FINAL PROGRAM 6TH EDITION - EuroMediCom

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