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In short, it’s time for ‘gentle’ fillers used in small ‘brush strokes’ to redesign the face. On the other hand, a clear ‘against’ trend is recorded on the front of fillers with a lifting effect, often used too generously.

Tired of those ‘boxer in the sixth round’ faces, many women are turning to the plastic surgeon again for a lifting (even in ‘mini’ format) traditional. But for those who don’t really like the scalpel, a series of alternative or complementary techniques to ‘filler’ fillers are gaining ground to obtain a non-surgical lifting effect. It is the case of fili for example that they are experiencing a second spring and a great revival and a series of ‘physical’ techniques such as the radio frequencies or again of microneedling. Skin aging is caused by an imbalance between degradation and synthesis phenomena of some structural components such as hyaluronic acid, glycosaminoglycans, collagen and elastin. The objective of the so-called injective ‘biostimulants’ is precisely to reactivate the ‘constructive’ metabolism of the skin cells by stimulating the synthesis of the components of the cellular matrix. A novelty in this field is represented by the CHAC Technologya sort of anti-wrinkle ‘mesotherapy’ which allows the active ingredients to be stabilized without the use of chemical reagents (abstract 165, Davide De Rossi), releasing them gradually in order to prolong and intensify the effect of the treatment. This technology therefore makes it possible to obtain biostimulants with stable and effective active ingredients for longer.

In the 30-40 age group, the so-called treatment is increasingly required ‘full face’ which consists in reshaping with hyaluronic acid-based fillers (with different characteristics based on the area to be treated, using different injection techniques) various areas of the face (forehead, nose, cheekbones, lips, jaw profile and chin), in a single seat, to harmonize the volumes without derogating from the elegance of the shapes. In other words, making small adjustments only where they are actually needed. Dynamic fillers are particularly suitable for treating a young face. The results – assure the experts – are immediate and guarantee an effectsocial glam’ always respecting elegance and balance. And to ‘erase’ the wrinkles, an innovative technique appears on the horizon, the so-called ‘micro-coring’ (ELLECORE VENUS CONCEPT), a latest generation robotic technology for the treatment of deep wrinkles on the cheeks and lower third of the face. The technique consists in removing a series of ‘rods’ of skin with special needles with an internal diameter of less than 0.5 mm, thus creating ‘columns’ of holes so small that they heal without leaving scars. Approximately 30 minutes of treatment, 5-7% of the skin is removed and wrinkles are erased.

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L’coupled botulinum toxin-filler continues to enjoy excellent health and show a growing trend; the novelty in this field is represented by neurotossine long-acting (up to 6-9 months) such as Daxi®, with long-lasting activity due to the fact that the neurotoxin is linked to a protein which helps prolong its activity at the muscle level. The effects become fully visible after two weeks and can last up to 6-8 months (against 3-4 months for current toxin formulations). For now, Daxi is approved only in the US (by the FDA), but it should also arrive in Italy shortly. For the face and under-chin area, a new technology is represented by ‘synchronized’ ultrasound (multiple beam synchronous ultrasound) which deliver heat (about 65°) to a depth of about 1.5 mm. It allows to obtain a visible lifting of the treated tissues, reducing their laxity (abstract Carlo Borriello). Finally, to improve the results of aesthetic medicine treatments in menopausal women, a new proposal is represented by a nutricosmetic based on red clover, vitamin D and niacin. The combined and synergistic contribution of plant extracts, minerals and vitamins enhances the anti-aging effect of these treatments in the menopausal age (abstract Magda Belmontesi).

How I rejuvenate your mitochondrion. Unfortunately, the skin ages like the rest of the body, with the difference that it is immediately visible. Wrinkles, spots and laxity are the results of the action of the intrinsic and extrinsic factors of ageing, represented by environmental factors (exposure to the sun and pollution, incorrect nutrition), genetics and naturally by the ‘time’ variable. All these contributing causes affect the performance of the mitochondria, the energy plants of our cells which, as we age, produce an excess of ROS which contribute to oxidative stress; this triggers theinflammaging which results in skin aging. And the new frontier of anti-aging cosmetology has mitochondria as its target. One proposal comes from a new technology, the Permeable AntioxidantS System (PASS), developed to obtain effective cutaneous absorption of molecules with an antioxidant action at the mitochondrial level, through the use of vesicles of ascorbic and oleic acid. Thanks to the PASS it is possible to convey molecules such as Glutathione, Coenzyme Q10, vitamin C which counteract oxidative stress and prevent skin ageing. With the same technology, a buccal food supplement (IN-OUT protocol) has been developed (abstract 199, Anadela Serra Visconti; abstract 165, Simon Ugo Urso)

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“Rejuvenation must give way to maintenance. It is essential that the objective of the aesthetic doctor is to do bring the patient her age well – comments the president of SIME Emanuele Bartoletti Any excessive attempt at rejuvenation is pathetic often with grotesque results. This is why Aesthetic Medicine must focus on therapies which, if performed after a precise diagnosis, and if repeated constantly over time, keep the skin in excellent condition and delay the damage caused by ageing. Watchwords: PREVENT and MAINTAIN”.

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