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February 15

Botox vs. Fillers - Know the Difference

The number of non-surgical procedures is growing exponentially worldwide, motivated by high demand, sophisticated and advanced technology, and the acceptance and normalization of users on social media who are willing to share their experience with these treatments openly. Indeed, among so many new treatments for different purposes, it is customary to mix some concepts up. Too many indications and devices, but which should you use if you are looking for rejuvenation treatments and combatting the early signs of aging? What to use for achieving a youthful look? As the years go by, Botox®, also known as, Botulinum toxin and hyaluronic acid, are the two most popular and great allies to keep our faces young and smooth. At first, you might think they are both used for the same purpose, and the results are identical. However, this is a beauty myth. Keep reading because we will explain carefully the differences between them, advantages and disadvantages, and which one is the ideal candidate for you. What is Botox®? Botox® is the commercial name used to refer to the Botulinum toxin. This toxin injection is a very effective procedure that improves wrinkles and unsightly expressions of aging or tiredness. How does Botox® work? The responsible agent in such a popular treatment is a neurotoxin that blocks the communication between the nerve and the muscle, thus preventing the muscle from contracting. Relaxing the muscle and reducing its contraction prevents the wrinkle from forming. Contrary to popular opinion, the Botulinum toxin cannot make your wrinkles disappear; instead, this procedure is ideal for preventing wrinkles and early signs of aging when they are not very noticeable. What are dermal fillers? The name dermal fillers refer to hyaluronic acid injections into your skin to add volume, increase hydration, and improve overall texture. Hyaluronic acid is a natural substance in our bodies responsible for absorbing water, retaining moisture, giving a volumizing effect, and creating a smooth surface for wrinkles and early signs of aging. It is very usual that when people think about Hyaluronic Acid fillers, they tend to think about the lip, cheek, or chin fillers that, ultimately, are used to enhance, sharpen or add volume in those areas. But what you probably didn’t know is that dermal fillers, aka, hyaluronic acid fillers for the skin, are actually perfect to get rid of wrinkles and fine lines. How do Dermal Fillers work? The first signs of aging appear when our body starts to lose its natural fat, collagen, and hyaluronic acid that are responsible for maintaining a youthful look and a structure that gives us a vivid and healthy appearance If you are at a point in your life where you feel like no natural remedy can work for your skin, or you want faster results, you might want to opt for some hyaluronic acid dermal fillers. By injecting hyaluronic acid through a syringe, the gel penetrates into the skin, creating a surface that fills the crease or line, and as a result, fine lines and wrinkles almost disappear, making their appearance barely noticeable. Besides this solution, they can be used as a plumping and lifting effect adding more volume to the area. Genefill has created the ultimate solution for getting rid of the early wrinkles and signs of aging through its vegan line of biphasic fillers. Its two products Genefill Soft Touch and Genefill Soft Fill have been specially designed for treating the periorbital and perioral area and superficial folds. Thanks to their cross-linked formulation, they can help your skin improve its facial contours and restoring the lost anatomical structures of the face. See how Genefill can give your face a fresh, glowy, and healthy look. Dermal fillers and Botulinum Toxin: Similarities - They can be applied to both men and women. - The technique used in both is through small injections into the skin. - The duration is temporary, and both are gradually reabsorbed by the body. - Both have a rejuvenating effect Dermal fillers and Botulinum Toxin: Differences - Although the purpose may seem similar, Dermal Fillers fill the wrinkles to create a smooth surface whereas Botulinum Toxin prevents their appearance. - Botulinum Toxin is usually used in the upper third of the face and hyaluronic acid in the lower third due to its results and benefits in both cases. - The injection technique is different, as Botulinum Toxin would be applied on the specific facial muscle, and hyaluronic acid on the wrinkle or mark to be filled. - Botulinum Toxin is used to correct dynamic wrinkles (formed by contracting) especially between the eyebrows, forehead and crow's feet while the filler can be used to treat both dynamic and static wrinkles.

January 2

Hyaluronic Acid Body Fillers for the Treatment of Cellulite: My Clinical Practice

Greek Plastic Surgeon Dr. Athanasios Christopoulos shares his input on the keys to treating cellulite with hyaluronic acid fillers such as the different factors to keep in mind and the necessary steps to achieve optimal but safe results. Cellulite is a common condition that usually affects the thigh and buttocks areas. Various treatments are currently available to treat cellulite. Although we offer different options to improve the skin’s appearance, including LPG and mesotherapy, one of my preferred and most used methods to treat cellulite is using hyaluronic acid (HA) dermal fillers. HA body fillers offer results that last over a year, avoiding constant touch-ups and increasing patient satisfaction. Regarding the choice of filler, it must have a high normal force to project and elevate the skin in the area to be treated. Cellulite presents an irregular skin topography evident by skin dimpling due to fibers pulling the skin downwards, so a filler with a higher capacity to push the skin tissues to project them is needed. Another important consideration is the quantity of material to be used. Usually, around 10 ml of filler is required; thus, from a cost-benefit perspective, it is more convenient to use body fillers in which prices/ml are lower. I use Genefill Contour and Hyacorp MLF1. There are several factors to consider when performing this treatment. First, I determine if the patient is the right candidate for the procedure by assessing the laxity of the skin on the area to be treated. Evaluating before treatment if the patient has cellulite or pseudo-cellulite (skin laxity) is crucial to ascertain that the patient is fit for this type of treatment and if satisfactory results are possible to achieve. Moreover, it helps to manage the patient’s expectations as results in pseudo-cellulitis would not be as effective. Although different methods have been used to measure skin laxity, I prefer to rely on practical experience. Second, before the procedure, it is necessary to review the patient’s medical history, e.g., the use of blood thinners. It is always essential to disinfect the area well to avoid infections. Also, the transfer of the product from a 10 mL syringe to a 1 mL syringe allows smaller needles and easier and more precise placement of the filler. Third, regarding the injection technique, I place the body filler under the skin, between the dermis and the fat, applying multiple injections. During the procedure, there might be skin dimplings with fibers pulling the skin down perpendicularly. Some of these fibers are lax, allowing placement of the filler and elevation of the skin. However, some of these fibers hold down the skin impeding volume restoration by the filler. In these cases, it is necessary to cut the fiber using a Nokor needle and place the filler, which will act as a spacer between the skin and future new fibers helping to maintain results longer. Finally, filler effects will be noted immediately after the procedure, offering a high rate of satisfaction to the patient with a very low rate of adverse reactions. source: https://www.genefill.com/blog/hyaluronic-acid-body-fillers-for-the-treatment-of-cellulite-my-clinical-practice

October 15

How to Get the Perfect Buttocks

Celebrities such as Jennifer Lopez and Kim Kardashian might share many things in common. Still, one of them especially can stand out when it comes to physical appearance: a big difference in the waist- to hip ratio enhanced by sculpted and voluminous buttocks. Indeed, this has perpetuated a big trend in today’s cosmetic market: “the butt is the new breast.” Interestingly, working towards achieving the buttocks of your dreams will not only boost your confidence but also there are many health benefits of having big buttocks. Advantages of having big buttocks 1. A straighter posture Having a big butt helps to lengthen the hip flexors, maintaining body alignment and thus maintaining good posture. On the other hand, small hips and buttocks prevent proper posture, especially when sitting, which is what causes back pain. 2. Good cholesterol levels According to some research, women with voluminous buttocks are less likely to suffer from diabetes or hypertension, or dyslipidemia. This is because they all have higher levels of good cholesterol and lower levels of bad cholesterol. Thus, they are less likely to suffer from cardiovascular diseases. 3. A less sensitive to pain back The buttocks are the strongest muscle of our body. Consequently, a large buttock helps protect our back. On the other hand, when the buttocks are thin, the leg joints involve other muscles during walking. These are the ones that cause back pain. How to achieve the perfect buttocks? Now that you know all of the benefits behind toned and rounded buttocks, we will explain how to actually get there. There are various ways to achieve your desired butt: Exercise The butt is a muscle, so a perfect way to start off with this growing journey is by working out. A personalized routine tailored to your physiological needs is the perfect formula to target the butt area. There are some must-exercises that you need to be doing to improve your legs and butt overall. Squats, Deadlift, Lunges, and Hip Thrusts, are one of the many exercises that focus on the butt and legs, promoting a rounded and lifted effect on your buttocks. We highly recommend you consult a trainer to teach you the proper technique to execute these exercises so that you don’t injure yourself. Diet As always, diet has a significant role in our health and physical appearance. If you are looking to achieve a better-shaped and rounded butt, you probably either have to gain more muscle or lose some fat in that area. By eating a healthy diet and implementing greens, healthy fats, protein, and carbs, you will notice a difference in how your body looks and feels. Aesthetic Procedures Getting the buttocks you desire is not something you can get in one day, a week, or even months. It takes hard work, consistency, and discipline. For those who can’t find the time, life gets busy, and genetics are not in your control; there are some ways of getting the figure you desire in a shorter amount of time. Invasive solutions for buttocks augmentations - Brazilian Butt Lift The famous Brazilian Butt Lift, also known as “BBL,” is a procedure that requires surgery. In this type of procedure, liposuction is performed in several areas of the body to obtain the necessary amount of fat to insert in the buttocks. The result will be a slimmer silhouette thanks to liposuction with voluminous and defined buttocks thanks to lipofilling. Note that surgical procedures might come with the risk of complications such as infection or bleeding, and downtime from the patient is required. - Implants Implants for buttocks augmentation is another surgical procedure that consists of implants filled with a cohesive silicone gel that makes them very strong. The surgeon chooses the size and shape of the prosthesis, taking into account the original appearance of the patient's buttocks. Note that surgical procedures might come with the risk of complications such as infection or bleeding, and downtime from the patient is required. Minimally- Invasive Solutions for buttocks augmentations On the other hand, there is a way of achieving prominent buttocks without having to undergo surgery, with minimal downtime, and with quick and long-lasting results; and that is thanks to Hyaluronic Acid Fillers. For those who are very familiar with hyaluronic fillers for the face but not so much with those for the body, Genefill has a range of fillers that have been specially formulated for targeting some body areas such as buttocks, hip dips, calves, hands, and other concave deformities. This is a simple body contouring procedure for achieving a bigger butt. Injecting genefill hyaluronic acid injections in the buttocks of the patient immediately adds volume, contour and hydration to achieve an uplifted effect overall and improve the skin quality and texture. Genefill Contour Plus is the perfect solution to add volume to more expansive body areas, i.e., buttocks. Thanks to its high-quality hyaluronic acid body contouring filler, it provides a prolonged duration and a safer outcome for the patients since Hyaluronic Acid is a natural substance already found in our bodies. Source: https://www.genefill.com/blog/how-to-get-the-perfect-buttocks

May 20

Buttocks Augmentation Using Genefill HA Fillers

With the surge in demand for body procedures, it is crucial to recognize the multitude of possible options available and determine their safety and efficacy to support well-informed decisions. Read the article to know more about the non-surgical procedure of gluteal augmentation with HA-based fillers recently published in the bimonthly PMFA Journal. The magazine prominent among the professionals for its comprehensive review of plastic, maxillofacial, aesthetic medicine and dermatology professions presented the medical piece in its December/ January 2021 Issue. Dr. Luis Campos, a board-certified plastic surgeon writes about the case of buttocks enhancement with Genefill Contour, demonstrating his technique and treatment strategy. There has been a notable increase in the popularity of body procedures over the years. The advancement in non-surgical body treatments has made it convenient for people to get the body they desire without having to deal with downtime or risks of complications. In my opinion, minimally invasive body procedures are increasingly demanded because men and women do not want to be held back by their insecurities. My favourite body filler is Genefill from BioScience (Germany) since it is the only body filler that has helped my patients achieve naturally enhanced buttocks, with long-lasting results and minimal side-effects. BioScience manufactures the only body fillers that are CE Mark certified and from my extensive experience, it also satisfies my expectation with its positive safety profile and clinical research. With the help of body fillers, it is convenient to add volume to the buttocks in under 45 minutes with minimal pain and downtime. HA body fillers can prove to be a safe and effective treatment, provided that the injecting professional is equipped with appropriate knowledge and the right technique. PREPARATION The protocol for HA body correction is mostly similar to that of dermal fillers for the face. The selection ensures optimal results that can minimise complications. The ideal candidate would be looking to volumize their buttocks either because they are genetically small, have lost their natural curves due to age or weight loss, or simply want to achieve a rounder shape. I consult my patients providing details of what the procedure will entail, the kind of product I am using, and what to expect during and after the treatment to maintain transparency. The duration, risks, and possible side-effects are also clarified, in order to manage expectations. Choosing the correct patient and knowing how to rule out patients who are not candidates for this technique is essential to achieve a good aesthetic effect and achieve the objective that the patient seeks, but to obtain this you must know how to inject the product, what the complications are and above all how to solve them. PROCEDURE To begin with, I photograph the patient, so they can distinctly notice the difference after the procedure. I examine the buttocks from the back and sides to determine the specific injection area. This must be done while the patient is standing, as lying down augments the natural gravity and shape. Before disinfecting, I begin marking the upper gluteal and sub-gluteal areas. The injection points are also clearly identified at this stage. The procedure is performed under local anaesthesia. After the lidocaine injection, I use an 18G needle to create an opening for the 18G cannula. Usually, for the purpose of volumising, filler is injected into the upper gluteal region, which lifts up the gluteal area as well as the sub-gluteal crease. In case the lateral area lacks volume, I inject filler to enhance the dips. For this procedure specifically, I recommend using a 100mm cannula using the fanning injection technique. To make sure the results are symmetrical, I assess the patient again while they are standing, as the results may not be visible accurately. Ideally, I recommend an injection of 30-40cc of hyaluronic acid gel for each buttock and no more than 100cc per session, especially if it is the patient’s first time. I also prefer to inject the deep sub-dermal layer and subcutaneous fat up to 3-4cm from the skin. After the injection, I assess the product distribution and gently massage from bottom to top if necessary. AFTER CARE After the procedure, dressing the injected points with a disinfectant is very important. Taping the area in a triangle shape is necessary, in order to help the product integration with the dermis. I strongly advise my patients to keep it on for at least three days and avoid getting it wet. Immediately after the treatment, patients may experience a slight swelling. This can be dealt with using paracetamol. I also recommend that patients do not undergo strenuous workouts, consume excessive amounts of alcohol or expose themselves to extreme temperatures. For bruising, arnica supplements are recommended. The final outcome will not be seen immediately, but in about two to three weeks when the swelling and redness have subsided.

May 11

Genefill ATT Technology

The core of Genefill is defined by the Advanced Thixotropic Technology (ATT), which determines how gel molecules behave during and after injection to ensure the most desirable qualities of hyaluronic acid dermal fillers: a smooth application and strong stability degree. Hyaluronic acid, which is the primary element of the biphasic range of Genefill dermal fillers, is a naturally occurring polymer found abundantly in the cellular matrix of the tissue. Due to its extremely biocompatible and biodegradable nature, the life of this HA in its most naturally occurring state is very short. In order to prevent a futile case of cosmetic treatment, the ‘Advanced Thixotropic Technology’ was developed and patented by BioScience GmbH that can safely delay the degradation of the HA gel in addition to the commonly utilized cross-linking methods. ATT allows for a special type of synthesis of the Genefill gel. This primarily helps the gel to become less viscous under pressure bearing the injection force substantially and immediately returning to its original viscosity when the pressure is no longer applied. The gel in this way is prevented from breaking down and getting exposed to excessive enzymatic degradation. Injection with Genefill Gel The Genefill gel molecules do not break during the passage through the syringe, under the injection force. Standard Injection Other gel molecules break down during the passage through the syringe, under force. Benefits Thixotropy-based products guarantee considerably better results in terms of increased volume, outstanding treatment goals, and enduring effects. The patented technology further equips Genefill products with: • Longer Duration The Genefill gel’s molecules are covalently bonded ensuring that they remain in the tissue longer. Additionally, the special structure of these thixotropic molecules also reduces the diffusion rate of the enzyme hyaluronidase, resulting in a longer-lasting gel. • Stable Due to the covalently bonded molecules of the Genefill Gel, they are harder to disintegrate making them significantly more stable. • Easy to Inject By having the ability to become less viscous under the injection pressure, the Genefill gel is easier to inject into the skin tissue. This equips the doctors with the ability to keep high control on the procedure like the placement of the product, quantity injected, etc. Source: https://genefill.com/

May 7

Pbserum Active Recombinant Enzymes

The Pbserum cosmeceuticals line contains as active principles the first recombinant enzymes of bacterial origin, with proven efficacy, which guarantees visible and prolonged results in a short time and from the first application. This innovative treatment is the result of long years of biotechnological research in the cosmetic and pharmaceutical industries, which allowed the development of biologically active principles that act selectively and specifically in several skin pathologies and subcutaneous tissues, being the natural and safe alternative to classical chemical molecules. Active ingredients Keratinase PB333 Origin: Bacillus Licheniformis. Mechanism of action: Degradation of keratin. Effects: Keratolytic. Acts as the core of the Smart Peeling effect, which recognizes the needs of the skin and acts where it is needed. With its selective technology, it naturally promotes cell renewal and gently, yet effectively, exfoliates the skin without causing irritation. It increases permeability and improves the penetration of other active ingredients. Hyaluronidase PB3000 Origin: Streptococcus Pyogenes. Mechanism of action: Degradation of polysaccharides. Effects: Draining. Corrects complications after hyaluronic acid filler injections. Degrades excess polysaccharides responsible for fluid retention, increasing dermal permeability, and promoting lymphatic drainage. It improves microcirculation and skin appearance, helping to achieve a slimmer figure. Collagenase GH PB220 Origin: Clostridium Histolyticum. Mechanism of action: Degradation of collagen fibers. Effects: Anti-fibrotic. Promotes the regeneration and reorganization of collagen fibers in the dermis, improving the texture and appearance of the skin as well as increasing its suppleness and tonicity with a powerful firming effect. Lipase PB500 Origin: Thermus Thermophilus. Mechanism of action: Triglyceride degradation. Effects: Lipolytic. Activates lipid metabolism within the adipocyte, reducing excess volume and localized fat without damaging the tissue. Eliminates excess sebum at a superficial level, leaving the skin clean, improving its appearance and texture, while facilitating the absorption of active ingredients. Lyase PB72K Origin: Streptococcus Pyogenes. Mechanism of action: Proteoglycan degradation. Effects: Draining. It increases tissue permeability and penetration of collagenase and lipase. Also, it degrades the molecules responsible for the retention of liquids and toxins of the extracellular matrix, reducing body volume and improving the skin’s appearance. Source: https://pbserum.com/enzymes/recombinant-enzymes/

May 5

Pbserum Enzyme Biotechnology

Recombinant Enzymes Pbserum recombinant enzymes are the result of years of biotechnological research by specialized biologists, biochemists, and engineers in our laboratories based in Albacete, Spain. Seeking to boost the regenerative power of enzymes, our group of expert scientists developed the unique technology of Pbserum, which has transformed the way various skin diseases and disorders are managed in clinical practice all over the world. Being a true revolution in global medicine, Pbserum has opened countless therapeutic possibilities to doctors, specialists, and of course, to patients. Biotechnological active principles that act in synergy with recombinant enzymes: o Vitamin A Works in synergy with keratinase to reduce hyperkeratosis and promote cell renewal. Reduces the excessive production of sebum which is responsible for acne breakouts. Stimulates the production of endogenous collagen and helps to maintain correct moisture levels in the dermis. o Vitamin B complex The complex of vitamins B1, B3, B5, and B6 act on the different problems associated with oily skin, thanks to its sebum-regulating, anti-inflammatory and skin-barrier repairing action. Minimizes the appearance of pores and comedones and revitalizes the skin. o Vitamin C A powerful antioxidant that prevents and delays the cellular aging process. Stimulates the production of collagen in the skin, improving its firmness and inhibiting melanin production, reducing the appearance of spots and providing luminosity to the skin. It also helps treat small inflammatory processes. o Vitamin E Lipophilic antioxidant that neutralizes free radicals caused by UV radiation and other external agents. Stimulates cell growth in the dermis and increases water retention at the cellular level. o DMAE It is a natural antioxidant with an immediate lifting effect. Improves the tone and the elasticity of the skin, reducing expression lines. o Hyaluronic acid Low molecular weight hyaluronic acid can penetrate the deep layers of the skin. Fills in wrinkles, fine lines and improves cell cohesion, by inhibiting trans epidermal water loss. Technology Pbserum enzymes are of bacterial origin and were developed through a complex biotechnological process exclusive to Pbserum. A key factor is the use of genetic DNA recombination technology, known as recombinant technology, to obtain enzymes synthesized by bacterial microorganisms, yet have the same structure and sequence as the human enzyme. Thanks to this, procedures based on recombinant enzymes offer a low level of immunogenicity, allowing a safe, effective, pure, and biological treatment. Lyophilization is a dehydration method of the active ingredients by rapid freezing and subsequent sublimation of the ice formed under reduced pressure conditions. A product of high purity and safety is then obtained. This method achieves high stability of the active principles, reserving 100% of the enzymes ’and vitamins’ activity and properties while avoiding the need to use preservatives and additives. Microemulsions are oily solutions that are obtained by the union of two immiscible liquids with a very small-sized particle. This stabilizes enzymes in microcapsules to improve their penetration efficiently and safely. Additionally, the texture of this type of formulation facilitates massaging, without leaving residues and helps to obtain optimal results. ¬¬¬ Efficacy pbserum’s recombinant enzymes base their efficacy on their high specificity and substrate selectivity, as well as on the important role they play in tissue regeneration mechanisms. Through pbserum enzymes, we have managed to enhance this regenerative function and thereby improve the condition of one of the most complex organs that contributes the most to general health: the skin. Using the appropriate recombinant enzyme or the ideal combination of enzymes, as well as the correct therapeutic application, it is possible to reduce skin damage in an accelerated way, including aging signs (wrinkles, expression lines, flaccidity, hyperpigmentation), blemishes, sequelae of acne, scars, fibrosis, cellulite and localized fat, among others. ¬¬¬ ¬ Source: https://pbserum.com/enzymes/recombinant-enzymes/

May 1

Cheekbones Correction With Genefill DX

Correction of the zygomatic region is a key moment in facial rejuvenation. When the volume of the cheekbones is restored, the lower third of the face is automatically lifted, the nasolabial folds are reduced, and the oval of the face becomes more apparent. This case presents a method for injecting dermal fillers to restore the volume of the cheekbones. The patient came to the clinic with the problem of insufficient cheekbones volume and the initial manifestations of the deformative type of aging which is characteristic of the inhabitants of our region. The deformation type of aging is characterized by a predominance of facial tissue swelling and drooping, pronounced laxity, especially in the middle and lower third of the face. Along with this, wrinkles and pigmentation disorders are not typical, the skin is dense enough, shiny, and sometimes porous, as in this case. Since the patient was not ready for lipofilling or surgical implantation, we have decided to correct the cheekbones with fillers. The choice of a cheekbone volumetric preparation is very important. This is because the tissues in this area are quite heavy. The product of choice was Genefill DX from the Genefill dermal fillers line, a new generation of bi-phasic HA fillers. The safety of their use is confirmed by the international quality certificate CE (Conformité Européenne). Genefill contains crosslinked HA particles integrated into uncross-linked HA carriers. The basis of the entire Genefill line is the Advanced Thixotropic Technology solution, patented by BioScience (Germany), which determines the behavior of gel molecules during and after injection. It is aimed at optimizing the injection procedure as much as possible and providing the most desirable properties of hyaluronic dermatological fillers: smooth injection, high degree of stability, and predictability of the result. Through a special manufacturing process, the thixotropic molecules in Genefill have the ability to become less viscous under piston pressure upon injection. Therefore, Genefill products are easier to implant with smaller needles, while minimizing pain levels and maximizing patient comfort during the procedure. Hyaluronic acid molecules in conventional gels tend to degrade under the influence of injection pressure, which negatively affects the duration of fillers in the injection area and, consequently, reduces the effectiveness of their use in dermatology. The thixotropic molecules in Genefill (unlike other gels) return to their original viscosity after injection, thus providing a long-lasting and stable effect. Additionally, 1 ml of Genefill DX alone contains 50 mg of dextranomer microparticles, which stimulate endogenous growth of collagen fibers and have pronounced anti-in-flammatory properties. Due to this, a decrease in edema at the injection area is achieved and the duration of the drug’s stay in tissues is increased. The choice of a cheekbone volumetric preparation is very important. This is because the tissues in this area are quite heavy. The drug of choice was Genefill DX from the Genefill dermal fillers line, a new generation of biphasic HA fillers. THE PROCEDURE The marking was carried out from the point of intersection of the line connecting the ear tragus with the lip’s commissure of the corresponding side and the continuation of the line of the nasolacrimal sulcus with an indentation of 3-4 cm towards the beginning of the nasolacrimal sulcus. This facial area has a good blood supply since near the zygomatic bone on the anterior surface of the maxillary bone there is a place where the infraorbital artery exits, the exit point of which is a dangerous zone for needlework. For the safety of injection, the place of exit of the infraorbital artery and nerve was previously found by palpation. Choosing between needles or cannulas to carry out the procedure, we have chosen a needle for the following reasons: a thin cannula is partially displaced in the tissues during drug injection, and a thick cannula, in turn, during blunt passage through the tissues gives significant trauma which results in a large swelling. Local anesthesia can be used for this procedure, but it was not required in this case. Fillers were installed after three times of gloves and the patient’s face pre-treatment with 0.05% Chlorhexidine solution. The level of the drug installation is periosteal. The 27 G needle was inserted perpendicular to the bone, with a cut in the direction of the jaw angle (photo 1 A-C). The filler was inserted deep into the periosteum. The volume of the drug was limited to 1 ml since the patient’s request was not for a radical change in facial features, but only a decrease in the signs of aging. The injection technique was “depot”, the drug was injected as a bolus at one point, but smoothly enough for its good distribution in the tissues. After the procedure, the patient’s face was re-treated with 0.05% Chlorhexidine solution, and Traumeel S ointment was applied. As a result of the procedure, a gentle cheekbone increase with a long-term effect was obtained. The patient was satisfied with the result and did not need further correction. Source: https://genefill.com/

April 30

GeneFill DX

While Genefill is popularly known for its unique body contouring solutions and their ability to volumize the buttocks, correct the concave deformities, and enhance the calves and hands. Not many are familiar with its other innovative offering, Genefill Dx. It is a sterile resorbable gel-suspension of positively charged dextranomer microspheres in a hydrogel consisting of cross-linked hyaluronic acid sodium salt (Hylan Gel). The unique gel of Genefill Dx is designed to provide a 2-in-1 effect to the area with augmentation and onset of skin regeneration. The product supports the replacement of HA and encourages the process of neocollagenesis (Type 1 Collagen), ensuring increased fibroblast stimulation and collagen deposits for an overall regeneration of the dermal matrix and an overall healthy, youthful appearance. The highly viscose nature of the gel with increased stability against enzymes such as hyaluronidase also maximizes the results’ duration. Genefill Dx is an ideal solution for the effective treatment of skin defects such as prominent wrinkles, deep-set folds, and the recessed nature of cheeks, chin, and jawline. What is Genefill Dx? Genefill DX is an absorbable skin implant with a high level of purity. It is a sterile, apyrogenic, visco-elastic, biologically compatible (non-immunizing, non-inflammatory, non-toxic) gel implant that is insoluble in water and produced from a hyaluronic acid gained through fermentation. Genefill DX contains a sterile viscous gel consisting of a suspension of dextranomer microparticles and cross-linked hyaluronic acid of non-animal origin. It is a biocompatible and biodegradable implant for tissue augmentation. The cross-linked hyaluronic acid serves mainly as a vehicle for the dextranomer microparticles. They stimulate the connective tissue at the locality of injection for a longer lasting result and naturally radiant look. Composition Every 1ml of Genefill DX is composed of 12 mg of cross-linked hyaluronic acid sodium salt, 50 mg of dextranomere, 6.9 mg of sodium chloride, and 1 ml of water injection. Both hyaluronic acid and dextranomer-microparticles of the products under discussion are biodegradable and biocompatible. What makes Genefill DX Unique? Like every Genefill product, Genefill Dx is also supported by the synergetic technologies of Advanced Thixotropic Technology and CRM technology. The former allows for stable and long-lasting results, while the latter enables excellent flowability in tissue for optimal dermal integration. In addition to these, the dextranomer as the key ingredient of Genefill Dx stimulates collagen production, ensuring even longer-lasting results. Furthermore, Genefill Dx stands out as a unique product across the aesthetic landscape due to its Bio-Stimulation with positively charged microspheres and its unique combination of Hylan gel and dextranomers. Application The product is introduced to the injection site (subcutaneous tissue) by way of a dedicated sterile needle. It is explicitly injected in the intracutaneous and subcutaneous layers using the 25G needle to sculpt and define the face’s form. What is Dextranomer? Dextran is a complex branched glucan (polysaccharide derived from the condensation of glucose). Dextrans are a “branched poly-α-d-glucosides of microbial origin having glycosidic bonds predominantly C-1 → C-6”. Dextranomer microspheres are composed of cross-linked dextran molecules with a positive surface charge. Dextranomer is a biodegradable glucose biopolymer and is hydrophilic. Interestingly, dextranomer was initially developed for use in gel filtration chromatography. The medical-grade is a purified form that is sterilized*. Dextran is synthesized from sucrose by certain lactic acid bacteria, the best-known being Leuconostoc mesenteroides and Streptococcus mutans. Safety Similar to the entire Genefill Line of dermal fillers, GeneFill DX is also CE Mark certified and produced only in ISO-verified state-of-the-art facilities based in Germany. Furthermore, Genefill Dx is also certified as medical device class III since 2009. Source: https://genefill.com/

April 21

The Risk Associated With Using Uncertified Dermal Fillers

The Risks Associated with Using Uncertified Dermal Fillers Dermal fillers have come to play an essential role in the management of aging skin, becoming part of the grooming regime for women and men. The exponential growth of dermal fillers’ market is the result of increasing demand for non-surgical treatments, as well as improvements in the manufacturing of new types which allow to not only correct the wrinkles and folds but also contour and replace the lost volume. Safety Considerations Injectables are generally considered safe, however, as in any other medical procedures, there are some risks related with using them, especially if relevant precautions and contraindications are not adopted from both doctor and patient. The probability of side effects taking place can significantly increase when, firstly, products used in the treatment are of non-confirmed origin and with unapproved ingredients and, secondly, non-certified or non-trained practitioner conducts the injections using an inappropriate technique. First Step: Licensed Medical Professional Those looking to get dermal fillers should look for the licensed and board-certified healthcare professional, with a speciality in dermatology or plastic surgery, and trained to perform this kind of procedure. Dermal fillers are now being promoted as “lunch-time” treatments that can be done in under 30 minutes and maybe that’s why they sometimes look so easy to conduct. The truth is these procedures require extensive knowledge of the facial anatomy and various injection techniques, which can be possessed only by a qualified surgeon or dermatologist. A dermal injection conducted in the wrong way can have severe consequences, starting with undesired patient’s appearance (facial or body asymmetry, skin stretching, lumps) and finishing with serious skin damage (such as wounds, infections and scarring) or even blindness. Online Businesses and Fake Dermal Fillers An immense threat comes also from a growing interest in purchasing dermal fillers online, which only contributes to the rise in sales of counterfeit products from illegal businesses run by unlicensed distributors. Dermal fillers are officially qualified as medical devices and no lawful company would ever sell them directly to the consumer. When purchasing products online, patients can never be sure what’s inside the packaging, because even if it's mentioned it’s hyaluronic acid, it can be literally everything. Non-sterile Environments This all is accompanied by not enough awareness about the risks of undergoing the treatments in non-medical settings, for example in the privacy of someone’s home, with consumers going as far as injecting themselves after watching YouTube tutorials. According to the Consumer Complaints Audit Report 2017-2018 published by Save Face , 33% of complaints were results of treatments conducted in domestic setting, 26% in a beauty salon, 17% using services of a mobile practitioner, 11% during a treatment party, 9% in a hair salon and 4% on training venues and conferences. According to the same source, 84% of patients didn’t know what products were used during the procedure and 31% weren’t aware of what qualifications or training their practitioner had undertaken. As scary as it sounds, the results of such activities can be irreversible. Enhanced Regulations On a positive side, we are witnessing the introduction of the tightened control mechanisms for medical devices throughout Europe which are meant to ensure better protection of public health and increase patients’ safety by improving the quality of the medical devices and harmonizing the legislation within the EU. The EU Medical Devices Regulation (MDR), published on 5th May 2017, replaced the EU’s Medical Devices Directive (93/42/EEC) and Active Implantable Medical Device Directive (90/385/EEC) with a 3-year transitional period. That means that all dermal fillers are now being classified as medical devices and must be CE-certified by a notified body to be allowed to be sold after 26th May 2020, with current certificates in accordance with the old directive (93/42/EEC) remaining valid until the expiry. The new directive classifies injectable dermal fillers with hyaluronic acid as the highest risk class – III, which refers to medical devices with absorbed ingredients. Safety and Quality Commitment At BioScience, we truly believe that the growth in the aesthetics and injectables market should be primarily about the quality, not quantity. We’re proudly holding a CE mark 2409 for all of the ranges of dermal fillers for not only face but also body and we have confidence that only demanding legislation and tight regulations can boost confidence in the medical devices industry. We want to draw the attention to the risks that may arise after the misuse of dermal fillers and at the same time stand for the rules that should be paramount for everyone operating in this field to promote only certified and verified products. Source: https://biosciencegmbh.com/