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IMCAS	
  PRESS	
  OFFICE	
  -­‐	
  P.B	
  Communication	
  
7	
  Villa	
  des	
  Sablons–	
  92200	
  Neuilly	
  sur	
  Seine	
  	
  -­‐	
  Tel	
  :	
  +	
  33	
  1	
  47	
  31	
  11	
  06	
  	
  -­‐	
  E-­‐mail	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
	
  
	
  
	
  
PRESS	
  KIT	
  	
  
THURSDAY,	
  JANUARY	
  26th	
  2012	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
   	
  
 	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  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	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
2	
  
	
  
	
  
	
  
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	
  	
  
	
  
	
  
	
  
	
  
	
  
 	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  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	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
3	
  
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	
  
	
  
 	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  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	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
4	
  
	
  
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	
  market
1
	
  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	
  	
  
 	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  PRESS	
  FILE	
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  Paris	
  -­‐	
  January	
  2012	
  
	
  
	
   IMCAS	
  PRESS	
  OFFICE	
  -­‐	
  P.B	
  Communication	
  	
  
7	
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  des	
  Sablons–	
  92200	
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  sur	
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  -­‐	
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www.imcas.com	
  
	
  
	
  
5	
  
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	
  Asia
2
,	
  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	
  
 	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  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	
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  -­‐	
  E-­‐mail	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
6	
  
	
  
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.	
  
	
  
 	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  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	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
7	
  
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	
  
	
  
	
   	
  
 	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  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	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
8	
  
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).	
   	
  
 	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  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	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
9	
  
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.	
  
 	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  PRESS	
  FILE	
  –	
  Paris	
  -­‐	
  January	
  2012	
  
	
  
	
   IMCAS	
  PRESS	
  OFFICE	
  -­‐	
  P.B	
  Communication	
  	
  
7	
  Villa	
  des	
  Sablons–	
  92200	
  Neuilly	
  sur	
  Seine	
  	
  -­‐	
  Tel	
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  06	
  	
  -­‐	
  E-­‐mail	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
10	
  
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.	
  	
  
 	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  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	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
11	
  
	
  
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.	
  
	
  
	
  
	
   	
  
 	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  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	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
12	
  
	
  
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.	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
   	
  
 	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  PRESS	
  FILE	
  –	
  Paris	
  -­‐	
  January	
  2012	
  
	
  
	
   IMCAS	
  PRESS	
  OFFICE	
  -­‐	
  P.B	
  Communication	
  	
  
7	
  Villa	
  des	
  Sablons–	
  92200	
  Neuilly	
  sur	
  Seine	
  	
  -­‐	
  Tel	
  :	
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  06	
  	
  -­‐	
  E-­‐mail	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
13	
  
	
  
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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  FILE	
  –	
  Paris	
  -­‐	
  January	
  2012	
  
	
  
	
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  OFFICE	
  -­‐	
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7	
  Villa	
  des	
  Sablons–	
  92200	
  Neuilly	
  sur	
  Seine	
  	
  -­‐	
  Tel	
  :	
  +	
  33	
  1	
  47	
  31	
  11	
  06	
  	
  -­‐	
  E-­‐mail	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
14	
  
	
  
Buttocks	
  Implants	
  
How	
  to	
  obtain	
  a	
  perky	
  and	
  nice	
  “derriere”	
  
	
  
	
  
Raul	
  GONZALEZ	
  -­‐	
  Plastic	
  surgeon,	
  Brazil	
  
	
  
On	
  the	
  past	
  
Thirty	
  years	
  ago,	
  on	
  the	
  70
th
’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	
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  -­‐	
  P.B	
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7	
  Villa	
  des	
  Sablons–	
  92200	
  Neuilly	
  sur	
  Seine	
  	
  -­‐	
  Tel	
  :	
  +	
  33	
  1	
  47	
  31	
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  06	
  	
  -­‐	
  E-­‐mail	
  :	
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www.imcas.com	
  
	
  
	
  
15	
  
	
  
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	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
16	
  
	
  
	
  
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	
  	
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  Tel	
  :	
  +	
  33	
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  06	
  	
  -­‐	
  E-­‐mail	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
17	
  
	
  
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	
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  06	
  	
  -­‐	
  E-­‐mail	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
18	
  
	
  
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	
  :	
  pbcom@wanadoo.fr	
  
www.imcas.com	
  
	
  
	
  
19	
  
	
  
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.	
  
	
  
	
  
	
  
	
  
	
  
	
  

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Communiqué de Presse IMCAS - PB Communication - Février 2012

  • 1. IMCAS  PRESS  OFFICE  -­‐  P.B  Communication   7  Villa  des  Sablons–  92200  Neuilly  sur  Seine    -­‐  Tel  :  +  33  1  47  31  11  06    -­‐  E-­‐mail  :  pbcom@wanadoo.fr   www.imcas.com             PRESS  KIT     THURSDAY,  JANUARY  26th  2012                  
  • 2.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       2         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              
  • 3.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       3   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    
  • 4.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       4     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  market 1  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    
  • 5.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       5   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  Asia 2 ,  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  
  • 6.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       6     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.    
  • 7.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       7   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        
  • 8.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       8   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).    
  • 9.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       9   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.  
  • 10.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       10   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.    
  • 11.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       11     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.          
  • 12.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       12     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.                                                      
  • 13.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       13     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.            
  • 14.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       14     Buttocks  Implants   How  to  obtain  a  perky  and  nice  “derriere”       Raul  GONZALEZ  -­‐  Plastic  surgeon,  Brazil     On  the  past   Thirty  years  ago,  on  the  70 th ’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.          
  • 15.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       15     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.                    
  • 16.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       16       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!                                              
  • 17.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       17     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!                            
  • 18.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       18     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.                                
  • 19.                                                                                                                                                                  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  :  pbcom@wanadoo.fr   www.imcas.com       19     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.