There are 500 patients a year who turn to the Fatebenefratelli clinics in Rome, which has become a point of reference for the complications of treatments throughout Italy. Added to these are the ‘repentants’, those for whom one too many tattoos or fillers can turn out to be anti-aesthetic or even cause damage. There are new techniques just for the ‘repentant’ and there is also a warning: it is better to learn to listen to the doctor’s ‘no’. Overdoing hyaluronic acid-based fillers over time can lead to buildups; although hyaluronic acid is ‘absorbable’, with repeated treatments, perhaps without giving the filler time to ‘disappear’ naturally, anti-aesthetic increases in volume can be created. The new trend is therefore to use a sort of ‘antidote’ to hyaluronic acid, the enzyme hyaluronidase, to speed up the resorption process and erase over-treated areas. “But it is a wrong trend – says Emanuele Bartoletti, president of Sime -. Corrections must always be made gradually and one must know how to stop when a harmonious result has been achieved. This is not always perceived by patients. We must invite people to listen if the doctor says ‘no’ and the doctors not to passively ‘accept’ every patient’s request.” Hyaluronidase has proved to be a useful drug for the resolution of filler complications. “It can happen – explains Bartoletti – that an excessive use of the filler in dangerous areas for a specific vascularization such as the nose or the mouth region, leads to a compression of an arterial vessel which can cause ischemia of the part, up to the necrosis of the tissues. Hyaluronidase solves these problems. This is why it is a drug that every aesthetic doctor should have, before injecting fillers with hyaluronic acid”. More and more people then choose semi-permanent make-up performed with pigments for aesthetic use to draw gull-wing eyebrows or redesign the lip contour. The effect of these aesthetic procedures is not always the one hoped for. For those who regret cosmetic tattoos (brow liner and lip liner), the solution is entrusted to the ‘tattoo changing’ laser technique where Q-switched lasers and picosecond lasers are the masters. “A dentist will never be able to make an aesthetic medicine visit.
And he will never be able to practice aesthetic medicine because he is not a doctor.
But he will be able to use, according to the new legislation, therapies that are normally used in our discipline to do aesthetic dentistry. The problem will be skills, this is what we will ask the institutions to pay attention to”, says Bartoletti, president of Sime, the Italian Society of Aesthetic Medicine, on the sidelines of the congress in Rome after the approval in the Chamber of an amendment to the simplification bill which would allow dentists to carry out non-invasive or minimally invasive aesthetic medicine activities.
“In aesthetic medicine -adds Bartoletti- you need to be prepared, behind every therapy there is a possible complication.
The doctor must already undergo a special training course, otherwise he risks harming the patients. The problem is not that dentists do aesthetic medicine, but to safeguard the health of patients. When they have the skills to be able to do it, it will be different, but at this moment perhaps the cart has been put before the horse, perhaps this step should have been prepared by providing training”.
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 ‘boxer in the sixth round’ faces, many women are returning to turning to the plastic surgeon for a traditional facelift (even in ‘mini’ format). It emerges at the Sime congress, the Italian Society of Aesthetic Medicine. For those who don’t like the scalpel, alternative or complementary techniques to ‘filler’ fillers are gaining ground to obtain a non-surgical lifting effect. This is the case of wires, for example, which are experiencing a second spring, radio frequencies or even microneedling. A novelty against skin aging is CHAC Technology, an anti-wrinkle ‘mesotherapy’ which allows the active ingredients to be stabilized without the use of chemical reagents, gradually releasing them so as to prolong and intensify the treatment effect. This technology makes it possible to obtain biostimulants with active ingredients that are stable and effective for longer. In the 30-40 age range, the ‘full face’ treatment is increasingly required, which consists in reshaping with hyaluronic acid-based fillers (with different characteristics in 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 session, to harmonize the volumes without derogating from the elegance of the shapes. Making small adjustments only where they are actually needed. The results – assure the experts – are immediate and guarantee a ‘social glam’ effect, always respecting elegance and balance. And to ‘erase’ wrinkles, a new technique appears on the horizon, ‘micro-coring’, a latest generation robotic technology for the treatment of deep wrinkles on the cheeks and lower third of the face. The eyes, then, are one of the favorite locations for the signs of aging. From viper venom, to hydro-stetching, to electromagnetic fields, there are many new techniques to correct the periocular region.