Day 1 :
Keynote Forum
Ramamurthy
Aesthetic Academy Asia, Malaysia
Keynote: Pain management in aesthetic medicine
Time : 09:15-10:00
Biography:
Ramamurthy has completed his Medical studies in India in year 1996 and has pursued his Diploma in Dermatology (Cardiff - 2000), Fellowship in Laser Surgery (Bangkok - 2002) and Certification in Pain Management (Paris - 2003). After being appointed as the Vice President of Association of International Certified Aestheticians in 2012, he was awarded the Letter of Credentialing and Privileging (Aesthetic Medicine) from the Ministry of Health in 2013 and currently Heads the Asia Academy of Aesthetic Medicine. He has been lecturing in several universities in Malaysia. He is also the key Opinion Leader for several renowned aesthetic pharmaceuticals companies.
Abstract:
Managing pain in aesthetic medicine takes a different leap when compared to general medicine or surgery, where some level of pain or discomfort has already set in. Pain in an aesthetic medical procedure is multifactorial; it depends on the type of procedure (botulinum toxin, fillers, threads, lasers, radiofrequency, infrared and chemical peel), site of treatment (face, body, bony area and hairy area), type of pain–nociceptive, neuropathic or inflammatory and patient’s threshold to pain. To some, the psychological pain of what may go wrong can be more than the physical pain caused by the procedure. There is also the proportion of pain to skin color in laser related procedures. It is well known that anxiety and fear also play an important role in aesthetic procedures. Managing pain is just as much about managing expectations and it starts during consultation. Giving an insight to the pain and describing the sensation helps to prepare the patient. A holistic approach will be to provide a soothing ambience, clinical hypnotherapy and engaging all the senses - sight, hearing, smell, taste and touch, which are proven adjuvants in minimizing pain. Thereafter, simple and easily available approach will be to use ice cubes, cold sprays, ice gels, topical anesthetic cream, etc. Pharmacological pain relief can be classified into non-sedative and sedative options, with proper monitoring and emergency facilities required for the later. With so many options available, the physician’s suggestion for pain management must be discussed with the patients and must not be carried out without their consent. Additionally, the choice of pain management must not interfere with the treatment outcome, such as using sedation when the patient’s input is important during augmentation procedure. Other options include regional blocks, field blocks, use of tumescent and the correct concoction. Every physician will use his / her favorite formula. Pain management agent for Lasers will be different compared to pain management in injectables. We reviewed over 250 journals in aesthetic medicine which has some suggestion in pain management and narrowed it down to 10 best pain management practices, for selected procedures. The objective for today’s aesthetic professionals must be to minimize the fear of pain, as well as effectively reducing the physical pain that ensues. With so many techniques and pain relief formulations available in aesthetics, the old saying, ‘No pain, No gain’ should not have a place in aesthetic clinics. The best practitioners need to keep their pain management protocol under review, operate a feedback system with patients, learn from
individual experiences and adapt to tailor future pain management strategies.
Keynote Forum
Kong Chee Kwan
University of Malaya, Malaysia
Keynote: Essentials of facial local flaps in respecting aesthetic units when reconstructing skin lesions
Time : 10:00-10:45
Biography:
Kong Chee Kwan has served as a General Surgeon at the Ministry of Health Hospitals before underwent sub-specialist training and board certified as a Plastic and Reconstructive Surgeon. Consequently, University of Malaya appointed him as a Senior Lecturer and Clinical Specialist in the Department of Surgery. He has trained many general surgeons as well as plastic surgeons in the country. He has published numerous papers in reputed journals and has been serving as an Editorial Board Member of Medical Journal of Malaysia.
Abstract:
The principle of facial aesthetic units is essential in designing local flaps for facial coverage. Local flaps are routinely done for skin lesions that are too big to be closed primarily. The ideal local flap for reconstruction is the one that can be designed within the same aesthetic unit as that containing the lesion. Scars are best concealed by placing incisions along aesthetic margins. When a defect involves two or more aesthetic units, it is better to compartmentalize the reconstruction. Each skin flaps are planned to reconstruct the separate components of the defect that are located within separate aesthetic units. This may provide similarity of skin quality but, more essentially, places scars in the aesthetic margins. It is often beneficial to extend the primary defect by increasing the defect to an aesthetic margin or even to extend the defect to occupy an entire aesthetic unit. Reconstruction of the defect with a local flap will then position a border of the flap in an aesthetic unit for improved scar concealment. Several case studies will be presented with this idea in mind.
- New Trends by Aesthetic Therapies | Plastic & Cosmetic Laser Surgery | Aesthetic or Cosmetic Dermatology | Psoriasis | Alopecia & Trichology | Cutaneous Conditions | Skin Infection & Therapeutics
Location: Bunga Anggerik
Chair
Chandran Rajagopal
Academy of Family Physicians of Malaysia, Malaysia
Co-Chair
Ummer Yaseen
Consultant Dermatologist Mubarak Hospital, India
Session Introduction
Ummer Yaseen
Consultant Dermatologist Mubarak Hospital, India
Title: Hairline designing: A retrospective study of our patients
Time : 11:00-11:30
Biography:
Ummer Yaseen has completed his MD in Dermatology from Government Medical College, Srinagar in the year 2010. After completing his MD he did Fellowship in Dermatosurgery from Rajiv Gandhi University of Health Sciences, Bangalore. Since 2011, he is actively doing all dermatosurgery procedures and has a special interest in hair transplant. He has joined International Society of Hair Restoration Surgery in 2011. Currently he is an Associate Member of ISHRS and has been nominated as a Member of Communications and Public Relations Committee for the year 2020. He has 15 publications to his credit both national and international. He has presented his work in annual meeting of ISHRS Chicago and has published his work on beard transplantation in the hair transplant forum international. Presently he is the Life Member of Association of Cutaneous Surgeons (ACSI), Indian Association of Dermatologists, Venereologists and Leprologists (IADVL), Cosmetic Society of India (CSI) and Contact Dermatitis Forum of India (CODFI).
Abstract:
Background: Hair transplantation has undergone enormous changes since the 1950’s when Norman Orentreich transplanted 2-4 mm grafts. These grafts produced unnatural doll like hair in the hairline. This was not acceptable to the patients and as the concept of follicular unit transplantation came into vogue, the hairline designing improved considerably and mimicked the natural hairline as much as possible.
Method: We studied the hairline designing of 100 consecutive male patients one year post hair transplantations. The parameters that were studied included cobble stoning, pitting, frontal point, F-T recession, temporal points (if any) micro and macro irregularities, patient satisfaction and physician assessment. We harvested the grafts using FUE technique. The punch used was 0.9 mm serrated punch. The grafts were placed by using 19 G and 20 G needle. The hairline was designed using the standard techniques and placement of hairline was as per donor recipient ratio.
Result: This study was a retrospective study on 100 male patients. The only cosmetic concern in 2% of the study group was the cobble stoning. Piting was absent in the study group. More than 90% patients were highly satisfied with their hairline. The physician assessment also rated the quality of hairline as excellent in >90% of the study group.
Conclusion: The standard technique of hairline design should be followed while designing a hairline in hair restoration surgery. 19 G and 20 G needles are excellent and low cost instruments that can be used to produce a natural hair line.
Goh Ming Chun
Clique Clinic, Malaysia
Title: Picosecond laser: A breakthrough in scar treatments
Time : 11:30-12:00
Biography:
Goh Ming Chun has obtained his Medical degree from University Putra Malaysia. He has then pursued his Aesthetic training in Medical Aesthetic Certification Program (MAC) and American Academy of Aesthetic Medicine (AAAM). He is highly experienced in conducting wide range of minor surgical procedures, wound care and scar management. Prior to joining Clique Clinic, he has worked at the Penang General Hospital in the Plastic and Reconstructive Surgery Department
Abstract:
Permanent scar resulted from overwhelming acne or varicella-zoster infection is a challenging condition affecting many men and women in our Malaysian population, linking to poor self-esteem, embarrassment, depression and altered social interactions. Current treatments involve improving appearance of scars via topical preparations, chemical peel, micro-needling, laser resurfacing, subcutaneous incision and fillers. Many of these modalities are used alone or in combination and deemed to be safe with transient adverse reaction. The results vary for each individual as it depends on type of scars and the person’s skin type and lifestyle. Recently, the use of a picosecond laser with a Micro Lens Array (MLA) was introduced in the treatment of scars. Picosecond ND:YAG laser allows powerful energies to bypass the epidermal layer to target the deeper structures, creating the so called LIOB (Laser Induced Optical Breakdown) which works like subcision of the scar tissues. This will then stimulate a healing response, causing skin rejuvenation, collagen generation and reconstruction of cell tissues. We explored the role of picosecond laser in management of scar tissues.
Chandran Rajagopal
Academy of Family Physicians of Malaysia, Malaysia
Title: Anatomy of the muscles of facial expression in aesthetic medicine
Time : 12:00-13:00
Biography:
Chandran Rajagopal has completed his Graduation from the Madras Medical College, University of Madras in 1972. After his Graduation from MMC, he served in the Malaysian Health Service in the fields of Psychiatry and General Surgery. He continued his training in Dermatological Surgery in US with the American Academy of Aesthetic and Restorative Surgery in New Orleans, Louisiana under Professor George Farber and became a Fellow of the Academy and later as an International Fellow of the American Academy of Dermatologists.
Abstract:
This study aimed to understand the anatomy of facial muscles which is intricate and vital for the aesthetic medical practitioner in the practice of cosmetic dermatology. Such study can be performed through cadaveric dissection or through study of virtual anatomy. These muscles of facial expression are located in the subcutaneous tissue and originate from bone or fascia, where they are inserted onto the skin. The muscles of facial expression are found to be broadly being split into three groups: Orbital, nasal and oral. Orbital group of muscles is associated with 2 muscles arising from the eye socket; they are orbicularis oculi and corrugator supercilii located posterior to the orbicularis supercilii. The nasal group of facial muscles is associated with movements of the nose and the skin around it. They are the nasalis, the largest of the nasal muscles. Procerus is the most superior part of the nasal muscles. Depressor septi nasi assists the alar part of the nasalis. Next is the oral group of muscles which play an important role in facial expression and are responsible for the movements of the mouth and lips. They are the orbicularis oris and the buccinator. There are also other oral muscles acting on the lips and mouth, they are the lower group comprising of the depressor anguli oris, depressor labii inferioris. The upper group contains the risorius, zygomaticus major, zygomaticus minor, levator labii superioris, levator labii superioris alaeque nasi and levator anguli oris. Profound knowledge of the facial anatomy and their action will enhance the proficiency of the aesthetic physician in their application of aesthetic procedures.
Exhibitor Presentations 14:00-14:30 @ Bunga Anggerik
Michael Lim
Aesthetic Medicine Kuala Lumpur, Malaysia
Title: Stem Cells research and treatment
Time : 14:30-15:15
Biography:
Abstract:
Yeow Hui Qian
Clique Clinic, Malaysia
Title: A novice treatment for body aesthetic: Hyperthermic Diode laser for skin rejunevation on top of fat reduction
Time : 15:15-15:45
Biography:
Yeow Hui Qian has obtained her Medical degree in Volgograd State Medical University, Russia. She has completed her training in Hospital Sultan Abdul Halim, Kedah before becoming a Medical Officer in Surgery and Psychiatry Department. Prior to joining Clique Clinic, she secured a Master of Science (MSc) degree in Medical Aesthetics, Anti-aging and Regenerative Medicine at UCSI University. With her creditable interpersonal skills, she is good at connecting with patients to understand their needs and delivering her best advice and treatments to her patients. Her interests include laser medicine, facial and body aesthetics.
Abstract:
Non-invasive fat reduction therapy has been well accepted due to its efficacy, lesser complication and downtime as compared to surgical method of fat reduction. The 1060 nm diode laser delivers heat at 42-47 oC which destroy the cell membrane integrity of the adipocyte, causing an inflammatory process. 1064 nm is highly absorbable by the subcutaneous fatty layer but minimally absorbed by the dermis, thus the surrounding tissues are not damaged. Visible results of fat reduction and skin tightening are seen as early as 2 months after one treatment and unwanted side effects are minimal. It is also highly acceptable by patients taking into account on the comfort level and treatment duration.
Prasetyadi Mawardi
Sebelas Maret University, Indonesia
Title: Lucio phenomenon: Negleted leprosy reaction
Time : 15:45-16:15
Biography:
Prasetyadi Mawardi is an Active Staff and Lecturer in Department of Dermatology and Venereology in Dr. Moewardi General Hospital/Medical Faculty of Sebelas Maret University in Surakarta, Indonesia. He has completed his Graduation as a Dermatovenereologist from Diponegoro University in Semarang, Indonesia. His major interests include cosmetic medic, skin tumor, skin surgery, acne, aging, laser and light modality and tropical dermatology also dermatopathology. His has achieved his Doctoral (PhD) studies from Brawijaya University in Malang, Indonesia. He not only often acts as a Speaker and Lecturer in national and international dermatology forum, but also actively publishes his research and reviews in some international journals.
Abstract:
Leprosy can be caused by an infection of Mycobacterium leprae commonly acquired through contact with an infected person. M. leprae multiplies slowly and the incubation period of the disease, on average, is 5 years. In some cases, symptoms may occur within 1 year but can also take as long as 20 years to occur. Clinical presentation depends on the patients’ immune status at the time of infection and during the course of disease. Leprosy is spread by person to person contact. Although the most important route is unclear, it is believed that M. leprae is spread either thought the inhalation of infectious aerosols or through skin contact with respiratory secretions and wound exudates. Numerous M. leprae are found in the nasal secretions of patients with lepromatous leprosy. Lucio phenomenon is a special type of reactions observed in uniformly diffuse shinny infiltrative non nodular form of LL. The etiopathogenesis is less well understood. M. leprae are found unusually in large numbers in the endothelial cells of superficial blood vessels and this finding may be responsible for the serious vascular complications seen during the reactive phase. Leprosy patients tend to have leprosy reactions based on immune response patterns that occur and depend on these mechanisms further subcategorized. There is marked vasculitis and thrombosis of the superficial and deep vessel resulting in hemorrhage and infarctions of the skin.