VolumeVolume 65 •• Number 32

OcialOfficial Newsletter ofof thethe International International Society Society of of Aesthetic Aesthetic Plastic Plastic Surgery Surgery Join us in Geneva in September he 21st Congress of ISAPS will have Tthe largest faculty in our 42-year history, and activities surrounding this biennial event will span an entire week. Registration numbers already exceed our expectations with plastic surgeons coming from 76 countries – the largest delegation from Switzerland, as might be expected. Our hosts in Geneva have planned unique social events with a definite Swiss flavor, and day tours have been organized to show our guests the beautiful mountain villages, chocolate factories, and the surrounding area. Geneva is a truly international city, as befits our truly international organization.

continued on page 32 May – August 2012 www.isaps.org president’s message Board of Directors PRESIDENT Jan Poëll, MD – Switzerland Jan Poëll, MD St. Gallen, Switzerland ISAPS President [email protected]

PRESIDENT-ELECT Carlos Uebel, MD, PhD Dear Friends and Colleagues, Porto Alegre, RS, Brazil [email protected] ime passes fast and soon my two years as President of this noble society will be over. FIRST VICE PRESIDENT Susumu Takayanagi, MD It’s been an interesting time that I wouldn’t have wanted to miss. It will end with Osaka, Japan Tan unforgettable biennial Congress in Geneva in September. I had a lot of work, [email protected] but interesting such that I recommend to every young colleague to try to become involved SECOND VICE PRESIDENT Renato Saltz, MD in the management of our society either through a committee or as a National Secretary. Salt Lake City, UT, United States The latter are the closest to their country and best informed about local ethnic and cultural [email protected] specialties. THIRD VICE PRESIDENT Jorge Herrera, MD ISAPS has grown a lot these last years and our future is very promising. We are the Argentina leader in international education of aesthetic plastic surgery. Being part of ISAPS, you are [email protected] one of the leading aesthetic plastic surgeons in the world or will become so with all the SECRETARY GENERAL Miodrag Colic, MD education we offer in our ISAPS courses and other meetings. But being a leader is not only Belgrade, Serbia a pleasure. You have to act as such. [email protected] As President, you mainly change your title during two years, but the work is done by a TREASURER Daniel Knutti, MD team including our Board of Directors, our Executive Director and her team, and last but Biel, Switzerland [email protected] not least our National Secretaries - all together a fantastic team always ready to serve our society. As a member, you’ll find colleagues all over the world, by now in 93 countries, with ASSISTANT TREASURER Dirk Richter, MD open doors always ready to accept you as a visitor. Köln, Germany [email protected] We’re one big happy family together with CONTENTS other societies with the same goals and also con- IMMEDIATE PAST PRESIDENT Foad Nahai, MD MEDICAL AEsthEtICs: Join us in Geneva 1, 32 cerned about our specialty and patients’ safety. Atlanta, GA, United States [email protected] President’s Message 3 Our courses are improving every year and Message from the Editor 4 PARLIAMENTARIAN so is our biennial Congress. Therefore, the best Thomas Davis, MD it’s A Question Strategic Planning 5 is still to come! We have never had such a big Hershey, PA, United States [email protected] Course: India 6 international faculty before. The social program NATIONAL SECRETARIES CHAIR Symposium: Philippines 7 is superb and all is included in the registration Lina Triana, MD Aesthetic Surgery Training 8 fee. Don’t miss it! Cali, Colombia of QuAlity [email protected] Patient Confidence 8 I’ll see you in Geneva on September 4th until At Allergan, we passionately believe in quality. EDUCATION COUNCIL CHAIR LSNA-BCRF-ISAPS Award 9 the 8th where you’ll experience a great educa- Nazim Cerkes, MD Our 35 years of commitment to science and innovation in medical aesthetics tional and relaxing program and meet a lot of Istanbul, Turkey Global Perspectives 10-16 [email protected] means that practitioners and their patients can make decisions with confidence. new friends. History of Injectables 17-19 TRUSTEE – PAST PRESIDENT Congress: Geneva 20-26 Bryan C. Mendelson, MD We are launching a landmark public awareness and education campaign to help Melbourne, VIC, Australia start a conversation between practitioners and patients about why quality matters. Pillars of ISAPS 28, 35 [email protected] Jan Poëll, MD National Secretaries 29 ISAPS TRUSTEE – ELECTED Ask your AllergAn representAtive for more informAtion. Vaud artist Bernard Völlmy whose Theodore Voukidis, MD Facility Accreditation 30 landscape of the Lavaux vineyards, President Athens, Greece a UNESCO World Heritage site, [email protected] RealSelf Milestone 33 and Lake Geneva, with the Alps in the background as viewed from EXECUTIVE DIRECTOR Calendar 36-37 above, is featured in the set of phi- Catherine Foss lately stamps issued by Swiss Post March 2012 UK/0326/2012 New Members 38 last year. Hanover, NH, United States [email protected] 35 years of quality, science and innovation 2 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 3

12997 EU_UK Quality Trade Advert resized for ISAPS.indd 1 25/06/2012 10:43 strategic planning

Message from the Editor First ISAPS Strategic Planning Meeting J. Peter Rubin, MD – United States Renato Saltz, MD – United States 2nd Vice-President and Chair of Strategic Planning ISAPS News Editor

s Chair of the Ad Hoc Strategic Planning elcome to this issue of ISAPS News. I cannot wait We also see in this issue a fantastic historical piece by our Committee, I am pleased to report to the mem- for our ISAPS Congress in Geneva! We are all ISAPS News Historian, Riccardo Mazzola, on the history of bership on the outstanding achievements of Wlooking forward to this wonderful gathering of injectables. I think that you will be surprised to see some of A Comments from some of the participants: the first meeting held on May 2nd in Vancouver, British our colleagues from around the world at what is guaranteed the origins of this technique! • “I want to take this opportunity to thank to be an exceptional educational experience. It is also an excel- I hope that you enjoy this issue of ISAPS News. I look Columbia, Canada preceding the ASAPS Annual you for this perfectly prepared meeting. lent opportunity for camaraderie with our friends, both old forward to seeing you in Geneva! Meeting. That it had big results is thanks to and new. In this issue, we see an exciting preview of the events The participants included Jan Poëll (President), Carlos to come this September. Warm regards, Uebel (President-Elect), Susumu Takayanagi (1st Vice- you. We must absolutely make this an In addition to our regular columns, this issue features President), Nazim Cerkes (Education Council Chair), Lina institution.” –Jan Poëll, Switzerland a global perspective on aesthetic breast surgery. It is so Triana (National Secretaries Chair), Dirk Richter (Assistant • “It was an outstanding strategic planning interesting to see the different approaches and philosophies Treasurer), Tom Davis (Parliamentarian), Hank Spinelli meeting.” –Carlos Uebel, Brazil our member surgeons employ in their practices. I am sure J. Peter Rubin (Aesthetic Plastic Surgery Editor), Joao Sampaio Goes (Past • “The meeting was very productive and that you will enjoy this topic and the way that it is presented. ISAPS News Editor President), Eric Auclair (member), Sami Saad (member), I believe we can move ISAPS in a much Grant Stevens (member), and Catherine Foss (Executive better direction.” –Susumu Takayanagi, Director). Japan The main topics discussed during the meeting were selected “As always it’s a pleasure to work with by the participants and included: Marketing and Branding • ISAPS; Increasing ISAPS Membership; Improving ISAPS’ you, Renato. This group was really very objective and productive. I am very IFATS Educational Mission; Relationships with Other Societies and specialties; a New Board Structure; and Searching for New confident about the future of our Society, Québec City Leaders. warmest regards.” –Joao Sampaio Goes, After an exhausting five hours that followed an intense Brazil 10th ANNIVERSARY SYMPOSIUM ADIPOSE STEM CELLS AND 2 0 1 2 agenda, the group determined a substantial list of excellent • “It was indeed a great and fruitful CLINICAL APPLICATIONS OF ADIPOSE TISSUE recommendations that were predominately approved by the meeting. Thank you for inviting me.” IFATS provides a premier international venue for leading basic science, clinical, October 5-7, 2012 Board of Directors during their board meeting two days later. –Sami Saad, Lebanon, ISAPS National and translational investigators from academia and biotech to exchange state of Loews Hôtel Many of the changes will soon be implemented to benefit Secretary the art information on the development and use of adipose tissue and cells for the membership, worldwide aesthetic plastic surgery, and • “As a European surgeon, my observation cosmetic and reconstructive surgery and therapy. The Society is dedicated to an Le Concorde ultimately, our patients. open exchange of ideas and concepts based on sound science and international was that this meeting was refreshing and Québec City, Before coming to Vancouver, all the participants read The standards of ethical patient and animal care. encouraging. The group seemed focused Servant – A Simple Story About the True Essence of Leadership Québec, Canada on improving collaboration among by James Hunter, a very special book which has been a great national societies of plastic surgery in inspiration to me for many years. I recommend it highly to Europe and around the world. I am sure colleagues who care about service, about ISAPS, and about after this experience that ISAPS will our specialty worldwide. help us in this approach.” –Eric Auclair, www.ifats.org France, ISAPS Member and President, SOFCEP

4 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 5 AESTHETIC EDUCATION AESTHETIC EDUCATION ISAPS Course in Goa, India – January ISAPS Symposium: Boracay Island, the Philippines Susumu Takayanagi – Japan ISAPS 1st Vice President

n March 12, 2012, the day before the 16th I would also extend my cordial gratitude to Dr. Nazim ASEAN Congress of Plastic Surgery chaired by Cerkes (Chairman of the ISAPS Education Council), Dr. ODr. Alexander G. De Leon, an ISAPS Symposium Jan Poëll (President of ISAPS) and Ms. Catherine Foss, was held in Boracay Island, the Philippines. I served as a who supported us to conduct the symposium successfully. I osted by the Association of Plastic Surgeons of India, about 40 miles from the hotel where the proceedings were course director for this symposium held at Boracay Regency thank our splendid team! the January ISAPS Course in Goa, India was held at the transmitted live. The operative session was also made available Beach Resort Hotel on a beautiful beach, attended by approxi- Grand Hyatt hotel. Dr. Lokesh Kumar, ISAPS National by webcast. Three cases were operated by international faculty H mately 150 people. Most of the participants were from Asia, Secretary for India, was the organizing chairman and ISAPS Dr. Cerkes and Dr. Enrico Robotti. In the evening, the faculty Education Council Chair, Dr. Nazim Cerkes of Turkey and Dr. dinner in the hotel ballroom was very well attended as most of with some from Europe, the United States, Australia and Vakis Kontoes of Greece were the Course Directors. Goa is a the faculty members had arrived. South America. beautiful city located in western India near Mumbai, famous for The first day meeting commenced with an introduction and The faculty included Drs. Florencio Lucero (Philippines), its beaches and churches, and very popular with international opening remarks by Program Chair, Dr. Cerkes followed by Akihiro Ichinose (Japan), Darryl Hodgkinson (Australia), tourists. This is a warm, welcoming place with a rich colonial 24 lectures and video presentations on various topics covering David Daehwan Park (South Korea), Yu-Ray Chen (Chinese culture. periorbital and facial rejuvenation including minimally invasive The course faculty included a good balance of international surgery and fat grafting. Taipei), Asko Salmi (Finland) and me, Susumu Takayanagi as well as local members who delivered lectures on different The Chief Secretary of the Government of Goa attended (Japan). I would like to express my heartfelt appreciation to topics and covered the entire spectrum of aesthetic surgery. and Dr. Jindal, Dean of Goa Medical College was the Guest of all members of the faculty who came from around the world Faculty members who participated in the meeting included: Honor. Dr. Lokesh Kumar made a power point presentation to give their excellent presentations. about ISAPS and its role in disseminating knowledge to various We discussed various subjects including Facial Rejuve­ parts of the world. He also highlighted the importance of aes- Nazim Cerkes – Turkey Chris Ladas – South Africa nation, Rhino­plasty, Breast and Eyelid. I sincerely thank Paraskevas Kontoes Suhan Ayhan – Turkey thetic surgeons joining ISAPS. The inauguration was followed Dr. Florencio Lucero who, despite very short notice, gave – Greece Andreas Foustanos by a Gala Dinner on the Lawns of the Grand Hyatt. Dr. James Grotting (USA), Dr. Darryl Hodgkinson (Australia), Akin Yucel – Turkey – Greece The second day’s scientific session included 31 lectures in a perfect presentation replacing Dr. Bryan Mendelson who Dr. Susumu Takayanagi (Japan) Nuri Celik – Turkey L. D. Dhami – Mumbai sessions on laser, rhinoplasty and breast surgery. The evening could not attend due to a sudden change in schedule. Enrico Robotti – Italy V. D. Singh – Chandigarh was kept free and most people took this opportunity to visit A faculty dinner took place at another resort hotel on the Goa’s famous Saturday night bazar. Dirk F. Richter – Germany Shahin Nooreyezdan island. Each member of the faculty enjoyed fine food and Daniel A. Knutti – Delhi The last day of the meeting was devoted to body contouring, wine under palm trees, hearing the sound of waves, and – Switzerland Kuldeep Singh – Delhi hair transplant and miscellaneous sessions with a total of 16 looking up at the stars. It was a most memorable evening. Kulwant S. Bhangoo – USA Rakesh Kalra – Dehradun lectures presented. The course was officially endorsed by the Gianluca Campiglio – Italy Manoj Khanna – Kolkata Medical Council of India providing CME credit hours. The gala dinner of the ASEAN Congress which Patrick Tonnard – Belgium Suresh C. Gupta – Delhi The Association of Plastic Surgeons of India expresses their immediately following the ISAPS Symposium was hosted Lina Triana – Colombia Dinesh Bhargava – Delhi gratitude towards the ISAPS faculty who travelled long dis- on the beach of the Regency Hotel. Participants of the tances to be with us and contributed to the success of this meet- Ari Arumugam – USA Rajeev B. Ahuja – Delhi congress, who were grouped by nationality, enjoyed karaoke, Woffles Wu – Singapore Ashok Gupta – Mumbai ing which benefitted the plastic surgery community in India performances and dances. Being blessed with good weather Tunc Tiryaki – Turkey Lokesh Kumar – Delhi and has spread lots of awareness about ISAPS. Many plastic Michael Stampos – Greece K. Ramachandran – Chennai surgeons have enquired about membership and some have and the beauty of natural surroundings, both the faculty and already completed applications. the participants had lots of fun until late into the night. The content of the scientific program was rated excellent by I am deeply grateful to Dr. Jose Joven Cruz who played a Dr. Florencio Lucero and his wife, Dr. Susumu Takayanagi and his The first day of the meeting was dedicated to a pre-con- most of the delegates and there was overwhelming demand leading role as a local organizer in planning and preparing wife, Dr. DaeHwan Park, Dr.Rene Valerio and his wife ference Rhinoplasty operative workshop which was held at from participants to organize another ISAPS Course soon in for the symposium. Thanks to his hard work, the entire Wockhardt Hospital Aesthetic Surgery Centre in South Goa India. Symposium went very smoothly.

6 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 7 AESTHETIC EDUCATION

Training Plastic Surgeons The LSNA-BCRF-ISAPS ISAPS is collecting data in Aesthetic Surgery for the Third Global Study AWARD of Aesthetic Plastic Professor James D. Frame – United Kingdom Jacques van der Meulen, MD – The Netherlands Gregory Hetter, MD – United States Surgery Procedures to establish global statistics n the UK, Holland and, we suspect, in most other ISAPS issue being addressed, closely followed by quality of care. BCRF Treasurer for 2011. member countries, Cosmetic/Aesthetic Surgery (as How each country chooses to organize and recognize such Iopposed to Plastic/Aesthetic Surgery) is learned by attend- training will vary, but as a society we should be proactive and he Lipoplasty Society of North America (LSNA) was started in 1982 This professionally designed and analyzed ing lectures and meetings and by witnessing or possibly seek to resolve this in a professional way. This may, for exam- as an educational organization with a primary goal of teaching survey is completely anonymous. assisting at some surgeries. Seldom do residents get involved ple, simply involve “Certification” from an ISAPS “Certified” TNorth American plastic surgeons the technique of lipo-extrac- The information we collect is important to in the total care of aesthetic patients and review of outcomes. Unit. In both Holland and the UK, chairs in Aesthetic Plastic tion of fat developed by Yves Gerard Illouz of Paris, France. Between all plastic surgeons, the media, industry In the 21st century, and with an increasingly litigious popula- Surgery have been installed in an attempt to structurally 1982 and 1988, twenty hands-on teaching courses were held around and the public. We need your help. tion, this hardly seems the right way to train plastic surgeons. incorporate this field into the Plastic Surgery training cur- the USA, Mexico and Canada to teach this revolutionary technique. If you have previously contributed data, For too long, we have accepted, although reluctantly, riculum. For example, Anglia Ruskin University has spent During this time, Doctors Yves Gerard Illouz, Richard Mladick, we thank you. that other specialties have crept into this lucrative indus- the past two years developing a degree that recognizes train- Carson Lewis and I built the society into a 1,000 member organization. If not, please answer the short try, mainly because we have failed internationally to accept ing in Aesthetic Plastic Surgery (http://www.anglia.ac.uk/ To fund research, both clinical and basic, LSNA founded and questionnaire. that Cosmetic/Aesthetic Surgery should be recognized as ruskin/en/home/prospectus/pg/aesplast.html). This qualifi- funded the Body Contouring Research Foundation (BCRF). These two a “Super-Specialty” that requires additional and acceptable cation will be visible on a website where the majority of UK organizations have worked with ISAPS over the years to promote safe To include your procedures in this qualifications of competency. patients can find a surgeon. In Holland, there are not enough lipo-suction surgery. international study, please go to this Until now, ISAPS has supported Aesthetic Surgery edu- “Aesthetic training posts” to accommodate the demand from Assets in excess of $250,000 belonging to LSNA-BCRF were website. cation by producing and endorsing a variety of conferences trainees which is the reason why an international fellowship transferred to ISAPS several years ago to fund clinical and basic https://www.iisecure.com/ISAPS/survey.asp where knowledge is passed on in a classic, one-directional was introduced (http://www.dafprs.nl). research by younger plastic surgeons in the fields of lipo-suction, body Thank you for your participation. way. The board has been reluctant to support a more pro- We think structural hands-on education in Aesthetic contouring and basic science, specifically in the areas of fat and stem ductive, two-directional concept of education by means of Surgery is essential for the acknowledgement and evolu- cell research. The income derived from this capital is used to fund Joao C. Sampaio Goes, MD, PhD – Brazil hands-on teaching. We and probably others feel that it is our tion of Aesthetic Plastic Surgery and feel it is important that two prizes at each biennial ISAPS Congress. In order to stimulate Chair, responsibility to provide “hands-on” training for plastic sur- ISAPS supports this viewpoint. If any individual member or interest in this area of plastic surgery, the age criteria stipulate that ISAPS Communications Committee geons in Aesthetic Surgery to a recognized level of compe- National Secretary feels as we do, please contact us and we will the authors of the papers should be younger plastic surgeons under tency that the public and media will accept as evidence of lobby the ISAPS Board to reconsider their stance. j.frame@ the age of forty-five. training in this field. Clearly patient safety is the primary btinternet.com and [email protected] Clinical Prize: The award is US$3,000 for the best clinical paper by a younger plastic surgeon. Breast Implants and Patient Confidence Research Prize: The award is US$6,000 for the best research paper Alison Thornberry – UK within the field of fat cells, fat stem cells and fat metabolism. Managing Director, Sure Insurance We encourage those with accepted papers who meet the criteria Not registered for listed above to notify the Executive Office that they wish their paper SAPS members not only state that they believe in patient The insurance cover would provide to be considered for these awards. The BCRF Awards Committee will the Congress yet? safety, but are also supporting discussions on how to gain removal and re­­placement surgery should make their decision during the Congress in Geneva and the winners Ipatient confidence following the PIP fiasco. the implants be declared not fit for purpose. The cover would will be officially recognized there. ISAPS insurance partners have been working with still be valid even if the implant manufacturer had been We want the younger members of ISAPS to be aware of these The last deadline for governments, implant manufacturers, surgeons and hos­ declared insolvent. There would be no additional costs to the awards as they begin their careers in plastic surgery and to know that discounted fees is August 21. pitals in putting together an insurance solution with a data patient for their removal and replacement surgery. these prizes are available to them in competition with others. Avoid the on-site rate and collection programme. These new developments will be discussed during the We hope these prizes will encourage younger surgeons embarking register soon. A solution of this nature and scope must be available Global Summit on Patient Safety on the opening day for the on their careers to add to our specialty’s body of knowledge of www.isapscongress2012.org and supported on a global level if it is to gain consumer ISAPS Congress in Geneva in September. lipoplasty and body contouring through an increased interest in confidence. clinical and basic research.

8 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 9 GLOBAL PERSPECTIVES: AESTHETIC BREAST SURGERY GLOBAL PERSPECTIVES: AESTHETIC BREAST SURGERY

Perspectives on Current and PERSPECTIVE from Russia Future Trends in Breast Surgery Alexey Borovikov, MD – Russia in South America he fall of the Iron Curtain was followed actually by all “CE” mark hold- Ruth Graf, MD, PhD – Brazil a milestone for Russians, breast ers. It testifies to our market capacity macryl and Interphall (originally meant surgery being no exemption. though there is no sales data for exact T for phallus enlargement) versions of e are all aware that the concept of beauty varies Brazil now ranks second in the world for the amount of Before 1990, there were no private estimation. Such a thing as a National PAAG grew, so did the visibility of with time and environment, and with social and aesthetic plastic surgery performed, with breast augmenta- practices and just two or three small Breast Implant Registry is unimagina- complications, and eventually it was Wcultural patterns. St. Thomas Aquinas described tion and liposuction being the most popular procedures. institutions that provided so called ble in Russia. Both distributors and sur- banned by professionals (not by medi- beauty as “that which when beheld provokes pleasure,” and Breast surgery offers an excellent prism for observing, if you “cosmetic services.” A doctor would do geons would never report actual figures can be further defined as an emotion evoked by something will, the plasticity of beauty concepts and trends over time. cal authorities). We are dealing with hundreds of dermaplanings or tattoos officially, for taxation reasons, or to the aesthetic and essentially based on a symmetry and proportion- As an interesting side-note, recent beauty trends in Brazil dozens of unlucky patients each year, for every breast reduction/pexy per year public where they advertise implants as ality. In South America as in the world, what constitutes this itself and Latin America in general reveal two important but again, having no statistics, we can- for a fixed, negligible salary, no mat- “most demanded.” Of course, nobody symmetry and proportionality, or “beauty,” has been repeat- cross-trends: the Latin American adoption of North Amer- not grade the complication rate. As ter what he or she did. It could be just ever reports complication rates. That is edly revisited and redefined up through the present with each ican standards for beauty relative to breasts, and North the injections were widespread for a an old-fashioned Biesenberger pedicle why the FDA Core Studies data are so social and cultural change and trend. Plastic surgery has mir- American adoption of Latin American standards for beauty decade, there may be dozens of thou- with inverted T scar with a high rate of important for us as, presumably, for the rored, accompanied and even advanced these trends, integrat- relative to the buttocks. sands of women still happy. I personally nipple slough. In augmentation, our rest of the world. ing the changing views of the human form and the beautiful, Up to and through the mid-1990s, Brazilian women in cannot blame PAAG as indisputably as innovating and adapting itself to this intrinsically linked duet particular desired a body contour that featured a slim but predecessors attempted home-made, Virtually all the breast augmentation I did earlier because of dealing more of variables. curvaceous body, with relatively small breasts. In Brazil, bizarre devices like solid rubber or controversies are present in Russia. and more with the silicone implant Although plastic surgery has been considered its own this was accompanied by a strong focus on a high, rounded two plastic hemispheres put separately Teardrop devices are popular among problems. specialty for about 100 years, aesthetic plastic surgery only “bum-bum,” or buttocks, with the buttocks being culturally inside the pocket and then joined, at a large number of younger surgeons The second wave of injectables – began to achieve significance in Brazil and the rest of Latin more essential to female appeal than breasts. Given this first stage, and removed a month later with limited experience. They take Macrolane – rose and fell within just America with the creation of the Brazilian Society of Plas- trend, the most common aesthetic breast procedures were filling the capsule with organic oil at for granted the notorious slogans like three or four recent years. The product tic Surgery (1949) and the Latin American Society of Plastic reduction mammoplasty/mastopexy. Breast augmentation/ the second stage. Academician Viktors “form stable,” “efficient texture,” “dual appeared to be too expensive to com- Surgery (1941). The arrival of the great Prof. Dr. Ivo Pitanguy implants were mostly used in cases of marked asymmetry, Kalnbërzs (born in 1928 and still active) gel” (ironically always coming along pete with silicone implants and too on the scene in the 1960s was the next major boost for the hypomastia, and disproportionately small breasts, with an from Latvia used autologous fat chunks with futile “dual plane”) at numerous specialty, and his own words perfectly reflect the relationship average implant size of about 175cc. As the ’90s progressed, quick to cause problems in Europe. or even cadaver or large porcine pieces. educational meetings where sensible between plastic surgery, human self-image, and beauty: (The and with the explosion and ubiquity of world access to North I cannot help but refer to the recent After the anticommunist revolu- validations are never provided. Sur- pursuit of plastic surgery) “is the attempt to harmonize the American media and a “globalization” of beauty standards, issue of this Newsletter (vol. 6, #1), tion of 1991, rapid and chaotic spread geons with substantial personal expe- body and spirit, emotion with reason, to establish a balance breast implants became increasingly popular in Latin Amer- where Dirk Richter talking about the of cosmetic surgery took place. Breast rience prefer round implants with low that allows the individual to feel in harmony with his own ica, accompanied by the emergence of buttocks contouring PIP scandal, has said: “One is tempted implants were bootlegged from abroad, texture or smooth because they have image and the universe around him.” An aesthetic relativist, and augmentation, but using relatively small breast implant to believe that Europeans are being mainly Mentor saline because of the sil- learned that it is the implant volume/ Pitanguy puts primary focus on what the patient wants and volumes compared to North American aesthetic trends, used as guinea pigs for Americans.” feels, and in a country and continent where many patients which favored large breasts and boyishly slim hips. icone scandal of 1992 and because vol- tissue quality ratio that matters most of Well-known Russian sluggishness hap- have mixed African, indigenous and European ancestry, he As the Brazilian “bum-bum,” also known as the “J-Lo ume adjustment seemed an advantage the time. pened to make us closer to Americans. observes that aesthetic ideals vary by epoch and ethnicity. Shelf,” entered the American beauty scene, so did the idea for a novice. Then domestic manufac- Poliacrylamid gel (PAAG) injec- The third wave, still rising cur- Dr. Pitanguy’s seminal work in aesthetic breast surgery and of larger and larger breasts become part of the Latin Amer- turers emerged with silicone implants of tions fiercely competed with silicone rently, is, of course, breast lipofilling. his influence on what constitutes a beautiful breast, and how ican idea of beauty. By the early 2000s, it became common in extremely poor quality, which remained implants in the mid to late nineties. Roger Khouri is a frequent speaker to achieve that goal, must be considered the starting point Latin America to use implants 300cc and larger. In contrast on the market for about ten years due One could see ads like: “Flying to the in our country and we had a national for discussing current Latin American and Brazilian trends to naturally rounded upper pole that was the mark of a lovely to their low price. Eventually, they were beach? Why not enhance your breasts meeting on the subject this past April vis-à-vis breast surgery. totally replaced by western companies. right now, right here, painlessly and continued on page 19 Mentor and Allergan dominate now, bloodlessly?” As popularity of Phor- continued on page 16

10 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 11 GLOBAL PERSPECTIVES: AESTHETIC BREAST SURGERY GLOBAL PERSPECTIVES: AESTHETIC BREAST SURGERY

New Trends in Aesthetic PERSPECTIVE from JAPAN Breast Augmentation from FRANCE Susumu Takayanagi, MD – Japan ISAPS 1st Vice President Eric Auclair, MD – France President, French Society of Aesthetic Plastic Surgeons (SOFCEP) reast surgery, as one aspect of and because there are many cases of plastic surgery, incorporates a complications in breast reconstructions degree of ptosis, there is no way out variety of surgical techniques resulting from the effect of radiation, I he introduction of Lipo-filling in the breast by Delay1 • Lipomodelage advocated by Delay1, Khouri2 is the ideal B of long scars on breasts. Most patients including breast reconstruction, aug- think that lumpectomy with radiation in 2006 completely changed patients’ vision of breast solution, but bears numerous limitations such as the vol- are very sensitive about visible scars mentation mammaplasty, reduction and/or total mastectomy will become augmentation, as it created the opportunity to con- ume of disposable fat, the lack of projection, the insuf- and if long scars cannot be avoided T mam­­­maplasty, and mastopexy. more popular. sider very natural results. The improvement in the quality of ficient recipient site even with Brava and the fact that it to make satisfactory modifications of In the past, there were not many Breast reconstruction employs va­­ the implants with the introduction of cohesive gel and a multi- cannot be used in every case; ptosis, they often give up the idea of breast cancer patients in Japan. rious techniques such as surgery using layer shell is the other important point to take into consider- • Augmentation with implants remains the most popular undergoing surgery. However, over the last 10 years, the an implant, Latissimus Dorsi flap, ation when we try to put the future of breast augmentation procedure and allows one to obtain significant gains in Augmentation mammaplasty is the number of breast cancer cases has TRAM flap, VRAM flap, and DIEP flap into perspective. the quality of the results, after the important work of Teb- most popular type of breast surgery shown rapid increase, particularly in among others. Now surgeons had to adapt their mental approach and bets3 to improve the coverage of the prosthesis, and the in Japan. Hyaluronic acid injection, large cities. I am inclined to believe that In the past, during reconstruction surgical techniques to these new elements with the develop- efforts of manufacturers and surgeons to diminish the fat injection and augmentation mam­ this change is linked to a preference for of one breast, augmentation mam­ ment of: rate of capsular contracture; maplasty with implant are all practiced. calorie-rich foods, changes in eating maplasty, reduction mammaplasty, • Pre-muscular approach to avoid bottoming out and ani- • Composite Breast Augmentation published in 2009 In the past, augmentation mamma­ habits, and an increase in the number or mastopexy of another breast was mation; (Auclair4) combines the advantages of both, the core vol- plasty with implant was very popular of women who do not give birth, popularly practiced. Nowadays, fewer • Use of shape implants in thin patients to obtain a more ume of the implant and the natural aspect of fat injections, in Japan. Recently the number of cases particularly in urban areas. Due to the patients wish to have such surgeries natural contour of the reconstructed breast; and represents a reliable alternative to lipomodelage and has been significantly decreasing. The rapid growth in the number of breast done on another breast, perhaps for • Auxiliary approach and endoscopic control of dissection implants, particularly in thin patients. cause could be attributed to the slow cancer cases, the number of breast economic reasons. Therefore, I am and hemostasis to have better control over the limits of economy in Japan and the increase in References reconstructions has been increasing afraid that there is a considerable the pocket to avoid rotation of shaped implants and to cases of fat injection and hyaluronic 1 Delay E, Garson S., Toussoun G., R Sinna R.: Fat injection to the accordingly. number of patients who keep their lower the percentage of capsular contraction by control- breast: technique, results, and indications based on 880 procedures acid injection. The problem is that non- With regard to surgical techniques breasts unsymmetrical. ling bleeding; over 10 years. Aesth Surg Journal 2009; 29: 360-76. plastic surgeons consider fat injection 2 Khouri R. MD, Eisenmann-Klein M. MD, Cardoso E. MD, Cooley for breast cancer, total mastectomy, Reduction mammaplasty for cos­ • Better control of the aseptia with the use of a funnel to and hyaluronic acid injection easier B. PhD, Kacher D. MS, Gombos E. MD, Baker T. MD: Brava and partial mastectomy with radiation, metic purposes has not been popular introduce the implant for instance. Autologous Fat Transfer is a Safe and Effective Breast Augmenta- than augmentation mammaplasty and nipple sparing mastectomy are because firstly there are not many tion Alternative: Results of a 6-Years, 81 Patients, Prospective Mul- with implant and they are flooding These different aspects can be summarized by the for- ticenter Study. Plast. Reconstr. Surg. 2012,129: 1173-1187. popularly practiced. For the time being, Japanese women who have very large the market with advertisements for mula: 3 Tebbetts J. B. Dual plane (DP) breast augmentation: optimizing lumpectomy with radiation is not very breasts, and secondly long scars on these procedures, in spite of many NO BLEED / NO BLOOD / NO BACTERIA implant soft-tissue relationships in a wide range of breast types. popular in Japan. breasts tend to be visible on Asians’ Plast. Reconstr. Surg. 2006; 118 (S): 81S-98S. cases of complications caused by There have been growing numbers skin and sometimes they become Future trends in Aesthetic Breast Augmentation will 4 Auclair E.: Apport du lipomodelage extraglandulaire dans les aug- their injections. In either fat injection mentations mammaires à visée esthétique. (note technique). Ann of breast reconstruction cases after hypertrophic scars. Reduction mamma­ probably be a combination of the following: or hyaluronic acid injection, proper Chir Plast Esthét 2009, 54, 491-495. radiation treatment. These are plasty is not expected to be popular in procedures are vital for a good result. more susceptible to complications future either. I fear that because injection seems an because the skin has less extensibility Mastopexy to modify ptosis of easy technique to non-plastic surgeons, and poorer blood flow than the breasts is popular. As Asians’ skin they are performing injections without skin of patients who have had no tends to scar more easily, techniques proper consideration that are resulting radiation treatment. Because partial that leave the smallest possible scars, mastectomy has a weak point in that such as periareolar incision, are breast deformation is highly visible preferred. However, in cases with high continued on page 16

12 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 13 GLOBAL PERSPECTIVES: AESTHETIC BREAST SURGERY GLOBAL PERSPECTIVES: AESTHETIC BREAST SURGERY

Perspectives FROM BELGIUM: Perspective from Canada Frank Lista, MD – Canada Modern Short-Scar Mammaplasty he field of aesthetic breast surgery has seen many Moustapha Hamdi, MD, PhD – Belgium advances in the last few years. After many years of little Tchange, new techniques and devices have altered the granted to add textured and form stable anatomic implants was lucky enough to be trained in Brussels when it was the techniques that used vertical scar to close the breast are still possibilities available for plastic surgeons to provide improved results to our patients. to their armamentarium. Many studies give support to the prominent center for practicing the vertical scar mamma- called “Lejour’s technique.” Therefore, it is much better to It wasn’t very long ago that the vast majority of breast observation that textured implants decrease the risk of cap- plasty. In the early 1990s, I watched the technique, which describe the mammaplasty technique based on the pedicle I reduction and mastopexy surgery meant giving the patient an sular contracture in the subglandular position. The benefits is based on a superior pedicle evolve first through the dedica- used rather than giving a proper name – such as the sur- anchor type scar. This was the universally accepted gold stan- of texturization in the subpectoral position have yet to be tion and efforts of Dr. Lejour and later by her followers at the geon’s name. dard for these procedures. Wise pattern techniques meant confirmed. While texturization has demonstrated distinct Free University of Brussels. Vertical scar technique is not a technique of mammoplasty. leaving our patients with a fairly extensive scar burden and a benefits in the reduction of rates of capsular contracture in During that time, I had been taught to perform vertical It is just a way to close the breast using a vertical incision typical appearance associated with anchor incisions, namely some patients, the role of these implants in the development of late seromas, double capsule formation and the remote scar mammaplasty, or so called “Lejour’s Technique” as the together with the periareolar one. A mammaplasty is a tech- the wide looking breast with little breast projection. One risk of ALCL has yet to be clearly determined. “premier” and the “only” technique in breast reduction and nique of breast reduction/pexy, which is based on a transposi- of the most commonly heard comments at meetings was Finally the recent controversy surrounding the manufac- mastopexy. As a trainee, I experienced both triumphs and tion or rotation pedicle of the nipple-areola complex. always, “I am not very pleased with the scars, but the patient ture of PIP implants demonstrates the need for plastic sur- defeats, successfully achieving large reductions, but then I’m still convinced there is no “best” technique that can was happy.” Such statements were an attempt to justify the use of less than optimal techniques which we, as aesthetic geons to be ever attentive to the observation of our results. suffering through unexpected complications. With careful be applied to all breast reductions; rather, there are masters plastic surgeons, were less than pleased with. As plastic sur- In this day and age of paid consultancy, it behooves us to analysis of the technique, I found many surgical details that I of some techniques based on enormous experience that can geons we are well aware that shape is more important than remember that our ultimate responsibility is to the patients used to perform without hesitation or questioning. I learned apply a particular technique to most cases, and then there scars, but quite frequently, anchor incisions were associated who entrust us with their appearance, wellbeing and ultim- to manage the unexpected and seize every opportunity to are other cases that require different, more tailored tech- with results which provided neither an optimal shape nor ately their lives. optimize the outcome for the benefit of my patients. Modifi- niques. Therefore, modern plastic surgery should adopt a pleasant scars. A significant problem is that the horizontal cations to already existing techniques or even developing dif- new strategy of technique selection depending on patient scar is often the least favourable of scars on the breast.

ferent techniques were among my armamentarium in breast characteristics rather than attempting to fit one technique to In response to the shortcomings associated with anchor incisions, vertical orientated procedures have improved not surgery during my years in practice. all kind of patients/indications. only the scarring, but also the shape of breasts in reduction Similar experiences happened to many of us and verti- With better knowledge of breast anatomy and vascu- and mastopexy procedures. Despite the fact that early pro- Solta Medical, a global leader in medical aesthetics, cal scar mammaplasty has been a valuable technique of lar supply, one can base the pedicle on two blood sources, provides innovative solutions for patients while ponents of these techniques had been advocating their bene- breast surgery for several indications. On the other hand, the superficial (based on dermal or subdermal plexus) and enhancing the market for physicians. The company fits for many years, the widespread use of vertical techniques addresses multiple skin issues with six brands: many others experienced different pathways. Surgeons who the deep (based on intercostal perforators) resulting in a have been slow to gain popularity, especially in North Amer- Thermage®, Fraxel®, Isolaz®, Clear + Brilliant™, had mainly major complications, high revision surgical pro- safer technique and a better blood supply to NAC. Modern Liposonix® and CLARO™. Thermage is a non- ica. Surgeons appear to be reluctant to abandon a technique cedures, or unacceptable aesthetic results abandoned the techniques use dual-pedicle mammaplasty such as: supe- invasive radiofrequency procedure for tightening which they have become accustomed to using. Despite these and contouring skin. Fraxel, fractional laser technique quickly. Even in the hands of many of Lejour’s rior-medial, superior-lateral, inferior-central, or based on challenges, vertical scar reductions and mastopexy are gain- technology, delivers minimally-invasive therapy to followers/trainees, the technique was highly criticized and Wuringer’s septum. For mastopexy, surgeons tend to cre- ing popularity, to the great benefit of our patients. Surgeons resurface damaged skin. Isolaz is the leading inflammatory acne treatment. Clear + Brilliant uses only few of them are still faithful to the original technique ate two-separated pedicles: one to carry the NAC and one to who have adopted these techniques are rewarded with not fractional laser technology to prevent early signs of described by the “chef.” At the same time, several articles enhance the breast projection. only a breast with less scarring, but usually a breast with aging. Liposonix is a non-surgical treatment to more projection. This is due to the central incorporation of reduce waist circumference with high-intensity and international presentations have shown the difficulty Simultaneously, the concept of reduced scar breast sur- focused ultrasound technology. CLARO is a of achieving reproducible outcomes using “Lejour’s Tech- gery has now been accepted and is here to stay. However, medial and lateral tissue, which we previously discarded in personal acne care system. anchor techniques. nique.” Personally, I find it unfair to criticize a techniqueper reducing scar should not compromise the aesthetic outcome. Breast reduction and mastopexy are not the only breast [email protected] se as the only factor responsible for the outcome. If Lejour’s It is clear that reducing scar resulted from reduction or pexy surgeries subject to advancement and controversy. After a +31(0)20.653.7060 technique didn’t work, we wouldn’t have used it for so many breast procedure is a “boon” for the patients especially in www.solta.com long hiatus of using saline implants alone, American plas- years. Moreover, not every vertical scar technique is an tic surgeons are now able to offer their patients silicone Visit us at ISAPS Congress – Booth 70 absolute synonym to “Lejour’s technique.” Many described continued on page 16 cohesive gel implants. The latest approvals have now been 14 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 15 GLOBAL PERSPECTIVES: AESTHETIC BREAST SURGERY HISTORY

Perspective Belgium, continued from page 14 Perspective Russia, continued from page 11 those who have high risk of bad scaring. In addition, a ver- in St. Petersburg. It is not quite relevant to this report to THE HISTORY OF INJECTABLES tical-directed pexy of the breast tissue adds more projection discuss controversies of lipofilling, like rate of take, role Riccardo F. Mazzola, MD – Italy and consequently better breast shape. On the other hand, a of stem cells, or technical innovations. What is pertinent, ISAPS Historian breast reduction done using a vertical scar closure, but result- to my mind, is the prediction that the more costly the pro- ing in unsatisfactory aesthetic shape either due to inadequate posed technique, the less likely it may be competitive with gland resection, skin dog-ear or highly repositioned-nipple, the syringe. Another prediction: look at the first and second orrection of contour irregularities, depressions and might make revision procedures more difficult to perform. waves. asymmetries by injecting substitutes of living tissues The outcome would be often considered as the result of verti- Since the nineties, a lot of Russian surgeons now travel Chas been the ideal goal of every cosmetic surgeon. cal scar technique and a “curse” for the patient. abroad. They have picked up as large a variety of techniques The history of injectables, often disseminated by disas- The vertical scar is often modified into small-inverted T, L as the geography of their educational pilgrimages. In terms trous and sometimes tragic results, is very instructive. or J shape scar to avoid secondary revision procedures and to of breast reduction/pexy, M. Lejour’s vertical mammaplasty PARAFFIN better fit patients with large breasts. Once again, it is much was initially most fashionable. As obedient apprentices, we better to use the term “Short-Scar Mammaplasty,” which strictly followed instructions and whole-heartedly trusted Paraffin wax, discovered in 1830 by Baron Carl von Reichen- amplifies the concept of reduced scar technique rather than in allegedly long-term “upper pole fullness” and “increased bach (1788-1869), a notable German chemist and a member use only “Vertical-Scar Mammaplasty.” projection.” Long-term observations eventually came with of the prestigious Prussian Academy of Sciences, was the Plastic surgeons are well positioned to provide patients high rates of revisions. The spells of “revolutionary new first injectable material ever used in modern times. seeking breast reduction/pexy surgery the entire spectrum principles of the vertical approach” kept falling on our heads J. Leonard Corning (1855-1923), a New York City neurolo- Fig. 1 – The paraffin heater (from: Kolle .F S., 1911) of options. Many techniques are available nowadays and the and thus we looked for magic wands able to stabilize the gist, the discoverer of spinal anaesthesia and the Viennese surgeon must use the technique that he/she masters the upper pole fullness. There was plenty in the western litera- physician Robert Gersuny (1844-1924) began to experi- most but which also answers the patients criteria. ture in the last decade. The most eagerly accepted in Russia ment with paraffin in the late nineteenth century apparently I always say: there is no bad technique, there is only a bad was the chest wall based glandular flap, first shown to us by simultaneously and independently. Leonard Corning used technician! Tom Biggs in 2000, and then by the “inventor” – Ruth Graf. paraffin to prevent reunion of nerves after subcutaneous Having studied the literature, we now label this technique as neurotomy and to enhance the antalgic effect of cocaine on Perspective Japan, continued from page 13 the Ribeiro-Bozzola-Botti-Daniel flap. The good news from some nerves of the sensibility, whereas Gersuny to solve fea- in many cases of complications. the innovator’s point of view is their logic in substantiating tural imperfections, urinary incontinence, velo-pharyngeal In France, augmentation mammaplasty­ with filler is 1 the obvious merits of their techniques. The bad news is that incompetence, Romberg disease, and others. prohibited. In Japan, hyaluronic acid distributors are not later results of their admirers may not confirm the originally But one of the most common indications was correction permitted to sell their products to be used in augmentation Fig. 2 – Injection of paraffin into the nose (from: Stein .AE., 1904) stated merits. As J. Walden states: “no matter what you do, of saddle nose deformity due to cartilage reabsorption, a mammaplasty. Nevertheless, augmentation mammaplasty eventually they look the same.” We still are looking at you, very frequent problem for the diffusion of syphilis. In the by hyaluronic acid injection is still popularly practiced. guys. The rising concern is that you talk of what is fashion- late nineteenth century, syphilis was popularly viewed as the Hyaluronic acid is absorbable. Therefore it costs more to able at the moment only. Do not betray us, our mentors new plague, and Americans soon realised that one of the keep breasts enlarged by hyaluronic acid injection. With whom we are used to trusting so much. most typical stigmata of syphilis was the depressed nose. Its The armamentarium was easy obtainable: the paraffin in regard to fat injection with negative pressure provided improvement was particularly difficult to manage. Attempts pearls or in cubes, a pot for melting the wax (fig. 1), and a to breasts, as Asians’ skin is firm and less extensible, the to build up noses using internal prostheses or bone and syringe (fig. 2).1,2 negative pressure doesn’t cause their skin to stretch much negative pressure device is seldom used in Japan. In spite of cartilage grafts were numerous, but these techniques were With the diffusion of the procedure and the immediate and there is no major change in the size of breasts in many all these problems, for the time being I think this technique challenging, time-consuming, and often unsuccessful. Par- favorable results obtained, an order of charlatans climbed cases. It is difficult for many Asians to get as satisfactory a can become popular depending on future improvement. affin, in contrast, seemed the ideal solution. With a melting on the paraffin success bandwagon. They began to advertise result from a single fat injection as Caucasians do; therefore, If augmentation mammaplasty with filler and fat injection point between 46 and 68 °C (115 and 154 °F), paraffin could in newspapers, yellow pages, and to give demonstrations multiple injections are often needed. Furthermore, as this remain without any substantial improvements, augmentation be introduced without incisions either alone or, at different in beauty salons and drugstores. Paraffin represented the technique often develops pigmentation in Asian patients, I mammaplasty with implant might be preferred as a reliable times according to Gersuny, in combination with Vaseline, panacea for a variety of cosmetic and functional applications find difficulty in adapting it to Asians. In addition, the device method to have breasts enlarged and procedures will increase or Vaseline alone, or Vaseline with olive oil. Apparently the is not adapted to many Asians’ breast size. Therefore, a in numbers to become mainstream again. resulting material was inert.1 continued on page 18

16 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 17 HISTORY HISTORY

History continued from page 17 History continued from page 18 Sydney Coleman, has been the object of a publication in the January issue of into young, erase wrinkles and change hypoplastic breasts REFERENCES ISAPS News.4 into a C-cup, with minimal problems. Its story curiously 1. Stein A.E. Paraffin-Injektionen. Theorie und Praxis. Stuttgart, recalls the paraffin affair. Enke, 1904 2. Kolle F.S. Plastic and Cosmetic Surgery. New York, Appleton, 1911 OTHER FILLERS While augmentation surgery for breasts using foams or p. 209 Charles C. Miller (1880-1950) from other materials evolved significantly between the ’50s and 3. Goldwyn R.M. The Paraffin Story. Plast Reconstr Surg. 1980; 65: Chicago, one of the first cosmetic ’60s, the unofficial practice of silicone injections gained 517-524 surgeons, called either “the father popularity.6 Considered an inert material that could be eas- 4. Mazzola R.F. The intriguing story of Fat grafting: from ram fat to stem cells. ISAPS News 2012; 6: 10-12 of modern cosmetic surgery” or “an ily sterilized, the liquid was injected directly into women’s 5. Miller C.C. Cannula Implants and Review of Implantation Technics unabashed quack,” published in 1926 breasts particularly in Japan – and the “procedure” spread so in Esthetic Surgery. Chicago, Oak Press, 1926 “Cannula implants,” a book on fillers to rapidly that silicone available for implantation was difficult 6. Haiken E. Venus Envy A History of Cosmetic Surgery. Baltimore, modify featural imperfections.5 He pro- to find. The Johns Hopkins University Press, 1997 Fig. 3 – Example of publicity appeared in yellow posed the use of gutta-percha, celluloid pages at the turn of the century (from: Stein A.E., However, after an initial honeymoon period, dramatic 1904) or rubber sponges ground in a mill and complications such as discoloration, infections, migration, Perspective Brazil, continued from page 10 heated before injecting them to correct granulomas formation, the so-called “siliconomas,” harden- breast for decades, the high, artificially round upper pole is depressions, crows feet, naso-labial F ig. 4 – Paraffinomas of the face with attempt of ing of tissues, were soon being documented. today’s in-demand look, and is seen in everyone from cocktail removal (from: Loeb H.W. Operative Surgery of grooves and saddle noses. He asserted Liquid silicone has been used for soft tissue increase for waitresses to professional women to top models. Brazilian the Nose, Throat and Ear. St. Louis, Mosby, 1914) that these materials were inert, well over 30 years. Numerous authors have reported on facial women who previously underwent breast reductions a dec- without the need for the surgical knife. tolerated and particularly effective. He treatments, particularly lips, breast, buttocks augmentation. ade or two ago are back in the plastic surgeon’s office seeking News of this apparently ideal substance used a special syringe with barrel to Due to the adverse side effects, employing silicone for cos- augmentation, and are looking for a natural result. Women began to spread through the medical introduce the material subcutaneously. metic purposes ceased in January 1992, when the US Food who had small implants inserted a few years ago are often community. The demand for removing and Drug Administration (FDA) declared a moratorium on requesting larger implants when it is time to replace them, but 3 SILICONE the typical characteristic of saddle nose story, described the drama of one cel- the use of this device. not too large as in some other countries. deformity was great and the immediate ebrated victim of paraffin, the Duchess James Franklin Hyde (1903–1999), an With the proliferation of breast augmentation, there has outcome particularly favorable (fig. 3). of Marlborough, who, in 1935, had par- American chemist, is credited with the CONCLUSIONS also been a trend toward ever-younger women requesting Complications appeared soon. The affin and wax introduced into her face launch of the silicone industry in the In recent years, demand for rejuvenation using fillers has the procedure, to the point that one of the frequently seen new miracle begun to fade. Forma- and forehead, causing an incredible 1930s. For this he was called the “Father dramatically increased. Patients are seeking more and more topics at congresses is whether or not breast augmentation tion of granulomas by foreign body number of bumps and swellings. She of Silicones.” His work led to the forma- quick recovery and minimally invasive non-surgical proce- should be performed on girls under the age of eighteen. Looking forward, the globalization of beauty standards has reaction, specifically named “paraffi- was completely disfigured, becoming a tion in 1943 of Dow Corning Corpora- dures. This is the reason why filler selection has consider- also been accompanied by a universal demand for ever-more nomas,” due to wax, oil and Vaseline recluse for the rest of her life and saw tion created to pioneer the development ably expanded ranging from collagen to poly-l-lactic acid, discreet surgical scars and it will be our continuing challenge penetrated within the tissues was the only close friends, despite that she was of silicone products as a result from the hydroxylapatite, hyaluronic acid (HA), among others. to keep up with this demand. The trend of more and more most common event almost impossible considered one of the most beautiful alliance between Corning Glass Works Fillers represent one of the most popular cosmetic pro- women having implants also challenges us to think about to solve (fig. 4). In fact, removing par- women on the planet before the event and the Dow Chemical. cedures. A huge business is behind them. Nowadays, fillers how, over time and with multiple implant replacements, we affin proved to be more difficult than Because of their low toxicity, pure can achieve spectacular results, but may give rise to numer- occurred. She died in 1977 completely can offer the desired look with the least possible complica- silicones presented a small risk of unfa- ous dramatic complications (e.g. formacryl). Their story is injecting it. forgotten. tions and scarring. We must also watch how the trend for lar- vorable biological reactions and had fascinating and at the same time instructive. Kolle in his book on cosmetic sur- ger and larger breasts in other countries is progressing. Are 2 obtained widespread recognition and gery, published in 1911, report a series FAT The lesson drawn from their use, often uncontrolled, women eventually looking to reduce their breasts with age popularity in medical circles. In the of side effects ranging from inflamma- To contrast paraffin complications, indicates that physicians must always carefully develop a and progressive replacements? Is the pendulum swinging tory reactions, to tissue necrosis and fat injection as a more natural filler ’60s, a new miraculous filler appeared clinical performance measure before injecting products not back to a more natural look? If this is the case, Latin Amer- embolism. Despite this, paraffin con- was proposed in 1909. The story of on the market: liquid silicone, an amaz- sufficiently tested or whose side effects are not clearly docu- ican plastic surgeons will be wise to “stay ahead of the curve” tinued to be injected mainly into the fat grafting, originally developed by ing chemical product – manufacturers mented. and give wise counsel to their patients to seek a proportional, nose, face and breast until the ’60s. the German surgeon Eugene Hollän- advertised – that could turn old faces natural look over the exaggerated look of an expiring trend. Goldwyn, in his paper on the paraffin der (1867-1932), and more recently by continued on page 19

18 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 19 CONGRESS – LUNCH SEMINARS CONGRESS – LUNCH SEMINARS

Lunch Seminars Lunch Seminars

Silhouette Lift Seminar Baxter Seminar Wednesday, September 5th Thursday, September 6th Mentor Seminar Ulthera Seminar 1:00 - 2:00 pm 1:00 - 2:00 pm Thursday, September 6th Friday, September 7th Lower Level - Room 18 Lower Level - Room 18 1:00 - 2:00 pm 1:00 - 2:00 pm Main Meeting Room Lower Level - Room 18 Dr .Javier de Benito will present his views on the significant change The Benefits of Full Surface Adherence for Improving Plane that has taken place in our specialty as a result of factors including Approximation ® the worldwide economic crisis, the elimination of aggressive Dr. Ludwik Branski: ARTISS in Burn Surgery, My Experience Improved Patient Outcomes: science and quality as a basis for Ultherapy , the non-invasive “lunch time” procedure, has gained techniques for facial rejuvenation and their replacement with Prof. Stefano Bruschi: Tissue Adhesives in Face Lift and Body implant selection and optimal aesthetic results widespread attention throughout the world, including notice in Vogue Magazine, Harper’s Bazaar, and the New York Times. less aggressive techniques – minimally invasive or non-invasive Contouring Surgery, Benefits to Post-Operative Care In light of recent events, the quality of silicone breast implants has procedures. It will be an opportunity to share his experience about Experienced Ultherapy users will introduce the science and use commanded increased importance. Aesthetic procedures aim to of Ultherapy’s micro-focused ultrasound for lifting skin and Silhouette Lift Mid-face Suspension Sutures, as a mini invasive mid- Baxter’s panelists will discuss the benefits of a slow setting fibrin achieve optimal patient outcomes by utilizing safe silicone breast face technique. The new cosmetic treatment, Silhouette Soft, will sealant in real world applications. Dr. Branski will discuss his demonstrate how it is unique from other energy-based devices. implants while minimizing the risk of complications. Please join The discussion will show how Ultherapy is complementary to be introduced. This is a new bidirectional resorbable suture without experience in treating pediatric and adult burns in the US and us for a panel discussion with international experts over lunch. The incision for face rejuvenation complementary to cosmetic treatments Germany. Professor Bruschi will present his experience in facial other cosmetic procedures and how this innovative technology fits panel will aim to provide an update on the scientific evidence, tips into an aesthetic practice. The Ulthera® System is the first-ever such as fillers, fat injections, and botulinum toxin. plastic surgery and body contouring surgery. Please join us for this for managing risk and important quality/safety considerations for interactive panel. energy-based device to receive a skin lifting indication from the appropriate implant selection. FDA. Procedures can be performed in 60 minutes with no patient downtime and yield consistent results that last one year or more. Silimed Seminar Wednesday, September 5th Cynosure Seminar SFR - Clinic Accreditation Seminar 1:00 - 2:00 pm Thursday, September 6th Thursday, September 6th Level 2 - Room 14 1:00 - 2:00 pm 1:00 - 2:00 pm ZELTIQ Aesthetics Seminar Level 3 - Rooms 5 & 6 Speaker: James D. Frame, MD Level 2 - Room 14 Friday, September 7th Why I Switched to Polyurethane Breast Implants 1:00 - 2:00 pm Cellulaze: A Revolutionary New Device in the Treatment of An introduction to the AAAASF international accreditation pro- Level 2 - Rooms 7 & 8 Silimed Breast Implants are used throughout the world and have just Cellulite: FDA Study Results and Clinical Experiences cess and the relationship between accreditation and patient safety gained FDA approval for usage in the USA. Mentor and McGhan will be presented by Dr. Ronald Iverson, SFR/AAAASFI Chairman CoolSculpting® by ZELTIQ: New Advances in Cryolipolysis and implant performance data is now available through the FDA 2011 Join Drs. Grant Stevens and Barry DiBernardo as they discuss their of the Board. the Non-Invasive Treatment of Fat report and there is room for significant improvement. Polyurethane most recent, clinically researched techniques with Cellulaze, a CoolSculpting is today’s most popular and effective non- covered Silicone Gel implants have been used in many countries for breakthrough in the treatment of cellulite. Cellulaze is a minimally invasive treatment for the removal of stubborn fat. Based on many years and data supports clear advantages over conventional Gel invasive surgical laser procedure that attacks the very structure groundbreaking Cryolipolysis technology, it is the only treatment implants. They have only recently regained popularity with Plastic of cellulite for long lasting results after just one treatment. Learn myoscience Seminar that selectively targets and eliminates adipocytes, and has more Surgeons in the UK . Professor James Frame, President of UKAAPS, how Cellulaze makes it feasible and practical for you to focus your Friday, September 7th than 300,00 CoolSculpting procedures worldwide and over 20 will present 27 years of unbiased experience using a variety of breast surgical skill on the treatment of cellulite. Don’t miss this ISAPS 1:00 - 2:00 pm peer-reviewed publications and abstracts. implants and giving his reasons why Polyurethane Cone Shaped lunchtime seminar offered by Cynosure. Main Meeting Room implants should be considered the implant of choice for most Join ZELTIQ for a presentation and live demo on CoolSculpting, women having Primary and Secondary Breast Augmentation and Focused Cold Treatment – A new era in medical aesthetics the proven leader in non-invasive fat reduction. Reconstructive Plastic Surgery of the Breast. ISAPS-LEAP Strike Force Representing an exciting advance in aesthetic medicine, • Gain insight into the latest clinical research myoscience introduces its innovative technology at ISAPS. • Learn new techniques to optimize results Thursday, September 6th • Discover ways to maximize your CoolSculpting ROI Dr. Kai-Uwe Schlaudraff and Professor Daniel Cassuto discuss 1:00 - 2:00 pm • Learn how to incorporate best practices to enhance results Level 2 - Rooms 7 & 8 how myoscience has taken the well-established medical principles Solta Medical Seminar of cold into facial aesthetics. The myoscience advanced smart-tip Wednesday, September 5th technology delivers Focused Cold Therapy, precision controlled Drs. Tunc Tiryaki and Craig Hobar will present the new joint disaster 1:00 - 2:00 pm delivery of cold, targeting nerves to smooth the appearance of relief program – a combined effort between ISAPS members and the dynamic forehead lines. It provides immediate results whilst Level 2 - Rooms 7 & 8 LEAP Foundation with the goal of providing reconstructive plastic leaving nothing behind in the skin; meeting the needs of an surgical services in a rapid response fashion in any country affected This workshop will introduce Liposonix®, a non-invasive entirely new patient group who seek toxin free treatment. high-intensity focused ultrasound (HIFU) system designed to by a disaster. Dr. Tiryaki will discuss his experience in multiple permanently destroy subcutaneous fat in the abdomen, love Turkish earthquake relief efforts and Dr. Hobar will recount the handles, hips, thighs, and buttocks. The workshop will cover the LEAP Foundations experience in the Haitian earthquake. Together basics of HIFU technology, a review of current published peer- they will describe the founding principles of this new joint strike reviewed clinical data, appropriate patient selection criteria, and force program. various tips and techniques to maximize the Custom Contouring™ capabilities of the Liposonix system. In addition, there will be a live demonstration of the Liposonix system and a review of typical before and after results. See how the Liposonix HIFU system fits both your patients and your practice by delivering a one-pant-size reduction after a single one hour treatment.

20 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 21 CONGRESS – PROGRAM congress – FACULTY

21st Congress of ISAPS - Geneva 2012 ARGENTINA Jorge HERRERA, MD Christian Joachim GABKA, MD Claudia MEULI-SIMMEN, MD Tuesday, September 4 Current as of July 1 Antonio Aldo MOTTURA, MD, PhD Wolfgang GUBISCH, MD Brigitte PITTET-CUENOD, MD 8:00 am - 5:00pm Registration - CICG Main Lobby Juan Carlos SEILER Sr., MD Dennis O. von HEIMBURG, MD, PhD Jan Gordon POËLL, MD 9:00 - 8:00 pm Exhibit Hall Opens AUSTRALIA Darryl J. HODGKINSON, MD Norbert PALLUA, MD Pierre QUINODOZ, MD 12:00 - 12:15 Welcome + Opening Remarks Bryan C. MENDELSON, MD Dirk F. RICHTER, MD, PhD Kai-Uwe SCHLAUDRAFF, MD, FEBO 12:15 - 6:00 Session 1: GLOBAL SUMMIT ON PATIENT SAFETY AUSTRIA Katharina RUSSE-WILFLINGSEDER, MD Rainer RUPPRECHT, MD Frank TREPSAT, MD 6:00 - 8:00 OPENING CEREMONY & WELCOME RECEPTION BELGIUM Albert M. G. DE MEY, MD GREECE Vakis KONTOES, MD, PhD THAILAND Sanguan KUNAPORN, MD Wednesday, September 5 Moustapha HAMDI, MD, PhD Theodore VOUKIDIS, MD, FACS, PhD Charan MAHATUMARAT, MD Patrick L. TONNARD, MD Csaba MOLNAR, MD Bouraoui KOTTI, MD 7:00 - 8:00 am Master Classes Meetings in this Column will be held in HUNGARY TUNISIA 8:00 - 10:00 Session 2: RHINOPLASTY I Room B - CICG 5&6 - Level 3 Ivar VAN HEIJNINGEN, MD INDIA Lokesh KUMAR, MD TURKEY Nuri CELIK, MD 10:00 - 10:30 Coffee Break - Exhibit Hall Alexis VERPAELE, MD IRAN Mohammad Reza FARAHVASH, MD Nazim CERKES, MD 10:30 - 12:30 pm Session 3: RHINOPLASTY II BRAZIL Ana Zulmira Diniz BADIN, MD ISRAEL Marcos HAREL, MD Ismail KURAN, MD Free Papers 2: Rhinoplasty Ricardo BAROUDI, MD Michael SCHEFLAN, MD Cemal Tg SENYUVA, MD 11:50 - 12:30 Free Papers 1: Rhinoplasty (10:30-12:30) Carlos CASAGRANDE, MD ITALY Giovanni BOTTI, MD Tunc K. TIRYAKI, MD 12:30 - 2:30 Lunch & Special Meetings and Seminars Ewaldo Bolivar DE SOUZA PINTO, MD, PhD Claudio CALABRESE, MD Reha C. YAVUZER, MD 2:30 - 4:30 Session 4: PERIOCULAR REJUVENATION I Rolf GEMPERLI, MD Gianluca CAMPIGLIO, MD, PhD Akin YUCEL, MD 4:30 - 5:00 Coffee Break - Exhibit Hall Raul GONZALEZ, MD Domenico DE FAZIO, MD UNITED ARAB EMIRATES 5:00 - 7:00 Session 5: PERIOCULAR REJUVENATION II Ruth M. GRAF, MD, PhD Andrea GRISOTTI, MD Luiz Sergio TOLEDO, MD Free Papers 4: Periocular Surgery Farid HAKME, MD Riccardo F. MAZZOLA, MD UNITED KINGDOM James D. FRAME, MD 6:20 - 7:00 Free Papers 3: Periocular Surgery (5:00-7:00) Alan LANDECKER, MD Mario PELLE-CERAVOLO, MD Nigel MERCER, MD 7:30 - 12:00 FACULTY DINNER Fabio Xerfan NAHAS, MD, PhD Enrico B. ROBOTTI, MD Alison THORNBERRY Thursday, September 6 Joao de Moraes PRADO NETO, MD JAPAN Kunihiko NOHIRA, MD USA Sherrell J. ASTON, MD, FACS Osvaldo Rib SALDANHA, MD Yasushi SUGAWARA, MD Daniel C. BAKER, MD 7:00 - 8:00 am Master Classes Joao Carlos SAMPAIO GOES, MD, PhD Susumu TAKAYANAGI, MD Thomas M. BIGGS, MD 8:00 - 10:00 Session 6: FACE AND NECK REJUVENATION I Marcos Paulo SFORZA DE ALMEIDA, MD Kotaro YOSHIMURA, MD Daniel DEL VECCHIO, MD 10:00 - 10:30 Coffee Break - Exhibit Hall Carlos Oscar UEBEL, MD, PhD JORDAN Mutaz ALKARMI, MD Barry E. DIBERNARDO, MD Free Papers 5: Face & Neck Rejuvenation 10:30 - 11:50 Session 7: FACE AND NECK REJUVENATION II CANADA Frank LISTA, MD Ghaith F. SHUBAILAT, MD Felmont F. EAVES III, MD, FACS (10:30-11:50) Richard WARREN, MD LEBANON Sami SAAD, MD Jack FISHER, MD 11:50 - 12:30 pm OHMORI Lecture CHINA Sufan WU, MD, PhD MEXICO Jose Abel DE LA PENA SALCEDO, MD Dana FOX 12:30 - 2:30 Lunch & Special Meetings and Seminars CHINESE TAIPEI Philip Kuo-Ting CHEN, MD Antonio FUENTE DEL CAMPO, MD John FRASER, PhD Free Papers 6: Cosmetic Medicine & Patient 2:30 - 4:30 COLOMBIA Lina M. TRIANA, MD MOROCCO Fahd BENSLIMANE, MD James C. GROTTING, MD, FACS Session 8: PRACTICE MANAGEMENT Safety (2:30 - 4:40) COSTA RICA Alberto ARGUELLO CHOISEUL, MD Abdennasser LAHLALI, MD Ronald P. GRUBER, MD, FACS 6:00 - 11:00 EVENING AT THE CIRCUS CZECH REPUBLIC Bohumil ZALESAK, MD, PhD NEW ZEALAND Janek S. JANUSZKIEWICZ, MD Joseph P. HUNSTAD, MD Friday, September 7 DENMARK Anne Mette DONS, MD NORWAY Gunnar KVALHEIM, MD Douglas S. INGRAM 7:00 - 8:00 am Master Classes Poul T. HARBOE, MD PERU Julio Daniel KIRSCHBAUM, MD Ronald Edward IVERSON, MD, FACS 8:00 - 10:00 Session 9: ABDOMINOPLASTY & BODY CONTOURING I ETHIOPIA Asrat MENGISTE, MD PHILIPPINES Florencio Quiogue LUCERO, MD Glenn W. JELKS, MD, FACS 10:00 - 10:30 Coffee Break - Exhibit Hall FRANCE Eric Michael AUCLAIR, MD PORTUGAL Jose Carlos Santos PARREIRA, MD Mark L. JEWELL, MD 10:30 - 12:30 pm Session 10: ABDOMINOPLASTY & BODY CONTOURING II Alain BONNEFON, MD, FACS ROMANIA Dana Mihaela JIANU, MD, PhD Jeffrey KENKEL, MD Free Papers 8: Abdominoplasty & Body 11:50 - 12:30 Free Papers 7: Abdominoplasty, Body Contouring Bernard CORNETTE DE SAINT-CYR, MD Constantin STAN, MD, PhD Roger K. KHOURI, MD, FACS Contouring (10:30-12:30) Emmanuel DELAY, MD RUSSIA Irina KHRUSTALEVA, MD, PhD Catherine MALEY, MBA 12:30 - 2:30 Lunch & Special Meetings and Seminars Henry DELMAR, MD, FACS Kirill P. PSHENISNOV, MD, PhD Timothy J. MARTEN, MD, FACS 2:30 - 4:30 Session 11: FAT HARVESTING & CELL THERAPY I Gerard FLAGEUL, MD SAUDI ARABIA Jamal A. Habiballah JOMAH, MD Constantino G. MENDIETA, MD, FACS 4:30 - 5:00 Coffee Break - Exhibit Hall Alain FOGLI, MD SERBIA Miodrag M. COLIC, MD, PhD Ryan MILLER 5:00 - 7:00 Exhibitors Depart Sebastien GARSON, MD SINGAPORE Woffles T. L. WU, MD Foad NAHAI, MD 5:00 - 7:00 Session 12: FAT HARVESTING & CELL THERAPY II Olivier GERBAULT, MD SOUTH AFRICA Peter Desmond SCOTT, MD Marie B. V. OLESEN Free Papers 10: Fat Harvesting, Cell Therapy 6:20 - 7:00 Free Papers 9: Fat Harvesting, Cell Therapy Claude LE LOUARN, MD SOUTH KOREA David DaeHwan PARK, MD, PhD Jason POZNER, MD (5:00 - 7:00) Guy MAGALON, MD SPAIN Miguel CHAMOSA, MD, PhD Oscar M. RAMIREZ, MD FREE EVENING IN GENEVA Ali MOJALLAL, MD Javier DE BENITO, MD J. Peter RUBIN, MD Saturday, September 8 Bernard MOLE, MD Antonio DE LA FUENTE, MD Renato SALTZ, MD, FACS 7:00 - 8:00 am Master Classes Jean-Francois PASCAL, MD Joan FONTDEVILA, MD, PhD Henry M. SPINELLI, MD 8:00 - 10:00 Session 13: AESTHETIC BREAST SURGERY I GERMANY Johannes C. BRUCK, MD SWEDEN Igor A. NIECHAJEV, MD, PhD W. Grant STEVENS, MD, FACS 10:00 - 10:30 Coffee Break Axel-Mario FELLER, MD, PhD SWITZERLAND Jean-Francois EMERI, MD Bryant TOTH, MD 10:30 - 11:50 Session 14: AESTHETIC BREAST SURGERY II Joachim Graf von FINCKENSTEIN, MD Daniel A. KNUTTI, MD Simeon WALL Jr., MD Free Papers 11: Aesthetic Breast Surgery & Breast Free Papers 12: Aesthetic Breast Surgery & 11:50 - 12:30 Reconstruction Breast Reconstruction (10:30 - 12:30) 12:30 - 2:00 Lunch 2:00 - 4:30 Session 15: COSMETIC MEDICINE 4:30 Closing Remarks

22 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 23 CONGRESS – ENTERTAINMENT ARTISS [Solutions for Sealant]

Provides time for the finishing touch full surface adherence eliminating dead space1,5

ARTISS – first and only fibrin sealant custom designed for subcutaneous tissue adherence in plastic, reconstructive and burn surgery1 • Allows up to 60 seconds to manipulate and to position the flap1,2 “Everything about Circus Knie is Magical!” • significantly reduces drainage volumes compared to standard of care1 • may eliminate the need for surgical drains1 • reduces the incidence of hematoma and seroma compared to standard of care1,3 So says Romero Britto, the Brazilian-born pop art phenom- magical and yet elegant and certainly memorable event • frozen ready-to-use formulation – no mixing or diluting required4 enon who designed the current season’s posters. Now a you simply cannot miss. world-famous painter and sculptor, Romero was born in ISAPS has bought the entire circus for our gala evening a poor district of Recife, won a scholarship to study art, in September. A reception and dinner will be served in a SIXTY and eventually designed the 1989 advertising campaign for special catering tent, and the performance will provide seconds position and Absolut Vodka. Now his work hangs in the Louvre in Paris. all our guests, young and old and in-between, with a very re-position

Like the circus he has represented in his images this unique and entertaining evening. Don’t make other plans 1 rohrich rJ et al., Artiss improves flap Adherence following rhytidectomy through full surface Adherence Between the Wound Bed and Applied tissue which eliminates Areas of dead space often Associated With hematoma and seroma: results of a Phase 3, multicenter, Prospective, randomized, clinical study. American Association of Plastic surgeons (AAPs) 90th Annual meeting, Boca raton, fL, April 9-12, 2011. http://meeting. aaps1921.org/abstracts/2011/P31.cgi - accessed June 20, 2012 2 Artiss (solutions for sealant), summary of Product characteristics, oct. 2011 3 mustoe tA et al., reduced hematoma/seroma occurrence with use of year, Romero is inspired by the gaiety and joie de vivre that on Thursday, September 6th. You will want to be a part of fibrin sealant during facial rhytidectomy: results of an integrated Analysis of Phase 2 and Phase 3 study data. AsPs meeting 2011, denver colorado, sept. 23-27. Plastic & reconstructive surgery 128(4s):7 4 mittermayr r et al., skin graft fixation by slow clotting fibrin sealant Applied as a thin Layer. Burns 2006; 32: 305–311 5 foster K et al., fs 4iu vh s/d clinical study group. efficacy and safety of a fibrin sealant for Adherence of is typical of the oldest family-owned circus in Europe. An this special event that everyone will be talking about the Autologous skin grafts to Burn Wounds: results of a Phase 3 clinical study. J Burn care res. 2008; 29(2): 293-303 This abbreviated summary of product characteristics (SmPC) is intended for international use. Please note that it may differ from the licensed SmPC in the country where you are practicing. Therefore, please always consult your country-specific SmPC or package leaflet. evening with this award winning troupe – that happens next day! ARTISS, Solutions for Sealant, deep frozen COMPOSITION: ARTISS consists of: • Human Fibrinogen (as clottable protein) 91 mg/ml • Synthetic Aprotinin 3000 KIU/ml • Human Thrombin 4 IU/ml • Calcium Chloride 40 μmol/ml INDICATIONS: ARTISS is indicated as tissue glue to adhere/seal subcutaneous tissue in plastic, reconstructive and burn surgery, as replacements or adjuncts to sutures or staples. In addition, ARTISS is indicated as adjunct to hemostasis on subcutaneous tissue surfaces. CONTRAINDICATIONS: ARTISS is not indicated to replace skin sutures intended to close surgical wound. ARTISS alone is not indicated for the treatment of massive and brisk arterial or venous bleeding. ARTISS must never be applied intravascularly. Hypersensitivity to the active substances or to any of the to be in residence in Geneva during our Congress – is a excipients. SPECIAL WARNINGS AND SPECIAL PRECAUTIONS FOR USE: For epilesional use only. Do not apply intravascularly. Life threatening thromboembolic complications may occur if the preparation is applied intravascularly. Soft tissue injection of ARTISS carries the risk of local tissue damage. Caution must be used when applying fibrin sealant using pressurized gas. • Any application of pressurized gas is associated with a potential risk of air embolism, tissue rupture, or gas entrapment with compression, which may be life-threatening. • ARTISS must not be used with the Easy Spray / Spray Set system in enclosed body areas. • ARTISS must be sprayed only onto application sites that are visible. • Air or gas embolism has occurred with the use of spray devices employing pressure regulator to administer fibrin sealants. This event appears to be related to the use of the spray device at higher than recommended pressures and in close proximity to the tissue surface. When applying ARTISS using a spray device, the pressure should be within the range recommended by the spray device manufacturer. Spray application of ARTISS should only be done using the provided spray appli- cation accessories and the pressure should not exceed 2.0 bars. In the absence of a specific recommendation ARTISS should not be sprayed closer than 10-15 cm from the tissue surface. When spraying ARTISS, changes in blood

pressure, pulse, oxygen saturation and end tidal CO2 should be monitored because of the possibility of occurrence of air or gas embolism. • ARTISS should be applied as a thin layer. Excessive clot thickness may negatively interfere with the product’s efficacy and the wound healing process. ARTISS is not indicated for hemostasis and sealing in situations where a fast clotting of the sealant is required. Especially in cardiovascular procedures in which sealing of vascular anastomoses is intended ARTISS should not be used. ARTISS is not indicated for use in neurosurgery and as a suture support for gastrointestinal anastomoses or vascular anastomoses as no data are available to support these indications. Before administration of ARTISS care is to be taken that parts of the body outside the designated application area are sufficiently protected/covered to prevent tissue adhesion at undesired sites. Oxycellulose-containing preparations may reduce the efficacy of ARTISS and should not be used as carrier materials. As with any protein-containing product, allergic type hypersensitivity reactions are possible. Signs of hypersensitivity reactions may include hives, generalized urticaria, tightness of the chest, wheezing, hypotension, and anaphylaxis. If these symptoms occur, the administration must be discontinued immediately. ARTISS contains aprotinin. Even in case of strict local application, there is a risk of anaphylactic reaction linked to the presence of aprotinin. The risk seems to be higher in cases where there was previous exposure, even if it was well tolerated. Therefore any use of aprotinin or aprotinin containing products should be recorded in the patients’ records. As synthetic aprotinin is structurally identical to bovine aprotinin the use of ARTISS in patients with allergies to bovine proteins should be carefully evaluated. In the event of anaphylactic/anaphylacto- id or severe hypersensitivity reactions, administration is to be discontinued. Remove any applied, polymerized product from the surgical site. Adequate medical treatment and provisions should be available for immediate use in the event of an anaphylactic reaction. State-of- the-art emergency measures are to be taken. In case of shock, standard medical treatment for shock should be implemented. Standard measures to prevent infections resulting from the use of medicinal products prepared from human blood or plasma include selection of donors, screening of individual donations and plasma pools for specific markers of infection and the inclusion of effective manufacturing steps for the inactivation/removal of viruses. Despite this, when medicinal products prepared from human blood or plasma are adminis- tered, the possibility of transmitting infective agents cannot be totally excluded. This also applies to unknown or emerging viruses or other pathogens. The measures taken are considered effective for enveloped viruses such as HIV, HBV, and HCV, and for the non-enveloped virus HAV. The measures taken may be of limited value against non-enveloped viruses such as parvovirus B19. Parvovirus B19 infection may be serious for pregnant women (fetal infection) and for individuals with immunodeficiency or increased erythropoiesis (e.g., hemo- lytic anemia). It is strongly recommended that every time that ARTISS is administered to the patient, the name and batch number of the product are recorded in order to maintain a link between the patient and the batch of the product. UNDESIRABLE EFFECTS: Inadvertent intravascular injection could lead to thromboembolic events and DIC and there is also a risk of anaphylactic reactions. Hypersensitivity or allergic reactions (which may include angioedema, burning and stinging at the application site, bradycardia, bronchospasm, chills, dyspnoea, flushing, generalized urticaria, headache, hives, hypotension, lethargy, nausea, pruritus, restlessness, tachycardia, tightness of the chest, tingling, vomiting, wheezing) may occur in rare cases in patients treated with fibrin sealants/hemostatics. In isolated cases, these reactions have progressed to severe anaphylaxis. Such reactions may especially be seen if the preparation is applied repeatedly, or administered to patients known to be hypersensitive to aprotinin or any other constituents of the product. Even if a first treatment with ARTISS is well tolerated, a subsequent administration of ARTISS or systemic administration of aprotinin may result in severe anaphylactic reactions. Antibodies against components of fibrin sealant may rarely occur. Adverse reactions reported from clinical studies as well as from postmarketing surveillance are summarized in the following. Known frequencies of these adverse reactions are based on a controlled clinical study in 138 patients where skin grafts were fixed to excised burn wounds using ARTISS. None of the events were classified as serious. Unknown frequencies are based on spontaneous reports from postmarketing surveillance of Baxter‘s fibrin sealants. The ADRs and their frequencies are: Common ≥( 1/100 to <1/10): pruritus, skin graft failure; Uncommon (≥1/1000 to <1/100): dermal cyst; Unknown (cannot be estimated from the available data): anaphylactic responses, hypersensitivity, : bradycardia, tachycardia, hypotension, haematoma, dyspnoea, nausea, urticaria, flushing, impaired healing, oedema, pyr- exia, seroma. For the Posology, incompatibilities and interactions, please refer to your locally approved full SmPC. Medicinal products are subject to medical subscription. May 2012 The full Swiss prescribing information is available from www.documed.ch. Baxter, EasySpray and Artiss are trademarks of Baxter International Inc., its subsidiaries or affiliates. BS-BS-701 June 2012

24 Baxter Healthcare S.A.,P.O. Box, CH-8010 Zürich, Switzerland ISAPS News Volume 6 • Number 2 www.baxterbiosurgery.com

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CONGRESS – EXHIBITORS ASSI ® Breast Retractors ISAPS Exhibit Hall - 20th Congress San Francisco 2010 are like Diamonds... Created for Performance. Crafted for Perfection. Master Sponsors brumaba GmbH & Co. KG – 49 Motiva – 69 Allergan – 28 Canfield Scientific Europe, BV – 64 MTF - Musculoskeletal Transplant Cut with Precision Cynosure, Inc. – 26 Ceatus Media Group LLC – 17 Foundation – 32 ...the way you do. Cheyladerm AG – 47 Nagor – 21 Supporters Cytori Therapeutics, Inc. – 10 NeoGraft – 75 Baxter Healthcare SA – 58 ASSI •ABR 38326 Dale Medical Products – 71 New Medical Technology, Inc. – 54 180x25mm wide blade, Canton de Genève EDIPEC SCCL – 9 Novus Scientific – 72 without endoscopic Mentor Worldwide LLC – 24 Esthetic med – 7 Orcos Medical AG – 30 scope sheath myoscience – 51 Estheticon – 74 Pacifica Handels AG – 62 Silhouette Lift, Inc. – 42 Eurosilicone S.A.S – 22 pfm medical AG – 63 ASSI •ABR 13326 Silimed Ltda – 67 G. E. Lombardozi – VOE – 34 POLYTECH Health & Aesthetics 220x27mm wide blade Solta Medical – 19 ASSI •ABR 35826 with fiber optic Groupe Sebbin – 11 GmbH – 12 180x16mm wide blade Ulthera, Inc. – 52 Harley Street Plastic Surgery, Ltd. – 66 PNC International Co., Ltd. - 55 molded handle, ASSI •ABR 35426 ZELTIQ Aesthetics, Inc. – 46 with fiber optic 180x16mm wide blade Helena Rubinstein – 73 Q-Med, a Galderma Division – 61 with fiber optic Exhibitors HUCO Vision S. A. – 25 Quality Medical Publishing, Inc. – 41 human med AG – 4 Regen Lab SA – 2 ASSI •ABR 36826 American Society for Aesthetic Plastic ASSI •ABR 2349326 180x25mm wide blade International Confederation for Plastic, SciVision Biotech Inc. – 50 with fiber optic Surgery (ASAPS) – 83 80x16mm wide blade, American Society of Plastic Surgeons Reconstructive & Aesthetic Surgery Seattle Software Design – 45 without teeth with fiber optic & suction (ASPS) – 85 (IPRAS) – 86 SFR/AAAASFI – 87 Keller Medical, Inc. – 81 Sound Surgical Technologies – 76 Anteis – 18 ASSI •ABR 2180526 ASSI •ABR 25326 Aptos, Ltd. – 53 Laboratoires Arion – 44 Sure Insurance – 79 80x16mm wide blade, 180x25mm wide blade Liquid Smile – 57 Swiss Stem Cell Bank – 80 with teeth with 4mm endoscopic Biomatrix, Ltd. – 56 with fiber optic & suction scope sheath, ASSI •ABR 33926 Biomet Biologics – 78 Marina Medical Instruments, Inc. – 39 TEOXANE Laboratories – 1 single stop-cock 180x16mm wide blade, Black & Black Surgical, Inc. – 65 Medic Service AG – 48 Tulip Medical Products – 82 ASSI •ABR 27326 with 120˚ & 130˚angles, Medicon eG – 33 150x16mm wide blade ASSI •ABR 13726 with suction Bona Forma – 77 with fiber optic & suction 180x25mm wide blade Brazilian Society of Merz Pharma AG – 31 with 5mm endoscopic ASSI •ABR 34826 MicroAire Aesthetics – 70 scope sheath, 180x25mm wide blade, Plastic Surgery (SBCP) – 84 ASSI •ABR 25926 single stop-cock with 120˚ & 130˚angles, 180x25mm wide blade with suction with fiber optic & suction ASSI •ABR 142326 ASSI •ABR 35026 180x25mm wide blade with 10mm endoscopic 180x27mm wide blade, 76 COUNTRIES REPRESENTED scope sheath, with 120˚ & 130˚angles, single stop-cock with suction IN CONGRESS REGISTRATIONS ASSI •ABR 77026 180x30mm wide blade, with 120˚ & 130˚angles, Algeria Colombia Germany Kazakhstan Pakistan South Africa with suction Argentina Costa Rica Greece Kuwait Philippines South Korea Australia Cyprus Hungary Kyrgyzstan Poland Spain Austria Czech Republic Iceland Latvia Portugal Sweden Azerbaijan Denmark India Lebanon Qatar Switzerland Belarus Dominican Rep Indonesia Lithuania Romania Thailand Belgium Ecuador Iran Luxembourg Russian Tunisia

Brazil Egypt Iraq Macedonia Federation Turkey ® Bulgaria Estonia Ireland Mexico Saudi Arabia Ukraine ACCURATE SURGICAL & SCIENTIFIC INSTRUMENTS® Canada Ethiopia Israel Morocco Serbia United Arab For diamond perfect performance® Chile Finland Italy Netherlands Singapore Emirates accurate surgical & scientific instruments corporation China France Japan New Zealand Slovakia United Kingdom 300 Shames Drive, Westbury, NY 11590 Chinese Taipei Georgia Jordan Norway Slovenia United States 800.645.3569 516.333.2570 fax: 516.997.4948 west coast: 800.255.9378 www.accuratesurgical.com ©2012 ASSI® 26 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 27 NATIONAL SECRETARIES NATIONAL SECRETARIES

Quiet Pillars of ISAPS SAPS has 71 National Secretaries in our 93 member countries. Any country with at least three members is eligible to elect a Lina Triana, MD – Colombia National Secretary to represent them in the leadership of ISAPS. One new country now qualifies for a National Secretary and Iis highlighted in bold. Recently elected National Secretaries are also highlighted in bold text. Chair of National Secretaries

ARGENTINA Maria Cristina PICON, MD ISRAEL Marcos HAREL, MD hank you to all who believed in me and allowed me Today we know that medical intrusion (meaning non-core ARGENTINA ‡Juan Carlos SEILER Sr., MD ITALY Gianluca CAMPIGLIO, MD, PhD the honor of representing our National Secretaries health professionals doing aesthetic plastic surgery proce- AUSTRALIA elections currently in process JAPAN Hiko HYAKUSOKU, MD AUSTRALIA ‡Graeme SOUTHWICK, MD JORDAN Mutaz ALKARMI, MD and being part of this Board. dures) is a common problem worldwide. We have seen in T AUSTRIA Katharina RUSSE-WILFLINGSEDER, MD LEBANON Sami SAAD, MD past newsletters how many countries are escalating their We National Secretaries are the quiet pillars of ISAPS AZERBAIJAN Vagif GALANDAROV, MD, PhD MALAYSIA Viswanathan SURENDRANATHAN, MD efforts to legally protect plastic surgery practice. and our hard work sometimes goes unnoticed. Our Board BAHRAIN Tariq M. SAEED, MD MEXICO Arturo RAMIREZ-MONTANANA, MD We strongly believe that we need to be well known to the BELARUS Vladzimir PODGAISKI, MD, PhD MEXICO ‡Jaime O. SALCEDO-MARTINEZ, MD understands our position in this society; they know that we public – to show that we are here for our patients. Along the BELGIUM Ivar VAN HEIJNINGEN, MD MOROCCO Fahd BENSLIMANE, MD really are there for the organization; and they have seen that way, we implemented the patient safety program, improved BRAZIL Raul GONZALEZ, MD NETHERLANDS Jacques J. N. M. van der MEULEN, MD when our input is really needed, we are there for ISAPS. BULGARIA Yolanda K. ZAYAKOVA, MD, FACS NEW ZEALAND Janek S. JANUSZKIEWICZ, MD contributions to the global statics survey, and now we are We have shown how our actions have a positive result. For BULGARIA ‡Mihail R. SKERLEV, MD NORWAY Petter Frode AMLAND, MD, PhD focusing on having better internet exposure. example, how with our encouraging communications we CANADA Elizabeth HALL-FINDLAY, MD PAKISTAN Shahab GHANI, MD Our patients and their wellbeing are the reason we work CHILE Teresa DE LA CERDA, MD PANAMA José Agustín ESPINO, MD actively helped improve registration for our Geneva meet- so hard every day and they are also the reason ISAPS has to CHILE ‡Daniel JACUBOVSKY, MD PERU Julio Daniel KIRSCHBAUM, MD ing. Thanks to all of you for this. be strong and grow. ISAPS’ mission to promote education CHINESE TAIPEI Philip Kuo-Ting CHEN, MD PHILIPPINES Florencio Quiogue LUCERO, MD It is true that we are an expanding society, but we must COLOMBIA Lina M. TRIANA, MD POLAND Maciej KUCZYNSKI, MD of aesthetic plastic surgeons means better safety standards continue to pursue quality members. Our patient safety COSTA RICA Alberto ARGUELLO CHOISEUL, MD PORTUGAL Jose Carlos Santos PARREIRA, MD and improved final results. ISAPS goals are being achieved strategy continues to serve not only our patients, but also CROATIA Zdenko STANEC, MD, PhD ROMANIA Dana Mihaela JIANU, MD, PhD thanks to the hard work of the National Secretaries. I thank CYPRUS Lefteris L. DEMETRIOU, MD RUSSIA Irina KHRUSTALEVA, MD, PhD has strengthened our commitment so that patients come you all for your hard work and for making sure aesthetic CZECH REPUBLIC Bohumil ZALESAK, MD, PhD SAUDI ARABIA Jamal A. Habiballah JOMAH, MD first worldwide. plastic surgery is respected worldwide. DENMARK Per BJERREGAARD, MD SERBIA Violeta M. SKOROBAC, MD National Secretaries have promoted ISAPS educational SINGAPORE Martin HUANG, MD Our ISAPS brand is growing worldwide in name and Dominican Republic Ramon Andres courses, symposia and endorsement of national meetings in MORALES PUMAROL, MD SLOVAK REPUBLIC Jozef FEDELES, MD exposure every day. When we hear about aesthetic plastic our countries. Thank you to all of our members who have ECUADOR Aldo MUIRRAGUI, MD SOUTH AFRICA Peter Desmond SCOTT, MD surgery, not only plastic surgeons but the public are begin- EGYPT Aly MOFTAH, MD SOUTH KOREA worked hard on this task and have shared with their col- David DaeHwan PARK, MD ning to think of us: ISAPS. We have achieved what we once ESTONIA Peep PREE, MD SPAIN Enrique ETXEBERRIA, MD, PhD leagues that our continuing educational efforts are so impor- wanted to be: the best reference to the world about aesthetic FINLAND Timo PAKKANEN, MD, PhD SPAIN ‡Miguel CHAMOSA, MD, PhD tant. FRANCE Bernard MOLE, MD plastic surgery. It is nice to see this happening even in a SWEDEN elections currently in process Most National Secretaries have positions of leadership GEORGIA Konstantin MATITASHVILI, MD SWEDEN ‡Ulf SAMUELSON, MD world where non-core doctors or even non-doctors want to within their own countries’ plastic surgery societies and GERMANY Dennis O. von HEIMBURG, MD, PhD SWITZERLAND Daniel F. KALBERMATTEN, MD, MPhl offer aesthetic procedures to the public. It is our responsi- GREECE Vakis KONTOES, MD, PhD from that platform they promote ISAPS among their col- THAILAND Sanguan KUNAPORN, MD bility to show the world what their best choice is when they HONG KONG, CHINA Ming Shiaw CHENG, MD TUNISIA Bouraoui KOTTI, MD leagues highlighting ISAPS goals and objectives. Many of think about aesthetic plastic surgery. HUNGARY Gusztav GULYAS, MD, PhD TURKEY Nuri CELIK, MD us bring to ISAPS new ideas that are brewing in their coun- INDIA Lokesh KUMAR, MD I never get tired of saying that we National Secretaries are UKRAINE Gennadiy PATLAZHAN, MD tries so that we may all learn and incorporate these ideas into INDONESIA Audy BUDIARTY, MD UAE Marwan AL ZAROUNI, MD important roots of the ISAPS tree. Without our active partici- ISAPS’ strategies for the benefit of all members worldwide. IRAN Mohammad Reza FARAHVASH, MD UNITED KINGDOM Lena ANDERSSON, MD pation, ISAPS could not be where it is now. I have worked IRAQ Ahmed NAWRES, MD Some of us actively participate in the development of ISAPS’ UNITED STATES Mark L. JEWELL, MD with passion in this job and followed my beliefs for con- IRELAND Margaret O’DONNELL, MD URUGUAY Gonzalo BOSCH, MD worldwide strategy which includes promoting patient safety structing every day a better ISAPS. At the beginning of this VENEZUELA Betty Milagros PÁRRAGA DE ZOGHBI, MD and education for the general public. voyage, we had some turbulent waters. The board wanted ‡ Term ending We surely have grown as an important worldwide soci- more active National Secretaries and I surely worked on a ety. Efforts such as our ISAPS global statistics survey have strategy to make it happen. We certainly had to make some served not only to concentrate data on aesthetic plastic sur- gery all over the world, but also to improve ISAPS visibility continued on page 35 worldwide.

28 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 29 FACILITY ACCREDITATION

SFR/AAAASF International Accreditation Update Combining superior innovation and the industry’s most desirable technologies!

Jeff Pearcy AAAASF Marketing/Executive Vice-President

onald Iverson, MD, Chairman of the Board and I, The common denominator in accrediting clinics, Jeff Pearcy, Executive Vice-President have been rig- regardless of size of facility, specialty, or location, is our Rorously expanding the marketplace for the global goal of patient safety. We are especially pleased to be able BODY CONTOURING SKIN TIGHTENING & accreditation of ambulatory surgery clinics. SFR has become to unequivocally assure facilities, regulatory agencies, and • single treatment CONTOURING synonymous with AAAASF International (AAAASFI) the general public that it is this goal which has guided the • non-invasive • single treatment which continues to make progress accrediting facilities in development of AAAASF and AAAASFI through past and • one pant/dress size smaller • non-invasive Latin America. Relationship building around the world has current leadership and certainly help future leaders succeed. • natural-looking results proven successful and eventually results in accredited facili- AAAASFI accreditation sets you and your clinic apart from ties. There are 46 accredited clinics worldwide, with many competition, giving you a much stronger market advantage in the process. by providing resources to surgery centers worldwide to In January 2012 AAAASFI was invited to meet a cluster enhance patient safety and surgery facility efficiency. of dental clinics in Medellin, Colombia. Oscar Molina (Latin In two large studies, representing 2,445,249 procedures, America representative) and I went to Medellin and made there was one only one death that occurred on the same a formal presentation to twelve clinic representatives. The day the surgery was performed, indicating safe patient afternoon was spent answering questions followed by tours routing through office based facilities. Surgery performed DEEP-PORE PURIFICATION of two dental clinics. The host on this visit was the former in AAAASF and AAAASFI accredited facilities is associated SKIN RESURFACING FOR ACNE Minister of Health. The primary source of patients who with a low incidence of unanticipated sequelae. • the authentic fractional laser • treats comedonal & pustular acne travel to Colombia for medical/dental services come from AAAASFI accreditation program is peer based. • treats a wide range of conditions • destroys acne causing bacteria • predictable results either Spain or they are former residents of Colombia who Inspections are performed by surgeons and dentists who • life-changing results for acne patients return for services. Seven clinics have been accredited in also understand local customs and culture. There is a peer- Colombia so far with over twenty surgical and dental clinics based Global Standards Advisory Committee ready to review in Costa Rica. subtle nuances, along with vast differences in AAAASFI Recently, AAAASFI had completed a successful inspection Standards appropriate for each country. of a surgery clinic in Beirut, Lebanon. Accreditation was A complete list of Globally accredited clinics can be found awarded to the Beirut Beauty Clinic which is directed by on our newly re-designed web site www.aaaasfi.org. EMEA: AUS/NZ: • [email protected] • [email protected] Roger Elkhoury, MD. The Beirut Beauty Clinic’s mission SFR Board members include: Robert Singer, MD, Ronald • +31(0)20.653.7060 • +61(02)9999.1081 is to provide the most advanced and innovative techniques E. Iverson, MD, James A. Yates, MD, Michael F. McGuire, • www.solta.com • www.solta.com

in plastic surgery. In this state-of-the-art facility, patients MD, Alan Gold, MD, Joao Carlos Sampaio Goes, MD, Foad SKIN REJUVENATION Americas: ASIA: enjoy a private and secure setting with a warm and Nahai, MD, Lawrence S. Reed, MD, Ivar Van Heijningen, • improves tone, texture and radiance • [email protected] • [email protected] • minimizes pore appearance • +1 510.782.2286 • +852.2145.2533 serene atmosphere, unlike the experience of the hospital MD, Alberto Arguello, MD (to be seated in the fall 2012), • www.solta.com • www.solta.com • quick and comfortable environment. and Harlan Pollock, MD.

Products not available in all areas. Indications for use: Thermage: Non-invasive treatment of periorbital wrinkles and rhytids including the upper and lower eyelids; non-invasive treatment of wrinkles and rhytids; temporary improvement in the appearance of cellulite. Fraxel DUAL 1550/1927: Dermatological procedures requiring the coagulation of soft tissue, as well as for skin resurfacing procedures. Dyschromia and cutaneous lesions, such as, but not limited to lentigos (age spots), solar lentigos (sun spots), actinic keratosis, and melasma, and for treatment of periorbital wrinkles, acne scars and surgical scars. 1927 nm: Dermatological procedures requiring the coagulation of soft tissue and the treatment of actinic keratosis. Clear + Brilliant: Dermatological procedures requiring the coagulation of soft tissue and general skin resurfacing procedures. Isolaz: Mild to moderate acne, including pustular acne, comedonal acne and mild to moderate inflammatory acne (acne vulgaris) in all skin types (Fitzpatrick I-VI). Liposonix: Important Safety Information: The Liposonix system is for use when there is at least 1.0 cm of subcutaneous adipose tissue beyond the selected focal depth setting of the system in the area to be treated. Most frequently reported side effects during Liposonix treatment are discomfort, pain, cold, prickling, tingling, or warmth. Treatment is contraindicated for patients who are pregnant or suspected to be pregnant. The most frequently reported side effects after Liposonix treatment, as recommended, are pain (discomfort), bruising, redness, and swelling, which are generally described (or rated) as mild. Liposonix Intended use & Indications for use: The Liposonix system delivers high-intensity focused ultrasound (HIFU) energy that can disrupt subcutaneous adipose tissue (SAT) to provide a non-invasive approach to body contouring to achieve a desired aesthetic effect. US: Indicated for non- invasive waist circumference reduction (i.e., abdomen and flanks). EU: Indicated for trunk and lower extremities excluding the lower leg (i.e., abdomen, flanks, hips, thighs and buttocks). Canada: Indicated for abdomen, flanks, hips, thighs and buttocks. © 2012 Solta Medical, Inc. All rights reserved. Thermage, Fraxel, Isolaz, Clear + Brilliant, and Liposonix, are trademarks or registered trademarks of Solta Medical, Inc. or its subsidiaries.

30 ISAPS News Volume 6 • Number 2 PRACTICE MANAGEMENT

Geneva, continued from page 1

The most valued aspect of our the Welcome Reception that immedi- No meeting of this magnitude hap- RealSelf Hits a Milestone: Congress is our dedication to excel- ately follows will be held in the CICG pens without a small army of dedicated lence in aesthetic plastic surgery edu- conference center to make it conve- individuals who have been working 2.5 Million Aesthetic Consumers cation. The program committee had a nient for everyone. For our traditional on every detail for nearly three years. to consumer questions about cosmetic answers to questions about cos- wealth of talent from which to draw in gala evening, we will take you to the From the social events to the exhibits; n May 2012, over 2.5 million procedures and post images of before metic surgery; our 94 member nations. The sharing fabulous Circus Knie for a private show from the innovative scientific program consumers visited RealSelf.com and afters where proper patient con- 2. Update social media sites with one- of knowledge among the many cultures just for ISAPS. An adjoining tent will development to the website design; I(www.realself.com), an ISAPS sents are in-place. RealSelf reports that click: Enjoy the efficiency of creat- represented, among younger and older host our exclusive reception and din- from the food selection to the contents partner. With this milestone, Real­ doctors made a half-million posts to the ing content that gets automatically surgeons, and between established and ner and you will enjoy the oldest fam- of the congress bags; from the invita- Self claims to be the most vis- site in the past three years. sent to Twitter, Facebook, LinkedIn, emerging centers of aesthetic plastic ily-owned, most award winning circus tion, confirmation, and coordination of ited website devoted to educating Most doctors respond to a list of and RealSelf; surgery around the world is what makes performance you have ever seen. If you more than 300 faculty and presenters and informing global consumers questions that are emailed each day 3. Generate word-of-mouth: Consum- this United Nations of Plastic Surgery have not been to the circus since you to the publicity planning and imple- about plastic surgery and cosmetic or week to their personal address. A ers prefer to share, “Like,” and link such a unique and special event. Our were a child, it’s not what you remem- mentation; from the hotel accom- medicine. surgeon may choose to be sent ques- to doctor answers. This helps drive Congresses tend to surpass those that ber. If you have never been to the cir- modations down to the name badges “We’re excited to see consumer visits tions that are only relevant to a topic awareness beyond your own website came before, and the 21st Congress of cus, we have a wonderful surprise in – nothing has been left to chance. It is grow over 100 percent annually,” states like breast augmentation, such as and blog. ISAPS will be no exception. store for you. impossible to include the list of all the Tom Seery, CEO and Founder of Real­ “Can I get breast augmentation sur- This Congress will feature sixteen We applaud the support of all our details involved. Self. “A critical driver for our growth While RealSelf is an English lan- gery before becoming pregnant?” The early morning Master Classes, general exhibiting companies, chief among Your attendance at this Congress will has been the continuous support of guage-dominated site, traffic to the online answer to this question gener- sessions in all aspects of aesthetic sur- them our Master Sponsors, Allergan make all our work worthwhile and you thousands of plastic surgeons, who site comes from over 100 countries, ates visibility for the responding doctor gery employing our successful combi- and Cynosure. Each of our exhibitors will not be disappointed. Old friends have devoted significant hours away and both London and Sydney are in within the RealSelf community, and can nation of video presentation, panels, is making a special effort to both dis- will be welcome, and new ones will be from their practice to answering ques- the top 10 cities for location of site visi- be automatically posted to the doctor’s and free papers, lunch-time seminars play their products and services and encouraged to join us. If you have vis- tions posted by consumers, encourag- tors. Dozens of ISAPS members have own social media profiles, as well as the sponsored by our corporate colleagues, to educate our audience about the lat- ited Geneva in the past, you know what ing patients to share their experiences already set up accounts and post con- doctor’s own website. and electronic papers and procedural est trends and advances in the industry a beautiful and truly international place on RealSelf, and posting photos of their tent in order to raise visibility and help videos you can view as often as you like. that supports your efforts as surgeons. it is. If you have not, you will not regret surgical before and afters,” adds Seery. 3 Key Benefits from Sharing Your consumers get properly informed. As Geneva is a small town, our We encourage you to visit with them your visit in September. For those not familiar, RealSelf is Expertise ISAPS members are invited to join guests will occupy more than 30 differ- and appreciate that their contribution We look forward to welcoming you designed to support a consumer’s The idea behind Q&A is to make it RealSelf, establish a free profile, and see ent hotels. The Opening Ceremony and supports this magnificent congress. to Switzerland! desire to learn from peers and medical easy to attract new patients with engag- for themselves whether Q&A and other experts on whether a cosmetic proce- ing content that reflects your voice and RealSelf services are right for their dure is right for them. The center point your expertise. RealSelf states that Q&A online marketing strategy. of the robust conversation on RealSelf is can: Visit http://www.realself.com/doctor doctor Questions and Answers (Q&A). to learn more and to apply to join. 1. Differentiate your practice: Adver- 500,000 Posts by Doctors tising isn’t enough to get noticed. Doctors — plastic surgeons and “core” RealSelf helps you create a social aesthetic medical providers — respond presence based on your expert

32 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 33 ISAPS Executive Office National Secretaries continued from page 28 EXECUTIVE DIRECTOR changes while we were sailing this boat, but today we can say started his work using the hammer, the sandpaper, the mea- Catherine Foss that we have a good team. Many new challenges will be faced suring tape and the screwdriver. A plain piece of wood was [email protected] by our next National Secretaries Chair. Let us never forget converted into a beautiful piece of furniture. When the car- DIRECTOR OF MARKETING that when we wear the ISAPS T-Shirt, there is nothing that penter left, the tools continued their discussion. The ham- Jodie Ambrose Did you know that SWISS is [email protected] offering special airfares to Geneva? will let us down. mer said: “It has been demonstrated that we all have defects, DIRECTOR OF ACCOUNTING Swiss International Air Lines is proud to be the Official I want to leave my ISAPS team members with these nice but the carpenter works with our qualities, highlighting our Edward Tracey Carrier for the 21st Congress of ISAPS in Geneva and is of- words: valuable points, and that is why instead of looking at our [email protected] fering special congress fares to all participants. These fares weaknesses we must concentrate on our strengths”. And MEMBERSHIP SERVICES MANAGER The Carpenter and His Tools offer reductions of up to 25% depending on the fare type, they all understood that the hammer is strong, the screw- Jordan Carney There was once a meeting when the carpenter’s tools [email protected] route and space availability. driver unites and gives strength, the sandpaper is special to discussed their differences. The hammer wanted to be the SPECIAL PROJECT MANAGERS Congress fares are valid on the entire SWISS route net- iron out uneven parts and level all surfaces for good contact, chief, but the rest of the tools said he made too much noise. Gael DeBeaumont work for flights to Switzerland, including flights operated and the measuring tape is precise and exact. They knew they [email protected] by partner airlines under an LX flight number. These fares The hammer accepted this fault, but said the screwdriver were a team capable of producing quality furniture and a Michele Nilsson can now be booked for the travel period beginning 14 days must be expelled because he made too many turns to achieve great joy surrounded them once they realized how lucky they [email protected] prior to until 14 days after the congress. anything. The screwdriver accepted the argument, but said were to work together. When we seek the strong points in ISAPS EXECUTIVE OFFICE To take advantage of this offer, book easily and conve- the sandpaper had a rough manner with others. The sandpa- each other, the best human tendencies come to the surface. 45 Lyme Road, Suite 304 per acknowledged this, but said the measuring tape always Hanover, NH, USA 03755 niently through the SWISS.COM Event Link You will need It is easy to find defects. To find qualities is the province of to enter your email address and the special event code that measured the others like he was the only perfect one. At this Phone: 1-603-643-2325 the wise. Fax: 1-603-643-1444 is sent with registration confirmations. moment the carpenter arrived, put the tools together, and Email: [email protected] SWISS looks forward to pampering you on board with Website: www.isaps.org typical Swiss hospitality.

ISAPS news Management Editor-in-Chief J. Peter Rubin, MD (United States)

Chair, Communications Committee João Carlos Sampaio Góes, MD, PhD (Brazil)

Managing Editor Catherine B. Foss (United States) Anteis SA is a Swiss company specializing in the development, manufacturing and Designer Barbara Jones (United States) distribution of innovative injectable medical devices based on biopolymer transformation. It Editorial Board Kirill Pshenisnov, MD (Russia) provides revolutionary solutions to challenges Ivar van Heijningen, MD (Belgium) in the fields of aesthetic dermatology, DISCLAIMER: ophthalmology and orthopedics. With a broad

ISAPS News is not responsible for facts as presented by the authors range of products on the market, Anteis is or advertisers. This newsletter presents current scientific informa- successfully following its aim of making a tion and opinion pertinent to medical professionals. It does not provide advice concerning specific diagnosis and treatment of difference in the patient’s health and beauty. individual cases and is not intended for use by the layperson. The International Society of Aesthetic Plastic Surgery, Inc. (ISAPS), the ANTEIS S.A. editors, contributors, have as much as possible, taken care to ensure that the information published in this newsletter is accurate and up Chemin des Aulx 18 to date. However, readers are strongly advised to confirm that the 1228 Plan-les-Ouates information complies with the latest legislation and standards of practice. ISAPS, the editors, the authors, and the publisher will not Geneva, Switzerland be responsible for any errors or liable for actions taken as a result +41 (0) 848 747 848 telephone of information or opinions expressed in this newsletter. ©Copyright + 41 (0) 848 949 849 facsimile 2012 by the International Society of Aesthetic Plastic Surgery, Inc. All rights reserved. Contents may not be reproduced in whole or in part www.anteis.com without written permission of ISAPS. Visit us at ISAPS Congress – Booth 18

34 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 35 CALENDAR CALENDAR

July 2012 Date: 26 September 2012 - 28 September 2012 Date: 10 October 2012 - 13 October 2012 February 2013 Meeting: 2nd World Congress of Plastic Surgeons of Date: 20 July 2012 - 22 July 2012 Meeting: XVIII International Course on Plastic & Aesthetic Date: 15 February 2013 - 18 February 2013 Lebanese Descent Meeting: Aesthetic Plastic Surgery/ Anti-Aging Medicine: Surgery Meeting: 5th American-Brazilian Aesthetic Meeting Location: Cancun, Mexico The NEXT Generation Location: Barcelona, Spain Location: Park City, UT Contact: Jose Luis Haddad Tame Location: New York, New York Venue: Clinical Planas Venue: Park City Marriott Email: [email protected] Venue: Conrad New York Contact: Course Secretariat Contact: Susan Russell Tel: 52-55-5615-3191 Contact: Barbara Williams Email: [email protected] Email: [email protected] Fax: 52-55-5615-3191 Email: [email protected] Tel: 34-93-203-2812 Tel: 1-801-274-9500 Website: http://www.congressmexico.com/lspras2012 Tel: 1-212-717-2855 Fax: 34-93-206-9989 Website: http://www.americanbrazilianaestheticmeeting. Fax: 1-866-477-1258 Date: 27 September 2012 - 30 September 2012 Date: 12 October 2012 - 14 October 2012 com Website: http://www.nextgenmtg.org/ Meeting: ISAPS Course - Lima & Machu Picchu Meeting: Third World Congress for Plastic Surgeons of Date: 22 February 2013 - 23 February 2013 August 2012 Location: Lima & Machu Picchu, Peru Chinese Descent Meeting: ISAPS Course - SOS (Secondary Optimazing Contact: Julio Kirschbaum and Carlos Uebel Location: Xian, China Date: 01 August 2012 - 04 August 2012 Surgery) Email: [email protected] Contact: Dr. Wei Xia Meeting: 31st Jornada Carioca de Cirurgia Plastica Location: Cologne, Germany Tel: 511-715-0808 Email: [email protected] Location: Rio de Janeiro Venue: Pullman Cologne Hotel Fax: 511-718-8849 Tel: 86-29-84775512 Venue: Hotel Sofitel Email: [email protected] Website: http://www.sociedadperuanadecirugiaplastica.com. Fax: 86-29-84775301 Contact: Paulo Leal May 2013 pe/ Website: http://www.2012wapscd.org Email: [email protected] Date: 02 May 2013 - 04 May 2013 Date: 29 September 2012 - 29 September 2012 Date: 26 October 2012 - 30 October 2012 Tel: 55-21-2286-7527 Meeting: 58th Annual Meeting of the Plastic Surgery Meeting: Plastic Surgery 2012 Fax: 55-21-2286-7527 Meeting: MACS-Lift Course: Minimal Access Cranial Research Council Suspension Location: New Orleans, LA, USA Date: 23 August 2012 - 26 August 2012 Location: Santa Monica, California Location: Ghent, Belgium Venue: New Orleans Convention Center Meeting: 4th European Plastic Surgery Research Council Contact: Catherine Foss Venue: Ghent Marriott Hotel Contact: American Society of Plastic Surgeons (EPSRC) Email: [email protected] Contact: Elien Van Loocke Email: [email protected] Location: Hamburg Harbor, Germany Tel: 1-603-643-2325 Email: [email protected] Tel: 1-847-228-9900 Venue: Freighter MS Cap San Diego Fax: 1-603-643-1444 Tel: +32 9 269 94 94 Fax: 1-847-228-9131 Contact: Kelli Gatewood Website: http://www.ps-rc.org Fax: +32 9 269 94 95 Website: http://www.plasticsurgery.org/ Email: [email protected]; [email protected] Website: http://www.coupureseminars.com November 2012 Date: 29 May 2013 - 31 May 2013 Tel: +49 3641 311 63 20 October 2012 Meeting: Beauty Through Science Fax: +49 234 325 20 80 Date: 01 November 2012 - 03 November 2012 Location: Stockholm, Sweden Website: http://www.epsrc.eu Date: 05 October 2012 - 07 October 2012 Meeting: ISAPS Course - Athens Venue: Stockholm Waterfront Congress Centre September 2012 Meeting: IFATS 10th Annual Meeting Location: Athens, Greece Contact: Anna Eliasson Location: Quebec City, Canada Contact: Vakis Kontoes Date: 04 September 2012 - 08 September 2012 Email: [email protected] Contact: Jordan Carney Email: [email protected] Meeting: 21st Congress of ISAPS Tel: + 46 8 614 54 00 Email: [email protected] Tel: +30-210-6985966 Location: Geneva, Switzerland Fax: +46 8 6145420 Tel: 1-603-643-2325 Fax: +30-210-6998731 Venue: Centre International de Conferences Geneve Website: http://www.beautythroughscience.com Fax: 1-603-643-1444 Website: http://www.isaps2012athens.com Contact: Catherine Foss September 2013 Website: http://www.ifats.org Date: 29 November 2012 - 01 December 2012 Email: [email protected] Date: 10 September 2013 - 14 September 2013 Date: 05 October 2012 - 07 October 2012 Meeting: The Cutting Edge Aesthetic Surgery Symposium Tel: 1-603-643-2325 Meeting: 15th International Society of Craniofacial Surgery 2012 Advanced Sculpting of the Nose Fax: 1-603-643-1444 Meeting: OSAPS 2012 Biennial Congress Location: Seoul, South Korea Location: New York, NY Website: http://www.isapscongress2012.org Location: Jackson Hole, Wyoming, USA Venue: Asan Medical Center Venue: Waldorf Astoria Hotel Date: 12 September 2012 - 15 September 2012 Venue: Teton Village Contact: Ms. Jessy Lee Contact: Bernadette McGoldrick Meeting: Laser Innsbruck 2012: Advances and Controversies Contact: Catherine Foss Email: [email protected] Email: [email protected] in Laser and Aesthetic Surgery Email: [email protected] Tel: 82-23452-1855 Tel: 1-212-249-6000 Location: Innsbruck, Austria Tel: 1-603-643-2325 Fax: 82-2192-3955 Fax: 1-212-249-6002 Venue: Faculty of Catholic Theology of the University of Fax: 1-603-643-1444 Website: http://www.osaps2012.org/ Website: http://www.aestheticsurgeryny.com Innsbruck Website: http://www.iscfs2013.org Contact: Katharina Russe-Wilflingseder, MD Date: 30 November 2012 - 01 December 2012 Email: [email protected] Meeting: Facial Rejuvenation - Surgical & Nonsurgical Tel: 43-512-25-2012 Procedures Fax: 43-512-25-2737 Location: Munich, Germany Website: http://laserinnsbruck.com Venue: Hilton Munich Park Hotel Email: [email protected]

36 ISAPS News Volume 6 • Number 2 May – August 2012 www.isaps.org 37 ISAPS NEW MEMBERS

Admitted in June 2012 * Associate Member

Argentina Egypt Lebanon Switzerland Gustavo Gulberto ABRILE, MD Mohamed ABDEL MAGEED Jean EL HAGE, MD Sandra BALDI BALMELLI, MD Raul BANEGAS, MD HASSAN, MD Firas HAMDAN, MD, FACS Konstantina BELOULI JOBIN, MD Juan Jose GALLI, MD Shady HAYEK, MD Marc FURRER, MD Juan Carlos PAILLET, MD Finland Boutros SAYEGH, MD Bernd HENNECKE, MD, FEBOPRAS* Pablo Ruben PAOLUCCI, MD Eeva SIITARI, MD Christian HORT, MD Gabriel C. ZANETTA, MD Anna-Liisa VESALA, MD Luxembourg Rene Denis LARGO, MD* Serge SCHMITZ, MD France Sophie MARTELLA FAVRE, MD Australia Martino MEOLI, MD* Janet HUANG, MBBS, FRACS* Emad Ed DANNAN, MD, Mexico FeEBOPRAS* Carlos CASTANEDA, MD* Claude OPPIKOFER, MD Mark Andrew LEE, MBBS, FRACS Simone PINTUS-STOSS, MD Mark McGOVERN, MBBS, FRACS Guillaume DROSSARD, MD Jorge Ernesto ECHEAGARAY Eric PLOT, MD HERRERA, MD Dominik SCHMID, MD Belgium Ary PAPADOPULOS, MD Xavier TENORIO, MD Carole AZZAM, MD Georgia Roberto SEGOVIA- Jacques Alexandre ZUFFEREY, MD Alexander KUZANOV, MD, PhD Jozef Peter I.A. DOORNAERT, MD BLUMENKRON, MD Tunisia Iva KUZANOV, MD, PhD Bertha TORRES GOMEZ, MD Brazil Iagor (Guga) KUZANOV, MD, PhD Samia AOUN KANOUN, MD Barbara Helena BARCARO George SULAMANIDZE, MD New Zealand Turkey MACHADO, MD Stanley LOO, BHB, MBCHB, Germany Emrah ARSLAN, MD Tiago BODANESE, MD* FRACS (Plas) Leyla ARVAS, MD, PhD Augusto S. CAMARA VALENTE, MD Juliane BODO, MD Jonathan WHEELER, MB ChB, Alexander HANDSCHIN, MD Ercan CIHANDIDE, MD Luiz V. de Fortuna CARNEIRO JR., MD FRACS* Hasan FINDIK, MD Francisco CARVALHO, MD Johannes Franz HOENIG, MD, PhD Georgios HRISTOPOULOS, MD Philippines Ozlem GUNDESLIOGLU, MD Thiago CAVALCANTI, MD* Fatih SIRIN, MD Dany CUBRIC, MD Niklas NOACK, MD Gerald SY, MD, MBA Dan Mon O’DEY, MD, PhD Giancarlo DALL’OLIO, MD, PhD* Poland Ukraine Marcos FLORIAN ARDENGHI, MD Alexander SCHOENBORN, MD Alexander KORNIENKO, MD Daniel THOME, MD Janusz SIREK, MD, PhD Henrique LOPES ARANTES, MD Jaroslaw STANCZYK, MD, PhD Sergiy KYYLO, MD Luciano LOSS, MD Reinhard TITEL, MD Luis LUNA, MD Marc WEIHRAUCH, MD, PhD Portugal United Arab Emirates Leonora MANSUR, MD* Mario Jorge FREIRE-SANTOS, MD Khalid ALAWADI, MD* India Ioannis Michail SALIVARAS, MD Vinicius MELGACO DE CASTRO, MD* Milan DOSHI, MBBS, MS, MCh Luísa MAGALHÃES RAMOS, MD* Isaac Ephima MOURA, MD Ravi Kumar MAHAJAN, MS, MCh United Kingdom Ernesto Garzon NOVOA, MD* Romania Ramasamy MURUGESAN Constantin STAN, MD, PhD Richard KAROO, MBChB MRCS(Eng), Jose Luis Araujo PASTOR, MD* Ram B.R. PONUGOTI, MD, MCh MPhil FRCS(Plast) Renato PERALI, MD* V. SUDHAKAR PRASAD, MD, MCh Russia Marc PACIFICO, BSc(Hons), MBBS Graziela SCHMITZ BONIN, MD* Georgy SARUKHANOV, MD MD, FRCS(Plast) Vasco SENNA-FERNANDES, MD Iran Valeriy YAKIMETS, MD, PhD Alexandre SENRA, MD* Hossein ABDALI, MD Uruguay Gustavo STEFFEN ALVAREZ, MD* Mohammad Reza Saudi Arabia Jesus Ricardo MANZANI BALDI, MD AKHOONDINASAB, MD Ayman HELMI, MD, FRCS(Plast) Hugo MERCATINI, MD Canada Peiman GOHARSHENASAN, MD* Daisy PERI VIDAL, MD Gloria M. ROCKWELL, MD, Jamshid KHAK, MD Serbia FRCS(plast) Goran JOVANOVIC, MD, PhD USA Iraq Stevo MARTIC, MD Boris ACKERMAN, MD China Zakaria ARAJY, MB ChB, FRCS Joel B. BECK, MD, FACS Shengkang LUO, MD, PhD Kadhum SHABAA, MB ChB, FICMS Slovak Republic Jay CALVERT, MD, FACS Marianna ZÁBAVNÍKOVÁ, MD, PhD Colombia Marek DOBKE, MD Israel Peter ZIAK, MD Celso BOHORQUEZ E., MD Jennifer EMMETT, MD* Ron AZARIA, MD Robert Harold GOTKIN, MD, FACS Ricardo H. BONILLA BONILLA, MD South Africa Sarit COHEN, MD Robert S. HAMAS, MD Hugo H. CORTES OCHOA, MD Johan VAN HEERDEN, MBChB, FC Yitzchak RAMON, MD Raffi HOVSEPIAN, MD, FACS Maria Mercedes CRISTANCHO, MD* Plast (SA), MMed (SA)* Luis H. GONZALEZ CAICEDO, MD Italy Glenn W. JELKS, MD, FACS Alfredo HOYOS, MD Giorgio DE SANTIS, MD South Korea Nolan KARP, MD Beatriz S. PEREZ DE GARAVITO, MD Hanns Henrich DEETJEN, MD Min-Hee RYU, MD Maria Helena LIMA, MD* Monica RESTREPO, MD Giorgio RAFANELLI, MD Yoon SEOK, MD Z. Paul LORENC, MD Alfonso RIASCOS, MD Massimo SIGNORINI, MD Leonard MILLER, MD, FACS Spain Juan Esteban SIERRA MEJIA, MD Fabrizio TOMASSETTI, MD Larry POLLACK, MD Kai Oliver KAYE, MD, PhD Daniel PYO, MD Czech Republic Japan Marisa MANZANO SURROCA, MD Remus REPTA, MD Libor KMENT, MD Kenichiro IMAGAWA, MD Jose R. MARTINEZ- Ralph ROSATO, MD, FACS David STEPAN, MD MENDEZ, MD, PhD Lorne ROSENFIELD, MD, FACS Latvia Andres NEMSEFF, MD Ali SAJJADIAN, MD, FACS Dominican Republic Janis GILIS, MD, PhD Gabriel PLANAS RIBÓ, MD, PhD Kamal SAWAN, MD, FACS Rafael Ernesto ESTEVEZ Raluan SOLTERO, MD HERNANDEZ, MD* Sweden Gregory SWANK, MD Ramon A. MORALES PUMAROL, MD Disa M. E. LIDMAN, MD, PhD Andrew TURK, MD, FACS Bruce VAN NATTA, MD, FACS

38 ISAPS News Volume 6 • Number 2 Quality is a necessity, not a luxury.

Choose well. Choose wisely. As a world leading manufacturer of high-quality breast implants for over 25 years, our experience results in products that you Choose MENTOR® and can rely on and that are made under strict standards of design PERTHESE™ Breast Implants. and testing.

Our breast implants conform to applicable standards and regulations: • CE-Marking for MENTOR® and PERTHESE™ Breast Implants • US FDA approval for MENTOR® MemoryGel™ and Saline Breast Implants1 • ISO 10993 “Biological Evaluation of Medical Devices” 2 • ISO 14607 “Non-active surgical implants – Mammary Implants – Particular requirements” 3 • ISO 13485, “Medical devices – Quality management systems – Requirements for regulatory purposes” 4 • 93/42/EEC Medical Device Directive 5

®

1 The MENTOR® Breast Implant products approved by the FDA are the MENTOR® MemoryGel™ Round Profile Cohesive I™ Breast Implants and the MENTOR® Saline-Filled Breast Implants. / 2 International Organization for Standardization, Geneva, Switzerland. / 3 Ibid / 4 Ibid / 5 Council Directive 93/42/EEC of 14 June 1993 concerning medical devices, updated 2007

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