Since the embryo, to adolescence, cortisol, for example, is a necessity to create the serotonin system. Estradiol, in both genders during early months of life, is a central hormone to facilitate the synaptic brain net.
We already understand that some adult diseases can find their origin in hormone-neurotransmitters imbalance. Steroid hormones are strong neurotransmitters modulators. Cortisol in deficiency decreases the serotonin pathway, but in excess it overloads the brain dopamine circuits, increasing the appetite in both cases. Testosterone and estradiol facilitate greatly the acetylcholine transmission and give new synapses, able to induce the hippocampus activity against the cortisol excess, destroying cells and protect this brain area of Alzheimer's disease.
In the same field, progesterone can create new Schwann cells, new neurons, and, more than a GABA stimulator, can also, by the allopregnanolone, participate to help the memory processes. The luteal phase modulates the adrenal function, and dopamine action. Pregnenolone for example, directly by the membrane action, blocks the GABA, but Dhea uses the receptor itself for the same action.
The GABA modulation is one of the most neurotransmitter used by the humanity, since the ancient time, by alcohol, and benzodiazepine recently; now, some hormones can do the same, without danger. Another case is the thyroid gland, associated with dopamine, with brain excitability, Memory, and energy. Neurotransmitters, as hormones, are linked to our fabulous brain clock, and moment is different to take one of them in function of the effect you want to get.
Preserve or accelerate the longevity process depends in part of these actions, interacting with genes. We can multiply the examples. Our behaviours, all life long, depend on this link between hormones and neurotransmitters; Appetite, dreams, reproduction, mood, stress, sensitivity to pain, Learning, some psychiatric disorders, Memory, sexuality… Without forgetting that the skin is a wonderful milieu of interactions between hormones and neurotransmitters, able by itself to secrete, for example, melatonin, serotonin.
In a senescent body, aging processes, leading to neurodegenerative diseases, can be prevented by neurotransmitters preservation, and this is reliable, cellulite vs no cellulite rapidement part, to hormones.
We can help our body to play its roles more completely, by modulating these parameters, like on a musical instrument, for life. But we know that scientifically tested plan for brain care can help you attain your peak level of health, physical vitality and mental functioning. The onset of new technology has enabled anti-aging specialist to test variety of lab tests and then learn what you can do to keep these chemicals in balance. A balanced brain can prevent premature aging, improve general health, and arrest or reverse the course of many illnesses.
Brain neurotransmitters are excitatory and inhibitory. Metabolism of neurotransmitters is affected by neurostress. Very important is connection between brain chemistry and electricity : Voltage energy or metabolism : is the brain getting the necessary nutrients to function? Speed Memory : How well is the brain processing information?
Symmetry Mood : Are the left and right hemispheres functionally connected? Because each of the neurotransmitters has a natural nutrient precursor, these deficiencies can be threated first with diet and nutritional supplements.
Global ageing manageability depends on global ageing measurability. Reduced functionality causes ageing, so it is worth measuring the interactions between biological, psychological, social and emotional functions.
Lifestyles and relationships guide our genes, measuring their consequences will help coaching clients correctly. To realize the physiological reality of a human being and to detect its reactions on influences from inside and outside during day and night is as fascinating as to enter men with the help of a small ECG, detecting different kinds of variability between one heartbeat and another in a sample of Reading those phenomena means to know how the autonomous nervous system is tuned.
Silent inflammation as a precursor of Depression Alzheimer, Multiple Sclerosis and other CNS-dysfunctions goes ahead with a withdrawal of vagal activity PizziCarpeggiani Effects of anti-inflammatory therapy can be evaluated by encouraging vagus activity.
The importance of the vegetative function in this context is confirmed by fundamental research on the role of acetylcholine as effective anti-inflammatory agents Tracey Examples of healthy and diseased people demonstrate the consonance of Heart Rate Variability with the exploration of neurotransmitters, hormones, micronutrients and psychometric methods.
Ageing management based on that non invasive tool, useable for diagnosis, monitoring and evidence, offers a new approach for progress in preventive medicine. However there is no clear association between the degree of subjective complaints and the biological consequences of stress. Chronic permanent stress without adaptation may furtheron deplete adrenal reactivity by loss of diurnal adrenal cortisol secretion, leading to burnout, weakness, fatigue and pain.
In addition immune system will be stimulated directly by NE via transcriptionfactor NF? B, as well as loss of immune supression through the low cortisol. For that reason the simple fatigue is characterized by hypocortisolism and reduced NTs, especially serotonin, which acts as a functional counterpart of the sympathetic nerve-system SNS. Catecholamines may be normal, reduced or enhanced, leading to specific additional symptoms.
The individual NT metabolism is basically directed by genetic and epigenetic as well as lifestyle attributes. ROS are normal signal molecules for the immune system and basically necessary for immune adaptation. This reaction is initiated not only by neurostress, but also by any biological stressor infection, physical and emotional trauma, operation, metabolic disorders, environmental toxins, chronic stress etc.
Modern diagnostic procedures enable to clearly define the cause and the stage of neurobiological, emotional and physical disturbance. Diagnostics used are: Description of stressors by stress-test, adrenal adaptivity by cortisol day-profile in saliva, neurotransmitters EN, NE, DA, serotonine, GABA 2nd morning urine, physical stress parameters HRV, bloodpressureas well as oxidative substrates total oxidative capacity or lipoid and aqueous radicalscitrullin 1st morning urine as parameter of NOproduction, as well as nitrosative substrates 2-nitrotyrosineand intracellular quenching substrates red.
Alzheimer are the leading diseases among chronic illness, leading to 8,4 depression and 6,3 m. Alzheimer loss of healthy years. Depression is known to be based on genetical polymorphisms of regulating genes for the synthesis of serotonine and Cortisol-receptors, as well as epigenetic influences pre- and perinatally, as well as negative lif-events during early childhood and adolescence. Hormones, nutrition and metabolism, micronutrients and biological stressors chronic stress, infection, trauma play an additional important role.
Especially chronic stress as undefinite anxiousness, inquiescence, uncertainty due to pessimistic scenario of the future are increasingly causative.
Stressors may independantly - whether emotional, infectious or somatic in origin - lead to a functional loss of mitochondrial energy-production and cellular function as well as inflammation. Preventive Medicine of depression and m. Alzheimer is focussing on the individual genetic, epigenetic and environmental basics. Main enhancers or second hits for the establishment of the disease eg trauma, permanent stress, infection should be detected and treated by an individual and integrative program.
Diagosis should be performed by stresstest as well as measurement of stress-parameters with saliva-cortisol day-profileneurotransmitters EN, NE, DA, Serotonin, Glutamate in the 2nd morning urine, HRV heart rate variability and bloodpressure.
Modificated order-therapy, stress reduction focused on the causes and personal amplifiers of stress, learing of relaxation technics, aerobic exercise and substrate therapy restitution of neurotransmitters, evtl hydrocortisone.
Additional establishment of social background and support, development of emotional intelligence, shift of type A to type B personality and coherence sense and value of life is needed.
Kawashima etc and selective substrates ginkgo biloba, omegaunsaturated fatty acids, estradiol etc. As physicians we should intervene with adequate personalized medical strategies, and not only with psychopharmacy. Une technique fiable et reproductible. Actuellement, la technique est fiable et reproductible. Qu'en est-il de la lipostructure et du Macrolane? Au niveau de la fesse, aucun souci. It will involve more or less al1 organs and generally refers to a complex process of multidimensional alterations.
Two independent process are governing the skin aging Intrinsic and Extrinsic aging. Intrinsic aging is the slow irreversible degeneration of tissue that affects almost al1 body organs. Extrinsic aging is thought to be due of exposure to environmental factors.
All three layers of the dermis are affected by the aging process collagen regime medicament pour maigrir pharmacie slow down, and elastin, the substance that enables skin to snap back into place, has bit less spring. While these changes usually begin in our 20s, the signs of intrinsic aging are typically not visible for decades.
The signs of Intrinsic aging are : Fine Wrinkles, thin and transparent Skin, loss of underlying Fat leading to hollowed cheeks and eyes sockets as well as noticeable loss of firmness on the Hands and Neck, bones shrink away from the skin due to bone loss, which causes sagging Skin.
The choice of suitable approaches will depend on individual patient linked factors and the type of visible signs. Recommendations should not only define realistic expectations but also avoid unrealistic hope as well as any inadequate risks. In the last few years doct ors have increasingly adopted minimally invasive techniques in body and face contouring. By using a combination of smaller surgical procedures with appropriate filler substances one can achieve optimal anti-aging results with less discomfort for the patient with immediate long lasting result.
The author will demonstrate in the paper different techniques and materials Fat Transfer to fillers. Laser is a specific tool for a specific indication. Every physician who wants to practice in aesthetic medicine needs some of these tools. In European countries, laser costs are high and this is why some devices may be useful before buying them. If you are in a solo 69 amwcconfbook.
With these different machines you will be able to treat a great number of skin diseases, without spending too much money. First demand is hair removal, then vascular and pigmentary treatments. Hyaluronidase Hase is a specific enzyme, which can dissolve hyaluronic acid HA. Hase is produced principally in the testis and derived from ovine, bovine or snake cobra venom. It is potentially allergenic and therefore a skin test must be performed before injecting it. Allergic reactions are not well described except by ophlamologists.
Meanwhile frequency would be around 0. A prick -test is more suitable than an intra dermal injection for detecting type 1 hypersensitivity. Several products are launched with each one's specificity. Load of protein may change and risk of hypersensitivity too. In cosmetic indications, it permits to dissolve in a few hours either a HA overcorrection or a HA complication. Hase is not present in all European market not in France for injections. References: - Andre P, Levy P.
Hyaluronidase offers an efficacious treatment for inaesthetic hyaluronic acid overcorrection. Successful management of an unusual presentation of impending necrosis following a hyaluronic acid embolus and a proposed algorithm for management with hyaluronidase.
Dermatol Surg ; However, the procedure still has, in some sub-groups of patients, a relatively significant rate of complications. The aim of this study is to point out the factors that could be improved in order to decrease these complications and to obtain better results in terms of scars and contour.
These factors will be detailed and discussed with the reference to the literature and to the own author's experience.
Some conclusions will be suggested. At about the same time, the fat in the subcutaneous layer which gives skin a plump, firm appearance also begins to disappear, the epidermis begins to sag, and wrinkles form. Many devices utilizing different technologies are available in the market now. All of them are aiming at deep tissue heating for an immediate collagen contracture and collagen stimulation and synthesis on the long term.
The differences between the available technologies, patient selection, expectations, the appropriate technique and treatment combinations will be discussed in an oral presentation. In most of the cases, the pathology is multilevel and affecting more than one layer of the skin and dealing with only one layer 70 amwcconfbook. Even in cases where the patient is presenting by a dermal problem, it would be helpful to improve the epidermal structure.
So, combination of techniques dealing with both the Dermis and the Epidermis is essential to get the best outcome. The role of non surgical lasers and light in the rejuvenation procedures will be discussed in a short oral presentation. During this process the microcirculation is affected which leads to edema and lymphatic stagnation further worsening the condition. Managing the local fat deposits and cellulite has to take into consideration the various etiological factors. Recently, Injection Lipolysis or Chemical Lipolysis has been one of the commonly used modalities of treatment of localized fat deposits and cellulite.
A short oral presentation will review the commonly used injectables, injection technique, common side effects and how to avoid. The main indications are treatment for acne, melasma, dyspigmentation, lentigines, actinic keratosis, fine lines, and dehydration. It is simple, safe, standardized and test proven aspeels have been performed since it was launched in USA, It has a track record of high rate customer satisfaction that makes doctors happy in terms of increase revenue and job satisfaction.
The active ingredients are a selected and a balanced mixture of TCA, Phenol, Ascorbic acid, Retinoic acid, Salicylic acid, and a propriety blend of vitamins and minerals. This brilliant system is based on the synergy of different components and their respective mode of actions.
It works on the principle that less of each ingredient causes less complication. Moreover, there is minimal or no pain due to the mixture of the acids. VI Peel is suitable for all skin types ranging from type 1 to type 6.
There is no prior need to pre condition the skin. Since the acids are balanced in a selected way, there is no risk for over correction. The post treatment protocol is straight forward with no limiting instructions exposure to sun etc.
So far, there are no long lasting complications recorded. Any irritation, hypersensitivity or rash can be calmed easily. As a clinician it is indeed rewarding to work with such a powerful and yet safe, predictable product for cellular rejuvenation.
Wrinkles: Traditional fillers and the art technology application Botulinum toxin associated with traditional and innovative points Sagging: Injections of acids and application of electric current machines, with lasers and radio frequency Hairs : Removal lasers: alexandrite or diode Peels: Chemical, mechanical and laser Mesotherapy: With products that stimulate the production of new collagen and elastin fibers Body: Cellulite: A combination of methods such as mesotherapy, endermologie, lymphatic drainage and carboxitherapy Streaks: Lasers, mesotherapy and fibroblasts transplantation Vessel sclerosis: Lasers and new products Localized fat: Deoxycholate Flaccidity: Radio frequency and carboxitherapy VALCINIR BEDIN, MD PHD Hair restoration: New techniques for optimal results Session: New Trends in Brazilian Cosmetic Dermatology and Aesthetic Medicine Saturday April 10th, 8.
Now hair restoration surgery is going through another important evolution that is improving both the naturalness and fullness that can be achieved from any one surgical hair transplant session. This graft density is as much as twice that of the standard follicular unit hair transplant procedure. Such high densities of transplanted hair typically produce the appearance of fullness even after only one surgical session. Patients also experience rapid healing and no le sport pour maigrir skin distortions due to the tiny size of these incisions.
Youth implies tissue plasticity, regularity of skin surface and shape and contour i. It takes profit from the expertise in fat lipostructure and from progress in quality of fillers products, essentially hyaluronic acids because, in our opinion, the non resorbable products still have to show their harmlessness and safety in the medium and long term. If today, above 70 brands of fillers are available in Europe, it's obvious that the future of filling will be shaped by research In term of volumetry, the goal and objective are to recreate volume insufficiencies thus to enhance or to restore the volume loss by the soft tissues atrophy, consequence of ageing thus to rejuvenate.
A young glance is full, a young smile is full. And, to restore or to emphasize: - An orbito-palpebral contour for a glance by correcting tear trough and peri-orbital shape. Here are the goals of facial volumetry: to correct shades, depressions, atrophies and to restore shape, contour, fullness, harmony, light and form. All these are synonyms of youth. It goes without saying that our technical expertise supposes a perfect understanding of anatomy, physiology, ageing-process and also a perfect knowledge of the injected products and their safety and of course a perfect understanding of the patient's expectations and desires.
That will enable us to answer the 3 fundamental questions: - What to inject? Technical expertise will seek primarily harmony. Never forget that volume is less important than balance and harmony of volumes. Un regard jeune est plein, un sourire jeune est plein. Results: 20 patients received each treatment.
The patients were matched for age, previous injections and injected products. Both groups received similar volumes of the study treatments mean vol 1. All patients were asked to start their lip treatment with no additional anaesthesia. The mean pain score was 7. No adverse events were reported in either group. Conclusions: The HA filler with pre-incorporated lidocaine showed higher scores for ease of injection, sculpting and massaging, aesthetic effect and smoothness compared to the HA filler without lidocaine.
These procedures are more acceptable to the busy, upward mobile young to middle-aged professional who cannot afford any time away from work. Non-invasive procedures require no surgical incisions and patients experience minimal to no convalescent recovery time after the procedure.
These treatments do not stop the face from aging, but they can take years off a person's appearance by tightening sagging skin and reducing facial wrinkles.
Different minimally invasive rejuvenation procedures currently available treat different types of age related skin changes and wrinkling that are ideal for the periorbital and perioral areas. Dynamic wrinkles of the periorbital and perioral areas are treated with botulinum toxin. Static wrinkles in those areas are treated with the new fractionated laser resurfacing techniques, while volume loss is enhanced by soft tissue fillers.
Examples of combined rejuvenation techniques will be illustrated with photographs of patients before and after treatments. Because it is a non-coherent gouter de 16h regime wavelength light source, IPL targets the multiple absorption spectra of both melanin and hemoglobin, enabling it to treat hair, pigmented and vascular lesions. With its interchangeable filters, optimal wavelengths can be delivered according to a patient's skin type and the amount of sun-tan present.
The chilled delivery tip protects the skin surface from epidermal burning allowing for the pulsing of higher fluences as compared to other types of traditional lasers. The large spot sizes allows for large areas to be treated easily and quickly. Its non-collimated, diffuse light is no more dangerous to the eyes than a flash of high intensity light. When administered appropriately, non-ablative IPL treatments produce no post-treatment purpura, epidermal burning or other side effects resulting in virtually no post-treatment downtime for the patient.
Between January and January a total of treatments were given to 89 patients for facial rejuvenation with the LumenisOne Lumenis, Ltd. An average number of four treatments were necessary to rejuvenate the face to both the patients' and physician-operator's satisfaction. Skin types of patients treated ranged from Amaigrissement de mon furet karcher. Preoperative diagnoses of the patients undergoing treatment included: telangiectasia, hemangiomas, treatment-resistant rosacea; lentigines and freckling; poikiloderma and solar elastosis.
Initially developed for the treatment of premalignant and malignant skin lesions, ALA combined with post application exposure to light of particular wavelengths is called photodynamic therapy PDT. Levulan and Metvixia are approved by the FDA for the treatment of non-hyperkeratotic actinic keratoses of the face and scalp.
ALA is absorbed through the epidermis 73 amwcconfbook. Levulan can be applied to the skin surface and left there for only one hour before it is exposed to IPL for cosmetic indications.
Modified treatments with Metvixia are still being developed in the United States. Between January and January a total of treatments were given to 38 patients for treatment of pre-malignant lesions and photodamaged skin with the LumenisOne IPL. IPL treatments with or without ALA-PDT particularly with the LumenisOne, are one of the safest and most effective ways to rejuvenate photodamaged skin of the face with virtually no down time and no adverse events.
Also, lipstick may bleed up into these vertical lines and onto the cutaneous lip while the vermillion border becomes ill-defined and flat. Then there are those women who just are not happy with the shape and size of their lips. To correct these problems, lips can be enhanced with various dermal fillers and treated with injections of BTX. In the United States, collagen fillers soon will not be available.
Therefore, all lip enhancement and rhytides attenuation must be done with hyaluronic acid fillers hyaluronans. Less robust hyaluronans can be injected along the border of the vermillion and cutaneous lip to enhance lip definition and eliminate vertical lipstick lines.
Hyaluronans injected into strategic places within the cutaneous lips can recreate the natural contours of youthful, ample lips. The hyaluronans are noted for their hygroscopic properties and are best utilized to enhance lips. Different types of hyaluronans will benefit individual patients in different ways and it is up to the physician injector to determine which product would work best for each individual patient. When planning an injection of a patient's lip with BTX, particular attention is needed because the perioral area is controlled anatomically by different muscles that function either independently of each other or in unison to create a sphincter effect of the lips.
It can be somewhat challenging to produce a unified effect with BTX without disturbing the symmetry and function of the lips. Diminishing the dynamic perioral vertical rhytides with BTX requires an expert knowledge of the interdigitating muscles in the perioral area that provide the synergistic functions of masticication, phonation, deglutition as well as the expression of emotion. Injections of BTX should be used only to weaken the superficial fibers of the Orbicularis oris so as to reduce the dynamic wrinkles of the lips without disturbing their synergistic functions.
Even if liposuction was developed 30 years ago, the lower limbs remain the most challenging area of the body to be sculpted. Total: photographs. All the photographs were inserted in a power point program.
The curves were outlined in different colors. Geometric modeling was used to identify the position of the ideals concavities and convexities on the ideal leg. In this study, a new aesthetic model of leg, as well as a new artistic drawing is proposed. The technical details for a safe liposculpture are described to achieve the smooth harmonious curves. The handling of these structures has always been very treacherous, and long-term follow-up quite often has shown unexpected results.
Based on Ishida's experience, we make use of abrasion treatment of the nasal cartilages with the burr power drill. This device can produce controlled weakening on determined regions of the nasal cartilages. If this weakening is done on just one side, the cartilage will bend to the opposite side.
To correct the alar cartilages, the burring is done either to enhance curvatures or to change the conformation of the alar cartilage itself. Our 4 years of experience using this method shows satisfactory results.
The method permits change of domus angle, corrections of alar deformities, projection of the tip and offers the surgeon the possibility to give whatever shape change without the need to resect, stitch or graft the nasal tip.
On the septal cartilage, this method can be used to straighten it by abrasion on its concave portion; on secondary rhinoplasty with severe loss and deformation of the alar cartilages it can help the surgeon immensily. Summary: We offer our experience of a new technique of injecting hyaluronic acid crosslinked with a specific periorbital cannula: hyalurostructure by orbitofacial filling. Indications were: hollow eye rings, hollow cavities, the valley of tears, the orbital part, temporal area and the region of the eyebrow.
Treatments has been realised with no anaesthesia using the same protocol as Collman lipostructure but using hyaluronic acid. The advantage of microplasty is that it is realised in office as a classic injection of hyaluronic acid for wrinkle treatment with same aseptic rules. Comparing to injection with needle, we notice less bruises 3 located in the place of pre incisiongym rides du front 43 surface irregularities by a better distribution of the product filling position and retro orbicular pre periosty and less lymphatic stasis 4 cases in the internal angle Conclusion: Peri orbital region and valley of tears treatment by hyaluronic acid injection is known.
But often the risks of this delicate anatomic region and bruises caused by needles followed by the appearance of dark coloured circles due to deposition of haemosiderin have limited the development of this technique.
We propose a new treatment for dark circles and for orbitofacial region adapted from lipostructure but with hyaluronic acid facilitating treatment protocol of that region with improved aesthetic results: Hyalurostructure. Design: 50 dr oz what causes cellulite reviews of associated nose and chin plasty performed simultaneously from to to evaluate the complications and the stability of the result.
Results: we recorded: pog' projection to TVL, mandibular height mandibular incisor tip to menton'. Conclusions: Even with a nice rhinoplasty the patient's face can lack balance or harmony. One of the causes of facial disproportion is that there is a strong nasal-to-cervical relationship. The associated rhinoplasty-chin osteotomy or filler operation gives a good solution in these patients avoiding the need for a second intervention thus providing the optimum in patient satisfaction.
Their role is not only to hold the facial tissues, but also to create the necessary anchor points to allow facial muscle activity. On the other hand, they are also our enemies since they are responsible for the visibility of the aging process.
These fixed areas of the face are a gift from nature and should not be destroyed. Regardless of the procedure we are applying, whether we are performing a face-lift or whether we are using volumizing fillers to soften the compartmentalization of the fat tissue, we have to use these fixed points to our advantage such as to obtain results that are more natural.
The face and the look should be treated vertically in monoblock, the neck in horizontal way, without any communication between the two surgical acts. This is the only solution to obtain a natural and harmonious result: bringing the tissues back to where they were before and not to somewhere else where they have never been before. The same reasoning applies for the new injection techniques: the closer we inject to the fixed area, the more effective the retensioning result will be.
C'est entre ces poulies de rappel, qu'existent des espaces mobiles, essentiellement graisseux, qui, au fil du temps, se compartimentent de plus en plus. Background: Radiofrequency devices for aesthetic applications such as body and face skin tightening, cellulite reduction, rhytids and body contouring treatments are becoming increasingly popular in clinics worldwide due to their demonstrated efficacy and safety combined with relatively lack of complications and down-time.
These devices focus low RF power from four electrodes deep into the dermal and hypodermal layers to stimulate dermal activity, tighten collagen fibers and increase new collagen production as well as to stimulate fat metabolism.
Objective: Dermal skin aging is defined, more particularly, by a decrease of dermal collagen with loss of tightening. An original ex vivo model Boisnic, Dermatology, 1, maintaining the skin in survival conditions during 12 days was used for histological and biochemical evaluations of the TriPollar clinical efficacy.
Such UV exposure has previously been shown to induce premature structural and cellular skin photo aging effects on fibroblasts and dermal collagen in human skin explants Boisnic, Skin Pharmacol Physiol,18 4 : maintaining.
The survival medium was changed three times a week. Skin samples were maintained alive for 12 days. To analysis restructuration efficacy of the 2 devices, dosage of new collagen synthesis and morph metric analysis of dermal collagen was made.
Skin tightening was also evaluated by dermal histology and quantitative analysis of collagen. Fat metabolism was evaluated by dosage of hypodermal glycerol release and fat layer histology. A significant increase in hypodermal glycerol release was detected using the POSETM device showing efficacy on cellulite.
Extremely of an experiment of almost medical rhinoplasties, we expose which are the new trends and the various solutions to modify in safety a nose without surgery. Introduction: Rhinoplasty is one of the most frequently procedure in plastic surgery. It remains a surgical act but the new fields of aesthetic medicine modify its philosophic and technical approach. The use of botulinum toxin in the treatment of the nasal wrinkles and the correction of the dynamics of the tip offers enthralling prospects for treatment.
Indeed the nasal musculature contributes at the time of the expressions of the face has to deform or raise a disgrace. For example the filling of the naso-frontal angle by the corrugator, the development of wrinkles on the dorsum by the contraction of the complex procerus-transverse. But the action of theses muscles is especially obvious on the level of the nasal tip to the smile by the traction of the septi-nasi muscle which will improve the hump.
The nostrils are also under the muscular dependence of groups that the botox can balance. Concerning the fillers, associate or not with procedures combined with botulinum toxin, they allow to correct the defects, the irregularities of the nasal frame. The medical rhinoplasty is born! These acts of medicine occupy a prevalent place today and make it possible to widen our field of activities.
Objectives: To describe the quoi manger pour maigrir des bras 83 methods of medical rhinoplasty, associating fillers and botulinum toxin without invasive surgery, to evaluate their effectiveness by a retrospective analysis of an experiment of patients over 4 years and to discuss precise indications of this new approach.
Materials and methods: between January and Octoberpatients profited from nonsurgical treatment of esthetic disgrace of the nasal pyramid. They were women and 75 men. The distribution of the indications was the following one: primary rhinoplasties, 90 final improvements of rhinoplasty.
It was of a treatment by fillers in cases, of a treatment by botulinum toxin isolated in 30 cases, and about an association of the 2 procedures in 84 cases.
The botulinum toxin used was a toxin of the type A. Concerning the fillers, it acted of hyaluronic acid in cases, of hydroxyapatite of calcium in 30 cases, phosphate of calcium in 2 cases, poly-lactic acid L in 5 cases and of polyacrylamid gels in 2 cases.
Results: In this series of cases, the index of satisfaction is very high, higher than that obtained in the treatment of the other wrinkles and defects of the face apart from the effects of botulinum toxin. The rate of complication is much reduced because only one reversible complication with type of infection of the tip multi operated case. The duration of the results depends on the product used: 4 months for botulinum toxin, 12 to 14 month after 2 injections for the temporary fillers.
Conclusion: The medical rhinoplasty offers a new range of therapeutic solutions for many corrections of the nose. This new approach of the rhinoplasty corresponds thus completely to current waitings of the patients. The conclusions made in this position are often interpreted differently given that there are currently multiple different techniques of which none have demonstrated a real superiority.
The face of a patient is more youthful in the supine position. A position with the head slightly lower augments this rejuvenation. This particular position, which enhances the youthful appearance, provides a unique model to study surgical methods of rejuvenation. The clinical model was used as the basis in this study to analyse the anatomical modifications that occur in the transition to the head down position and the technical manoeuvres that are necessary to ensure the maintenance of the facial rejuvenation on return to the sitting position.
Methods: A patient presenting with classical signs of ageing was photographed with frontal, three-quarter and profile views in 77 amwcconfbook. The rejuvenation obtained in the latter position and the modifications produced on the contours, volumes and the apparition of particular wrinkles were analysed clinically. Results: The study suggests the following. There is a negligible role on the signs of ageing by structural changes of fatty tissue, septae and bone in contrast to the apparent importance of the mechanical effect of the skin.
Two vectors very close to the vertical appear necessary for rejuvenation of the medial half of the midface and imply the need for orbital fixation. Two vectors near the horizontal but slightly oblique superiorly appear necessary for rejuvenation of the lateral half of the midface and neck.
The vertical and horizontal vectors must be performed simultaneously to ensure the rejuvenation is homogeneous and complete. The steps necessary to maintain the rejuvenation obtained in the lower head position on return to the sitting position should be focused on the fixation of the volumes at the level of the particular wrinkles which appear in the head down position.
Undermining and resection of skin should be limited to the zones of skin excess at the level of the wrinkles and stabilisation of the volumes. No tension is necessary when suturing the skin. Anatomical modifications produced by classical surgical procedures do not appear necessary to obtain the observed rejuvenation but they calendrier lunaire cheveux online have a role in the maintenance of the observed result when returning to the sitting position.
While this situation is understandable from the point of view of the general public fear of surgeryis it justified by any real shortcomings in the solutions currently offered by plastic surgery? On the other hand, non-surgical techniques to tighten the skin and correct the figure are enjoying quite a boom.
The question is whether the results currently obtained with the various available systems live up to the very legitimate buzz that these systems are generating in the media? Conclusions: That is why, before treating excess skin and local fat deposits, we believe the best approach is to carefully examine the indications, the respective results and the possible combinations of surgical techniques and non-surgical techniques. In the event that a non-surgical technique is chosen, it is also important to take on board the respective indications of the various available systems and to provide the patient with realistic and honest information.
En cas d'hypertrichose ou d'hirsutisme, nous rechercherons une anomalie hormonale. Quant aux exceptionnelles queues faunesques, elles feront pratiquer les bilans de dysraphie. The best way to accomplish this has been subject of passionate discussion. We present a fully nonendoscopic procedure with a transpalpebral approach combined with minimal scalp incision that can provide a cosmetic effect comparable to that produced by the coronal incision technique.
It also allows safe direct visualization of anatomic structures comparable to that allowed by the endoscopic-assisted technique but dispenses with tedious endoscopic instrumentation, and avoids the risk of a blind dissection close to the frontal branch of the facial nerve.
We present a stepwise approach to clarify our surgical systematization. It is an easy technique and the only essential requirement is thorough knowledge of the relevant anatomy.
Material and methods: A forehead lift with transpalpebral subperiosteal and subsuperficial temporal fascia undermining, 78 amwcconfbook. The fixation method: On both sides three suspension nylon sutures are placed at the superior edge of the temporal incision and with a modified reverdin needle that enters and leaves the anterior skin through the same point, a consistent amount of anterior galea is lifted.
The temporal incision is made as high in the scalp as a coronal incision is usually placed. The resulting suspension vectors will affect both the mid and lateral portion of the brow.
The transpalpebral approach: As the lateral temporal and supraorbital adhesions are not more than two centimeters far from the upper blepharoplasty incision, it is possible to release them under direct vision increasing the safety of this dissection. For a very experient plastic surgeon or those with skills in craniofacial surgery it may seem unnecessary to combine this approach with a temporal incision. However a blind dissection through the temporal port brings more risk of injury to the frontal branch of the facial nerve and makes more difficult the release of the dense and firmly attached supraorbital periosteum.
We are then proposing a stepwise approach to the brow lift that even for less experienced surgeons could be safe and effective. Results: In this series we did not have any hematomas or infection and there was just a light edema. The patient could return to its social activities after three to four weeks. After an initial phase when we could observe some overcorrection of the brow ptosis, the final position was gradually obtained and remained stable as we could see in a three years follow-up.
There was no definitive frontal paralysis although we had three case of transient paresis that totally recovered after three months. Also transient alopecia was observed at the temporal incision. Conclusion: Endoscopic-assisted views of the anatomic landmarks and planes helped surgeons better understand the dynamics of brow ptosis.
We are now adopting the same principles but avoiding the cumbersome endoscopic equipments with a direct visualization of the anatomic landmark in the orbital rim and inferior region of the forehead through the upper blepharoplasty incision and combined with a transtemporal access to provide a safe and reliable brow elevation. New trends are always challenging the plastic surgeon to adapt its clinical approach.
As a result we expect an evolution that should provide surgical techniques with less recovery time, more predictable and consistent results. In aesthetic breast surgery we have experienced an increased request for breast augmentation and for larger implants. The new generation of cohesive silicone gel implants made it possible and we also could improve the association of mastopexy and breast augmentation with shorter scars and more natural reshaping.
The polyurethane foam coated silicone breast implant has a very low rate of capsular contracture and may be the best option for its management. For this reason this is our first choice implant. We are presenting the long term results of this approach.
Nevertheless thanks to bariatric surgery, this procedure has became more and more performed recently and well codified. If we resp ect basics rules, this surgery allows to treat contour deformities 79 amwcconfbook. This circumferential bodylift provide a dramatic improvement in skin tightness and restore youthful contours especially to the buttocks and thighs. An abdominoplasty can only treat the front part that represents no more than one quarter of the trunk.
The result will be not harmonious and balanced like the one after a bodylift. By respecting patient selections and following preoperative planning we produce long lasting result with low risk of complications.
According to the World Health Organization, obesity is defined as an increased or abnormal accumulation of body fat mass to the extent that individual's health is negatively affected. Overweight is considered as top at risk condition in the world and it is mandatory to identify the physiopathological causes involved in adipose tissue enlargement and related metabolic and cardiovascular health disorders.
In this context adipose tissue has been under focus in the last decades and pivotal concepts have emerged from the studies of their complex biology. The adipose organ is not simply a site for passive energy storage. White adipose tissue WAT is composed of mature adipocytes, precursors preadipocytesendothelial cells, macrophages, mast cells, blood vessels, nerves and lymphatic and connective tissue.
Material and Method: The phenotype, amount and biology of each WAT component have been studied in human samples. Result: In addition to adipocyte metabolic dysfunction i:e lipogenesis and lipolysis capacitycellular stress including inflammation, oxidative, reticulum endothelial stress and hypoxia are part of the biological alterations which attract and retain inflammatory cells within the WAT and promote adipocyte insulin resistance.
Human adipocyte and preadipocytes demonstrate profound modifications of their biology when co-cultured with human macrophage media. A pro-inflammatory state, increased lipolysis and resistance to insulin are observed in adipocyte while the capacity of preadipocyte to differentiate is altered in presence of inflammatory stimuli. Inflammatory preadipocytes also acquire capacities to migrate and to synthesize profibrotic components.
The evaluation of transcriptomic interactions characterizing the adipose tissue of weight-stable obese subjects demonstrated the strong relationship linking inflammatory processes to extra cellular matrix ECM remodelling components. Our group showed that interstitial fibrosis accumulates in obese WAT as in many organs affected by low-grade inflammation in chronic diseases i. Conclusion: In this conference, some illustrative examples will be taken regarding the pathological alterations of the adipose tissue in human obesity including the local altered biology of the adipose tissue and the discovery of new biomarker linking enlarged adipose tissue to obesity complications.
References 1. Association between omental adipose tissue macrophages and liver histopathology in morbid obesity: influence of glycemic status. J Hepatol. Epub Apr 24 3. Adipose tissue transcriptomic signature highlights the pathological relevance of extracellular matrix in human obesity. Genome Biol. Macrophage-secreted factors promote a profibrotic phenotype in human preadipocytes. Mol Endocrinol. Reduction of macrophage infiltration and chemoattractant gene expression changes in white adipose tissue of morbidly obese subjects after surgery-induced weight loss.
Most fad diets are just a bright star regime adulte quickly fades. With so many fad diets, so many publications, so many dietary guidelines, so many claims, many find it difficult to know what action is appropriate in the management of weight especially before and after a body surgery. Consumers urgently need simple and practical tools to help them make healthy choices in a real life setting. It's necessary to translate nutrients into healthy foods and healthy eating patterns.
A comprehensive history relevant to the patient's history should be obtained. Some data suggest that both general adiposity and abdominal adiposity are associated with the risk of death and support the use of waist circumference in addition to BMI the weight in kilograms divided by the square of the height in meters. We put emphasis that an evaluation of both dental status and maigrir proteine whey dangereux ability in patients scheduled for surgery will be systematic.
Eating slowly increases the postprandial response of the anorexigenic gut hormones like Peptide YY and Glucagon Like Peptide 1. The patients must decrease the size of food portions. Weight loss is known to occur as a consequence of reducing the proportion 80 amwcconfbook.
Dietary advice should encourage increasing consumption of grain, cereals, fibre as well as vegetables and fruits. Lifestyle changes must incorporate physical activity to optimize the success in the weight stabilisation. We should focus on realistic goals and lifelong management to optimize body surgery. Nutrition counsel should be based on good clinical care and evidence based interventions. Patients should understand that weight management um regime facil 8.6 need to be lifelong.
When people get older the upper lip gets longer. The red lip is looking down instead of looking ahead. This surgery makes it sexier. It is very different from lip injections.
It does not thicken the lip. It can be combined with HA injections after one or two months but not often needed.
The author revisits a classical technique to associate it in the process of facial rejuvenation. It consists in shortening the upper lip through a sub and intranasal approach.
The author shows pre and post op results. The number of bariatric procedures increases regularly: in40 procedures were carried out in 38 countries, including Currently, a multidisciplinary approach integrating a surgical procedure bariatric program can agree with all objectives.
Contra indications of bariatric surgery are: - Important inflammation of the digestive tract. Currently, the 3 surgical procedures generally performed are: One restrictive procedure: Laparoscopic Gastric Banding LGB which slows down food intake. Advantages: simplicity, easy reversibility. Disadvantages: bad alimentary minceur et developpement humain frequents vomitingvery demanding follow-up, long-term complications.
Two restrictive and metabolic procedures: Roux en Y Gastric Bypass RYGBis restrictive, and also decreases food absorption and feeling of hunger by decreasing the rate of ghrelin. Advantages: very good efficiency, very good alimentary comfort, few long-term complications. Advantages: high efficacy, good alimentary comfort, no long-term complications. The overall mortality of bariatric surgery is 0. Causes of failure are always: - Lack of follow up - No amelioration of food practices - No regular physical activity Causes of success are always the same: - Initial motivation - Correct choice of the procedure - Regular follow up Conclusion: Bariatric surgery is a safe and efficient procedure when it is included in a multi disciplinary approach and performed by experimented teams.
Trends in mortality in bariatric surgery: a systematic review and meta-analysis.
Surgery, ; Townsend Jr. Philadelphia, Pa: Saunders; Decision modeling to estimate the impact of gastric bypass surgery on life expectancy for the treatment of morbid obesity. Arch Surg. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. To learn more, please consult the website www.
The media passion and the unrealistic request of the patients caused many anarchistic attempts which were often badly evaluated in various directions which have in common to be empirical steps: the use of chemical solutions Lipostabil of hypotonic solutions and ultrasounds whose theoretical bases are often not well documented.
For the scientific community and the researchers in the field of fat tissues, time comes to re-think of these promising treatments, according to recognized scientific protocols, to develop and evaluate these new processes. For the two last years, we have communicated and published our original technique of adipocytolysis using an aqueous solution with very low osmotic pressure combined.
It now becomes essential to communicate on: 1. The theoretical limitations of the method: the destruction of a large quantity of adipocytes releases very large amounts of free fatty acids and cellular fragments which are not drawn up if one wants to keep the non-invasive character of the procedure. This method is not without setting up fundamental and practical problems which are far from all to be well solved. But still our researcher biologists work hard to find reliable solutions.
Material and methods : Rational dental caries studies Use of a hypotonic very original solution and a patented membrane weakened. The cellular destruction is combined with the action of external ultrasounds. The new ways of research are described for the development and the validation of new substances aiming to weaken the membrane as well as the development of ceramics and specifically designed ultrasounds generating machines to achieve the destruction of the adipocytes.
The procedure is now well set up and as follows: - previous specific biological check up - drawing of the zones to be treated 82 amwcconfbook.
They enabled us to isolate a specific and extremely rare clinical form of residual non-inflammatory steatonecrosis. So we can propose an original and well-adapted protocol of care and follow-up. If necessary, a previous antioxidant supplementation is also recommended. They were the subject of a rigorous evaluation on a significant cohort of patients: with more than 1 year of post-treatment.
The adipocytolysis is indeed the only non-invasive method which allows the treatment of a complete anatomical territory and that it only can be described as true alternative to the liposuction. This expansion could be done only with a combination of both fundamental research and clinical evaluation.
However, the limits of this non-invasive lipo-sculpture appeared to us and will be discussed. The higher are the achievements, the more are some disadvantages related to the number of adipocytes destroyed and cellular debris left in place and which may exceed the capacities of resorption of the body.
This may involve : 1. An increase in the circulating levels of free fatty acids that, even in low concentrations, may lead to localized or generalized oxidative stress and proinflammatory reactions.
The persistence of nodules of cytosteatonecrosis in the treated zones which cannot be completely reabsorbed by the macrophages. Imaginez la psychose, non justifiée, si demain l'interdiction est actée!
Comment ces femmes seront-elles accompagnées? Pour Laurent Lantieri, il n'y a au contraire, aucune raison d'attendre qu'un problème survienne pour agir.
En cas de doute, il faut consulter son médecin. Société Santé. Par Florence Méréo Le 25 mars à 20h Quelles sont les marques concernées? La macrotexture, c'est quoi?