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PRESS KIT
THURSDAY, JANUARY 26th 2012
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IMCAS is one of the most important European Courses dedicated to Plastic Surgery and Cosmetic Dermatology. By welcoming more than 3 500 delegates each year during its annual conference, it represents a true "medical population sampling". Its main objective is to promote the highest possible standards in clinical practice, education and research within the plastic surgery / dermatology interface, as well as in related disciplines (facial plastic surgery, oculoplastic surgery, aesthetic medicine, research, etc…). It's now an institutional teaching congress, working with advices from several learned societies such as the SOFCEP (Société Française des Chirurgiens Esthéticiens Plasticiens), the ESLD (European Society for Laser Dermatology) and the ASDS (American Society for Dermatologic Surgery).
Benjamin ASCHER, French Board certified Plastic Surgeon and IMCAS Course Director
The Course Coordinators: David J GOLDBERG, Dermatologist (United States)
Bernard MOLE, Plastic Surgeon (France) Bernard ROSSI, Dermatologist, (France)
The Scientific Secretaries:
Olivier GERBAULT, Plastic Surgeon (France) Anne LE PILLOUER PROST, Dermatologist (France)
Serge MORDON, PhD – Research (France)
Minutes of the International press conference held on, January 26th – PALAIS DES CONGRES – Paris
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SUMMARY
Facial and neck rejuvenation – New trends Body shaping in 2012
IMCAS 2012: The cosmeto vigilance watcher IMCAS Industry Tribune: the largest observatory of the aesthetic market The aesthetic market: structure, features and trends: World, Europe and France A focus on the Asian Market: trends and figures
Laurent BRONES, Business Development Manager, SYMATESE-‐ France
Current and future trends in lasers and energy based devices in dermatology Moshe LAPIDOTH, Dermatologist -‐ Israel
Face lifting: fillers or surgery? Neck Lift: focus on non-‐invasive methods New trends in Botulinum Toxins Hyaluronic Acid: lift, volumize, block : Specific characteristics comparison
Benjamin ASCHER, Plastic surgeon – France PIP crisis : the IMCAS and the French Plastic Surgery position
Benjamin ASCHER, Plastic surgeon – France-‐ Scientific Director of IMCAS congress Olivier GERBAULT, Plastic surgeon-‐ France
Bernard Môle, Plastic surgeon-‐ France Bruno Alfandari, Plastic surgeon-‐France
President of National Union of Plastic, Reconstructive and Aesthetic Acellular dermal matrix (ADM): a revolution in aesthetic surgery
Olivier GERBAULT, Plastic surgeon – France Getting nice buttocks: how to give them volume, to treat sagging and to rejuvenate? Surgical reshaping: volume and downsides Raul GONZALEZ, Plastic surgeon – Brazil Cellulite and body shaping: what’s hot? David J. GOLDBERG, Dermatologist-‐USA Lipofilling, what’s new? Bernard MOLE, Plastic surgeon-‐ France Fat graft and stem cells: fundamentals & practical applications Ali MOJALLAL, Plastic surgeon-‐ France IMCAS as a talent scout: IMCAS Business Incubator and IMCAS AWARDS
Serge MORDON, PhD – Research, France
FOR MORE INFO, CLICK ON: LA NUIT DES IMCAS AWARDS
IMCAS INCUBATORS IMCAS WEB TV
Follow IMCAS on Twitter
Find IMCAS on Facebook
Join IMCAS on Linked In
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IMCAS INDUSTRY TRIBUNE
The largest observatory of the aesthetic market Benjamin ASCHER, Plastic Surgeon, IMCAS Course Director, FRANCE Laurent BRONES, Business Development Manager, SYMATESE, FRANCE Thierry CHIGNON, Investment Director, MATIGNON INVESTISSEMENT & GESTION, France
Analysis, prospects and trends of the medical and surgical aesthetic market, 2010-‐2016
-‐ Under embargo till January 26th included -‐ IMCAS Industry Tribune 2012, January 27th 2012 The Tribune IMCAS 2012 combines the data available on the medical & surgical aesthetic market, supplied by the Market Studies Societies (MRG & MII NEWS), the financial analysts and the industrial representatives attending the 2012 Tribune, including Allergan, Galderma, Skinceuticals, Syneron, as well as the data from the ISAPS (International Society of Aesthetic and Plastic Surgery) Study on the different procedures practiced over 2010. The IMCAS Tribune thus realised an exhaustive and unseen analysis on the different territories (Europe, USA, Pacific Asia, Latin America) between 2010 and 2016, in US$, covering the most important segments of the market: botulinum toxins, fillers, active cosmetics, lasers and energy devices, breast implants. The variations here observed between the different information sources available bring us to make an evaluation of the different market segments on two hypothesis: one high, one low.
A bipolar market: a 2-‐gears growth
Market facts and key figures By Thierry Chignon & Laurent Brones, co-‐coordinators of IMCAS Industry Tribune
The world market1 is evaluated between 3,2 and 3,8 Billions Euros for 2011, i.e. + 10,1% compared to 2010, with an expected growth of +11,2% in 2012, being thus a demonstration of the sector's dynamic state.
The European financial debt and crisis should impact the European Market in 2012, with a growth estimated up to +5% between 2012 and 2011. According to our high and low estimations, the European market should be in the range of 770 – 940 Billions euros to grow in 2012 to 808 – 985 Billions Euros.
Beyond 2012 and depending of the European Financial crisis evolution, the Tribune estimates the average annual European growth between 2012 and 2016 to be up to + 7% (10 to 12% on the other territories.)
Asia will know the stronger growth up until 2016, and will reach the European market standards to 1,1 – 1,3 Billions Euros with an average annual growth of 15,7%, against 7% only for Europe.
1 Including the sales activities from practitioners, users and distributors
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The United States and Latin America will know a growth of about 11%. The North America market will still represent 45% of the global market.
The annual growth of the market between 2012 and 2016 should be of 11,2%, reaching 5,4 to 6,4 Billions €.
Regarding the different market segments, the injectable products (toxins and fillers) are still the first market segment in value, and will keep on growing for an average of +10% per year through 2016, confirming their development potential for many years. The energy-‐based devices (laser, radiofrequence, ultrasounds) will catch up with the decrease in business due to 2008-‐2009 financial crisis, with a average annual growth of 13.2 % through 2016. The cosmeceutics (active cosmetics), new market segment analysis within the Tribune 2012, will follow the same trends than the injectable products. The breast implants will know a reduced progression, estimated to 5,7% through 2016, fitting the progressions observed those last years. Possibly subjected to an impact of the PIP affair, the market could evolve in a less favourable way, especially in Europe. The market segments are, sorted out by decreasing order of importance, are the following ones: (area sorted out by decreasing order)
1. Injectable products (Toxins and fillers) a. From 1,22-‐1,47 Billions Euros in 2011, projected to 2,04-‐2,46 Billions Euros to 2016 b. Average annual growth 2011-‐2016: +11,1% c. Main areas: USA, EU, Asia, South America.
2. Energy based devices
a. From 837-‐981 Billions Euros in 2011, projected to 1,63-‐1,91 Billions Euros for 2016 b. Average annual growth 2011-‐2016: +13,2% c. Main areas: USA, EU and Asia2, South America.
3. Breast prosthetic implants:
a. From 637-‐774 Billions Euros in 2011, projected to 855-‐1 039 Billions Euros for 2016 b. Average annual growth 2011-‐2016: +5,7% c. Main areas: USA, Latin America, EU, Asia.
4. Cosmeceutics (active cosmetic)
a. From 515-‐567 Billions Euros in 2011, projected to 887-‐973 Billions Euros for 2016, b. Average annual growth 2011-‐2016: +11,1% c. Main areas: USA, Asia, Latin America, EU.
2 The equipment market in Asia should overtake the European market in 2016
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More than trends, social phenomenon already: By Dr Benjamin Ascher, IMCAS Congresses Course Director NEW DEVELOPMENT AXIS Aesthetic surgery: a responsible specialty On the medical aspect: techniques and products are more and more efficient, especially when it comes to the face, which does not exclude an increased vigilance to optimise even more the ratio between profits and risks. The wrinkles fillers, volumetry products and botulinum toxins are a good example: the reinforcements of controls regarding the entrance market authorization (AMM for Toxins, CE for other medical devices) are already efficient for most of them, but the necessity of increasing clinical studies preliminary to the products introduction to the market, as well as the selection of doctors empowered to practice those techniques are sine qua non conditions in order to limit risks and misuses. In 2012, a two-‐gears growth, characterized by:
-‐ A growth of about 5% in Europe, compared to 2011 -‐ And a growth of about 15% in Asia. -‐ Cosmeceutics (active cosmetic) follow that growth trend, and the other classical techniques (peelings, lasers,
radiofrequences...) are even catching up with the decrease of business previously observed within their segment. Regarding the body, the controls and studies of remodelling devices and medical slimming products have to get through the same process as the face: the suspension of the decree forbidding any fat lysing method is only a temporary solution, which will have to lead to good processes, with a better documentation, especially when it comes to phosphatidyl (a soy derivative) injections, non authorized in France. It is to note than a close molecule, the desoxycholine, is subjected to a large clinical study, serious and multi-‐centric in Europe and in the U.S., to treat small double chins.
On the surgical aspect, the slowdown expected in Europe is limited Breast implants are subjected to a progression of about 6%, fitting the last data observed those past years. The general progression for surgery presents also 2 gears: +7% in Europe against +11,1% in the US but most of all +15,7% in Asia. The 2 most popular interventions are still, in the world as well as for each geographical area, the liposuction and the breast augmentation with prosthetic implants. But the lipofilling knows a more and more important development. NEW TRENDS IN 2011 1 – The trend for natural: in France, in Europe, in USA and more and more worldwide, the tend imposing itself nowadays is to restore and maintain at patients a beauty un-‐stereotyped, without the need to "look young at any cost". 2 – A more localised surgical lifting: whether it's done for the face, the arms or the internal face of the tights, the lifting is now less global, less invasive, with shorter scars. The objective is to never nip or tuck against nature and getting more discreet scars. 3 – Non-‐invasive therapies: in 2012, important innovations are expected, especially with new toxins, which will appear on the scientific change within the coming months. 4 – More and more combined techniques: non-‐invasive techniques are combined to one another, like toxin for the upper face and hyaluronic acid for the lower face. Moreover, those techniques are not in opposition with surgery but prepare or maintain the surgical gesture. The treatments are thus more and more combined within a single and precise therapeutic program.
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Surgical interventions and non-‐invasive procedures: the top 5 According to ISAPS data, the USA, Latin America, Europe and Asia represents respectively 24,6%, 19,6%, 21,4% and 31,7% of the surgical interventions practiced worldwide, thus revealing the success of plastic surgery in India and China. WORLDWIDE, the surgical interventions the most practiced are, here sorted out by decreasing order (countries sorted by decreasing order):
1. Liposuction: Brazil, USA, China, India, Japan 2. Breast augmentation USA, Brazil, Mexico, Italy China 3. Blepharoplasty (eyelids): Brazil, USA, China, India, Japan, Italy 4. Rhinoplasty: Brazil, USA, China, Japan, India 5. Abdominoplasty (tummy tuck): USA, Brazil, Mexico, India, China
WORLDWIDE, the non-‐invasive procedures the most practiced are, here sorted out by decreasing order (countries sorted by decreasing order):
1. Botulinum toxin: USA, Brazil, China, Japan, Mexico 2. Hyaluronic acid: USA, China, Japan, Italy, Brazil, 3. Lipofilling: Brazil, USA, China, Japan, India 4. Laser hair removal: USA, Brazil, China, Japan, India 5. IPL Laser treatment: USA, Brazil, Japan, China, India
In EUROPE, the surgical interventions the most practiced are, here sorted out by decreasing order (countries sorted by decreasing order):
1. Breast augmentation: Italy, France, Germany, Spain, Russia 2. Liposcution: Italy, Turkey, France, Germany, Spain 3. Blepharoplasty: Italy, France, Germany, Turkey, Spain 4. Breast reduction: Italy, France, Germany, Turkey, Spain 5. Breast lift: Italy, France, Germany, Spain, Russia
In EUROPE, the non-‐invasive procedures the most practiced are, here sorted out by decreasing order (countries sorted by decreasing order):
1. Hyaluronic acid: Italy, France, Germany, Spain, Turkey 2. Botulinum toxin: Italy, France, Turkey, Germany, Spain 3. Lipofilling : Italy, France, Turkey, Germany, Spain 4. Laser hair removal: Turkey, Italy, France, Germany, Spain 5. IPL Laser treatment: Italy, Turkey, France, Germany, Spain
In ASIA, the surgical interventions the most practiced are, here sorted out by decreasing order (countries sorted by decreasing order):
1. Liposuction: China, India, Japan, South Korea, Taiwan 2. Rhinoplasty: China, Japan, India, South Korea, Taiwan 3. Blepharoplasty: China, Japan, India, South Korea, Taiwan 4. Breast augmentation: China, India, Japan, South Korea, Taiwan 5. Abdominoplasty: India, China, Japan, South Korea, Taiwan
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In ASIA, the non-‐invasive procedures the most practiced are, here sorted out by decreasing order (countries sorted by decreasing order):
1. Botulinum toxin: China, Japan, India, South Korea, Taiwan 2. Hyaluronic acid: China, Japan, India, South Korea, Taiwan 3. Lipofilling: China, Japan, India, South Korea, Taiwan 4. Laser hair removal: China, Japan, India, South Korea, Taiwan 5. IPL Laser treatment:China, Japan, India, South Korea, Taiwan
In FRANCE, the breast surgery is still a major concern for women since the most practiced interventions are: 1. Breast augmentation 50 519 2. Liposuction 44 181 3. Blepharoplasty (eyelids) 44 133 4. Breast reduction 17 535 5. Breast ptosis 16 878
The non-‐invasive procedures have been generalized in France and the hyaluronic acid and botulinum toxin injections are now the leads:
1. Hyaluronic Acid Injections 84 445 2. Botulinum Toxin Injections 81 815 3. Lipofilling 21 595 4. IPL, Laser treatments 12 856 5. Laser hair removal 11 303
IMCAS: the Alert Congress IMCAS did not wait for the PIP crisis to make vigilance one of its main concern, and specially this year by organizing the following sessions:
• Sessions comparisons of hyaluronic acids, toxins and lasers, independent from the Industry • Session fillers complications, featuring the results of the first worldwide survey on the topic
• Session operative safety in dermatology and plastic surgery
• Session European vigilance in dermatologic and surgical aesthetic,
• To which was just added the session dedicated to the PIP crisis
About IMCAS Leader European congress dedicated to plastic surgeons, dermatologists and different experts of the medical and surgical aesthetic practice, IMCAS (January 26 to 29, 2012) has became in 14 years one of the most important worldwide meeting of the profession. This event welcomes each year more than 4 000 attendees from 60 different countries. That exchange between the most eminent international specialists made IMCAS the reference in excellence when it comes to education and information. Its main objective is to promote the highest possible standards in clinical practice, education and research within the plastic surgery / dermatology interface, as well as in related disciplines (maxilla-‐facial surgery, aesthetic medicine, anti aging...) IMCAS exports itself worldwide with 3 other meetings: IMCAS (New Delhi) IMCAS ASIA (alternatively in Singapore, Hong Kong, Bangkoe), IMCAS CHINA (Shanghai).
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Face lifting: fillers or surgery? Neck Lift: focus on non-‐invasive methods
New trends in Botulinum Toxins Hyaluronic Acid: lift, volumize, block: Specific characteristics comparison
Benjamin ASCHER, Plastic surgeon – France
Hyaluronic acid: to lift, volumize, block What can fillers do? Fillers, especially hyaluronic acids, are:
• either injectable products, of moderate thickness, to fill wrinkles
• either thicker injectable products to give some volume (volumize) They can:
Ø Moderately stop or slow down the skin and muscles slippage: there is indeed 3 face areas, located on the
front, where tissues slip down, tip and form lines: naso-‐labial fold (between the nose and the upper lip) bitterness line (between the lip and the chin), mandibular notch (between chin and oval). A good-‐positioned volumator on the front of those lines can fight the slip down from some of it.
Ø Volumize the hollow areas: volumators will there be active for face areas in the middle of the face: the tears valley, the temples, the eye rings, the orbital hollows but also the cheekbones and the nose. The idea is to restore the lost or missing volumes and contours. 2 misuses are to proscribe for they lead to caricature: the "balloon-‐shaped" faces, the triangular faces becoming "square-‐shaped". If fat is still one of the best transplant material, volumators have many advantages, such as: no need to go to the O.R., no harvesting area, painless injection with local anaesthesia or cream, fewer oedemas and bruises, especially with the almost systematic use of blunt tip micro-‐cannulas.
Ø Moderately lift the ptosis: fillers can moderately get some back face areas upper when they had slip down: the external eyebrow, the temple, the cheek, and the upcoming jaw sagging and the tip of the nose. But when a real slid down of the tissues has happened: sagging regard, real jaw sagging, the injection cannot do anything by itself. It can dissimulate the sagging without really treating it. Only a lifting (or if the patient is not ready, pink threads) can make the tissues get upper and thus give the wanted refreshed face. If we inject too much, we obtain a "balloon effect".
Lifting: injectable products or surgery?
Ø Evolution of the surgical lifting: whether it's for the upper or lower face, the arms or the tights, the lifting is now less global, less invasive. We don't peel the tissue as much as before, the gesture is more focused, more durable, and more discreet with shorter scars. A successful lifting is a natural one, which doesn't make the face looks lifted or tucked.
Ø Volumators: If fat is still one of the best volumator, hyaluronic acids have several advantages: the blunt tip micro cannulas improve the patient's comfort. But the lipofilling is more and more developed with a new trend: the superficial fat injection, which improves skin texture. -‐ Careful with excesses, that make «balloon-‐shaped» faces.
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Ø For a global treatment: When surgery is not necessary or not wanted: botulinum toxin, fillers, radiofrequency and soft lasers give a very efficient global effect. When surgery is necessary: sagging regard or real jaw sagging: lifting is the course of action Associated with lifting, injections, surface lasers are going to decrease the invasive aspect of that surgery, for people ask for an active but non-‐incapacitating treatment. The true revolution is actually in the step-‐by-‐step process. We first choose a really efficient treatment but as less invasive as possible. If a surgery is decided, it fits itself in a therapeutic plan.
• Prepare, with botulinum toxin and fillers • Lift, at the right time, by associating fillers or fat
• Maintain, by fillers and toxin, to avoid a possible second lifting. Far for being in opposition, those treatments optimize each other, as long as the right plan and the right timing are chosen. Fillers and toxin can allow delaying some surgeries (such as upper face). Did they replace it? No, but they optimize the immediate results as well as the long-‐term results. And in most of cases, they can produce by themselves a slow down, even sometimes a true prevention of aging. What can we expect from cosmetic botulinum toxin for tomorrow? There are 3 toxins available in Europe, efficient and safe, elsewhere; Chinese and Korean toxins, as well as American toxin are used. The innovation:
-‐ A toxin used as a cream: the Revance (from California) will be operative in 2013. This is a real "medicine cream" which has nothing to do with "magical" cosmeceutics cream, actually inactive, with Ox-‐names destined to make people dream. -‐ The hyaluronic acid, immediately mixed with small quantity of toxin can be superficially injected in areas which were so far not indicated for toxin treatment, such as cheekbones and cheeks. -‐ The cryoneuro-‐modulator realises forehead nerve refrigeration which lead to a durable "botox like" effect: it's expected to be launched in September 2012. -‐ Toxins seem to maintain an important growth, around +10% in Europe, through 2016
Focus – neck and jaw sagging, the soft treatments Radiofrequency, hyaluronic acids injections in horizontal wrinkles, vertical muscular chord treatments can lead to partial but durable results if regularly repeated, but:
-‐ If there's a real fat mass: only liposuction can treat it, but desoxycholate injections could be a good treatment for small mass within a year -‐ If there's a real slackness of skin and muscles, neck lifting is the right course of action. Pink threads don't treat the neck, only the lower face and for 2 years top. -‐ Neck lifting systematically includes the oval: the retightening of neck by lifting is always associated to a harmonious pull up of the oval. It's the same unit that has to be treated to obtain a natural result. When oval gets blurry, lipofilling reinforce in a natural way the contours thus the result.
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PIP crisis: the IMCAS and the French Plastic Surgery position
IMCAS Congresses and PIP Crisis
Benjamin Ascher, MD, IMCAS Scientific Director Bernard Mole, MD IMCAS Surgical segment, Course Coordinator Olivier Gerbault, MD, IMCAS Surgical segment, Scientific Secretary MCAS is supporting the French Plastic Surgeons Union, the two French Plastic Surgery Societies (SOFCPRE, SOFCEP) as well as the European and International Aesthetic Surgery Societies (EASAPS and ISAPS) in taking care of PIP patients. IMCAS Annual Meeting 2012 has invited major world famous experts (surgeons, engineers) in breast implants and breast surgery to share insights on how to manage PIP implants and proposals to avoid similar issues. IMCAS -‐ the Alert Congress: IMCAS has gathered surgeons, other experts in aesthetical medicine and industrials for 14 years to exchange on each other's expectations. IMCAS is concerned about safety and has set up an alert task force on medical devices and fillers for several years. This year IMCAS is going to publish the results of a worldwide survey on fillers complications and has put within its program some sessions independent from the industry, dedicated to patient safety, cosmeto and materio-‐vigilance and products (lasers, hyaluronic acids, toxins...) comparison Mammary Implants and cancer: Regarding breast implants, no link between any types of breast implants and breast cancer has been established in more than 30 years of international studies and surveys realized. Breast cancer is the most frequent cancer in women (around 10%), and it is expected that some of the women who had a breast augmentation (regardless of the implant’s brand) experience a breast cancer at some point in their life, like could experience any other woman with or without implants. When it comes to the PIP implants, some of them are filled with a non-‐medical silicone gel that may irritate the breast and surrounding tissues much more than a medical gel, especially in case of leakage. That gel may extrude and disseminate more easily than medical gel. This is the reason why a systematic removal of the defective implants has been asked by the French Plastic and Aesthetic Surgery societies and the French Plastic Surgeons Union. For the majority of the patients who have breast implants: these devices remain a secure device, and breast augmentation is one of the 2 TOP worldwide requested procedures in aesthetic surgery, with the higher degree of patients' satisfaction. However, controls should be reinforced to guarantee that the highest quality standards requested for breast implants manufacturing are respected as well as make sure than feedback about complications is provided to both scientific societies' and health ministry's vigilance task forces.
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The International PIP Health Crisis
Bruno Alfandari – Plastic surgeon-‐France, President of National Union of Plastic, Reconstructive and Aesthetic The PIP case is a major health crisis. It affects 30,000 of our patients in FRANCE and nearly 500,000 patients worldwide. Our union, The Representative Organization of French Plastic Surgeons, has immediately filed a complaint to shed light on this case, and has requested that those responsible for this situation be identified. In the meantime, we have asked our surgeons to inform all their patients about this issue and to begin the removal of all poor quality implants without delay. To date; more than 2,000 patients have already been treated. The French government, along with other countries including Germany and England, has endorsed our recommendations of preventive surgery. And today we have decided to take our commitment a step further. We believe it is necessary to remove ALL PIP silicone gel implants without exception, until the end of the moratorium. Our profession is committed to do so as quickly as possible and under the best conditions available. Our patients must know that they can count on us through this ordeal. We owe our patients the utmost security and we will, with the help of the authorities, do everything within our power to prevent a health issue of this scale from ever arising in the future.
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Acellular dermal matrix (ADM): a revolution in aesthetic surgery
Dr. O GERBAULT – Plastic surgeon, France Acellular dermal matrixes have profoundly changed aesthetic and reconstructive breast surgery, but also rhinoplasties and they could play a significant role in facial rejuvenation. ADM are flexible sheets of collagen reproducing the three-‐dimensional structure of the dermis, but devoid of all the dermal cells. This natural dermis can be of human, bovine or porcine origin. Their antigenicity has been eradicated by a chemical process, avoiding any rejection. The MDA gradually integrates the body, as if it was the own dermis that was grafted wherever desired. ADM have been used in different types of surgery for more than 10 years. Their application in plastic and aesthetic surgery is recent, and growing. The current major disadvantage of the MDA is their cost, but it should significantly decrease because of the increasing number of laboratories marketing this product. This dermal matrix has a triple interest: -‐ Reinforcement of a weak anatomic area: this property is used in breast implant reconstruction, to strengthen the operated breast skin which was traumatized by the surgery, the radiations… This reinforcement allows breast implant reconstruction to be much more reliable and simple. ADM are also useful in case of unfavourable result after breast augmentation, when implants have been poorly positioned at the first operation, or when the skin is very thin to avoid (or treat) folds or edges visibility. -‐ Camouflage of visible irregularities after surgery: this property is now used in Rhinoplasty, including for people with a thin skin, but also for re-‐operation of the nose. This ADM sheet is positioned between the reshaped bone and cartilage and the skin, to avoid imperfections visibility after a rhinoplasty (preventive camouflage), but also to treat them during a revision procedure. -‐ Volumetric augmentation: this property is used in Rhinoplasty (over resected noses, or too flat noses, which is often the case for ethnic rhinoplasties: in the African, Caribbean, Asian,etc.), but also in facial rejuvenation to compensate for the loss of volumes with age, but also to increase the volumes of too hollow faces, or flat faces. Finally, ADM has already changed the face of some areas of aesthetic and reconstructive surgery and will likely be the new natural tomorrow's aesthetic surgery implant.
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Buttocks Implants How to obtain a perky and nice “derriere”
Raul GONZALEZ -‐ Plastic surgeon, Brazil On the past Thirty years ago, on the 70th’s, there wasn’t any specific aesthetic procedure to improve the buttocks appearance, except some techniques for gluteal lifting with scars. There was no fat grafting and liposuction and 90% of the aesthetic surgeries were done in the anterior part of the body. So, the aesthetic surgery of the body was very limited. The first buttocks implants In 1980 the Mexican surgeon Gonzalez-‐Ulloa, idealized a gluteal implant to be placed in the gluteal fat, this implant was accompanied by a myriad of complications, and had a very short story, which was quickly forgotten. In 1984 an Argentine surgeon, Jose Robles, introduced a technique to put the implant implant.
The Brazilian experience, the first fat grafting to remodel the buttocks. In 1984 I began to use the fat of liposuction to remodel the buttocks, increasing the volume and filling the lateral depressions. These were the first non incisional procedures approaching the buttocks all over the world. My experience was published in 1986 and was the first medical article to show this possibility. Brazil is a tropical country; the beaches are crowded throughout the whole year. Bikinis are part of the Brazilian clothing. The Brazilian surgeons were very receptive with this new procedure and very quickly begun to spread out “the Brazilian buttocks lift”, the name this procedure received in USA. The gluteal implants, the Brazilian technique In 1986 I started to perform submuscular buttocks implants, the Argentinian method. After some experience I begun to notice the failures of this technique and I changed to use the implants inside the gluteus maximus muscle, that is, intramuscularly. Some years after, I published a medical article showing my method. The Gonzalez XYZ technique, as is called. A book to teach “Buttocks reshaping” In 1989 I begun to publish several medical articles to spread out my techniques about buttocks improvement, including fat grafting, lipofilling, implants, lifting, treatment of gluteal retraction and many others procedures I developed. The collection of these contributions gave rise to a book called “GLUTEOPLASTY OR BUTTOCKS RESHAPING” translated into several languages such as Korean, Italian, Spanish, Portuguese, English and Chinese, the next edition. The book was launched in 2006 and immediately the surgeons over the world answered. In some countries as on Brazil, Colombia and Venezuela, the numbers of buttocks implants procedures double in less than two years after the book.
PRESS FILE – Paris -‐ January 2012
IMCAS PRESS OFFICE -‐ P.B Communication 7 Villa des Sablons– 92200 Neuilly sur Seine -‐ Tel : + 33 1 47 31 11 06 -‐ E-‐mail : [email protected]
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The importance of buttocks on human being Among thousands of mammal species and about two hundred primates, man is the only one to have buttocks, or at least a nice perky volume projected at the base of the spine. The most plausible explanation for that is that when our quadruped ancestors learned to keep their balance on two hind legs, they had to develop the posterior muscles of the hips in order to stand erect. The importance of the buttocks for the female contour There is a fundamental difference between the female and the male body. A woman’s body is characterized by curvy, shapely lines and round volumes, while a man’s body is characterized by straight lines and square volumes. Prominent and projected volumes, like the breast and buttocks, are exclusive features of the female body. The importance of the buttocks on sexuality In human beings, the differences between male and female are essential to stimulate inter-‐sexual relations. Opposite poles attract and the differences are a woman’s major attraction in her relationship with a man. Somehow, the most evident sexual features in a human female figure have to do with procreation: the breasts for nursing, and the pelvis larger than a man’s for birth. Those are precisely the two sexual features of a woman’s body that bear the greatest differences between a woman’s and a man’s body; coincidently, they are the ones made of more curvy lines and projection. The modern aesthetic surgery of the buttocks Implants, lipofilling, liftings, liposuction and many others aesthetic interventions aiming buttocks appearance are part of the routine in most of the surgical centers nowadays. In some countries more than others. And they continue to gain popularity all over the world. Implants are reaching a rule on this scenario, it is the best way to achieve a perky and nice buttocks.
PRESS FILE – Paris -‐ January 2012
IMCAS PRESS OFFICE -‐ P.B Communication 7 Villa des Sablons– 92200 Neuilly sur Seine -‐ Tel : + 33 1 47 31 11 06 -‐ E-‐mail : [email protected]
www.imcas.com
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Cellulite and Body Shaping. What is Hot?
David J. Goldberg, Dermatologist -‐ USA Non-‐surgical body contouring, initially used on the face, is now being used off the face and for cellulite improvement. Various approaches have been used. These include laser and light based technology, radiofrequency approaches, and the use of focused ultrasound. This talk will focus on 2 very new different technologies for body contouring. One method (Bella Contour) leads to immediate, albeit temporary, improvement in body contouring. The second approach (Cellulaze) represents a radically different approach to cellulite that may lead to long-‐term or permanent improvement. Bella Contour uses a combination of electrodes placed on the skin, ultrasound and vacuum massage to create holes in fat cells (adipocytes). Treatment is painless and improved results are seen immediately after treatment. Generally 5-‐10 treatments are required. Because results are temporary, periodic re-‐treatments are required. The technology has both CE and FDA approval. Cellulaze is laser that approaches the 3 different skin regions that are thought to lead to cellulite formation. The fat, bands between the fat, and overlying thin skin are all treated. Long term results have been reported. Currently this device has CE clearance, but is pending FDA approval. Non-‐invasive body contouring and successful cellulite treatment have finally arrived!
PRESS FILE – Paris -‐ January 2012
IMCAS PRESS OFFICE -‐ P.B Communication 7 Villa des Sablons– 92200 Neuilly sur Seine -‐ Tel : + 33 1 47 31 11 06 -‐ E-‐mail : [email protected]
www.imcas.com
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Fat injection vs. foreign body filling: assets and limits.
(Lipofilling, fat transplantation…) Bernard Mole – Plastic surgeon, Paris In an attempt to adopt a more ecological approach, fat transplantation is undoubtedly the best course of action in the repair of a loss of cosmetic tissue: fat is a living material, stemming from ones own body, renewable, and theoretically “eternal”. On the one hand “lipofilling” has its limits, due to the possibility that the amounts required may not even exist in patients whose reserves have been exhausted by disease (e.g.: HIV) or high catabolism. However on the other hand the issue of high fat growth brings to dramatic questions concerning its long-‐term safety in particularly prone areas such as the breasts. In the French Plastic and Aesthetic Surgery Society there is a very apparent clash between the supporters of this method, who for the past decade have carefully studied the consequences of this act, and those who are upseted by the "precautionary principle enshrined in the Constitution," recommending a “wait-‐and-‐see” attitude. Nevertheless, a tentative step forward was taken at the last Congress, adopting the recommendation to young women (25 and under) with no family history of breast cancer, and willing to moderate increases in the chest to whom “lipofilling” may now be available. The PIP breast implant crisis will likely speed up the process, as over a period of weeks a feeling of distrust has arisen in many patients concerning silicone breast implants. This distrust has its place among various sources, including an extremely poor media onslaught for which you, the media, are directly responsible. The panic of the female population in recent weeks is indescribable and not based on any objective data. These are plastic surgeons who must accept the consequences of this extremely alarmed atmosphere, for which there is no true foundation. Among the recipients of likely defective implants (30 000 women), 3000 will inevitably suffer from the onset of breast cancer, with or without implants. Under such circumstances it should be wiser to forbid forever all motorcars responsible for a considerably higher annual death toll!
PRESS FILE – Paris -‐ January 2012
IMCAS PRESS OFFICE -‐ P.B Communication 7 Villa des Sablons– 92200 Neuilly sur Seine -‐ Tel : + 33 1 47 31 11 06 -‐ E-‐mail : [email protected]
www.imcas.com
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Fat graft and stem cells: fundamentals & practical applications
Ali MOJALLAL – Plastic surgeon, France
Among patients and physicians, the ability to remove unwanted fat from an area of the body and re-‐inject it into a more desirable location (fat grafting) is one of the most fascinating treatments in the field of aesthetic surgery. The transplantation of adipose tissue is a meticulous technique using specific instruments and a strict methodology. Its application in the fields of the face, breasts and extremities surgery showed very high satisfactory results, consistent and reliable. Recently it was shown that not only adipose tissue could restore the missing volumes, but it also had regenerative capacity. Indeed, since a about a decade, we know that adipose tissue (fat tissue) is the largest source of mesenchymal stem cells. These cells are used for tissue engineering and regenerative medicine. Therefore, when we do a fat transplant (fat grafting or lipo-‐filling), we put together a quantity of stem cells. The advantages of using stem cells from fat are: (1) the ability to continue to proliferate after transplantation because these cells are more resistant (2) the differentiation of these cells into multiple cell lines according to the recipient area, (3) the release of angiogenic growth factors and transforming stem cells into endothelial lineage increasing neovascularization that is to say, improving blood flow of the recipient tissue. These advantages are particularly attractive for elderly patients because the stem cells would improve the vascularization of tissue and therefore would improve the quality of tissues at the site of injection. The combination of volume restoration and regenerative capacities of fat via stem cells is a key element in rejuvenation cosmetic surgery and in regenerative medicine.
PRESS FILE – Paris -‐ January 2012
IMCAS PRESS OFFICE -‐ P.B Communication 7 Villa des Sablons– 92200 Neuilly sur Seine -‐ Tel : + 33 1 47 31 11 06 -‐ E-‐mail : [email protected]
www.imcas.com
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IMCAS as a talent scout: IMCAS Business Incubator and IMCAS AWARDS Serge MORDON, PhD – Research, France The 2012 IMCAS Incubator The purpose of the IMCAS Incubator, coordinated by Serge Mordon, PhD, research director of INSERM in Lille, France, is to enable innovative ideas, techniques and technologies, developed by physicians – and not yet submitted for further evaluation – to be presented for the first time to research and development (R&D) executives from the world’s leading companies in the aesthetic industry. A specific session will teach attendees how to access relevant clinical, business and capital resources. Experts in technology transfer have been invited: Thierry Bruhat, International Research Consultant, will present the different Technology Transfer systems in the United States and in Europe Natalène Hoepffner, Licensing -‐ Alliance Manager, Galderma International, will explain the expectations of the companies of such an incubator Gabriel Colboc, Lawyer, will share his experience in initiating and negotiating Transfer Contract. Furthermore, the IMCAS Incubator will include a Speed Dating Corner, created to optimize and support exchanges between attendees and the relevant management of the attending industry. Over two hours, at intervals of 15 minutes, innovative face or body treatment techniques and technologies will be presented to R&D executives from the aesthetic industry. Thanks to the IMCAS Incubator, IMCAS will hopefully become an important talent scout IMCAS AWARDS Dedicated to reward some of our best practitioner for their clinical studies/trials, medical or surgical, of 2011 15 nominees 4 of them will be granted with an award of an amount of 2000 euros.