracellular action, instead of an antifungal one.It takes more than 20 years that I cured people with my method and many patients healed completely from cancer even in the casesthe official oncology gave up. Many videos in my website www.cancerfungus.com show many patients that are testimonial of theeffectiveness of my therapy.The best way to try to eliminate a tumour is to put it in contact with sodium bicarbonate as close as possible, with oral administrationfor the digestive tract, with enema for the rectum, with washing out for the vagina and uterus; intravenously for the lung and the brain,with inhalation for the upper airways.Breast, lymph nodes and under skin lumps can be treated with local perfusions.The internal organs can be treated with sodium bicarbonate by locating suitable catheters in their arteries (liver, pancreas, prostate,limbs) or in the cavities (pleura, peritoneum).It is important to treat every kind of cancer with the right dosage, 500 cc 5% or 8,4% for the administrations in vein, artery and in thecavities.Every treatment has to consider that tumour colonies regress from the 3dh to the 4th day and collapse from the 4th to the 5th day, sothat a 6 day administration is enough.A complete effective cycle is made of 6 days on 6 days off treatment, repeated 4 times.The most important side effects of this care system are thirst and tiredness.In conclusion, sodium bicarbonate is really effective against the tumours and harmless as well, it should always administered to everycancer patient.ANTI-AGING MEDICINEDOES TESTOSTERONE CAUSE PROSTATE CANCER? THE EVIDENCE PRO AND CONTRALA TESTOSTERONE CAUSE-T-ELLE LE CANCER DE LA PROSTATE ? LES PREUVES POUR ET CONTREPETER LIM(SINGAPORE)When aging men receive testosterone replacement therapy (TRT), the primary concern is prostate safety especially the possibility ofstimulating prostate cancer. Although TRT results in modest elevations in prostate specific antigen (PSA) and minor changes inhaematocrit & urinary flow parameters, "there is no evidence that normal levels of testosterone promote the development of cancer ofthe prostate".However, it is clear that the administration of testosterone enhances a pre-existing prostatic malignancy. Since instances of prostatecancer in men receiving TRT reported in the past, careful monitoring for prostate disease is considered mandatory for men on TRT.This is currently our traditional view. Is there anything new to challenge our concepts pertaining to safety issues in TRT?Feneley and Carruthers recently reviewed 1500 hypogonadal men with a mean age of 54 years. Twelve had an abnormal PSA orabnormal DRE at screening and were found to have cancer. And of the rest, only seven in 2100 man years of follow up were diagnosedwith prostate cancer based on a change in PSA, or rectal examination-and all 7 of these had clinically localized disease.121

In 2006 two papers in the Journal of Urology looked at testosterone levels in men who were diagnosed with prostate cancer. Whatthey found was that low serum testosterone seemed to be associated with worse pathological staging.Massengill et al, J Urol, 2003 reported 879 men who had radical prostatectomies and had a preoperative testosterone drawn. Whatthey found was that patients with non-organ confined disease, T3 and T4, had lower mean testosterone levels than men with organconfineddisease.In Vienna, 39 men were looked at after their radical prostatectomy in terms of histologic parameters that might have indicated a worseprognosis. Of the 39 men, 16 had a testosterone level below 300, and 23 had a testosterone level of above 300. What was found wasthat parameters such as microvessel density, and androgen receptor density, were correlated with the testosterone level.That is, men with the lower testosterone levels were more likely to have these adverse findings. More importantly in the lowtestosterone group, the Gleason score was 7.4, and in the normal testosterone group it was 6.0 indicating more adverse picture inthose with low serum testosterone. With respect to PSA changes in men younger and older than age 50 there is initially a very smallincrease, and then over the next 36 months very minimal changes well within the normal range. Hence there appears little effect onPSA. Looking at PSA changes in men over the age of 50, again the PSA numbers were a little higher, but still well within the normalrange.Concerning testosterone and BPH, treating hypogonadal men with testosterone had little effect on BPH symptoms, PSA prostate size,or uroflow. Applying the IPSS Score for patients with LUTS, due to BPH who were treated with testosterone patch/gel it was noted thatafter 90 days there is no change in any prostate symptom score.DHT is the most powerful naturally occurring androgen. In view of its higher biopotency (3-6 times) than of testosterone, side effects,particularly on the main target organ of androgens, the prostate, are anticipated. However, DHT appears to be a prostate sparingandrogen for two reasons. Unlike testosterone, it does not undergo any further amplification in biopotency through 5a reduction in theprostate.Secondly, it probably leads to less aromatization of testosterone to estradiol in the prostate, thus reducing local estradiolconcentrations. Estrogens have been implicated in the etiology of benign prostate hyperplasia and prostate cancer. Aromatization oftestosterone has appeared to be essential for maintenance of bone mineral density.While (high dose) administration of DHT reduces circulating estradiol levels, resulting plasma estradiol levels remain above levelscritical for the antiresorptive effect of estrogens on bone.An effect of DHT administration is the reduction of circulating levels of SHBG which leads not only to higher levels of free andbioavailable testosterone but also of estradiol. In view of the potential prostate sparing effects of DHT more studies should test thepotential of DHT for treating the physical and psychosexual symptoms of androgen deficiency as it occurs in a number of elderly menSaturday April 12 / Samedi 12 AvrilSESSION 23AAANTI AGING WORKSHOP 8 TESTOSTERONE THERAPY8.30 am / 8h30TESTOSTERONE THERAPY IN MENLE TRAITEMENT PAR TESTOSTÉRONE CHEZ L'HOMMEPETER LIM (SINGAPORE)ANNA MODELSKA ZOLKIEWICZ (POLAND)ANTI-AGING MEDICINEROOM / SALLE PASSYTRAITEMENT PAR TESTOSTERONEANTI-AGING MEDICINEIntroduction: Current treatment options include oral tablets or capsules, intramuscular preparations, both long and short acting,implantable long acting slow release pellets and transdermal patches, both scrotal and non-scrotal. Neither injectable preparations norslow release pellets reproduce the circadian pattern of testosterone production of the testes. This is accomplish best by the dermalpatches, although oral testosterone may also approximate a circadian rhythm by dose adjustments. Common Testosteronepreparations are:INJECTABLES:Testosterone cypionate (Depo-testosterone cypionate) 200 - 400 mg every 3-4 weeksTestosterone enanthate (Delatestry) 200-400 mg every 4 weeksNebido (testosterone Undecanoate) 1000mg every 3 monthlyORAL:Fluoxymesterone* (Halotestin) 5-20 mg dailyMethyltestosterone* (Metandren) 10-30 mg dailyTestosterone undecanoate (Andriol) 120-160 mg dailyTRANSDERMAL:Testosterone patch (Androderm) 6 mg. daily or (Testoderm) 10-15 mg./dayNB: 17 alkylated testosterone products both fluoxymesterone and methyltestosterone are associated with serious liver toxicityOral preparations of Testosterone require special consideration. Since most oral testosterone preparations undergo rapid hepaticmetabolism they may fail to establish satisfactory serum levels of androgens 56. Oral agents available include the alkylated (to preventrapid hepatic metabolism) androgen preparations which generally provide erratic androgenic effects, significant changes in lipid profile,and have a high risk of adverse liver side effects. The hepatotoxicity includes hepatocellular adenoma, cholestatic jaundice andhemorrhagic liver cysts. In addition, alkylated androgens may result in increased low density lipoproteins (LDL) and decreased highdensity lipoproteins (HDL) levels with resultant possibilities of increased cardiovascular risksTestosterone undecanoate is widely used throughout the world. As a testosterone ester (the only one effective by the oral route), it is122

free of liver toxicity and effective in bringing levels of serum T within physiological range. It may, however, result in supraphysiologicallevels of dihydrotestosterone and rarely gastrointestinal side effectsThe drug is lipid soluble and should be taken with meals. The recommended dose is 120 to 200 mg in 3 divided doses, depending onthe degree of Testosterone deficiency, body surface, obesity and clinical response.Intramuscular injections of Testosterone are usually long acting. These formulations obtain a maximum concentration at approximately72 hours after injection which slowly diminish over the ensuing 10 - 14 days. The gradual decline frequently results in a very low nadirprior to repeat injection. Parenteral androgens do not provide normal circadian patterns of serum testosterone and the injections aresomewhat uncomfortable. Levels of DHT are normal but androgen metabolites are frequently not physiological while estradiol levelsmay become excessive in some men. In the first few days after injection supraphysiological serum testosterone levels occur whichmay result, in breast tenderness or gynecomastia.Intramuscular testosterone may also be administered as unmodified aqueous testosterone in its most elemental form. This preparation,however, is rapidly absorbed and degraded, requiring frequent administration and is unsatisfactory for chronic Testosteronereplacement.More widely used preparations include the 17-hydroxyl esters of testosterone which are administered with slow release oil basedinjection vehicles.These esters, however, lack inherent androgenic activity and must be hydrolyzed to testosterone before they becomepharmacologically active. The 17-hydroxyl esters of testosterone most widely used include the short acting testosterone proprionateand the longer acting testosterone enanthate and cypionate. Testosterone propionate is rarely used clinically because of its short halflifeand requirement for every other day injection to maintain normal serum Testosterone levels. Testosterone enanthate and cypionate,however, may be administered every 10 - 21 days to maintain normal average testosterone levels. It must be acknowledged, however,that testosterone levels with these preparations surge to supraphysiological levels as high as 1400 ng/ml at approximately 72 hoursafter administrationThe decline in serum Testosterone continues over 14-21 days reaching baseline at approximately 21 days. The significant peaks andvalleys (roller-coaster effect) of serum Testosterone in patients treated with parenteral Testosterone injections may produce significantmood swings and noticeable ups and downs in libido and sexual function. These long acting Testosterone preparations are however,the most cost efficient methods for androgen replacement.Dosage is 200 -400 mg every 2 -4 weeks. 200 mg injections will maintain normal T levels for approximately two weeks while 300 mgdoses are required to maintain eugonadal range for approximately three weeks. Higher doses will not maintain Testosterone levels inthe normal range beyond the three week limit.Effects: These agents have clearly been demonstrated to improve libido, sexual function, potency, energy level, bone density andmood if these abnormalities are caused by androgen deficiency. Supraphysiological levels of serum Testosterone may result ininfertility due to suppression of FSH and LH production. Reports of sexual aggressiveness and overall aggressive behavior during peaklevels following injectable testosterone have been reported anecdotally.Careful counseling about the possibility of these mood and behavioral changes for patients undergoing short acting parenteraltestosterone therapy is essential. Long acting Intramuscular Nebido injections is more acceptable in this respect. Tan et al haverecently reported the effects of parenteral Testosterone on HDL levels in 11 men receiving 250 mg of Testosterone enanthate at fourweekly intervals. While these doses of Testosterone resulted in sub-optimal serum levels, no significant changes in plasma cholesterol,triglycerides, LDL, or HDL occurred. Injectable Testosterone has also been implicated in abnormal erythropoeisis and increasedhemoglobin levels and sometimes hypercoagulability. These changes, however, have not been demonstrated with newer transdermalpreparations. As discussed below, there is a justified concern about elevated testosterone levels in elderly men and associatedprostate specific antigen (PSA) elevations, increased prostatic size with associated obstructive symptoms and the activation of occultprostatic malignancy.While some increases in PSA and prostate specific membrane antigen (PSMA) as well as increased prostatic size have beendocumented, these changes are not statistically significantly different from untreated hypogonadal men. Similarly, PSA elevations havenot risen beyond normal clinical values.Transdermal Testosterone Therapy (TTT), a higher priced but more physiologic approach to testosterone replacement, has recentlybecome available worldwide.ANTI-AGING MEDICINETTT is available in both a scrotal and non-scrotal patches. These preparations utilize elemental Testosterone absorbed transdermallyto obtain normal serum Testosterone levels and reproduce the diurnal physiologic variations of Testosterone observed in normalhuman testosterone secretion.Patches are applied at bedtime with peak Testosterone levels achieved in the early morning and a nadir prior to patch replacement.The first patch available was a scrotal one that required weekly scrotal shaving and was difficult for some patients to apply and maintainin position for 24 hours. Patients with small rugated scrotums had difficulties with absorbing higher doses of Testosterone. The scrotalpatch, while obtaining normal physiologic Testosterone levels and normal estradiol levels, was demonstrated to have abnormally highdihydrotestosterone levels as a result of high concentrations of 5-alpha reductase in the scrotal skin. Transdermal patches are nowavailable for non-scrotal use and include the Androderm and Testoderm systems.These non-scrotal patches also maintain diurnal serum concentrations with normal estradiol and dihydrotestosterone levels. Whilemost patients can be treated with a single non-scrotal transdermal patch, some patients require more or less Testosterone replacementdepending upon deficiency and absorption characteristics. Morning Testosterone levels should be evaluated within 2 -3 weeks ofinitiating therapy to identify peak Testosterone levels.Serum evaluations of these patients should be carried out between 8 and 10 AM to determine the highest daily level of serumTestosterone produced by the patch. Because androgen levels with these systems do not increase beyond normal, it is unlikely thatthere will be detrimental changes in mood with transdermal preparations. While psychological effects have not been carefully studiedin a long term series, no cases of aggressiveness with the transdermal patch systems have been reported. Follow-up studies oftransdermal T replacement have, however, demonstrated an improvement in Testosterone levels associated with improved sexualfunction, libido, nocturnal penile tumescence (NPT) response, with maintenance of normal hematocrit, lipid profile, PSA levels, andprostatic volumes. Most common side effects of the dermal patches include the inconvenience of applying them and dermatitis,sometimes leading to significant chemical burns.Other Techniques: Numerous techniques for Testosterone delivery remain investigational. They include long acting implantablepercutaneous pellets, spheres, and microcapsules under study in Europe. These subcutaneous capsules are fused pellets ofunmodified testosterone implanted every 4 -6 months. Because these pellets require the use of a trochar or a minor surgical procedure123

to be administered, they are less appealing than other Testosterone preparations. Further development of these pellets to decreaseinvasiveness of administration and increase patient acceptance may lead to their use for long term Testosterone replacement therapy.Their longevity and difficulty in removing them if serious adverse events occur, makes the implants and microcapsules less attractivefor elderly patients.Swiss Oats & Homeopathic Preparations:A recent trial demonstrated that this helped elevate free testosterone levels in those who were deficient and the vitamins, iron & otheringredients in this food supplement restored symptoms in andropausal men by releasing Testosterone bound to SHBG. Anothersupplement from the Tribulus family was shown laboratorily to raise serum DHEA which is a precursor of testosterone.SESSION 24AAANTI AGING WORKSHOP 9 STEM CELLS9.30 am / 9h30THE USE OF STEM CELL XENO-TRANSPLANTATION AS A TREATMENT OF AGING DISEASESLA TRANSPLANTATION DE CELLULES SOUCHES COMME TRAITEMENT DES MALADIES LIÉES À L’ÂGEMICHAEL E. MOLNAR(USA)CELLULES SOUCHESWorld believes dis-information by the media that stem cell transplantation was born in U.S.A. in 2001 and that only human embryonicstem cell transplantation is the acceptable way to carry out such treatment. Physicians have been victims of the same fiction spreadby peer-reviewed medical journals.In reality animal fetal precursor stem cell transplantation was first reported at the meeting of French Academy of Sciences by Brown-Seguard in 1889. Medical historians established 1931 as the year of birth of the new medical field of cell transplantation in Switzerland.To-date 99.7% of over 5 million patients treated by stem cell transplantation in the world have been treated by animal fetal precursorstem cell transplantation without a single fatality.This treatment is safer than taking a small dose of aspirin providing stem cell transplants are prepared in accordance with regulationof U.S. FDA 'PHS Guidelines on Infectious Disease Issues in Xenotransplantation' of January 19, 2001 (Federal Register, Volume 66,Number 19, pages 8120 - 1) by a lege artis method such as that of Bio-Cellular Research Organization LLC. This method incorporatesprimary organ culture and assures that there is no need for immunosuppression following SCT treatment.In 1956 cell xeno-transplantation was crushed in U.S., and since that time there are no German medical textbooks or journals dealingwith cell xeno-transplantation available at any U.S. medical school library.In 1997 cell xeno-transplantation was nearly quashed in Germany (with a reversal in 2000 by German Supreme Court).All regulations about cell xeno-transplantation disappeared in Switzerland, country of birth for this therapy.Since SCT has always focused on treatment of incurable or no longer treatable diseases there have not been any grounds to considerSCT a dangerous competition to the existing dominance of health care by the pharmaceutical industry.Claims that only human embryonic stem cell transplantation is 'the stem cell transplantation' have been contrary to all scientific factsto-date since such therapy has been recognized for 75+ years by all cell xeno-transplantation experts as oncogenic and thus neverused in clinical practice.Animal fetal precursor stem cell transplantation has been used in clinical practice in many countries: start in Switzerland, followed byGermany, France, Italy, Spain, Netherlands, Argentina, Mexico, Costa Rica, U.S.A (until 1956), U.S.S.R., Canada, Malaysia, Thailand,Hong Kong, Indonesia No ethical problems were ever encountered and reported anywhere.The described confusion, and repeated moves to destroy such a valuable therapy, deserves clarification.This paper is an attempt to do that.ANTI-AGING MEDICINESESSION 25AAANTI AGING WORKSHOP 10 PRACTICAL SESSION ON HOW TO IMPROVE THE DIGESTIVE SYSTEM11.00 am / 11h00INTESTINAL MUCOUS MEMBRANELA MUQUEUSE INTESTINALEINTESTINAL MICROFLORALA MICROFLORE INTESTINALEMICHAEL CULP(UK)FRANCISCO GUARNER(SPAIN)SÉANCE PRATIQUE SUR L'AMÉLIORATION DU SYSTÈME DIGESTIFCHAIR: GEORGES MOUTONMARCEL ROBERFROID (BELGIUM)124The human gut is the natural habitat for a large, diverse and dynamic population of micro-organisms which over millennia have adaptedto live on the mucosal surfaces or in the lumen. The interaction between gut bacteria and their host is a symbiotic relationship mutuallybeneficial for both partners. The host provides a nutrient-rich habitat and the bacteria confer important benefits to the host. Functionsof the microbiota include nutrition (fermentation of nondigestible substrates that results in production of short chain fatty acids,absorption of ions, production of aminoacids and vitamins), protection (the barrier effect that prevents invasion by alien microbes), andimportant trophic effects on the intestinal epithelium and the immune system (development and homeostasis of local and systemicimmunity).Symbiosis between host and gut bacteria can be optimized by prebiotics. Inulin-type fructans have been shown to improve the

microbial balance of the intestinal ecosystem by stimulating the growth of bifidobacteria and lactobacilli. These changes have beenassociated with several health benefits, including the prevention of gastrointestinal and systemic infections in animal models and humanstudies.Inulin-type fructans induce changes of the intestinal mucosa characterized by higher villi, deeper crypts, increased number of gobletcells and a thicker mucus layer on the colonic epithelium. Bacterial antagonism and competition of bifidobacteria and lactobacilli withpathogens, as well as the trophic effects on the intestinal epithelium may explain the protective role of inulin against enteric infections.In contrast, studies with rats on a low calcium diet suggested a negative effect of prebiotics on intestinal barrier function. However, theadverse effect was clearly ascribed to the strong reduction of dietary calcium as it could be reverted by oral administration of calcium.The adverse effect of a low calcium diet on intestinal permeability has not been observed in humans. Inulin and oligofructose are nowbeing tested in human studies aimed at prevention of bacterial translocation in critical health conditions. Mixtures of probiotics andprebiotics including inulin or oligofructose significantly reduced the rate of post-operative infections in liver transplant patients.Finally, inulin and oligofructose have proven useful to prevent mucosal inflammatory disorders in animal models and in patients withinflammatory bowel disease.SESSION 26AAANTI AGING WORKSHOP 11 OPTIMAL BRAIN AGING ASSESSMENT12.00 am / 12h00EVALUATION CÉRÉBRALENEW APPROACHES TO THE DIAGNOSISAND TREATMENT OF NEURODEGENERATIVE DISEASES: THE EPIGNETIC/METABOLOMICC APPROACH, AMONG OTHERSNOUVELLES APPROCHES DIAGNOSTIQUESET THÉRAPEUTIQUES DES MALADIES NEURODÉGÉNÉRATIVES : L’APPROCHEÉPIGÉNÉTIQUE / MÉTABOLOMIQUELUIZA SPIRU - ILEANA TURCU - CAMELIA GHITA (ROMANIA)AMOS KORCZYN (ISRAEL)SESSION 27AAANTI AGING WORKSHOP 12 RELAXIN AND OXYTOCIN2.00 pm / 14h00RELAXINE ET OCYTOCINERELAXIN, THE NEW HORMONE: HOW TO TREAT WITH IT ?RELAXINE, LA NOUVELLE HORMONE : SON UTILISATION EN TRAITEMENTSAMUEL YUE(USA)Relaxin (RLX): Its anti-aging properties.Relaxin (RLX) is a peptide hormone of about 6000 kDa from the super insulin family of hormone. Its chemical structure resemblesinsulin. However, RLX and insulin are distinct in their phylogenetic evolution, receptor affinity and biological effects. RLX acts on itstarget by binding to specific G-protein-coupled receptors (recently classified as Relaxin Family Peptide [RXFP] receptors).Originally assigned to the field of reproduction and fertility, the other side of RLX long escaped both scientific and medical awareness.While researches have been ongoing since the 1950s, only from 1980s onward did researchers began to recognize RLX as a pleiotropichormone, with prominent biological effects on many targets other than the reproductive ones, including connective tissue remodeling(collagen modulation), inflammatory response, hemostasis, neuromodulation (including hormonal regulation), body fluid homeostasisand cardiovascular function. Experimental studies in animal models of disease have provided sound evidence that RLX could be acandidate for novel therapeutic strategies for ischemic cardiac and peripheral vascular disease, cardiac failure, organ fibrosis, preeclampsiaany many other diseases.ANTI-AGING MEDICINELuteal extractive porcine RLX, the only hormone available for long time, has had extensive safe usage in human from 1950s-1980s.More recently, recombinant human H2 RLX have been the object of several clinical studies, mostly based on its effects on collagenremodeling and angiogenesis. Past and recent studies have indicated that RLX is usually well tolerated and lacks toxicity, teratogenicproperties and major side effects, even at high doses.Extensive experience, over the last 10 years, with the use of pRLX in clinic (in both oral and injectable forms) indicates that pRLX iseffective in the treatment of fibromyalgia, diabetes type 2 and in preservation of wellness in the aging population.-RLX appears to reverse and prevent decline of the overall organ functions in the fibromyalgia patients in addition to relieving the pain,spam and fatigue commonly associate with this disease.-RLX decreases the insulin resistance of the diabetes type 2 resulting in decrease insulin supplementation and or hypoglycemicmedication. It appears to prevent progression of the disease. Taken early it appears to delay or prevent the onset of the diabetic diseaseon patients who suffer from pre-diabetic condition.For baby bloomer and normal aging population, pRLX appears to have anti-aging or wellness preserving property. It prevent thepremature decline of the micro-circulation, modulated the production of good quality collagen, prevents premature aging of the organs,balances the secretions and augments the functions of various hormones in one's body.125

PRACTICAL OXYTOCIN THERAPY IN MEN AND WOMENLA THÉRAPIE À L'OCYTOCINE CHEZ L'HOMME ET LA FEMME EN PRATIQUEJORGE FLECHAS(USA)SESSION 28AAANTI AGING WORKSHOP 13 GLOBAL WARMINGRÉCHAUFFEMENT CLIMATIQUE3.00 pm / 15h00ANTI-AGING MEDICINECHANGING CLIMATE: IS THERE A NECESSITY FOR ANTI-AGING STRATEGIES AT ALL?DEVONS-NOUS PRENDRE EN COMPTE LE CHANGEMENT CLIMATIQUE DANS LE DÉVELOPPEMENT DE NOS STRATÉGIESANTI-VIEILLISSEMENT ?SESSION 29AABETTINA MENNE(ITALY)ANTI AGING WORKSHOP 14 HOW TO RUN AN ANTI-AGING CLINIC ?COMMENT MANAGER UNE CLINIQUE ANTI-ÂGE4.30 pm / 16h30IN ASIA / EN ASIEPAKPILAI THAVISIIN(THAILAND)Anti-Aging is about Prevention and Wellness program which needs the optimal Lifestyle for optimal health. Proactive and Holisticapproach are the keys success factors to achieve both body and mind health.Start with at least 1 hr. first consultation to collect patient's personal data including health status, health history, family history, life style,environment, diet, exercise, sleeping pattern, stress level etc. and physical symptom complaints.Together with total body physical examination the doctor should be able to identify the health problems either subclinical diseases orvitamins-minerals-hormones deficiency. Proper lab tests and further investigations will help confirm the patient's health status and wecan use it as a base line before treatment and a good tool for follow up program.126

Total body Anti-Aging (Vitality ) program should include nutritional & exercise program, life style adjustment, behavior modification andmost important stress management program. Comprehensive conventional medicine plus Complimentary / Alternative medicine willholistically enhance Anti-Aging for body and mind.IN EUROPE / EN EUROPEJEFF HOEYBERGHS(BELGIUM)WHAT MAKES A “GOOD” ANTI-AGING DOCTOR? / COMMENT ÊTRE UN “BON” MÉDECIN ANTI-AGE ?MIKE PERRING(UK)What Makes a 'Good' Anti-aging Doctor?In the new specialty of Anti-Aging medicine what is it that makes us 'good' at our job?My views are inevitably subjective, and speculative. They are based on 15 years in the anti-aging field, and borrowed from myexperience as a psychotherapist and my role in supporting doctors as they struggle with complex medical regulations in the UK.From what background in medicine do anti-aging doctors come?A straw poll taken at these conferences suggests the background of doctors practising in this field is wide: Generalists or GeneralPractitioners (as they are called in the UK); Endocrinologists; Dermatologists; Aesthetic Surgeons; Psychiatrists; plus academics andresearchers, to name but a few. There is a wide spectrum of age and the countries from which our specialty draws its membershiphas become worldwide.What are the attributes that serve us best in this specialty?Regulatory Guidelines of good medical practice in the UK (in all fields of medicine) emphasise competence and skills, professionalism,and good communication with patients.Medical Insurance companies say failure to communicate by doctors is the commonest cause of complaint by patients. Assessmentof doctors at annual Appraisal in the UK includes 'satisfaction ratings' from patients as well as 360 degree peer review.Communication includes the skills of listening to patients as well of giving (clear) information and non-verbal communication is highlyexpressive of our attitudes to one another.The attributes described by Carl Rogers that make 'good' therapists are described as empathy, non-possessive warmth and congruity.I suggest that this roughly translates in anti-aging medicine to caring about our patients, being real and honest with them, andunderstanding accurately what their concerns are.What about our skills and competence as practitioners?Revalidation of our competence as medical practitioners is now recognised to be necessary and, in the UK, will be required every 5years. The mechanism for doing this remains controversial and the idea of it is a source of anxiety for many doctors. One goodconsequence is that where competence is assessed being 70 or over is no longer considered a bar to continuing practice (surgery isan exception).Mental health is a serious problem within the medical community: among the issues are mental breakdown (depression, manicdepressives illness, addiction), loyalty in reporting medical colleagues, protection of public interest and the rehabilitation of recoveredpractitioners.What is specific to anti-aging doctors?The specialty is a new one and does not have recognition in some countries. It follows that we need to be very aware of our goodrelations with colleagues: to talk to them about our practice and write them letters about the patients we share with them, and to referto them when a patient's problem lies outside our competence. We should continue to learn more by attending meetings and havingpeer supervision. Collectively we need a recognised qualification, and agreed (international) guidelines.Finally, we should allow ourselves pride in choosing an innovative, developing and rewarding specialty alongside modesty in thecontinuing endeavour it requires.ANTI-AGING MEDICINESESSION 30AAANTI AGING WORKSHOP 15 SEXUALITY AND ANTI-AGINGSEXUALITÉ ET MÉDECINE ANTI-AGE5.30 pm / 17h30HOW TO INCREASE SEXUAL PLEASURE?COMMENT AMÉLIORER LE PLAISIR SEXUEL ?RONALD VIRAG(FRANCE)PSYCHOLOGICAL RESPONSES TO SEXUAL STIMULATION IN THE FEMALE (FILM)RÉACTIONS PSYCHOLOGIQUES DE LA FEMME À LA STIMULATION SEXUELLE (VIDÉO)GORM WAGNER(DENMARK)A 15-minutes film showing the physiological responses to sexual stimulation of the female under laboratory conditions will be shown.A discussion of the necessity for educational material in this field as well as an interpretation of the findings will be conducted.Ref.: www.medsexedu.dk127

AESTHETIC WORKSHOPSThursday April 10 / Jeudi 10 AvrilAESTHETIC WORKSHOPROOM / SALLE 242 ABAESTHETIC WORKSHOP 1 PROPOSED BY MEDIGEN COAdvanced contour thread: J.J.Miracle liftDerniers progrès sur les fils de suspension : J.J.Miracle liftJUNG HO WOO (S. KOREA)JJ Miracle Lift is far more advanced technique than (surpasses) the traditional Contour Lift in two ways: JJ Miracle Lift requiresabsolutely no incision, and it provides the strongest fixation of threads since it makes a downward U shape1. No incision at all2. The stronger fixation of threads3. The operation is done under local anesthesia, rather than general anesthesia4. Perfect for Asians who prefer oval shape and small face5. The lasting time is longest than any other thread lift.Comparison with Contour ThreadsContour TreadsJ.J. Miracle LiftSince 2004 Since 2005US cosmetic surgeonsInventor Dr. Woo Jung Ho In KOREASlight Incision (0.3~2.0cm) Absolute No IncisionUsually General Anesthesia Local AnesthesiaFixation onFixation onSMAS muscle LayerWhole LayerModerate fixationStrong Fixation[ 3 Types of J. J. Miracle Lift ]1. Type Aa. Main Purpose: Lifting saggy/droopy skin on faceb. What is it?-Type A of J. J. Miracle Lift is effective on lifting saggy/droopy skin of face.As you can see in comparisons with other facial lifting procedures, Type A of J. J. Miracle Lift is very effective, it lasts long time andefficient in lifting with long length of thread (about 40cm).2. Type Ba. Main Purpose: making oval shape/small faceb. What is it?- Type B of J. J. Miracle Lift is very effective for Asians who want to have oval shape/small face. As a supplementary method, Botoxcan be used as well.3. Type Ca. Main Purpose: Elevating skin tonesb. What is it?- Type C of J. J. Miracle Lift is like the "Miracle" of cosmetic surgery. Unlike Botox, Thermage Lift, or many other inds of procedures ofdermatololgy, Type C of J. J. Miracle Lift can recover the tone of the skin and rejuvenate the skin. It is for peri-orbital wrinkles (alsocalled "Crow's feet), frontal wrinkle, and wrinkles around cheeks. There is no omplications after procedure and the effectiveness issemi-permanent. The fundamental basis is to spread nets under the skin, just like the steel frame of building. As time goes by, theeffectiveness of J. J. Miracle Lift remains, lifting saggy/droopy skin of face and the elasticity of skin semi-permanently. The inventor,Dr. woo had J. J. Miracle Lift procedure on himself as well.AESTHETIC WORKSHOPSPROCESSING OF J.J.MIRACLE LIFT(1) DesignFirst, lift the face of a patient using your hands and choose the design you can approximately presume. Then, design the part of thetemporal lobe where you will insert a thread.(2) Local anesthesia in the designed areaThe advantage of this procedure is the ability to communicate the progresses made during the middle of the procedure with the patient.(3) Cutting needle is passed and thread is followed.The thread is followed by the needle to have the middle of the thread to be set in the scalp area..(4) DeploymentBefore putting a thread at the end , a long needle is inserted to two points where the threads are already out of the skin, and movedforward through the subcutaneous layer to the exit point and finally out of the skin.128

(5) ContouringUnlike Contour thread where contouring is done only once at the end, in JJ Miracle Lift, contouring is done each time two threads comeout of the skin In order to more strongly fixate the threads. If contouring is done only once at the end, vectors themselves might fightand the result will be less effective.(6) Cutting the threadThe thread from the exit point is pulled with a mosquito and cut with scissors. At this time, an artificial dimpling should be made.(7) Flattening the dimpling siteUnlike Contour thread where contouring is done only once at the end, in JJ Miracle Lift, contouring is done each time two threads comeout of the skin in order to more strongly fixate the threads. If contouring is done only once at the end, vectors themselves might fightand the result will be less effective.AESTHETIC WORKSHOP 3 PROPOSED BY TUXEDO CORPORATIONNew long lasting, degradable filler: Safety and effectiveness of REMAKE TM hydrogelLe nouvel agent de comblement longue durée et dégradable : sécurité et efficacité de l'hydrogel REMAKE TMJACQUES-ANDRÉ DAVID (FRANCE)EnglishASSESSMENT OF A NEW FILLING MATERIAL: REMAKEInjections of dermal fillers are used to fill the wrinkles which have appeared with time due to the decrease of cutaneous or musculartonicity and to correct some deficits or remodel some areas of the face.Depending on their origin or chemical composition, we classify those fillers in two main categories: fast degradable fillers and semipermanentor permanent fillers. An alternative to those fillers is of course the injection of autologous fat.The philosophy behind the development & research of REMAKE has three main objectives:- Providing a material which has the rare side effects of degradable materials- Providing a material which has the long durability advantage of the semi-permanent or pemanent materials.- Providing a material which acts somehow like the autologous fat injections with the possibility of correcting with it superficial deficits(fine lines and fine wrinkles) as well as lip augmentation and labial contour remodeling.Ideally, this material must be stable, non allergenic and absolutely biocompatible. Furthermore, in case of side effects, it must bereversible. Composed of water (96%) and polyethylen glycol di-acrylate, it forms a synthetic gel which is non allergenic. It is totallydegradable within 2-3 years (according to in vitro and in vivo studies) and does not migrate. It will be eliminated after a slowdegradation through the lymphatic ways.Actually, REMAKE, thanks to its formula, has a structure which is totally degradable since its chains are cross-linked only at theirextremities.The advantages of this product are the same as HA fillers (which last only 4-9 months) with an added advantage over those fillersthanks to its longer durability.Used in numerous applications - wrinkles, cheeks and chin remodeling, lip augmentation and remodeling, scars - and at any age, inany skin care type and for both genders, this product is available in two forms:- Remake Red : low viscosity, used in the lips remodeling and correction of fine lines- Remake Aesthetica: higher viscosity, used for the correction of medium and deep wrinkles such as nasolabial folds and for faceremodeling (cheeks and chin).We will try, in the following, to demonstrate the advantages of this product as well as injection techniques and our results.FrançaisEVALUATION D'UN NOUVEAU MATERIAU DE COMBLEMENT : LE REMAKELes injections de produit de comblement ont pour objet de combler les rides qui se sont creusées au cours du temps par la diminutionde la tonicité musculaire ou cutanée et de corriger certaines dépressions ou remodeler certaines parties du visage.Suivant leur origine ou leur composition chimique, on a pu classer les produits à résorption rapide - biodégradable et les produits àsemi-permanents ou permanents. Une alternative à ces produits de comblement étant l'injection autologue de graisse.La philosophie de la recherche sur REMAKE a principalement trois cibles :- avoir les effets secondaires très légers des matériaux à résorption rapide,- avoir les avantages de durabilité des matériaux semi ou non résorbables,- se comporter un peu comme les injectons de graisse autologue avec la possibilité supplémentaire de pratiquer des injectionssuperficielles pour de fines lignes et ridules aussi que pour l'augmentation du volume et le remodelage des lèvres.Idéalement ce matériau se doit d'être stable, non allergénique et parfaitement biocompatible. De plus, en cas d'effets secondairesindésirables, il doit être accessible à une correction médicale.Composé d'eau (96%) et de polyéthylène glycol di-acrylate, il forme un gel synthétique donc a priori sans réaction allergénique ; deplus, il est totalement dégradable en 2 à 3 ans (étude in vitro et in vivo) et ne migre pas. Il sera éliminé après une lente dégradationpar la voie lymphatique. En effet, REMAKE, par sa formule, a une structure très souple et ses chaines ne sont attachées qu'à leursextrémités évitant une structure trop rigide et donc difficilement dégradable.Les avantages de ce produit sont ceux des HA par exemple à dégradation semi-rapide (4 à 9 mois) mais avec une durabilité biensupérieure.Utilisé dans de nombreuses applications - rides, remodelage des joues et du menton, volume et contour des lèvres, cicatrices -quelque soit l'âge, le sexe ou le type de peau, ce produit est présenté sous deux formes :- Remake Red : viscosité basse, utilisé dans le remodelage des lèvres et des fines ridules- Remake Aesthetica : viscosité plus importante, pour les rides, sillons et remodelage de la face (joues - menton).AESTHETIC WORKSHOPSNous essaierons de démontrer les avantages de ce produit, les techniques d'injection et nos résultats.129

AESTHETIC WORKSHOP 5 PROPOSED BY Q-MEDRESTYLANE® Master Class: Advanced techniques with Restylane Lipp and Male esthetics with the Restylane RangeTechniques avancées avec Restylane Lipp et esthétique chez l’homme avec la gamme RestylaneGERTRUDE HUSS (UK) - HERVÉ PADEY (FRANCE)AESTHETIC WORKSHOP 7 PROPOSED BY MEDIFORMREVITACARE ® : Mesotherapy with vitamins as the basis of MesoplastyREVITACARE ® : La mésothérapie associée aux vitamines comme base de la mésoplastieSILVIA LLEAL (SPAIN)Mesoplastia integral facial treatmentThe rejuvenating technique of facial mesoplastia has been developed by Dr. Manuell Lee of Mexico. The evolution of thepharmaceutical products in aesthetic medicine, the patient demands for aesthetical results, along with improvements on existingesthetical facial medical treatments, has permitted us to develop a facial rejuvenating ambulatory technique. This technique isadaptable to different ages, with results of a natural look that patients demand which allow us the optimization of complementarytreatments that we want to apply. The vast experience that we currently have with the Mesoplastia technique, permit us to structureit to obtain reproducible and secure resultsThursday April 10 / Jeudi 10 AvrilAESTHETIC WORKSHOPROOM / SALLE 251AESTHETIC WORKSHOP 25 PROPOSED BY REGENLABRegenKit, the new autologous cell therapie for wrinkle and skin regenerationRegenKit, le nouveau traitement cellulaire autologue de régénération faciale et comblement de ridesJEAN-CLAUDE HOUDRET, GILBERT AMGAR, CLAUDINE HADIDAAESTHETIC WORKSHOP 4 PROPOSED BY POLLOGENTRIPOLAR RADIOFREQUENCYRADIOFRÉQUENCE TRIPOLAIREAESTHETIC WORKSHOP 6 PROPOSED BY CONTURA INTERNATIONALSHARING 7 YEARS EXPERIENCE OF AQUAMID ® WITH LIVE DEMONSTRATION7 ANS D’EXPÉRIENCE AVEC AQUAMID ® - DÉMONSTRATION EN DIRECTAESTHETIC WORKSHOP 8 PROPOSED BY MEDIGEN COEVOLENCE ® : TECHNIQUES FOR OPTIMAL ENHANCEMENTEVOLENCE ® : LES MÉTHODES POUR UNE AUGMENTATION OPTIMALEGHISLAINE BEILIN - SYLVIE BOISNIC (FRANCE)STEFANO PICCOLO (ITALY)PAUL LORENC (USA) - NOWELL SOLISH (CANADA)AESTHETIC WORKSHOPS130

Friday April 11 / Vendredi 11 AvrilAESTHETIC WORKSHOPROOM / SALLE 242 ABAESTHETIC WORKSHOP 9 PROPOSED BY LCA PHARMACEUTICALHYALUDERM REVITALIZE is an anti-aging treatment for the skin using micro-injections, made of natural hyaluronic acid,produced using genetic engineering technology.HYALUDERM REVITALIZE est un traitement anti-âge de la peau par micro-injections, composé d'acide hyaluronique naturel issu degénie génétique.CHRISTINE PEUCHANT (FRANCE)AESTHETIC WORKSHOP 11 PROPOSED BY NORDIC AESTHETICSAmalian Product LineLa gamme de produits AmalianSAID HILTON, (GERMANY)AESTHETIC WORKSHOP 13 PROPOSED BY ANTEISESTHÉLIS and FORTÉLIS: The complementary approaches for “blanching” wrinkles very superficially and correcting folds in-depthESTHÉLIS et FORTÉLIS : Approches complémentaires pour “effacer” les rides superficelles et corriger les rides profondesPATRICK MICHEELS (SWITZERLAND)AESTHETIC WORKSHOP 15 PROPOSED BY ADODERMVARIODERM: New generation of hyaluronic acidVARIODERM : nouvelle génération d'acide hyaluroniqueAESTHETIC WORKSHOP 17 PROPOSED BY TEOXANEAdvanced course of face remodeling with TEOSYALCours avancé de remodelage facial avec TEOSYALMICHAEL WEIDMANN (GERMANY)MARK LUPIN (CANADA)AESTHETIC WORKSHOP 20 PROPOSED BY PROMOITALIANew techniques for facial rejuvenation: Intradermal technique of fibroblast stimulation and Micro-Targeted Fibrosis with bipolarelectrode and suspension of soft tissue with barbed absorbable threads.Nouvelles techniques de rajeunissement du visage : technique intradermique de stimulation des fibroblastes et fibrose mico-ciblée avecélectrode bipolaire et suspension des tissus mous par des fils crantés résorbables.FULVIO VANNINI - ANNA MARIA FORENZA - CIRO ACCARDO (ITALY)Fibropen System New intradermal technique of fibroblast stimulation and Micro-Targeted Fibrosis with bipolar electrode.The Author presents a brand new Radiofrequency methodology obtained with the use of a device called Fibropen System able tocreate a fibroblast stimulation and a Micro-Targeted Fibrosis by means of bipolar electrodes.Each electrode includes both positive and negative pole, thus avoiding the use of the grounding pad during the treatment in order toclose the circuit.They are manufactured in 3 different lengths (3cm Soft, 4cm Mid and 5cm Ultra) and are used by the operator whoinserts them in the deep dermis following a well known linear retrograde technique during the emission of radiofrequency shots. Thefollowing parameters can be regulated:- Frequency- Power- Total time of the Session (CYCLE)- Time of RF emission (PULSE)- Time of Pause (PAUSE)This technique generates a fibroblast stimulation and a collagen remodelling, and creates a Micro-Targeted Fibrosis in the hypotonicarea of the face thus producing an absolutely natural filler and lifting effect.Additionally the device allows to induce the quantity of energy in a selective way into the area to treat with maximum results andminimal RF dispersion. As a consequence, all the therapeutic benefits of RadioFrequency can be applied even to the smallest wrinklesworking inside the tissue thus avoiding any thermal injury to the superficial layer of the tissue and any pain to the patient.AESTHETIC WORKSHOPSFibropen System is used for the treatment of:- Wrinkles:- Glabellar- Naso-Labial Fold- Periocular131

- Marionette Line- Forehead Wrinkles- Neck & Décolleté- Lips Contour- Vertical lifting- Acne pit: Depressions from Acne/Exanthemata diseases- Stretch Marks- Combination with Suspension Threads (Before, During After)- With Fibropen System all the therapeutic benefits of RadioFrequency can be applied even to the smallest wrinkles working insidethe tissue thus avoiding any thermal injury to the superficial layer of the tissue and any pain to the patientA global concept for beauty and wellness.Reharmonize your face with a new crosslinked hyaluronic acid with coesix technology in sinergy with a new cosmetic lifting systemand reshape your body with proslimelt low frequency ultrasound waves(Dr. Anna Maria Forenza & Dr Fulvio Vannini)People have always displayed a strong desire to keep a good looking facial and body features.Features that are distinguished by firm, volume full, smooth and wrinkle-free skin. When these features change for several reasons(such as advanced aging, life style, pollution, photo damages, etc) most peoples desire the need for an improvement of theirappearance.Dr Anna Maria Forenza and Dr Fulvio Vannini will suggest how re-harmonize the face with two brand new products: rosslinkedhyaluronic acid with Coesix Technology in synergy with a cosmetic lifting system containing Idebenone for a firming and long lastingeffect.For the re-shaping of the body and the treatment of localized lipodistrophies the Authors will show how Proslimelt, a device that useslow frequency ultrasound waves, can be a good alternative to traditional and invasive surgery.This new global concept play an excellent role in time reversing and allow to correct the whole aspect of face and body enhancing thequality o life.New techniques for facial rejuvenation: intradermal technique of fibroblast stimulation and Micro-Targeted Fibrosis withbipolar electrode and suspension of soft tissue with barbed absorbable threads.(Dr Fuvio Vannini, Dr Anna Maria Forenza, Dr Ciro Accardo)The authors present a new Radiofrequency methodology obtained with the use of a device called Fibropen System able to createa fibroblast stimulation and a Micro-Targeted Fibrosis by means of bipolar electrodes. The device has good results on wrinkles(Glabellar, Naso-Labial Fold, Periocular, Marionette Line, Forehead Wrinkles, Neck & Décolleté, Lips Contour), on Vertical lifting, Acnepit, Stretch Marks and Combination with Suspension Threads (Before, During After).The new techniques of insertion of suspension threads have many advantages such as the possibility to lift different areas of the facewithout leaving any scar on the skin.Dr Accardo will present the enhancement from the technological point of view of devices meant for realizing Thread Lifting. He willunderline here are the actual technological features of these unique devices and a brief history of their design development helped byaccurate scientific and histological studies observing in vivo reaction of the skin after the implant of the thread into the deep hypoderm.AESTHETIC WORKSHOP 22 PROPOSED BYQ-MEDMACROLANE Master Class: Body shaping with MACROLANEMACROLANE Master Class: Remodelage de la silhouette avec Macrolane TMPER HEDÉN (SWEDEN)AESTHETIC WORKSHOPS132

Friday April 11 / Vendredi 11 AvrilAESTHETIC WORKSHOPROOM / SALLE 251AESTHETIC WORKSHOP 10 PROPOSED BY LUTRONIC CORPORATIONA new approach to fractional resurfacing by an Er:Glass laser based on controlled Chaos Technology: MosaicRelissage cutané : Nouvelle technique fractionelle par laser Er: GlassJEAN-LUC LEVY (FRANCE)AESTHETIC WORKSHOP 12 PROPOSED BY AESTHETIC DERMALEXELLDERM (monopolar non thermogenic radiofrequencies), BoNta 568 and REPARESTIM : Differential no needle mesoliftEXELLDERM (radiofréquences monopolaires non thermogèniques), BoNta 568 et REPARESTIM : le mésolift différentiel sans aiguillePHILIPPE DEPREZ (SPAIN)AESTHETIC WORKSHOP 14 PROPOSED BY PROCYTECH / ACTIVE COSMETHICSOUTLINE / NUTRIACTIVE: Simple techniques for global care of each patient: Fillers, peelings, patches, serums…OUTLINE / NUTRIACTIVE : Techniques simples de prise en charge globale de chaque patient : comblement, peeling, patchs, serums…SPEAKER TO BE ANNOUNCEDXAESTHETIC WORKSHOP 16 PROPOSED BY FILORGA LABORATORIESAnti-Aging CE Mesotherapy: Full face polyrevitalizing treatment with NCTF 135 HALa mésothérapie CE anti-vieillissement : Traitement polyrevitalisant de l'ensemble du visage avec NCTF 135 HAPHILIPPE PETIT (FRANCE)AESTHETIC WORKSHOP 18 PROPOSED BY THERMAGEAdvances in skin tightening and body shapingLes progrès dans le rafermissement de la peau et le remodelage de la silhouetteAESTHETIC WORKSHOP 19 PROPOSED BY LIPOTOMY AQPLipotomy AQP / Non surgical water liposcultureLipotomie AQP / Liposculpture non chirurgicale par l'eauAESTHETIC WORKSHOP 21 PROPOSED BY MEDIFORMCO2 Laser - Universal Fractional CO2 Adapter OMNIFIT by Alma LaserLaser CO2 - L'adaptateur universel du CO2 fractionnel OMNIFIT par Alma LasersMICHAEL KAMINER (USA) JOANNA CZUWARA (POLAND)THIERRY PIRMEZ (BELGIUM) - JACQUES DURAND (INDONESIA)SPEAKER TO BE ANNOUNCEDAESTHETIC WORKSHOP 23 PROPOSED BY CAREGENFight against the aging process with Growth Factors and Peptide ComplexLutter contre le vieillissement avec un complexe de peptide et de facteurs de croissanceYONGJI CHUNG (KOREA)AESTHETIC WORKSHOPS133

Saturday April 12 / Samedi 12 AvrilAESTHETIC WORKSHOPROOM / SALLE 242 ABTUXEDOAESTHETIC WORKSHOP 24 PROPOSED BYNon Invasive Body Contouring with ULTRALYS ;Remodelage non invasif de la silhouette avec ULTRALYSCARMELO PROTOPAPA (ITALY)Clinical Evaluation of ULTRALYS - A Low Frequency Ultrasound System For Non-Invasive Body Contouring and Fat ReductionIntroduction: Body contouring and fat reduction options are limited to the very well-known and old technique of liposuction which isan invasive surgery not free of disadvantages: long recuperation period, risk of side effects and complications.In the following, we assess the efficiency and safety of an innovative and non invasive technique for body contouring and fat reductioncalled ULTRALYS. It uses low frequency ultrasound to improve the body contouring by reducing the fat in the area targeted by thetreatment. The procedure can be carried out in an office environment and does not require any special set-up. It is non-invasive,painless, easy and free from the common side effects associated with the liposuction or any invasive procedure.ULTRALYS selectively lyses the adipocyte membrane with no damage to surrounding structures. The released fat is eliminatedthrough the physiological pathways: when the membrane of the adipocytes is disrupted by the low frequency ultrasound, thetriglycerides inside those adipocytes is released into the interstitial fluid. Triglycerides are composed of 3 molecules of fatty acidsattached to a glycerol backbone. The fatty acids are transported by the albumin to the liver which uses them for the metabolic needs.The glycerol is recycled for energy. This treatment is totally safe since the capacity of the body to carry away triglyceride molecules ismuch larger than the amount of triglycerides which are liberated as a result of the treatment.Materials and method: The ULTRALYS system used is manufactured in Italy and constituted by the main unit and 2 transducersof different sizes. 30 healthy volunteers were enrolled in the study: 8 male and 22 female patients. All underwent 3 treatments, at 1week interval and were followed for 1 month after the last treatment. Areas treated were: abdomen, inner and outer thighs, flanks, innerknees, and hips.The method of work used consisted of: 1- measuring the fat depth with a digital picometer, 2- measuring the circumference of thetreated area with the accurate measurement tape MyoTape and 3- taking pictures before and after each treatment using a digitalcamera. The efficacy of the treatment was determined by change in fat thickness and change in the circumeference measurements.Results: The results are described in a detailed table and classified according to the treated area. In average, a patient loses around4.3cm in the abdominal area on each session! After 3 treatments, a patient loses in average 4 to 13 cm depending on the treated area,which is equivalent in the abdominal area to 3 sizes of pants!Conclusion: We have achieved satisfactory results in all treated patients assessed in terms of centimeters reduction of the treatedarea and photographic evidence. Besides, all patients were satisfied from the results and reported that the treatment was comfortableand totally painless.The main advantage of the ULTRALYS method is that it matches the current trend of "lunch treatments" and the growing demandfor non invasive procedures. ULTRALYS, a new and efficient system for non invasive, easy and painless body contouring, seems tooffer a solution to many persons who do not want to resort to surgery in order to improve their body's shape.From the encouraging results we have collected after this experience enrolling 30 patients, we can conclude that ULTRALYSrepresents a new era in the body contouring field and a promising alternative to invasive procedures.AESTHETIC WORKSHOP 26 PROPOSED BY ANTEISRehydrate your patient's skin with MESOLIS and MESOLIS+Réhydratez la peau de vos patients grâce à MESOLIS et MÉSOLIS+AESTHETIC WORKSHOP 28 PROPOSED BY TEOXANEAdvanced Techniques using TEOSYAL Ultra DeepTechniques avancées avec TEOSYAL Ultra DeepCHRISTIAN GAY (FRANCE)JULES MARTHAN (FRANCE)AESTHETIC WORKSHOPS134AESTHETIC WORKSHOP 30 PROPOSED BY Q-MEDRESTYLANE ® Master ClassAdvanced techniques with RESTYLANE SUBQRESTYLANE ® Master ClassTechniques avancées avec RESTYLANE SUBQAESTHETIC WORKSHOP 32 PROPOSED BY ALLERGANIntroducing volumetric contouring with VOLUMA ®.Remodelage volumétrique et contour avec VOLUMA ®Facial contours – The impact of aging / Contours faciaux : l’impact de l’âgeBuilding experience and confidence with Voluma ® / Acquérir expérience et confiance avec Voluma ®Questions from the Dermatologist / Les questions du DermatologueLive Demonstration / Démonstration en directWOFFLES WU (SINGAPORE)CHAIR: GREGOR WAHL (GERMANY)HERVÉ RASPALDO (FRANCE) - GREGOR WAHL (GERMANY)

AESTHETIC WORKSHOP 34 PROPOSED BY LUMENISNew rejuvenating techniques / Nouvelles techniques de rajeunissementResurfacing Active FX and Deep FX Fractional Laser / Relissage laser fractionnel Active FX et Deep FXMARIO TRETTI-CLEMENTONI (ITALY) - CLAUDIA VAN DER LUGT (THE NETHERLANDS)Facial skin tightening with ALUMA / Traitement du relâchement cutané du visage avec le système AlumaPHILIPPE MALET (FRANCE)AESTHETIC WORKSHOP 36 PROPOSED BY AURIGA INT.Pigmentation treatment and last updates on Anti-Aging research / Traitement de la pigmentation & dernières avancées dans larecherche anti-âgeNew technologies and new systems / Nouvelles technologies et nouveaux systèmesUse of vitamin C on dermatology / Applications de la vitamine C en dermatologieSpecific treatments of cellulitis and skin slack / Traitement spécifique de la cellulite et des relâchements cutanésOxygen cream and indications / Crème à l'oxygène et indicationsNew peeling systems / Nouveaux systèmes de peelingCHAIR: PHILIPPE BLANCHEMAISON (FRANCE)PHILIPPE HUMBERT (FRANCE) - RÉGINE BUIDIN (BELGIUM)YVON GALL (FRANCE) - ALFRED MARCHAL (BELGIUM)Pigmentation treatment and recent anti-aging research resultsNew technologies and new systemsAuriga International s.a. develops and markets innovative products in dermato-cosmetology using the latest technology. This meansworking on new concepts of actions and products, and on their skin penetration with adequate vectors for example nanosomes.In close collaboration with universities, we carry out research activities aimed at developing specific patented products for thetreatment of various skin disorders (vitamin C).The vitamin C developed by Auriga is the L-ascorbic acid and offers the following guarantees:- Stability: a study realized by Dr. J. Dubois, from the Université Libre de Bruxelles (Belgium), proves through the HPLC method thatthe vitamin C remains stable in the serum when in normal conditions (simple aqueous solution or in cream) it is totally destroyed within48 hours.- Skin Penetration and concentration: a study realized by Professor P. Humbert, from the Université de Besançon (France), shows that,due to its form as free laevogyrate in serum, the vitamin C penetrates more easily in the skin and its concentration is maintained totallystable for more than 9 hours.- Anti-radical effect: a study realized by the laboratory Dermscan in Lyon (France) proves, through the Tunel method, that the vitaminC plays a part in the process of protection and reparation of the cells undergoing apoptosis due to UV exposure.The protective effect following the application of serum is 58% because the vitamin C prevents damages caused by UV on the DNA.Besides, it stops the development of brown spots and maintains a bright and clear complexion.Applications of vitamine C in dermatologyVitamin C : " The anti-ageing vitamin " - 8% SerumL ascorbic acid acts on the formation and the synthesis of the triple helix in collagen, which is the cement of the skin cells and ensuresits elasticity. It also stimulates the production of collagen.The serum used by young women results in an increased preservation of the collagen and elastin integrity. This has a significant antiageingeffect because it slows down the formation process of wrinkles (happening when the production of collagen decreases and sothe skin loses elasticity).In older or menopaused women, it acts on the mRNA and stimulates the synthesis of collagen and polypeptide chains that form thebinding bridges in the triple helix. It also has a photo-protective effect and so helps the skin not to be marked after years ofoverexposure.Vitamin C : " The depigmenting vitamin " - 10% Serum (MelaClear ® )The innovative complex of Vitamin C with Phytic Acid acts as a quadruple lock on melanin synthesis and therefore guarantees a higheffectiveness on the brown spots removal and their reappearance. This complex inhibits the activity of tyrosinase and blocksmelanogenesis at three other levels allowing excellent results in the elimination of pigmentary spots.Vitamin C is known for its lightening and anti-oxidizing properties regarding the increasing or already existing melanin. It also exfoliatesthe dead surface cells and promotes penetration of the active ingredients.The ROS Modulator System ® of Auriga acts in synergy, as soon as it receives the primary messages to initiate the formation of melanin.It therefore allows the suppression of the triggering factors of hyperpigmentation.New peeling system (BRA): Biocell Rejuvenation Activator has a chemically superior formulation that achieves optimum skinrejuvenating. Formulated with specific agents, BRA safely and effectively expands the power of skin rejuvenation. BRA is a scientificallyadvanced product containing active ingredient enhancers that ensure an optimal penetration level.Cream with oxygen and indications (Chiroxy)An additional supply of oxygen regenerates and purifies the cells. This is brought about by an increase in cellular metabolism and inthe repair processes following activation of cellular respiration. The oxygen also protects against anaerobic microorganisms.In particular circumstances, such as after surgery or plastic surgery, the skin may require additional oxygen. Smoking and diabetesmay also constitute complicating factors during surgery, and have an adverse effect by slowing down the natural postoperative healingprocesses. Chiroxy is a cream designed to improve skin oxygenation.The mode of action of Chiroxy is based on the innovative oxygen vector system of nanosomes. The latter allows optimal productpenetration in the skin. Chiroxy may also bring a highly beneficial oxygen increase to people with poor circulation in the legs. Specificcellulite treatment (ECLA-CELL DUO)The deposits of fat and the retention of fluid in parts of the body such as the buttocks, the thighs and the upper part of the legsconstitute what is commonly known as gynaecolipodystrophy. This problem can appear just as well among slim women as those whoare 'rounder'. We can see irregularities in the skin and the presence of 'padding'; the skin looks like orange-peel. This phenomenonAESTHETIC WORKSHOPS135

Ecla-Cell Draining Emulsion (100 ml metallic spray) contains arnica Montana and organic silicon to decrease swellings and improvethe draining, a complex caffeine + diprophylin to increase the lipolysis, and cypress because of its tonic effects. This emulsion improvesthe blood circulation in the legs and favors the elimination of water. It must be applied in the morning by dynamic massages.Ecla-Cell Slimming Cream (100 ml metallic tube) contains caffeine and organic silicon (cf. properties of the Emulsion), as well as wrackextract, which is a powerful slimming agent containing important concentration of iodine. This cream must be applied in the evening,with "palpating and rolling" massages, so that it will favor the elimination of fat by lipolysis.Saturday April 12 / Samedi 12 AvrilAESTHETIC WORKSHOPROOM / SALLE 251AESTHETIC WORKSHOP 25 PROPOSED BY REGENLABRegenKit, the new autologous cell therapie for wrinkle and skin regenerationRegenKit, le nouveau traitement cellulaire autologue de régénération faciale et comblement de ridesJEAN-CLAUDE HOUDRET, GILBERT AMGAR, CLAUDINE HADIDAAESTHETIC WORKSHOP 27 PROPOSED BY AA-MEDICAL SYSTEMSCARBOXYTHERAPY, MESOTHERAPY AND OTHER BREAKTHROUGH TECHNIQUES: WHICH WINNING COMBINATIONS IN THE FAT REDUCTIONPROCESS AND THE TREATMENT OF WRINKLES? - CERTIFICATE OF ATTENDANCE DELIVERED ON SITECarboxytherapie, mésothérapie et autres techniques de pointe : quelle combinaison gagnante dans le traitementde la cellulite et celui des rides?GUSTAVO LEIBASCHOFF (ARGENTINA)AESTHETIC WORKSHOP 29 PROPOSED BY PROMOITALIAA global concept for beauty and wellness. Reharmonize your face with a new crosslinked hyaluronic acid with COESIX technology insinergy with a new cosmetic lifting system and reshape your body with PROSLIMELT low frequency ultrasound wavesUn concept global beauté et bien-être. Réharmonisez votre visage grâce à un nouvel acide hyaluronique réticulé avec la technologieCOESIX en synergie avec un nouveau système de lifting et remodelez votre corps avec les ondes ultrasons à basse fréquence PROSLIMELT.ANNA MARIA FORENZA - FULVIO VANNINI (ITALY)PROSLIMELT: low frequency ultrasound for the treatment of localized lipodistrophyesDr.Fulvio Vannini, presents the results of a clinical study conducted on 40 patients after 10 months of treatment using Proslimelt, aspecial device that uses specific ocalized low frequency ultrasound waves (working within a range of 30 to 70 Khz).This clinical evaluation is based on plicometric, perimetric measurements, blood sample analysis, echograhic and termographicpictures and histological exams.Proslimelt is an apparatus, that uses specific focalized low frequency ultrasound waves that produces a breakage of the cellularmembrane of the treated tissue and the exiting of the adipocytes from the cells, leaving the surrounding areas undamaged, with atermo-mechanical effect, in a comfortable, fast, safe and non invasive way.Dr.Vannini will show that the results reached by using this device have been encouraging in the consideration of stable and long lastingeffects with low frequency ultrasound waves are used for eliminating excess of localized fat.Based on these results, the author believes that this type of treatment could be an excellent alternative or complement to traditionalsurgery.AESTHETIC WORKSHOP 31 PROPOSED BY PRODERMANew, MESOEXPERT: Techniques of mesotherapy and liposculpture for face and bodyNouveau, MESOEXPERT : Techniques de mésothérapie et liposculpture pour le visage et le corpsAESTHETIC WORKSHOP 33 PROPOSED BY Q-MEDMACROLANE Master Class : Breast shaping with MACROLANEMACROLANE Master Class : le remodelage des seins avec MACROLANE TMDIMITRE DIMITROV (BULGARIA)SATORU YAMAGUCHI (JAPAN)AESTHETIC WORKSHOPSAESTHETIC WORKSHOP 35 PROPOSED BY ATLEANClinical renewal on facial aging with a safety stimulatory filler : ATLÉAN. Live Interactive demonstrationL'induction tissulaire sécurisée dans le traitement du vieillissement facial : ATLÉAN. Démonstration InteractiveAESTHETIC WORKSHOP 37 PROPOSED BY THE SKIN WORKSHOPClinical application of Micro-Needling TherapyApplication technique de la thérapie du Micro-NeedlingRICCARDO FORTE (ITALY)BEOMJOON KIM, (KOREA)Microneedle therapy system is a new powerful medical device which might be applied in various fields of dermatology. Although it wasused for mechanical vehicles for transepidermal drug delivery system, now its clinical application has been broadened into acne scars,136

wrinkles, striae distensae, hair growth, and keloids. Due to its deep penetration effect, microneedle therapy system may providesignificant collagen and elastin formation at the level of both papillary dermis and reticular dermis. And its tissue remodeling effectshould be maintained over than a month or later. Unlike laser or intense pulsed light treatments, microneedle therapy system lacksheat production, which maximize treatment efficacy without thermal damage. Although there are some adverse effects including postinflammatoryhyperpigmentation, folliculitis, allergic contact dermatitis, xerosis, and burning sensation, most of them are treatable andcan be prevented by appropriate post-treatment skin cares. Concerning transepidermal drug delivery, microneedle therapy system hasno limitation of topical applicants for the drug delivery in the skin because it is regardless of molecular weight and charge of the ions.It is more effective in the penetration and absorption rates of drugs when it compared with other medical drug delivery devices suchas iontophoresis and ultrasonic wave machines. Therefore, microneedle therapy system should be simultaneously applied withnumerous anti-wrinkle solutions, topical hair growth spray, bleaching cream for melasma or freckles, and acne solutions. Furthermore,it would be better if combined with fractional laser, vascular laser, intense pulsed light, full spectrum light, subcision technique, crossmethods in the treatment of acne scars and striae distensae.AESTHETIC WORKSHOP 39 RIOBLUSHLive Demonstration of C02 Rioblush Riojuvenation TechnologyDémonstration en direct de la technologie CO2 Rioblush RiojuvenationCARLOS ANTONIO ABRAMO (UK)AESTHETIC WORKSHOPSPOSTERSSTABILIZED HYALURONIC ACID-BASED GEL OF NON-ANIMAL ORIGIN, A PROMISING NEW DEVELOPMENTFOR BREAST ENHANCEMENTPER HEDÉN, MICHAEL OLENIUSIntroduction: The advent of minimally invasive procedures has facilitated the overall growth of cosmetic surgery. The search forimproved volume-enhancing procedures led to the use of solid implants and injectable materials. Fat transfer can provide substantialvolume to deficient areas, but the costs can be high and the surgery can be complex. Non-resorbable injectable products have beenassociated with granuloma formation and other safety concerns.A number of injectable, resorbable products using hyaluronic acid-based gel of non-animal origin (NASHA gel; Q-Med AB, Uppsala,Sweden) are well established in esthetics. To address the need for an injectable, biocompatible but resorbable material for bodycontouring and volume restoration, a new NASHA-based medical implant, Macrolane VRF, was developed and approved in 2007.In a pilot study of NASHA gel for breast enhancement, mammograms and magnetic resonance imaging (MRI) were performedfollowing treatment in 19 women. Injected NASHA gel had increased radiolucency compared with silicone or saline implants, allowingvisualization of tissue behind the gel. Furthermore, the MRI results showed only minor biodegradation of the implanted NASHA up to12 months post-injection. Some issues were identified regarding patient selection and local reactions; modifying the injection techniqueand improving the gel formulation were considered as possible solutions.Aims: The primary aim of this study was to develop optimal injection technique for NASHA gel breast enhancement. Secondary aimswere to assess the efficacy and safety of the treatment.Materials and methods: Women seeking breast enhancement were treated with NASHA gel (100 ml per breast). They were treatedin groups of four, to facilitate a step-wise approach for revising the injection technique. Touch-up was performed 6 weeks after the initialtreatment in case of unevenness or asymmetry. Patients rated breast improvement at 6 weeks, 3 months and 6 months, and physicianassessment was also undertaken. Safety was assessed by adverse event reporting and patient diaries.Results: Twenty women with a mean age of 37.3 years participated in the study. The average injection volume was 97 ml per breast.Touch-up was administered to one breast in one patient (20 ml). Although the first 8 women were treated under general anesthetic,local anesthesia proved acceptable in the remaining 12. The first 12 subjects were injected from the lateral upper pole of the breast,while the last 8 were injected from the lower lateral pole, by the breast inframammary fold. Key elements of the injection techniqueincluded: lifting the breast while inserting the cannula and while injecting; making a space below the parenchyma before injecting; andinjecting in multiple passes while still aiming for a single, consolidated implant.Breasts were considered to be improved by 100% of patients at 6 weeks, 92% at 3 months and 75% at 6 months. Correspondinginvestigator-assessed improvement rates were 100%, 83% and 100%. Twenty-eight treatment-related adverse events were reported- mostly swelling, pain, tenderness and nodules. Capsular contractions were reported in four subjects, 1-6 months after treatment;none of these required surgical intervention. The great majority of adverse events were mild or moderate, and there were no cases ofinfection or inflammatory reaction.Conclusion: These data suggest that a suitable injection technique for NASHA gel breast enhancement has been found, using localanesthesia. Experience from a larger number of patients is required for confirmation. NASHA gel is a promising material for minimallyinvasive, well tolerated breast enhancement.POSTERS_________________137

A SPLIT-FACE COMPARISON OF TWO HYALURONIC ACID FACIAL FILLERS IN THE TREATMENT OF NASO-LABIAL FOLDSPHILLIP LEVY 1 , HERVÉ RASPALDO 2 , KOENRAAD DE BOULLE 3Background: The ageing process, combined with volume loss and muscular hyperactivity, leads to the formation of folds and wrinklesin the face. Dermal fillers are commonly used to treat these and improve facial volume. Juvéderm? ULTRA 3 is a new addition to theaesthetic armamentarium of facial fillers. It is a smooth cohesive hyaluronic acid gel for injection into the medium/ deep dermis. It alsocontains 0.3% lidocaine, which has been shown to significantly reduce the pain of injection.1The objective of this study was to compare the injection comfort and ease of injection of Juvéderm ULTRA 3 with Restylane - Perlane?in a split- face, single-blind design.Method : One hundred and twenty six subjects were enrolled at three centres: one each in France, Belgium and Switzerland. Eachsubject received both products, which were randomly assigned to the right or left naso-labial fold. Subjects were blinded as to whichside was injected with each product.Using the British Pain Scale the level of injection pain and ease of injection was assessed by the injectors, while the patients assessedthe level of injection pain and stated if they had a preference for one treatment over another and if so, why.Results: The mean age of subjects was 52.9 years and 97% were female. The mean injection volume was 0.6ml for both products.When assessed by both injector and subject, pain of injection, pain of massaging the injected area and post-injection discomfort werestatistically significantly less on the side treated with Juvéderm ULTRA 3 ( p< 0.0001, for all parameters). 92% of the injections withJuvéderm ULTRA 3 were considered 'very easy' by the injectors and 8% were considered 'fairly easy'. This compared with 21% 'veryeasy' and 34% ' fairly easy' with Restylane - Perlane?. When asked which injection experience they preferred overall, 95% of subjectspreferred Juvéderm ULTRA 3.Adverse events were mild and transient with both products.Conclusions: Juvéderm ULTRA 3 provides superior comfort during injection, massaging and in the post- injection period comparedwith Restylane - Perlane? when assessed by both injectors and patients. Patients were able to feel the difference between the twoinjection experiences and commented that both products gave a good aesthetic result but that the Juvéderm ULTRA 3 injection wasa far more comfortable and gentle experienceReferences:1. Comparison of Injection Comfort and Ease with Juvéderm ULTRA 3 and Surgiderm 30 XP Poster presented at IMCAS, Paris, January 9-12 20081 Private Practice, Genèva; 2 Specialist Consultant in Facial Plastic Surgery, University of Nice; 3 Aalst Dermatology Group, Aalst, BelgiumTHE JUVÉDERM ULTRA EUROPEAN EXPERT EVALUATIONGREGOR WAHL 1 AND THE JUVÉDERM ULTRA 3 EXPERT GROUPBackground: The Juvéderm ® ULTRA range is a new category of hyaluronic acid filler, containing 0.3% lidocaine for improved patientcomfort both during and after injection. Juvéderm® ULTRA 3 is a smooth cohesive gel, indicated for injection into the mid / deepdermis. This evaluation was designed to assess injector and patient opinions of the comfort and aesthetic result of Juvéderm ® ULTRA3 in the naso-labial foldsPOSTERS__________________Method: 82 injectors from France, Italy, Spain, Germany and the UK were recruited and injected 806 patients with Juvéderm ® ULTRA3. All of these patients had received a filler in the naso-labial fold area within the previous 18 months and had returned to their aestheticpractitioner requesting another treatment.Both injectors and patients assessed the level of pain felt [British Pain Scale (0= no pain and 10 = worst pain imaginable)] during andafter the procedure and the aesthetic result achieved. Additionally injectors assessed the ease of the injection and reported whetherthey would recommend Juvéderm ® ULTRA 3 to professional colleagues and other patients seeking treatment with dermal filler. Patientswere also asked if they would recommend the treatment and how it compared with their previous experience with other dermal fillersResults: 806 patients were injected, 92% were female. Previous fillers included Restylane, Hydrafill and Surgiderm. Both injectors andpatients reported low levels of pain during the injection procedure, massaging or sculpting and 5-10 minutes after the injection. 86.9%of patients considered that the overall injection experience with Juvéderm ® ULTRA 3 was 'significantly' or 'somewhat' more comfortablethan with their previous filler injection.With regard to the aesthetic result, 94.9 % of the injectors and 95.7% of the patients considered the result 'excellent' or 'good'. Almost2/3 of injectors (64.1%) rated the aesthetic result as better than previous fillers. Both groups would recommend Juvéderm ULTRA 3 toothers. When asked about the ease of injection 98% of injectors found Juvéderm ® ULTRA 3 easy to inject and sculpt.Conclusion: Juvéderm ® ULTRA 3 with 0.3% lidocaine provides a more comfortable injection experience and improved aesthetic resultfor the patient compared with previous experience of dermal fillers.1 Private Practice, Berlin, Germanys138