Communiqué de Presse IMCAS - PB Communication - Octobre 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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IMCAS ASIA

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PRESS KIT

THURSDAY, October 4th 2012

PRESS Kit – Hong Kong -‐ October 2012


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IMCAS ASIA Returns to Hong Kong in 2012

October 4 to 6, 2012 Intercontinental Hotel

Convention Center

This year, for its 6th Asian edition, IMCAS is glad to organize its very first IMCAS Asian Press Conference, where all media and journalists worldwide are welcome. About IMCAS 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 worldwide conference in Paris, 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).

IMCAS Industry Tribune

Additionally, IMCAS is also strongly identified and recognized as a major information source when it comes to the economical and financial aspects of this segment. The IMCAS Industry Tribune, gathering each year the major players of the economical field (representatives from the most relevant companies, financial analysts, medical and economical journalists...), is indeed the leading forum in analyzing the aesthetic medical market. IMCAS Asia

What’s hot in IMCAS Hong Kong 2012?

It’s been six years since the International Master Course on Aging Skin (IMCAS) acknowledged that Asia holds a big part of the future of aesthetic surgery and medicine. IMCAS organized the very first Asian conference in 2007 in Bangkok, and since then has expanded to feature three Asian editions each year: IMCAS China (Shanghai; July 28-‐29), IMCAS Asia (Hong Kong, October 4-‐6), IMCAS Singapore, July 26-‐28, 2013 and IMCAS India (Goa, November 23-‐24, 2013); making Asia its second focus of action to continue growing, contributing and exchanging knowledge and information about aesthetic medicine and plastic surgery across a continent known best for its development and innovation. In 2012, IMCAS chose to reiterate an exciting Hong Kong’s edition for the 2nd time as this city appears to be a whole world itself, and one of the top medical and economical players on the globe. IMCAS is very tight to Hong Kong Scientific Committee and IMCAS Asia is a congress supported by not less than 3 Universitary learned societies:

The Hong Kong College of Dermatologists

The Hong Kong Society of Dermatology and Venereology

Hong Kong Society of Plastic, Reconstructive and Aesthetic Surgeons



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With the participation of experts known and recognized in Asia and well as all over the world:

COURSE COORDINATORS CHAN Henry Hin Lee, Dermatologist, HONG KONG WONG David Sau Yan, Plastic Surgeon, HONG KONG SCIENTIFIC SECRETARIES GOH Chee Leok, Dermatologist, SINGAPORE HO Henry Hing Fung, Dermatologist, HONG KONG ZAKINE Gilbert, Plastic Surgeon, FRANCE COURSE DIRECTOR ASCHER Benjamin, Plastic Surgeon, FRANCE

However IMCAS always sought to cover the whole Pacific Asia territory, thus explores different countries (Thailand, Singapore, Korea, Japan...) and has launched a brand new congress past July , the very first IMCAS China, which was a huge success beyond our expectations. A rich and affluent attendance has been noticed, considering IMCAS China 2012 was a first and managed to attract 1 200 attendees. In the end, IMCAS was able to put on the international stage the new blood from China, and was very happy and proud to bring the best of foreign speakers, whether European, American or Asian, in China. IMCAS Hong Kong It's the same goal we wish to reach here, as we did for each Asian edition of IMCAS Congresses: allowing exchange between experts from all over the globe, with a major focus on Asian practice of plastic surgery and cosmetic dermatology. The IMCAS HKG Scientific Board and Committee, with a consequent list of international faculty speakers, has built a challenging program, spread over 4 simultaneous rooms, each dedicated to scientific contents and formats: aesthetic surgery, cosmetic dermatology and interface, live demos and under full disclosure, satellite symposia from the exhibiting companies. Covering all the major topics and trends, IMCAS HKG program has been developed around diverse threads, with a narrative and logical evolution, from pathology to aesthetic. Staying true to its spirit of exchange, IMCAS intends to consolidate the aesthetic fundamentals while beneficiating from the expertise and specialities of HKG’s leading speakers and practitioners That's why we are proud to organize today this press conference with the greatest practitioners of Hong Kong: Dr. Henry Chan, Dr. Stephanie Lam and Dr. George Li, as well as speakers from all Asia (Singapore, Japan) and western experts Dr. Zakine…,Dr. Illouz, the father of the liposuccion technique. This press conference will open with a focus on the market figures – for IMCAS is also known as a primary information source when it comes to the aesthetic market Intel. The IMCAS INDUSTRY TRIBUNE, our economic forum, will follow the press conference, inviting any interested journalist to attend a 2-‐hour session featuring key economic actors of the market for round tables et debates. Welcome to the first IMCAS Asia Press Conference. Benjamin Ascher,MD, Plastic Surgeon, FRANCE IMCAS Scientific Director

SCIENTIFIC COMMITTEE (updated list on www.imcas.com) CASSUTO Daniel, Plastic Surgeon, ITALY

ILLOUZ Yves Gerard, Plastic Surgeon, FRANCE

LI George Kam Hop, Plastic Surgeon, HONG KONG

MANUSKIATTI Woraphong, Dermatologist, THAILAND

MOLE Bernard, Plastic Surgeon, FRANCE

MU David Xiongzheng, Plastic Surgeon, CHINA

OMI Tokuya, Dermatologist, JAPAN



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IMCAS HONG KONG The top-‐shelf of science-‐approved Asia aesthetic approaches

Aesthetics is foremost medicine, a discipline of its own, but often clouded by non-‐scientific works and reports which drive the segment offshores. As of today, it's not always easy to know who you're talking to. Doctor, non doctor? That's why it's essential to make sure that each treatment; intervention or technology is scientifically validated and clinically proven to work towards the risk 0. Thus IMCAS will present, analyze and discuss new treatments, secure procedures and tomorrow's technologies with experts known and recognized in Asia and around the world.

Asian beauty has its own standards and therefore its specific aesthetic approaches The main goal of IMCAS is thus to ensure medical and scientific validation

SUMMARY

INTRODUCTION • IMCAS: where are we? Why IMCAS ASIA in Hong Kong?

ASCHER Benjamin, IMCAS Asia Course Director

• IMCAS ASIA Industry Tribune: the largest observatory of the ASIA aesthetic market

The Asian aesthetic market: structure, features and trends taking into account the consequences of the current financial environment

Laurent BRONES, Business Development Manager, SYMATESE, France IMCAS Tribune Coordinator

Why the non-surgical approach is so popular in Asia?

Face and body treatments -‐ what’s new? -‐ Science to support! Body countouring: the recent advances of cosmetic dermatology

• IR, RF, IPL, YAG & tightening and other alternatives energy devices: does it really work? What results can be expected? … Up and downsides?

CHAN Henry Hin Lee, Dermatologist, HONG KONG Redraw the shape of the face with injectables

• How to treat upper, mid and lowerface volume? • Hyaluronic Acid: lift, volumize, block

LAM Stephanie Chuk Kwan, Plastic Surgeon, HONG KONG New trends in Cellulite and body shaping

• Injectables, InfraRed, Ultrasound, Lasers Radiofrequency, Roller: Indications & cons-‐indications DUCAN Diane Irvine, Plastic Surgeon, USA

Asian Toxin treatment • Product overview • New trends and future of Botulinum Toxins

ASCHER Benjamin, Plastic Surgeon, FRANCE The fake market in fillers and Toxins

• The dangers of counterfeiting in fillers and toxins • How to recognize the certified product?

PICKETT Andy, PhD Research, UNITED KINGDOM Toxin Science Limited



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Face and body procedures: what’s hot? Orbital reshapping

-‐ Combined treatments PENG Peter, Dermatologist, TAIWAN

Eyelids and “regard” -‐ Eyelid and surgical Asian approach: what’s hot?

LO Stephen, Facial Plastic Surgeon, SINGAPORE Refine her nose:

-‐ Asian rhinoplasty: Medical versus surgical ZAKINE Gilbert, Plastic Surgeon, FRANCE

Commentary: LO Stephen, Facial Plastic Surgeon, SINGAPORE

Safety in breast implants – What's hot in Hong Kong?

LAM Stephanie Chuk Kwan, Plastic Surgeon, HONG KONG

Update on stem cells & lipofilling – Face, breast & body: the Regenerative Medecine

ILLOUZ Yves Gérard, Plastic Surgeon, FRANCE



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IMCAS ASIA HONG KONG INDUSTRY TRIBUNE

Thursday October 4th -‐ 2012, from 4.30 PM to 6 PM ROOM 4

Medical and surgical aesthetic market, 2010 – 2016

Laurent BRONES, Business Development Manager, SYMATESE, France IMCAS Tribune Coordinator 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 executives 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. Market facts and key figures The world market1 is evaluated between 4,3 and 5,1 Billions US $ 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. Asia will experience the stronger growth up until 2016, and will reach the European market standards to 1,49 – 1,79 Billions US$ with an average annual growth of 15,7%, against 7% only for Europe.

The United States and Latin America will know a annual rate of about 11%. The North America market will still represent 45% of the global market.

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 1,04 – 1,27 Millions US$ to grow in 2012 to 1,46 – 1,78 Millions US $. The annual growth of the market between 2012 and 2016 should be of 11,2%, reaching 7,3 to 8,6 Billions US$. Procedures per area

1 Including the sales activities from practitioners, users and distributors



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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, radiofrequency, 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 analysed within the Tribune 2012, will follow the same trends than the injectable products. The breast implants will experience 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 1,65-‐1,99 Billions US$ in 2011, projected to 2,75-‐3,32 Billions US$ to 2016 b. Average annual growth 2011-‐2016: +11,1% c. Main areas: USA, EU, Asia, South America.

2. Energy based devices

a. From 1,13-‐1,32 Billions US$ in 2011, projected to 2,2-‐2,58 Billions US$ 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 860-‐1045 Millions US$ in 2011, projected to 1,15-‐1,4 Billions US$ for 2016 b. Average annual growth 2011-‐2016: +5,7% c. Main areas: USA, Latin America, EU, Asia.

4. Cosmeceutics (active cosmetic)

a. From 695-‐765 Millions US$ in 2011, projected to 1,2-‐1,31 Billions US$ for 2016, b. Average annual growth 2011-‐2016: +11,1% c. Main areas: USA, Asia, Latin America, EU.

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

2 The equipment market in Asia should overtake the European market in 2016



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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 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 (only plastic surgeons) 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



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Why the non-surgical approach is so popular in Asia?

Face and body treatments -‐ what’s new? -‐ Science to support!

Body countouring: the recent advances of cosmetic dermatology

IR, RF, IPL, YAG & tightening and other alternatives energy devices: does it really work? What results can be expected? … Up and downsides? CHAN Henry Hin Lee, Dermatologist, HONG KONG Skin laxity is one of the most common compliant in cosmetic practice and while surgical procedures such as face lift remains to be the gold standard, non-‐invasive procedures have gained much popularity due to lack of down time and much lower risk of complication. This talk will review the use of laser, light source, focused ultrasound and radiofrequency that have been used for skin tightening. The principle of skin tightening using medical devices involve deep tissue heating whereby energy is delivered to the deep dermis causing collagen damage, subsequently healing process leads to new collagen formation and skin tightening effect.

For medical devices, it can be achieved in three manners, non-‐invasive, semi-‐invasive and minimal invasive.

Redraw the shape of the face with injectables

How to treat upper, mid and lowerface volume? Hyaluronic Acid: lift, volumize, block.

LAM Stephanie Chuk Kwan, Plastic Surgeon, HONG KONG Asian faces are often square or round in shape. Using injectables such as Botulinum toxin and various types of fillers, we can redraw the shape of the face so that they are closer to the perceived ideal oval shape. Injectables treatments are effective, safe and can be tailored to individual needs. Especially in the use of fillers, the procedure can be gradual and interactive so that the patient can help decide on their final appearance. In experienced hands, the results can be natural, subtle yet dramatic, improving their looks as well as their self esteem.

New trends in cellulitis and body shaping DUNCAN Diane, Plastic Surgeon, USA A new understanding of the physiology of cellulite formation has lead to the development of new and better tools to treat the problem, with long term results. Cellulaze was recently given FDA clearance for treatment of cellulite-‐-‐not the usual "temporary" category. The device releases the retaining tissue that causes the visible depressions. Another totally non-‐invasive device gives excellent results with cellulite using a combination of radiofrequency energy plus vacuum. The RF heat tightens the loose fibrous connections, correcting tissue laxity. The vacuum aspect of the Reaction device releases the tight fibbers, helping to even out the irregular surface. Both devices cause some fat reduction. In cases of true cellulite, liposuction is rarely used any more as it tends to worsen the surface irregularity. An ideal solution for localized fat would be "melting" without any needles, surgery, swelling, or other recovery issues. The Tite FX is also RF based. It utilizes heat, vacuum, plus a boost of RF energy to reduce fat without any external signs of treatment. Our current DA study shows an average of 47% reduction of fat thickness with 8 treatments performed over an 8-‐week period. As technology improves, patient demands for better results with less scarring and downtime increase. Tissue tightening can be created with energy assisted liposuction instead of resorting to cutting out skin. Even scarless breast lifting has been able to achieve long term results lasting a year or more, using energy assisted tissue tightening.



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Asian Toxin treatment

Product overview New trends and future of Botulinum Toxins

ASCHER Benjamin, Plastic Surgeon, FRANCE BACKGROUND: Botulinum neurotoxin type A (BoNT-‐A)[1,2] is a simple, safe, and very effective treatment of the aging face, which acts through transitory and reversible minimal palsies of target muscles. Botulinum toxin type A reduces wrinkles, changes the shape and position of important facial structures, such as eyebrows, delaying or avoiding the need for invasive surgical interventions [3,4,5]. It can be combined with other invasive and/or minimally invasive procedures such as fillers and lasers, for better cosmetic [5] and natural results in order to improve beauty, with no distortions and keeping facial expression. INJECTABLES PRODUCTS, with a focus on the Asian market: The most widely known BT-‐A are Botox/Vistabel® (Allergan, Inc, Irvine, USA) and Dysport/Azzalure® (Ipsen Ltd, Maidenhead, UK). Following a huge series of well-‐referenced published papers, from both pathological as well as cosmetic indications, clinical conversion tables have been drawn up between the 2 first drugs: 1 unit of the Allergan product is approximately equivalent to 2,5 units of the Ipsen/ Galderma product [ 3, 4 ,5,6 ]. Both are registered in many Asian countries. In China Botox is registered for glabellar lines since 2011. Other toxins currently existing on the US and EU market, such as Xeomin/Bocouture® (Merz Pharmaceuticals, Frankfurt, Germany) seem to have around a 1:1 dose ratio compared with Botox. An other commercial preparation, PurTox® (Mentor/J and J Corporation, Santa Barbara, USA) with completed Phases III, has not been yet approved by the FDA territories. The BTX-‐ B Neurobloc from Ellan laboratory seems to be less effective in term of efficacy durability, and with some additional side effects. Although it was supposed to be dropped for the cosmetic indications, it seems to be available in certain Asian countries like Korea, and new US trials are in process. The Korean Toxin, Neuronox from Medy-‐Tox, is approved in aesthetics in Mexico, Brazil, and many Asian countries as well as the Korean Toxin Botulax from Hugel approved in Korean, Japan and other Asian countries. Meditox launched in 2006, trough the approval KFDA, is approved for Glabellar lines since, 2011 and seems to have a formulation clothed to 1:1 dose ratio compared with Botox. It is registered in 24 countries, like Asia Thailand, Japan and under many names : Siax, Botulift, Cunox as well as in India & China through the Ranbaxy distribution and under the name of Botulift through the Amgen distribution. The Chinese Prosigne®, BTXA (from Lanzhou Institute of Biological Products, Lanzhou, China) is approved in China since May 2012 and distribute in several Asian and Latin American countries. Some comparatives studies with Botox, mainly in neurology seems to promote a dose equivalence of 1:1 for both products. [ 7 ] All these Korean and Chinese toxins have not yet been submitted to the US and European commissions of approval with referenced published papers, in the purpose to be ordered in the EU and US countries.



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OTHERS PRODUCTS, TECHNIQUES and DEVICES: • The novel topical BT-‐A, RT001 (Revance Therapeutics, Newark, USA), from the nanotechnology field [8,9,10] allow the toxin to cross the skin barrier. Early results appear promising for the treatment of primary axillary hyperhidrosis and lines, however the product is still in phase II in USA and we don’t know when phase III will allow distribution. • Hyaluronic acid filler and Botulinum neurotoxin can be prepared in extamporane and delivered simultaneously in the same syringe. This technique may optimize the use of fillers and neurotoxins for some areas of the face, such as crow’s feet, glabella and DAO/ pre jowl areas. However, limitation of smiling could occur during few days. • Cold induced neuro-‐modulation using a minimally invasive Cryoprobe, from Myoscience (California, USA) (10) produce immediate dynamic line reductions after 2-‐8 Cryoprobe insertions near the motor nerves. Preliminary results suggest a “BTX-‐A like” result for forehead lines, however more studies with refined device planned are required. [11] CONCLUSION: Is the future lie with the standard Botulinum toxin injection? What will be the future of new products available, of new formulation of the classical products, of nanotechnologies, of alternative system of neuromodulation, new combined treatments? We don't know yet; however we do know the potential of development of these segment: 12% of growing per year until 2014 on the world market, and 15% in Asia. The injectable toxins are still one of the major cosmetic medical treatments. The rules of thumb for a safe injection are the following: know deeply facial anatomy as well as each product characteristic, make a careful selection of injection points, adapt the depth of injection depending on the muscle anatomy, physiology & muscle mass, use low injection volume, and use lowest effective dose per point to obtain a natural look with a good balance between efficacy and safety. REFERENCES 1. Carruthers J, Carruthers A. Botulinum toxin in facial rejuvenation: an update. Dermatol Clin 2009:27(4):417-‐25; 2. Brandt F, Swanson N, Baumann L, Huber B. Randomized, placebo-‐controlled study of a new botulinum toxin type a for treatment of glabellar lines: efficacy and safety. Dermatol Surg 2009:35(12):1893–1901. 3. . Ascher B, Talarico S, Cassuto D, et al. International consensus recommendations on the aesthetic usage of botulinum toxin type A (Speywood Unit) – part I: upper facial wrinkles. JEADV 2010; 24(11): 1278-‐1284. 4 .Ascher B, Talarico S, Cassuto D, Escobar S, Hexsel D, Jaén P, Monheit GD, Rzany B, Viel M. International consensus recommendations on the aesthetic usage of botulinum toxin type A (Speywood Unit) – part II: wrinkles on the middle and lower face, neck and chest. JEADV 2010; 24(11): 1285-‐1295. 5. Ascher B, Landau M, Rossi B. Injection treatments in cosmetic surgery. Informa Healthcare, London. Editor 2008 6. Rzany B., Ascher B. & Monheit G. Treatment of glabellar lines with botulinum toxin type A (Speywood unit) – A clinical overview. JEADV 2010, 24 (Suppl. 1): 1-‐14. 7. WU Y. chinese clinic studies overview, IMCAS Shanghai July 2012, Abstract 8. Collins A, Nasir A. Topical botulinum toxin. J Clin Aesthet Dermatol 2010;3(3):35-‐9. 9. Brandt F, O'Connell C, Cazzaniga A, Waugh JM. Efficacy and safety evaluation of a novel botulinum toxin topical gel for the treatment of moderate to severe lateral canthal lines. Dermatol Surg 2010;36 Suppl 4:2111-‐8. 10. Glogau, et al, Journal of Drugs in Dermatology, Volume 11, Issue 1, January 2012 11. Cold-‐Induced Modulation of Targeted Facial nerves: A Unique Procedure to Reduce Dynamic Forehead Lines Without the Use of Neurotoxins”, Francis Palmer & All, 2011 IMCAS JAN abstract.



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The Fake Market in Fillers and Toxins

Andy Pickett Director and Founder, Toxin Science Limited, Wrexham UK Adjunct Professor, Center for Botulinum Research, UMASS Dartmouth, USA Head of Development, Q-‐Med (a Galderma Division), Uppsala, Sweden As the demand for non-‐surgical facial aesthetic treatments increases around the world, there is also a demand for low-‐cost products. This demand arises from various groups, but mostly from patients -‐ who want to self-‐administer these products at home -‐ and a few practitioners, who just want to use the cheapest available products. Fortunately, this last group is very small and mainly restricted to illegal clinics and beauty centres. With this demand, we have seen an ongoing supply of these fake products from the Internet, readily available and colourful, attractive to people by interesting names which claim their benefit – Excellent, Amazing, Fine -‐ or even “technically” sounding – Syneurox, Refinex. Others of course like to copy directly the original, authentic product by counterfeiting the product or giving similar names, often confusing to the buyer. Whether dermal filler or botulinum toxin (BoNT), the situation is the same. The same name can also be given to either a BoNT product or a dermal filler. This is exceptionally dangerous as BoNT is used in minute quantities and the dermal filler in much larger quantities, to achieve the desired effects. One is an active blocker of muscle active, a muscle relaxant, the other an inactive material very similar to material naturally found in the skin. They are completely different. Added to all this, the ready availability of videos on-‐line showing patients how and where to inject themselves in the face is extraordinary. One Internet supplier even sends a copy of a DVD with their instructions! Dermal fillers and BoNT products have been available for many years from highly reputable companies, licensed and regulated by the countries where they commercialise the products in accordance with standards established to protect and safeguard patients. The quality of these products is exceptional. They are supported by clinical data looking at both safety and efficacy of the products in different applications. In areas such as the face, they are tested to the highest standards. These products are only available through recognised and established supply chains that guarantee product quality at all times. The cheap products are not comparable to the genuine, branded products. They should never be compared. Perhaps more important than anything else, there is no assurance that they are sterile, risking infection of the patient if used. The products will be discussed and the issues considered, with examples of fake products commonly available.



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Face and body procedures: what’s hot?

Eyelids and “regard”

Eyelid and surgical Asian approach: what’s hot?

LO Stephen, Facial Plastic Surgeon, SINGAPORE Through Asian double eyelid surgery, many patients wish to refashion their upper eyelids whilst preserving their ethnic identities. In the past, makeup artists, cosmetic and plastic surgeons produce a crease that is placed too high based on Caucasian measurements, assuming that patients wish to have a westernised eye. Today, this misconception is avoided by employing measurements suited for the Asian eyes. In addition, new concepts of fat preservation, permanent lid crease avoidance, periorbital rejuvenation, and ancillary procedures have been developed all aimed to achieve a more natural looking and aesthetic pleasing Asian eyelid.

Refine her nose Asian rhinoplasty: Medical versus surgical

ZAKINE Gilbert, Plastic Surgeon, FRANCE Commentary: LO Stephen, Facial Plastic Surgeon, SINGAPORE A too large and thick nose is a frequent complains of the patients which desire a rhinoplasty. Thinning the nose involved all the part of the nose with generally osteotomies. Nose anatomy, precise patient demand and anthropometric ethnic characteristics must be considered before surgery. The most common patient complains and several clinical cases which illustrate the procedure used to refine the nose with a closed or an opened approach are presented. Variations of the characteristics of the nasal bone, the cartilages, the nostrils, and the tip in several ethnics groups are presented. We describe their specific nasal anatomy, present theirs complains and descript the different surgical therapeutic options chosen. A wide dorsum with or without a hump, a large or globulous tip, an important alar flaring and an inter-‐alar width, a large tip with thick fibro-‐fatty subcutaneous layer which decreases nasal tip definition: are frequent patient complain. Hump resection, alar cartilage resection, tip thinning, lateral osteotomies, tip enhancement with cartilaginous graft, interdomal or interalar sutures and alar base resection permit to refine the nose. When cartilaginous graft or interdomal sutures are required, the open approach can’t be avoided. If the majority of rhinoplasty indications and patient complains, especially when nose thinning is desired, are treated by surgery, some indications can belong to a medical rhinoplasty, especially a mild hump of the dorsum or a multi-‐operated nose with small imperfection of the tip, or bony imperfection of osteotomy. Thinning the nose involved generally treatment of the tip, the dorsum and sometime alar rim.



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Update on stem cells & lipofilling

Face, breast & body: the Regenerative Medecine

ILLOUZ Yves Gérard, Plastic Surgeon, FRANCE Regenerative medecine is and will be the future most important part of medecine and plastic surgery -‐ First, the filling as a non invasive procedure will replace slowly and slowly most of the invasive procedure as face lifting, breast augmentation, buttock's augmentation.... -‐ Adipose Stem cells in the same time will produce a "real" rejunevation of the skin and even a rejunevation and regeneration of disable organs. -‐ The extra cellular matrix will be able to create completely new organs as kidney, lungs... So, in a very near future regenerative medecine will be able to treat almost all the non curable diseases with a minimum of trauma.

Patricia Bénitah -‐ IMCAS PRESS OFFICE Tel: + 33 6 29 44 83 09 – E-‐Mail: [email protected] May Lam – LOCAL PRESS OFFICE Tel: + 852 91 99 06 41 – E-‐Mail: [email protected] for more info, check:

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Communiqué de Presse IMCAS - PB Communication - Octobre 2012

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