OPENING SESSIONS Past, present, future: Who should do aesthetic medicine?   Changing environment of Aesthetic Medicine     Plastic Surgery   THE BUSINESS OF BEAUTY Capsule: Beauty industry for all and with agressive marketing, or by intimation only? Can we agree on the "meaning of beauty"? Debate: The business of beauty; scientific facts and results or public relations - which should come first? Pro: Agressive marketing leads to unrealistic expectations, and increased malpractice suits Con Marketing is the first stem in patient knowledge and empowerment The cosmetic industry: What evidence is there?     ADULT REGENERATIVE STEM CELLS: AN ADJUNCT TO FAT GRAFTING AND ITS OTHER APPLICATIONS Capsule: Increased interest in the role of fat-derived stem cells in fat grafting   Debate: Should we be using stem cells derived from fat tissue as an adjunct to fat grafting? Pro: Fat-derived stem cells can be used to improve the long-term results of fat grafting Con: Fat-derived stem cells are still under investigation: Risk of neoplastic induction is still unknown     INDUSTRY-PHYSICIAN RELATIONSHIPS UNDER CROSS-FIRE Capsule: What scientific tools are available for appraisal of the plethora of new compounds and devices striking the market so frequently?   Open panel of industry representatives and physicians on the dilemma of new treatment choices Questions for discussion What level of scientific evidence is necessary before introducing a new technique or compound? Who is responsible for complications related to products? Facial collagen-stimulating techniques: What type of documentation relating to clinical improvements should be demonstrated before release of a new technique? Is microscopic collagen increase without clinical improvement data enough? Skin contracture in body contouring: What type of documentation relating to clinical improvements should be demonstrated before release of a new technique? Are microscopic changes without clinical improvement data enough? When is clinical data sufficient? When is case demonstration enough and when do we need double-blind randomized investigations?   AUTOLOGOUS TISSUE VS. IMPLANTS FOR BREAST RECONSTRUCTION Capsule: Better results depend on the implant or the surgeon? Debate: Can modern implants achieve similar long-term results when both breasts are reconstructed? Pro: Bilateral treatment of breast cancer with implants provides long-term stability of results with less morbidity and scarring Con: Autologous breast reconstruction provides better long-term stability of results Debate: Breast 'fat grafting' vs. breast implants Pro: Breast augmentation using autologous fat is safe and results in long-term stability Con: Cosmetic advantages of fat augmentation are yet to be proven. Impairment in early detection of breast cancer remains a concern!   BREAST AUGMENTATION SURGERY WITH SILICONE IMPLANTS Capsule: Do the implants make a difference? Debate: Form stable high cohesive silicone gel implants or non form stable low cohesive silicone gel implants? Pro: Form stable anatomical implants produce a better result than non form stable ones Con: Round implants produce the same results as anatomical ones with lower rate of rotational problems   AUTOLOGOUS FAT HARVESTING AND GRAFTING Capsule: Why is there no agreement on the best technique for fat harvesting, processing and injection? The pros and cons of segmental and suction harvest fat: How should fat be treated to increase survival? Can a simple 'cook book' for fat grafting be devised? Debate: Is fat processing important for the success of injection? What are the risks? Pro: It is safer to harvest fat in a simple manner and inject it in its native form! Con: Processing of the fat before injection increases the success of the procedure! FAT GRAFTING II Capsule: Is fat grafting capable of replacing common injectable products? Debate: When should fat grafting be preferable to other nonsurgical and surgical techniques? Pro: Face ‘fat grafting’ has no quantity limits, achieves good, long-lasting results, and is the healthiest option Con: ‘Fat grafting’ results are not predictable Fat Injection: To correct or overcorrect? Facial fillers or fat injection – what is preferable? GENITAL SURGERY Capsule: Should a general plastic surgeon also embark on cosmetic genital operations? Labial and vaginal rejuvenation: What are the pitfalls? Who should perform the surgery? Penile implants and elongation: What improvements have been made? Who should undertake it? Gender assignment: What innovations are there?   WOUND HEALING   Debates on wound healing dressings and wound healing technologies   Session in development   DERMATOLOGY   NON SURGICAL BODY CONTOURING Capsule: Physicians are not always fully exposed to the methodology and results before embarking on newly introduced technologies and treatments.   Round table discussion: What evidence do we have for these new treatments? Sound-waves technology Meso-Therapy Endermology – LPG Radiofrequency and other noninvasive treatments (Thermage®, Vela Shape®) Percurtaneous ultrasound (Ultrashape®) PREVENTION AND TREATMENT OF ACNE Capsule: Acne is a disorder with a high impact from medical and psychological respects in adolescents. Therefore, acne patients and their treatment management should be taken seriously.   Debate: Local or systemic treatments? Pro: Local treatments result in subtle, predictable improvement Con: Systemic treatment is more agressive but has better results Counter view: Both techniques are essential for treatment. Early therapy avoids long-term deep scarring. Treatment of scars: Laser, filler or fat? Alternatives to acne scar treatment: where and when to treat, and when should it be stopped?     THE USE OF BOTULINUM TOXIN-A Capsule: Since BTX-A has become the shooting star in cosmetic pharmacological treatments, the indications, their treatment recommendations, and philosophy of use is in continuous evolution. What do we want, and what does the patient want from BTX-A treatment? Should we prefer one time long term solution over repeated BTX-A injections? Debate: Total freeze vs. the natural look? Debate: Surgical vs. Botulinum Toxin-A (BTX-A) for HYPERHIDROSIS AXILLARIES Surgical treatment is the ultimate solution BTX-A is non invasive and provides satisfactory results TREATMENT OF CELLULITE Capsule: Treatment of cellulite includes many options such as cream massage, endermology, lipodisolve, external ultrasound, radiofrequency, liposuction laser lipolysis. What are the indications and scientific documentation of these? Debate: Pro: Cellulite is a complex clinical condition that depends on genetic constitution, hormonal action, and collagen recombination, among others. Any mechanical type of treatment should have only a temporary effect. Con: There are many types of cellulite which are not distinguishable; cellulite is a symptom and should be treated as such! Laser lipolysis: First step or last resort? External ultrasound: What are the pitfalls? MELANOMA Capsule: Melanoma is the most threatening disease in dermatology. Continuous scientific developments change the therapeutic approach before treatment Debate: Pre therapeutic diagnostics in melanoma vs. immediate surgical removal FACIAL REJUVENATION (WITH FRACTIONATED LASERS) II Debate: Ablative vs. nonablative laser devices? Which treatment would you like for yourself? Counter view: Both techniques are temporary, and do not meet all expectations over time!   PLASTIC SURGERY & DERMATOLOGY   LIPOSUCTION Capsule: No agreement exists on the basic aspects of liposuction   Debate: What is preferable - wet, hyper-wet, or water-jet-assisted liposuction? Pro: Traditional liposuction is established as safe and reproducible hence no additional risky unproven methods are required Con: Hyper-wet liposuction, despite being a longer and more cumbersome procedure, facilitates more accurate body contouring and better skin redraping Post liposuction treatments (LPG - endormology, compression garments, creams, among others) - Do they play a role in the final outcome? Skin reducing body contouring (lifts) vs. liposuction: What are the limitations and indications?   FACIAL REJUVENATION I Capsule: With so many options in use, and so many users, can we reach a consensus about the best method and substance?   Debate: Permanent filler or absorbable? Pro: Despite higher costs and short activity, the absorbables should be preferable since they carry a low risk Con: The slight risk of non absorbables is not important in view of the long-lasting beauty results   Counter view 1: Both techniques are temporary and do not respect the entire evolution of the aging face over time   Counter view 2: Both techniques respect the social needs of invisible treatment with limited downsides   Can agreement be reached on the real indications and complication rate of facial silicone injections?      AGING FACE Capsule: The best method for facial rejuvenation remains the center of debate, not only within a discipline, but also among disciplines   Debate: Invasive vs. noninvasive approach to the aging face Plastic surgeon: Surgical approach is comprehensive and provides lasting results! Dermatologist: There are many non or minimally-invasive alternatives that should be tried first! What is the best basis for evaluation of a procedure? Ease of use? Patient satisfaction? Cost? Effectiveness? Noninvasive approaches: What makes them so popular? Affordability? Ease of mastering? Repeated use? Lack of risks?     COSMECEUTICAL PRODUCTS IN THE AESTHETIC CLINIC Capsule: Are cosmeceuticals any different from traditional cosmetic products?   Panel discussion of physicians and cosmetic scientists What is scientifically proven about different ingredients? What is the place of cosmeceutical products in an aesthetic clinic? Who should treat the patient - Plastic surgeon or dermatologists or skin therapeutic? What type of skin analysis should be done?      SKIN REJUVENATION: LASERS VS. FILLERS VS. CHEMICAL PEELS Capsule: What is the importance of the skin surface in facial rejuvenation?   Best method for collagen stimulation and rhytid removal Comparison among deep laser resurfacing, fractional laser peeling and other modalities such as radiofrequency, infrared and IPL Intense Pulsed Light treatments What is the best treatment for vascular lesions and pigmentation?     CONSULTATION PROCESS Session in development     SURGICAL VS. NON SURGICAL FACIAL REJUVENATION Capsule: Treatment for every face? Facial rejuvenation in a crossfire between dermatologist and plastic surgeon    Round table discussion   Questions to the panellists: Which method is preferable and why? Surgical technique Nonsurgical (permanent vs. non permanent) Fillers and fat Fillers Hyaluronic acids Polylactic acid Collagen Calcium hydroxylapatite Fat grafting techniques Lipostructure Lipofilling Implants       UPPER EYELID AND FOREHEAD REJUVENATION Capsule: Despite extensive experience no agreement exists over the basic treatment for forehead rejuvenation   Forehead lifting vs. neurotoxin and filler. What is preferable?   Open vs. endoscopic surgical approach   What type of forehead fixation technique is preferable and produces best result predictability?   Do long-term effects of nonsurgical technique treatments exist despite limited duration of the product?   The benefit of combined nonsurgical treatments   FACIAL REJUVENATION III Capsule: Additional treatments are as important but often not discussed, although they are essential for superior resutls Debate: Chemical Peeling, Dermabrasion, PDT, Photodynamic Therapy and IPL Intense Pulsed Light.  Can we live without them? Pro: These compounds are important additional tools for superior results Con: These compounds do not provide satisfactory, long-lasting results    MULTIDISCIPLINARY CLINIC   Round table discussion: How to establish a multidisciplinary clinic for aesthetic treatments - benefits, drawbacks, challenges and obstacles Discussion and practical tips between those who made it and those attempting to embark on an interdisciplinary clinic   CONTROVERSIES IN HAIR TRANSPLANTATION Session in development   MOHS SURGERY   Debate: Mohs surgery for BCC of the face – should this be the rule? Pro: Mohs surgery is the only procedure acceptable for basal cell carcinoma of the face Con: Mohs surgery should be performed only in the event of failure to achieve complete excision of tumor Debate: Pro: Malignant melanoma of the face should be treated by Mohs surgery Con: Mohs surgery is not accurate enough