Day 1 :
Founder of The Beautiful Skin Institute PLLC, USA
Keynote: Acne scar reduction: What is new?
Time : 10:00-10:45
Dr. Clemens Esche is a board-certified dermatologist who graduated from The Johns Hopkins dermatology program and held assistant professor appointments at the University of Pittsburgh, the Mayo Clinic and at The Johns Hopkins University. Dr. Esche founded The Beautiful Skin Institute PLLC in Herndon, VA, in 2016. He has received more than 10 academic awards for his pioneering research and has authored more than 70 publications. He was recognized with the Patient’s Choice Award in 2013 and became the National Winner of the Doctor’s Choice Award in 2014 and again in 2015.Dr. Esche treats adult, pediatric and cosmetic patients and specializes in minimally invasive cosmetic procedures with little to zero downtime.
Inflammation is the single greatest reason for acne scar development. Consequently, the extent of scarring is associated with acne severity and delay in treatment. Each scar is different and therefore requires a customized approach. Acne scars are currently classified into 3 different types: (i) atrophic, (ii) hypertrophic and (iii) keloidal.
A net destruction of collagen in the dermis results in atrophic scarring. It can be further classified as ice-pick (narrow and deep, 60%), boxcar (1.5-4 mm wide, 25%) or rolling (15 %). Less commonly, there is a net gain of collagen that results in hypertrophic or keloidal scars. Ice-pick (deep pit) scars are frequently the most severe, and, unfortunately, represent around 2/3 of cases. Fraxel or CO2 laser treatment have been considered the gold standard until recently. However, fractional radiofrequency and also the Chemical Reconstruction of Skin Scars (CROSS) technique tend to be superior to even the most advanced fractional laser for the treatment of ice pick and deep scarring. They also tend to work well for the boxcar and deep rolling scars. Four treatments at monthly intervals will serve many patients well. An added benefit is the shorter recovery time compared with Fraxel laser. TCA CROSS involves a high-strength TCA peel (50-100%) applied to the base of the scar to ablate the epithelial wall and to promote dermal remodeling. The degree of clinical improvement is proportional to the number of sessions.
Hypertrophic and keloidal scars can be injected with corticosteroids, 5-fluorouracil, bleomycin or verapamil. Alternatives include silicone dressings and cryotherapy. Freezing from within with cryoshape is advocated periodically.
Numerous 2017 publications challenge the cosmetic procedural delay following oral isotretinoin therapy. An algorithmic approach summarizes the updated recommendations.
Director & Founder of VIVA Skin Clinics
DR RUPERT CRITCHLEY BM MRCGP is the founder, director and lead practitioner at VIVA Skin Clinics (Est. 2004), a qualified Doctor and practicing GP. Dr Critchley graduated from Southampton University in 2009. Since beginning his career in non-surgical cosmetics whilst at Kings College London, he has developed a thriving aesthetics practice with clinics throughout London & the UK. Dr Critchley’s main focus has become set on the professional artistry of dermal fillers, developing his own particular techniques and consultation methodology. Dr. Rupert Critchley is highly regarded in his field and currently offers training in fine facial aesthetics internationally.
The 3D Face Refresh is a non-surgical treatment devised by Dr Rupert Critchley, formulated from the needs of a vastly expanding younger client demographic. The 3D face-refresh marries ‘patient want’ with ‘patient need’, applying a safe and methodical treatment approach to dermal fillers for the next generation. It addresses both subtle ‘Photoshop’ imperfections and early signs of ageing for contribution to overall aesthetics. A holistic approach is the basis for the treatment, dividing the face into upper, mid and lower face. Using small quantities of a volumizing hyaluronic acid based dermal filler, improvements can be made in these regions to tweak and improve minor imperfections. The Three Triangles of Beautification provides the practitioner with a template of safe points to address these using both syringe and cannula technique. The treatment is intended for the younger age category who want to tweak, touch up and correct minor imperfections which are commonly addressed using Photoshop and filters. The procedure involves small injections of a volumising dermal filler to create lift, volumisation and enhancement of most upper, mid and lower face. Using safe injection zones guided by facial anatomy, downtime and complication risk is minimal.
Imperfections addressed with the 3 beautification triangles:
Cheek Beautification Triangle
Cheek lift and volume/zygoma definition
Lateral tear-trough / dark circle
Jawline Lift and Contour Triangle J1-3 Jawline Contour Jowel Marionettes
Lower Face and Chin Shaping Triangle L1-3 Nasolabial fold Chin shape Marrionette
Dr. Rupert shall then speak about cultural differences in beautification – East meets West.
Director & Founder of Aesthetic med clinic, Italy
Dr. Bilchugova Luciani Ekaterina is the founder, director and lead practitioner at Aestheticmed Clinic, a qualified Doctor and practicing GP, Dr. Bilchugova Luciani graduated from Saint-Petersburg State University (Russia) in 2003, Chieti State University (Italy) in 2005. Has diploma in medical and surgical trichology and nutrition. AAAM Board Certified in Aesthetic Medicine 2018 (USA). Since beginning her career in non-surgical cosmetics at International School of Aesthetic Medicine (Rome, Italy) , she has developed a thriving dermatological (particular in aesthetics and trichological) practice with clinics throughout Italy. Dr. Bilchugova Luciani’s main focus has become set on the professional trichology and nutrition, and aesthetic medicine of different fields, developing her own particular protocols. Dr. Bilchugova Luciani is highly regarded in her field currently offers training in fine facial aesthetics internationally.
Cryotherapy is one of the recognized techniques for the destruction of local adipose. Originally used for induction lipolysis, note improve lowering the skin tone, technology has found its application also in the treatment of cellulite and for a other zones: arms, face, neck and décolleté. The recent evolution of the method of cryotherapy has introduced local application technology.
The new method has been applied for the rejuvenation of the skin of a group of 25 patients ( 22 women and 3 men ) with different aesthetic problems: aging face, neck and décolleté, arms, loss of skin tone and cellulite in the areas of the thighs and buttocks. The selected patients were healthy, with no active pathologies contraindicated in cryotherapy. All patients have received a detailed explanation of the procedure before the start of the course and have expressed their consent to this clinical research.
The method of evaluation: survey and photography before and 2 weeks after the cycle of 10 weekly treatments.
Clinical results were evaluated excellent in 30% of cases, good in 60 % and insignificant in 10 % of cases.
The study confirmed the benefits of local cryotherapy: the speed and ease use of techniques combined with the lack of recovery time, side effects and pain , seasonal or phenotypic constraints. In general, the procedure has been perceived by patients as a pleasant and relaxing massage . In addition , drainage and modeling function allows you to apply the method and is not only slimming and body conturing but also anti-cellulite, remodeling the figures , anti-aging strategies for the treatment of ptosis and wrinkles.
Local cryotherapy method when exposed to the epidermis can further improve the texture of skin wrinkling and as well as improving penetration of cosmetic deposited directly during the procedure.
A significant advantage of using local cryotherapy in relation to the classic combines a stimulating effect on the skin to combat cellulite, to stimulate deep dermis and the correction of skin texture while achieving the rejuvenation of all skin layers.