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New Age of Anti-Age

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  1. New Age of Anti-Age The Miracle and Science of Sculptra Aesthetic November 9, 2011 By MashaBanar, PA-C Cosmetic Surgery Injector of Sculptra of 7 years and personal user for 1

  2. Understanding aging helps restore youthful look in a natural way • Recent discovery: fat in the face is compartmentalized by ligaments which stretch and sag. • After 30 we start losing volume in our face. Skin loses support of the underlying fat and drapes with gravity (Rorich and Pessa). • Skeletal remodeling: deepened sockets, resorption of maxilla, “accordion effect”

  3. Aging of the face • Chronic UV light damage to skin • Smoking • Loss of subcutaneous fat • Gravitational changes from loss of elasticity of the tissue • Changes in the intrinsic muscles of facial expression and their influence on skin (9).

  4. Why Sculptra? • Most natural results, pt’s own collagen, moves w/face • Subtle gradual changes vs sudden big change w/fillers • Cost 600-2,500 vs fillers 600-2,500 BUT • Sculptra results last up to 2.5 years vs 1 yr w/fillers

  5. 4x1.5 cc Radiesse $2,500 Before After

  6. 3 sessions x 2 vials $3,000

  7. 1 session x 2 vials $1,300 Before 6 weeks after first injection

  8. Sculptra • Dermik Aesthetics • Poly-L-lactic acid • FDA approved • Series of 3-5 treatments 1 month apart (1).

  9. Corrects underlying causes of aging Replace Restore Refine PLLA collagen Injectable poly-L-lactic acid (PLLA)—the main component of Sculptra®Aesthetic—begins working within the deep dermis to replace lost collagen and reinforce skin structure.1-3 * As microparticles of injectable PLLA are absorbed, a collagen framework is provided to gradually restore volume.1-3 * This results in the smoothingout of shallow to deep facial wrinkles and folds for a more refined appearance that can last up to 2 years.1-4 * Based on preclinical evaluation in animals. Sculptra®Aesthetic is thought to work in a similar process. Please see full Prescribing Information available at this presentation. 1. Sculptra®Aesthetic Prescribing Information; 2009. 2. Mainil-Varlet P et al. J Mater Sci. 1996;7:713-721. 3. Gogolewski S et al. J Biomed Mater Res. 1993;27:1135-1148. 4. Data on file, Dermik Laboratories.

  10. Amount of product/treatments

  11. Facial assessment and Sculptra®(injectable poly-L-lactic acid) treatment areas • Perform assessment of the 3 distinct horizontal regions of the face1 • Upper face: hairline to glabella • Midface: glabella to the subnasale • Lower face: subnasale to menton • It is important to assess changes in the skeletal width and height, soft tissue stability, and fat loss • Sculptra is Indicated for Treatment in the Mid and Lower Face2: • Temples • Cheeks • Nasolabial folds Individual results and treatment regimens may vary. Please see full Prescribing Information available at this presentation. 1. Murphy MR, et al. In: Master Techniques in Facial Rejuvenation. Saunders; 2007:1-16. 2. Sculptra Prescribing Information, 2006.

  12. Treatment results with Sculptra®(injectable poly-L-lactic acid) Mapped* End of treatment One year after treatment Before treatment (all photos unretouched) Individual results and treatment regimens may vary. Photos courtesy of Dr. Rebecca Fitzgerald *Prior to Second Session Name: Jodi Total vials & sessions: 6 vials over 3 sessions Please see full Prescribing Information available at this presentation.

  13. Supplies • 3 cc syringes (about 3 per vial) • 25 Gauge needles, 1’ or 1.5’ long • Bacteriostatic water for reconstitution • Lidocaine 1% w/Epi

  14. Reconstitution guidelines • Reconstitute each vial with 6 cc of bacteriostatic water • Reconstitute at least 2 days in advance, can do 1-2 wks • Add 2 cc of Lidocaine w/Epi to each vial before treatment • Total volume should be 8 cc/vial

  15. Technique of injection DEPO

  16. Technique of injection-Fanning

  17. Injection technique-Subperiosteal

  18. Special considerations • Instruct patient to massage treated areas 5 times a day, 5 days in the row, 5 min at a time (rule of 5-5-5) • Risk of granuloma (nodule) is very small and virtually eliminated by proper reconstitution, technique, and massage • If granuloma developed, it is easy to subcise +/- inject with Kenalog, resolves completely

  19. Questions? Comments?