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Volume 6 • Number 1 Volume 5 • Number 3 Official Newsletter of the International Society of Aesthetic Plastic Surgery Official Newsletter of the International Society of Aesthetic Plastic Surgery The PIP Problem
CONGRESS What happened?
Claude Mas, founded a company called PIP See pages 14-17
(Poly Implants Prothèses) for information about the
headquartered in France. He stated that he had ISAPS Congress in
developed firm silicone and promoted lifelong Geneva, Switzerland
durability of his product. In 1997, Monsieur Mas September 4-8, 2012
managed to obtain the CE certificate and was regularly inspected by TÜV Rheinland. The approval of implants filled with saline had been refused in the US by the Food and Drug Administration (FDA) in the year 2000 due to considerable quality failure. continued on page 3 January – March 2012




BOARd Of dIRECtORS
MESSAGE fROM thE EdItOR
PIP Problem, continued from page 1
St. Gallen, Switzerland J. Peter Rubin, Md – United States
ISAPS News Editor dirk Richter, Md – Germany
Chair, ISAPS Patient Safety Committee Carlos Uebel, MD, PhD Porto Alegre, RS, Brazil Member, ISAPS Board of Directors for the health and welfare of our patients FIRST VICE PRESIDENT Susumu Takayanagi, MD What does it mean to be a member of ISAPS? It means that you are a and I applaud Dr. Richter's sage advice. This In 2009, the French authorities were mixture of about 25% medical-grade sili- associated with increased leaking and steward of our profession and that is a critical time for all plastic surgeons to informed about the increasing frequency cone and about 75% industrial silicone a higher rate of rupture. This was con- SECOND VICE PRESIDENT you uphold and promote the very highest step up, show our true level of professional- of early rupturing and unusually high was used. Whenever the TÜV Rheinland firmed by the investigations of the French Renato Saltz, MD standards of patient safety, excellent practice, ism and compassion, and help our patients leakage of the PIP prostheses. In addi- announced its inspection – usually ten authorities. However, the controversial Salt Lake City, UT, United States and ongoing education in aesthetic plastic through this difficult period. We are respon- tion, indications of criminal activity days in advance – PIP used high-grade methodology and the statistical results THIRD VICE PRESIDENT surgery. This issue of ISAPS News highlights sible for the outcome, even though we did led to prosecutors' investigations. Bills medical silicone and returned to the sub- are not fully reliable.
Jorge Herrera, MD were found in the PIP files for unusu- standard product after the inspectors left. On the 23rd of December 2011, the the global crisis concerning PIP implants. Dr. not create the problem.
Dirk Richter writes a comprehensive piece Also in this issue, we see your society at ally high amounts of industrial-grade Thus all evidence of illegal activities was French authorities recommended that silicone which had been purchased from SECRETARY GENERAL eliminated. Furthermore, it was found women with PIP implants discuss their covering the history of these implants and work producing valuable data to support Miodrag Colic, MD a company in Germany since 2001. In that since 2006 the previously used two- removal with their surgeon. The German Belgrade, Serbia the current situation. He implores of us, as our specialty practices. ISAPS statistics on contrast to any medical-grade sili- authorities initially advised to check surgeons and ambassadors of our specialty, aesthetic procedures appear summarized in cone, the substandard silicon had the implants, but changed the rec- to take the most responsible approach going this issue, and I thank our Communications By omitting the cleaning Daniel Knutti, MD not undergone a cleaning process. ommendation on the 6th of January Biel, Switzerland Committee headed by Dr. Joca Sampaio process, the company saved A higher amount of low molecular 2012 as a result of their own find- A trust has been violated. Even though Goes, our survey analyst Scott Hackworth, weight species that can be left over ings. They advised patients to remove ASSISTANT TREASURER about €1 million per year. Dirk Richter, MD this was not a transgression by the inter- and our member surgeons for providing data as part of the manufacturing pro- the implants, even if symptoms and national plastic surgery community, we are for this project. I hope that the summary of cess remained and showed high signs of rupture were lacking. In the unwilling participants. We are responsible figures and trends will be informative and biological activity. This silicone can European Union, the Netherlands IMMEDIATE PAST PRESIDENT useful to you in your practice. much more easily pass through the shell layer silicone shell had been replaced by and the Czech Republic followed the Atlanta, GA, United States Dr. Mark Jewell presents a very interest- by inducing instability thereby causing a single-layer shell to reduce production German recommendations. Other coun- ing global perspective on lipoplasty that irritation and inflammatory processes costs.
tries such as Britain, where about 50,000 Thomas Davis, MD will help frame our current techniques. Dr. in the surrounding tissues.
The French health products safety patients are estimated to have received Hershey, PA, United States By omitting the cleaning process, the agency, AFSSAPS, was able to demon- the PIP implants, plus Spain and Italy Riccardo Mazzola, our resident expert on PIP Problem 1, 3-5 medical history, tells us the story of fat graft- company saved about €1 million per strate through its own investigations an advised twice yearly clinical examina- NATIONAL SECRETARIES CHAIR tions and imaging, such as ultrasound Message from the Editor 2 ing throughout medical practice. This is a year. The implants also contained the increased inflammatory reaction by the lubricant Baysilone, a petroleum prod- silicone used. The results of the intra- wonderful article, not to be missed.
uct, and the substances Silopren and dermal irritation tests they performed EDUCATION COUNCIL CHAIR Clinical Feature 7 You will also find information about our What is the right decision?
Rhodorsil which are used in the rubber showed an irritant potential of the PIP Nazim Cerkes, MD 2012 Congress in Geneva as we prepare for Istanbul, Turkey industry. In April 2010, the implants silicone gel that was not found with the How reliable is the data? What should that biennial event. I look forward to seeing were withdrawn from the market along silicone gels from other prostheses, nor we recommend to our patients and our TRUSTEE – PAST PRESIDENT you in Geneva in September and I hope you with the implants of the company Rofil with the gel declared in the manufac- members? All of these issues arose at Bryan C. Mendelson, MD Melbourne, VIC, Australia enjoy this issue of ISAPS News. Medical in the Netherlands, which were turer's dossier.
the turn of the year 2011/2012 and con- manufactured under a PIP license and Experiments on mice showed no cerned the Board of ISAPS. Remarkably, National Secretaries 18-19 TRUSTEE – ELECTED were "identical." genetic changes nor were there indi- we received numerous opinions and Theodore Voukidis, MD estimations from our army of National The prosecutors' investigations re - cations of toxicity or increased carci- vealed that a high degree of heteroge- nogenicity. According to many reports Secretaries which were very valuable to EXECUTIVE DIRECTOR ISAPS News Editor neity existed in the nature of the gel: a from colleagues, the PIP implants are continued on page 4 Hanover, NH, United States ISAPS News Volume 6 • Number 1 January – March 2012 PIP Problem, continued from page 3
What about our own reputation?
our acts are politically motivated and in for an annual routine checkup, really? us, as it helped us to compile recommendations for our mem- But how do we trace our patients? How do our patients The past has shown that crises like no way rational. Poor old man! The annual renewal of a vehicle inspec- bers very swiftly.
find out what type of implants they have once the implant the Dow Corning scandal in the early However, we have to accept some mild tion sticker is compulsory. Why not Based on our mission of patient safety, we have only one ID card is lost, and the former surgeon cannot be found, nineties, problems concerning saline reproach from the authorities for appar- medical products? And can we sustain option: to advocate the removal of the implants. There have or the obligation to store the patient file has expired? These or hydrogel implants, and the unprec- ently not sufficiently attending to our lifetime warranties for implants, or are been no studies so far proving that non-medical-grade sili- commonly raised questions once again demand a centralized edented recall of soy oil implants, never duty to report faulty implants. We obvi- the rupture rates of 10 to 13% after 8 to cone is harmful and to what extent. But the fact of the mat- implant registry like those already existing in some countries. last long. A woman's wish for an upsize, ously know too little about the structured 10 years for the big manufacturers like ter is this: it has definitely not been tested, is not approved A registry can trace each implant from the manufacturer to or the desire for a breast reconstruction, processes and hence it is necessary to Mentor and Allergan hinting at a differ- and in particular, there is no study showing that it is harm- the patient, comparable to a recall in the automotive industry. often exceeds her worries about risks.
clarify the fact that each failure connected ent conclusion? less. Thus, for us, the only logical and reasonable conse- Now our own initiative on a national and international level This phenomenon is being experi- to a medical product is subject to report Do we have to actively approach our quence was to follow the recommendation of the French is needed. And we should make use of our influence on leg- enced again by concerned PIP patients in most countries. This is usually not patients and hand out appointment authorities – the removal of the implants – and to write a islative authorities. today who, almost without exception, a big deal and is a necessary require- reminder cards like most dentists do press release with our recommendation. The alternatives, all ask for a replacement. Almost none ment for the controlling institution to already? What else did we learn from this?
monitoring with ultrasound or magnetic resonance imag- decline new implants as it means a take note of faulty products that we are We should try to see things positively! ing, did not seem suitable to us because of the high rate of We learned that even highly recognized regulatory institutions clearly better quality of life. And this is already discussing at conventions or pri- As specialists in Plastic Surgery, we false-negative test results. Large like the German TÜV Rheinland something we should feel proud of as vate gatherings. Please check if there are bought a regular priced medical product studies have shown that a rupture cannot completely protect both plastic surgeons! Scientifically we are similar requirements in your country.
in good faith – a product that was accred- of the implants can be revealed Based on our mission of surgeons and patients from on the right track: studies of the high- We should not be surprised or even ited by the German TÜV. And we did the by ultrasound (performed by an criminal activity. We can only est evidence level have proven a signifi- raise our voice about the fact that now, patient safety, we have only best job possible. We cannot be blamed experienced examiner) in 30% of hope that the resulting loss of cantly improved quality of life for women with some delay, actions are taken in a for criminal activities, the profiteering cases and by using MRI in 90% trust in us as physicians will not one option: to advocate the
with implants, both for augmentations as bold yet considerate manner.
of unscrupulous manufacturers, or the of cases. Combining both meth- be too great as the media natu- well as reconstructions following breast Are we sufficiently attending to our removal of the implants.
purchase of cheap products. We can learn ods, the "hit ratio" increases to rally suggest that the surgeons cancer. Even the ten-year survival rate duty to follow up and secure safety infor- a lot from this episode – once again – 92% with costs of €1000 per year, used cheap implants intention- exceeds the one of the matching com- mation? Or should we rather be awak- and should improve on the deficiencies which certainly would have to be ally and for their own profit. Yet parison group. It should be pointed out ened by the current events? If patients, mentioned above: Implant registry + assumed in the first instance by the patient herself. In real- these implants were not at all cheap, but were sold in the that the patients with implants have a worried by daily headlines, cautiously attending to our duty to report + duty to ity, bad results are more likely to be expected, leading the medium price range of comparable products. What we need smaller risk of cancer through better enquire whether implanted prosthe- follow up = "customer care"! patient to a false sense of security.
to postulate at this stage is that an amendment to the act of monitoring and a smaller target organ. ses of 1975 have to be checked by now, We should make use of this opportu- Also, implant leakage cannot be detected by any of these medical products must be filed. Especially with regard to Additionally, medical silicone is the most there must be something wrong. How nity! Hopefully there will not be another tests, only through operative exploration. Waiting for evidence- unannounced inspections which are now possible at the very researched material for the human body. do we ensure that each patient returns chance that soon! based studies in order to provide best practice could mean first suspicion. We, the physicians, have to be ready for a sud- Medical silicone, that is! waiting for years. Would we advise the same to our closest den and unexpected inspection by the local health authority We cannot provide better proof that every day. Why should there be unequal principles for the we are still doing the right thing after all. A recommendation like this is certainly pointing the way industry? The American FDA has proved to be more effec- And if only to protect our own reputa- ahead and should be the foundation of our patient counselling tive in its controlling function even though it failed by poor tion, we should inform the public that as a specialist and member of ISAPS. Obviously, this means communication to its peers worldwide regarding the faulty the scandal was about cheap silicone as that we have a particular duty to inform patients, discuss the quality at PIP.
opposed to cheap products for doctors. pros and cons, especially of possible operative risks, individu- Did you ever wonder why big companies conduct trials The only one who gained, if at all, was ally and settle the coverage of costs involved.
in Europe in order to obtain the desired CE certificate? The Monsieur Mas, who is now being held By now the scandal has also extended to the titanium coated past has proven this way to be the quickest to an accreditation to account. Surprisingly, the guy himself TiBREEZE implants that were also filled with objectionable for a big market whereas an American accreditation is very does not feel remorse at all and cannot PIP silicone. Fortunately, only the relatively small number of bureaucratic and tedious, thus cost intensive. Time is money.
understand the scaremongering. To him, 728 implants was sold worldwide, but these were included in One is tempted to believe that Europeans are being used the recommendation for explantation by the German authori- as guinea pigs for the Americans.
ties, too. ISAPS also proclaimed this recommendation on the continued on page 5 same day in a second press release.
ISAPS News Volume 6 • Number 1 January – March 2012 ISAPS INtERNAtIONAL
PERSPECtIvES ON LIPOPLASty
SURvEy ON AESthEtIC/COSMEtIC
Mark Jewell, Md – United States
PROCEdURES PERfORMEd IN 2010
Scott hackworth, CPA – United States
Senior Vice President, Industry Insights, Inc.
ISAPS global surveys are the work of the % of total
% of total
Plastic Surgeons Surgeons
of excisional body contouring in order lipoplasty outcomes had been shown Communications Committee under the direction of Dr. Joao C. Sampaio Goes, MD, Brazil. Lipoplasty remains the "gold stan- dard" for contouring surgery. Its to improve contouring in all aesthetic to be improved with the reinjection of evolution over the last 27 years units. The lipoabdominoplasty proce- limited amounts of lipoaspirate.
in America has produced remarkable dure appears to have outcome benefits The other areas of interest in lipo- urvey participants completed a two-page, English- advances in clinical outcomes that make including reduced seroma incidence plasty are the emergence of non-invasive based questionnaire that focused on the number of surgical lipoplasty the most common and less reliance on quilting sutures to lipoplasty devices, based on High- surgical and non-surgical procedures they performed Korea, South
form of aesthetic surgery in the United abolish dead space.
Intensity-Focused Ultrasound (HIFU) States. Having been around from the Laser-assisted lipoplasty, while mar- and cryolipolysis. Both approaches have The International Society of Aesthetic Plastic Surgeons start of lipoplasty to where we are in keted by manufacturers as a "fat melt- been extensively studied and have a (ISAPS) issued an invitation to participate in the study to 2012, it is interesting for me to look ing" technology, appears not to be solid basic science mechanism of effect. approximately 20,000 plastic surgeons whose contact infor- back and review progress in this proce- capable of delivering improved out- While both of these technologies cannot mation is housed in their proprietary database. In addition, a request was made that all National Societies encourage 15 United Kingdom
dure. There have been all sorts of tech- comes over existing lipoplasty tech- inherently match the outcomes of surgi- their members/constituents to take part in the survey. Three niques and technologies applied, yet few nology. The same can be said for cal lipoplasty, neither has the downtime reminder requests were distributed in order to maximize the have consistently produced safer and radiofrequency (RF)-assisted lipoplasty. of a surgical procedure. Strategically, better outcomes than simple measures Tissue thermodynamics become prob- these devices have the potential to fill an A total of 698 completed responses were received in time of epinephrine-containing wetting solu- lematic beyond 43° Celsius for dam- unmet need of body contouring in men for tabulation.
tions and limiting lidocaine to <35mg/ age, yet do not reach the 55-60° Celsius who are interested in losing waist cir- Final figures have been projected to reflect international kg body weight. Ultrasonic solid probe required to tighten collagen. Tissue cumference, but who cannot take time Saudi Arabia
statistics and are exclusively based on the estimated number lipoplasty appears to have overcome just does not like being heated to near- off from work to recover from surgical of plastic surgeons in each country and the responding sam- technologic shortcomings of earlier lethal temperatures with RF or laser lipoplasty. Men seem inclined to want ple. Whereas the U.S.-based study funded by the American devices and causes less blood loss than under the guise of "tissue tightening." to invest about as much time as it takes Society of Aesthetic Plastic Surgery includes board-certified because studies such as this can experience substantial vari-plastic surgeons, dermatologists, and otolaryngologists, this conventional lipoplasty. The use of lipoaspirate for autolo- for a teeth cleaning procedure in terms ances within specific procedures. In addition, the overall international survey is focused entirely on board-certified (or What is remarkable about this pro- gous fat grafting (AFT) has become a of using one of these non-invasive tech- methodology was slightly modified and National Societies national equivalent) plastic surgeons. from several countries materially restated their estimated cedure is both its safety and the predict- popular technique in the United States. nologies to improve body contour.
To aid in tallying the worldwide number of plastic sur- number of plastic surgeons for 2010. Figures for 2009 were ability of its outcomes when performed While this may be an unintended con- Plastic surgeons are well-positioned geons, representatives from National Societies provided the not recomputed. by a well-trained practitioner. Former sequence, what was discarded is now to offer patients seeking body contour- counts for over 90% of the 33,000 total estimated plastic Though the confidence intervals change by proce- problem areas of lidocaine toxicity, being recycled (reinjected). Gluteal ing the entire spectrum of options, surgeons. For cases in which the National Society did not dure and by country – depending on the sample size and blood loss, and poor aesthetic outcome reshaping is largely dominated by from non-invasive, to minimally-inva- provide its country's total, a regression equation was created response variance of each – the overall survey portion of this appear less frequently due to the edu- AFT and implants are a rarity. AFT sive, to combination excision/lipo- to estimate the number of plastic surgeons in the country research holds a standard error of +/- 3.67% at a 95% level cational efforts of plastic surgery societ- within the face, performed at the time plasty procedures.
based on its population size and gross domestic product. ies. Americans have learned from their of facial rejuvenation procedures, is In cases where a country received an insufficient survey The International Survey on Aesthetic/Cosmetic Pro ce- response, the projection base included respondents from the Brazilian colleagues that lipoplasty well accepted by surgeons to address dures Performed in 2010 was compiled, tabulated, and ana- country's continent. A weighting system was employed to can be safely performed at the time attritional lipoatrophy of aging. Even lyzed by Industry Insights, Inc. (www.industryinsights.com), emphasize responses from the particular country. an independent research firm based in Columbus, Ohio. Caution is urged when comparing against prior years, ISAPS News Volume 6 • Number 1 January – March 2012 ISAPS-LEAP Strike force
tunc tiryaki, Md – turkey

What started as a conversation on a boat on the Neva societies' plans, recent natural disasters around the world River in St. Petersburg, Russia last June has rapidly suggest that it would be prudent for health professionals to developed into a new ISAPS humanitarian pro- improve their preparedness for a mass casualty incident. gram. The Boards of Directors of While acute search and rescue is ISAPS and The LEAP Foundation usually carried out by governmen- (LEAP) have agreed to collabo- What started as a conversation tal organizations, these efforts are rate to create a new ISAPS-LEAP limited to the first 72 hours after on a boat on the Neva River in Strike Force. In global disasters which the hope of rescue dimin- such as the recent earthquakes in St Petersburg, Russia last June ishes rapidly. Immediate triage Haiti and Turkey, the tsunami in and surgical intervention by emer- has rapidly developed into a new Japan, and extensive flooding in gency medical personnel during Thailand, attention to the victims ISAPS humanitarian program this period is critical; however, by various aid organizations, the between the 3rd and 10th days, military and surgical teams within there is a major shortfall in both hours is vital. However, what happens in the following days the triage activities and the first surgical interventions on the is the focus of this new initiative.
injured. These interventions are very often related to plastic While not generally addressed in most plastic surgery surgery.
continued on page 26 for more information please go to http://www.leap-foundation.org/about/disaster-relief/
ISAPS News Volume 6 • Number 1 filler. Adipose tissue, harvested from thE INtRIGUING StORy Of fAt GRAftING:
"healthy patients," was mixed with a harder type of fat collected from rams from ram fat to stem cells
to minimize reabsorption. The cocktail Riccardo f. Mazzola, Md – Italy
of human and ram adipose tissue was ISAPS Historian moderately heated until it became fluid and ready for introduction at blood tem- In the beginning, surgeons enthusiastically favored the perature, so as to improve unaesthetic Use of fat grafting to improve contour deformities or correct sequelae of scars goes back to the end of technique of fat grafting, alone or in combination with skin deformities like depressions, facial the nineteenth century, when the German surgeon flaps, as it often represented a unique tool to easily solve atrophy or post-mastectomy scars (fig. Gustav Neuber (1850-1932) first reported the transplanta- major problems. But in the '30s, with growing experience, 2). The author reported that patients tion of adipose tissue harvested from the arm into the orbital clinicians realized that the very encouraging early results suffered a painful rash for about 2-3 region to correct adherent scars from osteomyelitis.1 Shortly worsened at long term due to unpredictable reabsorption days. The technique was published in afterwards, in 1895, another German, Viktor Czerny (1842- rates and a tendency to form cysts and become fibrotic. This 1916) transferred a lipoma to the breast to re-establish sym- is the reason why use of fat transplantation was considered In 1926, across the ocean, the US metry, following unilateral partial mastectomy for fibrocystic questionable. cosmetic surgeon Charles C. Miller In the '50s, Lyndon Peer (1898-1977) accurately investi- (1880-1950) from Chicago recom- In 1919, the German maxillo-facial and plastic surgeon, gated the fate of autogenous adipose tissue transfer at one mended a variety of fillers like gutta fig. 2-a and 2-b – Pre- and post-operative view of a post-mastectomy patient, treated with fat injec-
Erich Lexer (1867-1937) devoted more than 300 pages of his year and demonstrated that about 50% of fat cells rupture percha, ground rubber and fat to cor- tion (from: Holländer E Die kosmetische Chirurgie, 1912) two-volume book Die Freien Transplantationen (Free Trans- and die after transplantation and the graft structure is rect nasolabial folds, crow's feet and plantations) to fat grafting with an incredible range of clinical replaced by fibrous tissue. Cells which do not rupture sur- saddle nose.6 He harvested a piece augmentation despite its dramatic con- world rapidly. On occasion, a too enthu- applications, from the correction of contour deformities for vive and these constitute the adipose tissue that remains. of adipose tissue from the abdomen, sequences. siastic aspiration of fat resulted in dis- sequelae of facial traumas, to hemifacial microsomia, micro- The new blood circulation in free autogenous fat graft arises inserted it into a screw piston syringe, appointing contour irregularities with genia, breast asymmetry, post-traumatic hand-stiffness and at about the fourth day through anastomosis between host thE AdvENt Of LIPOSUCtION
and injected it subcutaneously to fill in depressions and holes. Reintroduc- Dupuytren's disease to restore the gliding tissue around the and graft blood vessels. If this does not occur, early death of depressions (fig. 3). In the 1980s, Pierre Fournier and Yves- tion of the lipoaspirate using a syringe tendons.3 The source of adipose tissue was the lateral thigh. cells may develop with oil cyst formation in areas that have However, fat injection never became Gerard Illouz, both from Paris, inde- was regarded as the solution of choice. Lexer first used fat also in the facially disfigured from not been revascularized.4 popular among the plastic surgical cir- pendently introduced a new procedure But within a few weeks complete or World War I, to reconstruct the eye socket so as to accommo- Due to these considerations, fat grafting to the face fell cles and was seldom employed until the for removing fat from the abdomen almost complete reabsorption of the re- date a prosthesis (fig. 1), or to improve depressed or retracted from favour, gradually becoming an almost obsolete pro- advent of liposuction. On the contrary, and thighs of wealthy, overweight Pari- injected material was reported. facial scars from gunshot wounds in soldiers injured in cedure.
for numerous years paraffin remained sian ladies. Liposuction was an incred- At the end of the nineteenth century, paraffin was popu- the filler of choice for nose and breast ible success which spread all over the fat injection
lar among beauty doctors to correct depressions, re-establish Despite this unpleasant drawback, contour and modify sunken noses. These unpleasant defor- the idea of filling contour depressions mities – charlatans advertised – could be easily modified concurrent with liposuction using the in beauty salons and drugstores by simple local injections, same adipose tissue just harvested, avoiding any surgical procedure. Disasters appeared soon. awakened new interest in autologous Paraffin migrated causing not only hard swellings, difficult fat re-injection.
to remove, the so-called paraffinomas, but also pulmonary At the end of the 1980s, the Argen- embolism and infections. This recalls the recent story of tinean plastic surgeon, Abel Chajchir, liquid silicone injections, with the devastating side effects, described favourable and long-lasting the siliconomas, which affected the plastic surgery scenario results using fat injection.7 He con- from the '60s onwards. sidered cautious manipulation of the In the first decade of the twentieth century, to contrast the adipocyte to reduce potential rupture of paraffin complications, the German surgeon Eugene Hollän- its fragile cell, rinsing the lipoaspirate fig. 1-a and 1-b – Pre- and post-operative view of a soldier injured in der (1867-1932) proposed the injection of fat, a more natural
in saline to eliminate dead cells and WWI whose eye socket was reconstructed using skin flap, cartilage and fig. 3 – The syringe used by the US cosmetic surgeon Ch Miller in 1926 to inject fat
fat graft, so as to accommodate a prosthesis (from: Lexer E. Die Freien continued on page 11 continued on page 12 ISAPS News Volume 6 • Number 1 January – March 2012 THE JOURNAl
History continued from page 11
debris, and finally grafting fat into close contact with well The impact of the panel was significant. The procedure ISAPS JOURNAL IS
vascularized tissue – crucial steps to minimize failure.
was regarded as one of great clinical value. From that panel In the 1990s, New York plastic surgeon Sydney Coleman evolved the first textbook on this topic, Fat Injection from Fill- vAStLy UPdAtEd
systematized the procedure. His recommendations were: ing to Regeneration, which was published soon afterwards.12 henry Spinelli, Md – United States
harvesting fat using a 3mm blunt cannula connected to a CONCLUSIONS
10ml syringe at low negative pressure to reduce adipocyte Editor-in-Chief, Aesthetic Plastic Surgery trauma, purification by means of centrifugation for separat- Fat injection, empirically started 100 years ago to correct ing the oily, aqueous and adipose components, and finally contour deformities by combining human and ram fat,5 placement in multiple tunnels and in tight contact with well nowadays ranks among the most popular procedures, for it vascularized surrounding tissue, using a 18G cannula. He provides the physician with an incredible range of aesthetic called this technique Lipostructure. and reconstructive clinical applications with amazing regen- The latest issue of the official ISAPS Jour- group of 113 Section Editors, distributed over nal, Aesthetic Plastic Surgery, has under- 29 areas of expertise, are individually assigned gone a number of changes to improve manuscripts to oversee through the review its already stellar quality. Over the past several process. Furthermore, we have added a new In 1998, the first course on autologous fat graft was erative effects on the surrounding tissues. months, we have reformatted the journal to be Advisory Board to help philosophically guide organized in Marseille by Prof. Guy Magalon, having Syd- more reader-friendly by adding colored tabs at the journal into the future. The masthead has ney Coleman as guest speaker. This made the diffusion of 1. Neuber G. Über die Wiederanheilung vollständig vom Körper get- the top of each page signifying six different topi- been altered to reflect the addition of the new the technique in Europe easier. At that time, indications were rennter, die ganze Fettschicht enthaltender Hautstücke. Zbl f Chir cal sections: Aesthetic, Breast, General Recon- Section Editors and Advisory Board members mainly correction of contour deformities, post-burn scars, struction, Non-Surgical Aesthetic, Craniofacial/Maxillofacial, and our newest affiliation with the Brazilian Society of Plastic Romberg disease, hemifacial microsomia, and chronic sores 2. Czerny V. Plastischer Ersatz der Brustdrüse durch ein Lipom. and Experimental/Special Subjects. In a newly negotiated con- Surgery. The first issue with these changes will be the March/ of the leg. In 2005, Coleman published the first book on fat Arch f klin Chir 50: 544, 1895 tract with our publisher, the page count has been increased to April edition.
grafting, where the procedure is exposed in detail along with 3. Lexer E. Die freien Transplantationen. Stuttgart, Enke 1919-24 accommodate submissions that are currently at an all-time high. We anticipate that these changes will result in an even higher numerous clinical applications coming from his experience.8 4. Peer LA. Transplantation of Tissues. Baltimore, Williams & Wilkins Most importantly, we have replaced the previous Editorial quality publication, and we are committed to continuously mak- Board with Section Editors who will help us streamline the ing improvements. As always, we welcome comments from thE AdIPOSE-dERIvEd StEM CELLS:
5. Holländer E. Die kosmetische Chirurgie. In: Joseph M. (ed.) Handbuch der Kosmetik. Leipzig, von Veit 1912 review process to ensure that accurate decisions are made our members regarding the direction of our journal. A crucial discovery
6. Miller CC. Cannula Implants and Review of Implantation Technics in regarding publication of submitted manuscripts. Our esteemed At the beginning of the new millennium, the University of Esthetic Surgery. Chicago, Oak Press 1926 Pittsburgh's team of plastic surgeons and researchers coor- 7. Chajchir A, Benzaquen I. Fat-grafting injection for soft-tissue aug- dinated by Bill Futrell, made a crucial discovery: that adipose mentation. Plast Reconstr Surg 84: 921-934, 1989 tissue is the greatest source of adult mesenchymal stem 8. Coleman SR. Structural Fat Grafting. St. Louis, Quality Medical cells, the so-called Adipose-Derived Stem Cells (ADSCs), capable of differentiating into other types of tissues.9-10 This 9. Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, et al. Multiline-accounts for the reparative properties of fat for replacing age cells from human adipose tissue: implications for cell-based damaged or missing cells, once transferred into another part therapies. Tissue Eng. 7: 211-228, 2001 of the body. Gino Rigotti and co-workers11 applied the thera- 10. Zuk PA, Zhu M, Ashjian P, De Ugarte DA, Huang JL, et al. Human adipose Tissue is a source of multipotent Stem Cells. Mol peutic effects of the ADSCs, for the first time in a human Biol Cell 13: 4279-4295, 2002 being. He successfully managed the radiation tissue damage 11. Rigotti G, Marchi A, Galié M, Baroni G, Benati D, et al. Clinical with complete restitutio ad integrum of the treated tissues, Treatment of Radiotherapy Tissue Damage by Lipoaspirate Trans- through a process of replacement in a series of patients. This plant: a Healing Process mediated by Adipose-derived Adult Stem could be considered an example of Regenerative Medicine.
Cells. Plast Reconstr Surg 119: 1409-1422, 2007 In May 2006, during the 17th Annual Meeting of the 12. Coleman SR, Mazzola RF (eds). Fat Injection from Filling to Regen- eration. St. Louis, Quality Medical Publishing 2009 European Association of Plastic Surgeons (EURAPS), Ric- cardo Mazzola, at that time president of the association, organized the first international panel: Fat injection, expand- ing opportunities. A wide variety of clinical applications of fat transfer in the field of Regenerative Medicine were pre-sented by the faculty. ISAPS News Volume 6 • Number 1 CONGRESS – PROGRAM
CONGRESS – FACUlTY
21st Congress of ISAPS - Geneva 2012
thE CONGRESS fACULty
ARGENTINA Jorge HERRERA, MD Wolfgang GUBISCH, MD Claudia MEULI-SIMMEN, MD Antonio Aldo MOTTURA, MD, PhD Dennis O. von HEIMBURG, MD, PhD Brigitte PITTET-CUENOD, MD Juan Carlos SEILER Sr., MD Norbert PALLUA, MD Jan Gordon POELL, MD AUSTRALIA Darryl J. HODGKINSON, MD Dirk F. RICHTER, MD, PhD Pierre QUINODOZ, MD Bryan C. MENDELSON, MD Rainer RUPPRECHT, MD Kai-Uwe SCHLAUDRAFF, MD, FEBO Katharina RUSSE-WILFLINGSEDER, MD Vakis KONTOES, MD, PhD Frank TREPSAT, MD Albert M. G. DE MEY, MD Theodore VOUKIDIS, MD, FACS, PhD Philip Kuo-Ting CHEN, MD Moustapha HAMDI, MD, PhD HUNGARY Csaba MOLNAR, MD THAILAND Sanguan KUNAPORN, MD Patrick L. TONNARD, MD Charan MAHATUMARAT, MD Ivar VAN HEIJNINGEN, MD Mohammad Reza FARAHVASH, MD Bouraoui KOTTI, MD Alexis VERPAELE, MD Ana Zulmira Diniz BADIN, MD Michael SCHEFLAN, MD Ricardo BAROUDI, MD Giovanni BOTTI, MD Carlos CASAGRANDE, MD Claudio CALABRESE, MD Cemal Tg SENYUVA, MD Gianluca CAMPIGLIO, MD, PhD Tunc K. TIRYAKI, MD DE SOUZA PINTO, MD, PhD Domenico DE FAZIO, MD Reza C. YAVUZER, MD Rolf GEMPERLI, MD Andrea GRISOTTI, MD UNITED ARAB EMIRATES Luiz Sergio TOLEDO, MD Raul GONZALEZ, MD Riccardo F. MAZZOLA, MD UNITED KINGDOM James D. FRAME, MD Ruth M. GRAF, MD, PhD Mario PELLE-CERAVOLO, MD Alison THORNBERRY Alan LANDECKER, MD Enrico B. ROBOTTI, MD Fabio Xerfan NAHAS, MD, PhD Kunihiko NOHIRA, MD Sherrell J. ASTON, MD, FACS Joao de Moraes PRADO NETO, MD Yasushi SUGAWARA, MD Daniel C. BAKER, MD Osvaldo Rib SALDANHA, MD Susumu TAKAYANAGI, MD Thomas M. BIGGS, MD Joao Carlos SAMPAIO GOES, MD, PhD Rie YAMASHITA, MD Jay CALVERT, MD, FACS Carlos Oscar UEBEL, MD, PhD Kotaro YOSHIMURA, MD Bruce F. CONNELL, MD Claudio L. DE LORENZI, MD Mutaz ALKARMI, MD Daniel DEL VECCHIO, MD Ghaith F. SHUBAILAT, MD Felmont F. EAVES III, MD, FACS Richard WARREN, MD Jose Abel DE LA PENA SALCEDO, MD COLOMBIA Lina M. TRIANA, MD Antonio FUENTE DEL CAMPO, MD COSTA RICA Alberto ARGUELLO CHOISEUL, MD MOROCCO Fahd BENSLIMANE, MD James C. GROTTING, MD, FACS CZECH REP. Bohumil ZALESAK, MD, PhD Abdennasser LAHLALI, MD Ronald P. GRUBER, MD, FACS DENMARK Anne Mette DONS, MD NEW ZEALAND Janek S. JANUSZKIEWICZ, MD Joseph P. HUNSTAD, MD Poul T. HARBOE, MD Gunnar KVALHEIM, MD Ronald Edward IVERSON, MD ETHIOPIA Asrat Mengiste, MD Julio Daniel KIRSCHBAUM, MD Glenn W. JELKS, MD, FACS Gilbert AIACH, MD PHILIPPINES Florencio Quiogue LUCERO, MD Mark L. JEWELL, MD Eric Michael AUCLAIR, MD PORTUGAL Jose Carlos Santos PARREIRA, MD Jeffrey KENKEL, MD Alain BONNEFON, MD, FACS Dana Mihaela JIANU, MD, PhD Roger K. KHOURI, MD Catherine MALEY, MBA CORNETTE DE SAINT-CYR, MD Constantin STAN, MD Timothy J. MARTEN, MD, FACS Emmanuel DELAY, MD Irina KHRUSTALEVA, MD, PhD Constantino MENDIETA, MD, FACS Henry DELMAR, MD, FACS Kirill P. PSHENISNOV, MD, PhD Gerard FLAGEUL, MD SAUDI ARABIA Jamal A. Habiballah JOMAH, MD Miodrag M. COLIC, MD, PhD Marie B. V. OLESEN Sebastien GARSON, MD SINGAPORE Woffles T. L. WU, MD Olivier GERBAULT, MD SOUTH AFRICA Peter Desmond SCOTT, MD Oscar M. RAMIREZ, MD Claude LE LOUARN, MD SOUTH KOREA David Dae-Hwan PARK, MD, PhD J. Peter RUBIN, MD Miguel CHAMOSA, MD, PhD Renato SALTZ, MD, FACS Javier DE BENITO, MD Henry M. SPINELLI, MD Antonio DE LA FUENTE, MD W Grant STEVENS, MD, FACS Jean-Francois PASCAL, MD Joan FONTDEVILA, MD GERMANY Johannes C. BRUCK, MD Igor A. NIECHAJEV, MD, PhD Simeon WALL Jr., MD Axel-Mario FELLER, MD, PhD SWITZERLAND Jean-Francois EMERI, MD Christian Joachim GABKA, MD Daniel A. KNUTTI, MD ISAPS News Volume 6 • Number 1 January – March 2012 CONGRESS – ABOUT GENEVA
CONGRESS – GENEVA SOCIAl EVENTS
ISAPS CONGRESS SOCIAL EvENtS PLANNEd
Kai-Uwe Schlaudraff, Md – Switzerland

View of Geneva to the south. Mont Salève (in France) dominates the foreground, with the white summit of Mont Blanc just visible behind it and 70 km Local Arrangements Chair away to the southeast. To the left of Mont Blanc is the point of Le Môle. Alain Fogli (France) and Nazim Cerkes (Turkey), the ISAPS Scientific Program Chairs, have gathered together a stellar faculty of more than 165 world oGeneva is situated in the southwestern end of Lake Geneva, where the lake flows into the Rhône River. It is surrounded by two mountain chains, the Alps and the renowned plastic surgeons for the 21st Biennial Congress of Jura, and is part of the Canton of Geneva.
ISAPS in Geneva. The scientific program offers five days of intense training, round tables, hands-on courses and video oSecond most populated city after Zurich presentations to keep you up to date with the latest surgical oOfficial language of Geneva – French techniques plus advice from our Masters in Plastic Surgery during sixteen Master Classes. Jan Poëll and I are honored to oTemperature in September – 10-20°C (50-70°F) welcome both ISAPS members and visitors from all over the oPopulation – 192,000 world to Geneva in September.
Discover a vibrant city that combines Swiss traditions with oElevation – 375 meters (1230 feet) the flair of a multitude of International Organizations head- oGeneva is the seat of the European headquarters of the of UN international co- quartered in Geneva. operation center with New York, the United Nations High Commissioner for Refu- Enjoy authentic Swiss food, wine and traditional music at gees, the World Health Organization, the World Intellectual Property Organization, the Opening Ceremony and let yourself be carried away by the Opening Ceremony features world renowned Mummenschanz World Meteorological Organization, World Trade Organization, World Organization incredible Mime-Masque Theater, Mummenschanz. of the Scout Movement, International Federation of Red Cross and Red Crescent Indulge in famous Swiss chocolate on one of our spe- Societies, International Committee of the Red Cross and Médecins Sans Frontières cial tours, discover the world's finest watches and jewelery (Doctors Without Borders). Multi-national corporations with offices in Geneva on Rue du Rhône, and experience a truly incredible night at include Serono, Eli Lilly, Colgate-Palmolive, Givaudan, Gillette, Procter and Gamble, Caterpillar, Reuters, Rolex, Patek Philippe, Richemont, Verisign, Oracle, Lexmark, Learn about the stunning technology of the Large Had- Lockheed-Martin, Hewlett Packard, AMD, Agilent, and McDonalds.
ron Collider (LHC) at the European Organization for Nuclear Research, the famous CERN, and hear our honored guest oThe Geneva Conventions, comprised of four treaties and three additional proto- speaker tell us about the origin of our universe, or simply cols, establishing the standards of international law for the humanitarian treatment enjoy nature in the breathtaking mountain scenery of Verbier, of victims of war were signed in Geneva in 1864, 1906, 1929 and 1949.
Gstaad, Zermatt or Mont Blanc.
oThe city has been referred to as the world's most compact metropolis and the Join us in Geneva for an unforgettable experience. We are looking forward to having you here in September 2012! oGeneva first appears in history as a border town, fortified against the Celtic tribe Helvetii, which the Romans took in 121bc.
Swiss singers and dancers will add local flavor to ISAPS oThe name, Geneva, is probably of Celtic origin with one theory proposing that Geneva is derived from Genévrier, the French word for juniper.
Attractions fêtes de Genève Large Hadron Collider, CERN ISAPS News Volume 6 • Number 1 January – March 2012 NATIONAl SECRETARIES
ISAPS has 74 National Secretaries in our 93 member countries. Any country with at least three members is eligible to elect a National Secretary to represent them in the leadership of ISAPS. Two new countries now qualify for a National Secretary and are highlighted in bold. Recently elected National Secretaries are also highlighted in bold text.
Juan Carlos SEILER Sr., MD Mutaz ALKARMI, MD Graeme J. SOUTHWICK, MD Imad AL-NAJJADAH, MD Katharina RUSSE-WILFLINGSEDER, MD Vagif GALANDAROV, MD, PhD Viswanathan SURENDRANATHAN, MD Tariq M. SAEED, MD Jaime O. SALCEDO-MARTINEZ, MD Vladzimir PODGAISKI, MD, PhD Fahd BENSLIMANE, MD Ivar VAN HEIJNINGEN, MD Jacques J. N. M. van der MEULEN, MD
BOSNIA-HERZEGOVINA Janek S. JANUSZKIEWICZ, MD Raul GONZALEZ, MD Petter Frode AMLAND, MD, PhD Mihail R. SKERLEV, MD José Agustín ESPINO, MD
Elizabeth HALL-FINDLAY, MD Daniel JACUBOVSKY, MD Julio Daniel KIRSCHBAUM, MD Florencio Quiogue LUCERO, MD Philip Kuo-Ting CHEN, MD Maciej KUCZYNSKI, MD Lina M. TRIANA, MD Jose Carlos Santos PARREIRA, MD Alberto ARGUELLO CHOISEUL, MD Dana Mihaela JIANU, MD, PhD Zdenko STANEC, MD, PhD Irina KHRUSTALEVA, MD, PhD Lefteris L. DEMETRIOU, MD Jamal A. Habiballah JOMAH, MD WhEN EvERyONE WEARS thE t- ShIRt
Bohumil ZALESAK, MD, PhD Mico Z. DJURICIC, MD Per BJERREGAARD, MD Martin HUANG, MD
Lina triana, Md – Colombia
Aldo MUIRRAGUI, MD Jozef FEDELES, MD Chair of National Secretaries Marjan FABJAN, MD Peter Desmond SCOTT, MD Sometimes we think innovation comes Timo PAKKANEN, MD, PhD
Kwan Chul TARK, MD, PhD, FACS Miguel CHAMOSA, MD, PhD Today I bring you an interesting perspective about two employees working in the same company. As you read from the outside, when in fact there is great opportunity to Konstantin MATITASHVILI, MD Ulf SAMUELSON, MD, PhD these words, think about our organization, ISAPS.
impact directly on service to our clients, customers, members Dennis O. von HEIMBURG, MD, PhD Daniel F. KALBERMATTEN, MD, MPhl John works hard and loves his job. Diana regularly sends her from the inside. We need to develop the value of our brand. Vakis KONTOES, MD, PhD Sanguan KUNAPORN, MD CV to other companies and obviously is not happy where she Once customers (or members) connect emotionally with the HONG KONG, CHINA Ming Shiaw CHENG, MD Bouraoui KOTTI, MD works. Interestingly, they work at the same company with iden- organization, they will "wear the company T-shirt" and begin Gusztav GULYAS, MD, PhD tical salaries and the same boss. Why is John happy with his job to increase their productivity and results and make a difference Gennadiy PATLAZHAN, MD Audy BUDIARTY, MD Marwan AL ZAROUNI, MD and Diana is not? with their customers. Mohammad Reza FARAHVASH, MD Lena ANDERSSON, MD The reason is pretty simple: they have different views about We need to make what our company does more visible to Ahmed NAWRES, MD
Gonzalo BOSCH, MD what their company sells. Diana thinks the company's prod- everyone. How is our product used so customers can benefit Margaret O'DONNELL, MD Mark L. JEWELL, MD uct is ordinary, with no real value. John knows his company from it without forgetting what make us different from others Betty Milagros PÁRRAGA DE ZOGHBI, MD is innovative in the field, continually making improvements and why our innovations make it possible for others to have a Gianluca CAMPIGLIO, MD, PhD that provide extra value for their customers. Diana believes better life. The difference between John's vision and Diana's is Hiko HYAKUSOKU, MD that working in this company was not what she had dreamed understanding that innovations expand the company's vision. of when she started her career and therefore has problems pro- How we can transform the symbolic value of our product to moting the product to her customers. John knows he is suc- values that our clients and collaborators will understand and cessful because he works for a company that makes it possible appreciate is the challenge.
for all of us all have a better life. The difference between a proud and happy employee and The difference is the symbolic value that each of them sees one that is not lies in the symbolic value of the brand. What is in their company. If we analyze their productivity, we discover the symbolic value of the ISAPS's brand? that John sells more than Diana, his clients are more loyal, and this contributes to make him more enthusiastic about his job.
ISAPS News Volume 6 • Number 1 January – March 2012 15195_Gonzalez_7.75x10.1.qxd:ISN 1/10/12 12:30 PM Page 1 Jan Poëll, Switzerland – Chair
Nazim Cerkes, Turkey – Chair
Foad Nahai, US Renato Saltz, US Daniel Knutti, Switzerland Alain Fogli, France Carlos Uebel, Brazil Enrico Robotti, Italy Miodrag Colic, Serbia Patrick Tonnard, Belgium Susumu Takayanagi, Japan Daniel Kalbermatten, Switzerland Catherine Foss – Ex Officio Joao Prado Neto, BrazilAntonio Mottura, Argentina Lina Triana, Colombia foad Nahai, US – Chair
Susumu Takayanagi, Japan Jan Poëll, Switzerland Dae-Hwan Park, South Korea Carlos Uebel, Brazil Sami Saad, Lebanon Antonio Fuente del Campo, Mexico Vakis Kontoes, Greece Fabio Nahas, Brazil Jan Poëll, Switzerland – Ex Officio Abel Chajchir, Argentina – Alternate Carlos Uebel, Brazil – Ex Officio Catherine Foss – Ex Officio Catherine Foss, US – Ex Officio CONGRESS SCIENtIfIC PROGRAM
Janek Januskiewicz, New Zealand – Chair
Alain fogli, France – Chair
James Frame, UK Nazim Cerkes, Turkey – Vice Chair Peet van Deventer, South Africa Renato Saltz, US Carlos Uebel, BrazilSusumu Takayanagi, Japan tom davis, US – Chair
Daniel Knutti, Switzerland Dirk Richter, Germany Joao Carlos Sampaio Goes, Brazil – Chair
Luiz Toledo, Dubai Fabio Nahas, Brazil Raul Gonzalez, Brazil Grant Stevens, US Sami Saad, Lebanon Jorge Herrera, Argentina Pierre Quinodoz, Switzerland Florencio Lucero, Philippines CONGRESS LOCAL ARRANGEMENtS
Raul Gonzalez, Brazil Kai Schlaudraff, Switzerland – Chair
Igor Niechajev, MD, PhD Catherine Foss – Ex Officio CONGRESS ExhIBItS
Grant Stevens, US – Chair
W. Grant Stevens, US – Chair
Antonio Mottura, Argentina Lina Triana, ColombiaRichard Zienowicz, USDennis von Heimburg, Germany Tunc Tiryaki, Turkey January – March 2012 March 2012
Igor Niechajev, Sweden – Chair
dAtE: 16 MARCh 2012 - 17 MARCh 2012
dAtE: 03 MAy 2012 - 08 MAy 2012
henry Spinelli, US – Editor & Chair
Meeting: International Symposium for Plastic Surgeons:
Daniel Knutti, Switzerland – Treasurer Meeting: The Aesthetic Meeting 2012
Tom Davis – US Secondary Optimizing Aesthetic Surgery Location: Vancouver, British Colombia
Dirk Richter, Germany – Assistant Treasurer Location: Munich, Germany
Bill Curtis – Springer venue: Vancouver Convention & Exhibition Centre
Miodrag Colic, Serbia venue: Sofitel Munich Bayerpost
Contact: American Society for Aesthetic Plastic Surgery
Richard Hamilton, Australia Victoria Ferrara – Springer Contact: Theresa Brackmann
Jan Poëll, Switzerland Jan Poëll – Ex Officio Olof Poëll, Switzerland – Ex Officio Catherine Foss – Ex Officio tel: +49 (0) 89 - 1890 46 28
fax: +49 (0) 89 - 1890 46 16
GOvERNMENt RELAtIONS
NEW PROdUCt EvALUAtION
dAtE: 05 MAy 2012 - 09 MAy 2012
Connie Neuhann-Lorenz, Germany – Chair
henry delmar, France – Chair
dAtE: 23 MARCh 2012 - 25 MARCh 2012
Meeting: 36th Annual Meeting of Iranian Society of Plastic
Meeting: XIII International Symposium of Plastic Surgery
MEdICAL PROCEdURES ABROAd
Location: São Paulo, Brazil
Location: Tehran, Iran
James frame, UK – Chair
Peter Rubin, US – Editor-in-Chief
venue: Sheraton Convention Center
venue: Razi Convention Center, Tehran University of
Joao Sampaio Goes, Brazil – Chair, Contact: Hanna Stutz
Foad Nahai, US – Deputy Chair Alberto Arguello Choiseul, Costa Rica Contact: Mehdi Fathi, MD
Catherine Foss, US – Managing Editor Jaffer Khan, UAE tel: +98 21 8850 6456-7
Lina Triana, Colombia Editorial Board
fax: +98 21 8850 6456-7
Tongtip Bongsadadt, Thailand Kirill Pshenisnov, Russia April 2012
David Smith, US Ivar van Heijnningen, Belgium dAtE: 11 APRIL 2012 - 13 APRIL 2012
dAtE: 18 MAy 2012 - 20 MAy 2012
Patrick Briggs, Australia Hirmand Heydeh, US Meeting: XLVII Congress of the Spanish Society of Plastic,
Meeting: CATBBAS: Controversies, Art and Technology in
Sanguan Kunaporn, Thailand Reconstructive and Aesthetic Surgery (SECPRE) Breast and Body Contouring Aesthetic Surgery and I Iberian-Scandinavian Congress on Plastic, Location: Ghent, Belgium
Renato Saltz, US
Reconstructive and Aesthetic Surgery Contact: Elien Van Loocke
dirk Richter, Germany – Chair
Jan Poëll, Switzerland Location: Palma de Mallorca, Spain
Alberto Arguello Choiseul, Costa Rica venue: Nuevo Pueblo Español
Susumu Takayanagi, Japan Contact: Carlos Lázaro
Lina Triana, Colombia Jorge Herrera, Argentina Luis Perin, Brazil Tom Davis, US tel: 34 91 571 93 90 / 34 91 571 92 10
James Frame, UK – Ex Officio fax: 34 91 571 93 90 / 34 91 571 92 10
Website: http://iberian-scandinavian-secpre-congress.com
ABAM MEEtING IN fLORIANOPOLIS, BRAzIL
Renato Saltz, Md – United States
ISAPS 2nd Vice President
The Fourth American-Brazilian Aesthetic Meeting took families. The social events held every night were fully attended place in the beautiful island of Florianopolis, Brazil on and many people enjoyed the Brazilian hospitality until the February 1-5, 2012. Colleagues from 15 countries attended early hours of the morning. this year's meeting endorsed by ISAPS, ASAPS and SBCP (The For the first time since its inception in 2009, the Ameri- Brazilian Society of Plastic Surgery).
can-Brazilian Aesthetic Meeting was sold out two months in New features at this year's meeting were simultaneous trans- advance. Attendees and industry representatives had a great lation during all sessions, an extra day of Instructional Courses, time and are already planning to return for the next one when a Resident Review Course, and a 3-hour Live Injection Evening ABAM moves back to the United States for the weekend of Feb-Session. All these educational activities took place before the ruary 14-18, 2013 . We have reserved the Park City Marriot dur-meeting even started on Thursday morning. ing President's Weekend (US) and Carnaval Holidays (Brazil). The attendance was over 300 plastic surgeons who enjoyed Visit our website and reserve your place for next year's meet- the beautiful beach resort of Jurere International with their ing, www.americanbrazilianaestheticmeeting.com ISAPS News Volume 6 • Number 1 January – March 2012 IN MEMORIAM
June 2012
dAtE: 27 SEPtEMBER 2012 - 30 SEPtEMBER 2012
dAtE: 01 JUNE 2012 - 03 JUNE 2012
dAtE: 21 JUNE 2012
Meeting: ISAPS Course - Lima & Machu Pichu
Meeting: ISAPS Course: Como
Meeting: ISAPS Symposium: Facial Rejuvenation – Paris
Location: Lima & Machu Pichu, Peru
Location: Como, Italy
Location: Paris, France
Contact: Julio Kirschbaum and Carlos Uebel
Contact: Karen Rogerson
venue: Palais des Congres
Contact: Marie Christol-Souviron
tel: +39 02 49542901
fax: +39 02 43911650
October 2012
August 2012
dAtE: 04 OCtOBER 2012 - 07 OCtOBER 2012
JANOS zOLtAN, Md
dAtE: 06 JUNE 2012 - 08 JUNE 2012
dAtE: 23 AUGUSt 2012 - 26 AUGUSt 2012
Meeting: IFATS 10th Annual Meeting
Meeting: Rome Breast Surgery 2012, Reconstruction and
Meeting: 4th European Plastic Surgery Research Council
Location: Quebec City, Canada
Aesthetic: Excellence as the common challenge Location: Hamburg Harbor, Germany
Contact: Jordan Carney
Location: Rome, Italy
venue: Freighter MS Cap San Diego
Contact: Organizing Secretariat
Contact: Kelli Gatewood
tel: +39 (0)6 32282204
tel: +49 3641 311 63 20
fax: +39 (0)6 3222038
fax: +49 234 325 20 80
Website: http://www.epsrc.eu
dAtE: 10 OCtOBER 2012 - 13 OCtOBER 2012
dAtE: 07 JUNE 2012 - 09 JUNE 2012
Meeting: 2nd World Congress of Plastic Surgeons of
Meeting: Beauty Through Science
ELEAzAR fIGALLO, Md
Lebanese Descent Location: Stockholm, Sweden
dAtE: 04 SEPtEMBER 2012 - 08 SEPtEMBER 2012
Location: Cancun, Mexico
venue: Stockholm Waterfront Congress Centre
Meeting: 21st Congress of ISAPS
Contact: Jose Luis Haddad Tame
Contact: Anna Eliasson
Location: Geneva, Switzerland
venue: Centre International de Conferences Geneve
tel: + 46 8 614 54 00
Contact: Catherine Foss
fax: + 46 8 614 54 29
dAtE: 09 JUNE 2012 - 11 JUNE 2012
dAtE: 12 OCtOBER 2012 - 14 OCtOBER 2012
Meeting: VII International Plastic Surgery Course
Meeting: Third World Congress for Plastic Surgeons of
Location: Ekaterinburg, Russia
venue: World Trade Center
dAtE: 12 SEPtEMBER 2012 - 15 SEPtEMBER 2012
Location: Xian, China
Contact: Irina Vlokh
Meeting: Laser Innsbruck 2012: Advances and Controversies
Contact: Dr. Wei Xia
in Laser and Aesthetic Surgery Location: Innsbruck, Austria
venue: Faculty of Catholic Theology of the University of
Contact: Katharina Russe-Wilflingseder, MD
dAtE: 14 JUNE 2012 - 16 JUNE 2012
dAtE: 26 OCtOBER 2012 - 30 OCtOBER 2012
Meeting: 57th Plastic Surgery Research Council
Meeting: Plastic Surgery 2012
Location: Ann Arbor, MI
Location: New Orleans, LA, USA
venue: University of Michigan
venue: New Orleans Convention Center
Contact: Catherine Foss
Contact: American Society of Plastic Surgeons
dAtE: 26 SEPtEMBER 2012 - 28 SEPtEMBER 2012
Meeting: XVIII International Course on Plastic &
Aesthetic Surgery Location: Barcelona, Spain
venue: Clinical Planas
dAtE: 16 JUNE 2012 - 19 JUNE 2012
Contact: Course Secretariat
Meeting: 4th Eurasian International Aesthetic Surgery
dAtE: 01 NOvEMBER 2012 - 03 NOvEMBER 2012
Meeting: ISAPS Course: Athens
Location: Istanbul, Turkey
Location: Athens, Greece
venue: Lutfi Kirdar Convention and Exhibition
Contact: Vakis Kontoes
Contact: Yagiz Tutuncuoglu
ISAPS News Volume 5 • Number 3 Cutting Edge 2012 Advert: ISAPS Journal. 5(w)"x 8.5(d)" Four Colour ISAPS NEW MEMBERS
ISAPS Executive Office
ISAPS-LEAP, continued from page 8
Admitted in January 2012
EXECUTIVE DIRECTOR Catherine Foss catherine@conmx.net This new ISAPS-LEAP collaboration results from their informal working relationship that DIRECTOR OF MARKETING developed following the 2010 earthquake in Maria SANChEz, Md
Osam AL NAJJAR, Md
Jodie Ambrose jodie@conmx.net Haiti. LEAP, headed by CEO plastic surgeon Romed MEIRER, Md
Jerry WEISS, Md
DIRECTOR OF ACCOUNTING and ISAPS member, Dr. P. Craig Hobar, was Christian RAINER, Md
already on the scene with an established clinic Wolfgang ROhRBAChER, Md
Stefano BRUSChI, Md
Alexander SIEGL, Md
in neighboring Dominican Republic, and MEMBERSHIP SERVICES MANAGER ISAPS channeled both members' financial Ritsu AOKI, Md
Sébastien tOURBACh, Md*
donations and surgical skills through LEAP's yuko ASANO, Md
yoshiko IWAhIRA, Md
SPECIAL PROJECT MANAGERS organizational infrastructure. While ISAPS Antonio Cesar ASSAO, Md
yuzo KOMURO, Md
members have the skills and the willingness Ricardo EUStAChO dE MIRANdA, Md*
to help, the society cannot manage global Rodrigo ROSIQUE, Md*
Mahmoud fandi BAtAINEh, Md
mobilization in times of urgent need. Mahmoud WREIKAt, Md
Nikolay GEORGIEv, Md
After 21 years, LEAP is still a relatively ISAPS EXECUTIVE OFFICE Ilyo StOyANOv, Md
small but active global volunteer organization Antoine ABI ABBOUd, Md
45 Lyme Road, Suite 304 M. Kamel ABOUzAhR, Md
Hanover, NH, USA 03755 working in 18 countries to provide surgical Omar fOUdA NEEL, Md*
care where none is available on a non-emer- Kenneth SMIth, Md
Phone: 1-603-643-2325 Constantin ChERtIf, Md
Fax: 1-603-643-1444 gency basis. In joining forces, ISAPS will Email: isaps@conmx.net encourage and enlist its member surgeons Oscar GOMEz, Md
dimitry SLOSSER, Md
Website: www.isaps.org who are skilled in reconstructive plastic sur- Sophocles NICOLAIdES, Md
gery to volunteer for short-term interventions Ashley NOvO-tORRES, Md
ISAPS NEWS Management
in disaster zones, while LEAP will coordinate Jiri BORSKy, Md
the mobilization they already provide through Gertrude Maria BEER, Md
J. Peter Rubin, MD (United States) Ondrej MEStAK, Md*
Nathalia KRÜGEL SChNEIdER, Md
their established infrastructure. Together, zdenek PROS, Md
Chair, Communications Committee
Brigitte PIttEt-CUENOd, Md
they will register, help prepare and credential daniel StEhLIK, Md
João Carlos Sampaio Góes, MD, PhD (Brazil) Ret WEttStEIN, Md*
Karel URBAN, Md
ISAPS volunteer surgeons to be ready when Raphael WIRth, Md*
Managing Editor
they are needed.
Mirjam zWEIfEL-SChLAttER, Md
Catherine B. Foss (United States) Carlos BUChELI, Md
LEAP has already developed an informal, h. Utkan AydIN, Md*
Barbara Jones (United States) early interest, sign-up form on their website Paata JANAShIA, Md
Editorial Board
Oleg tKACh, Md
Haideh Hirmand, MD (United States) ISAPS is planning an informational Simone hELLMANN, Md
Kirill Pshenisnov, MD (Russia) lunch-time session during the Congress in Anselm Walter hieronymus PINOt, Md
Martin COAdy, Md
Ivar van Heijningen, MD (Belgium) Alexander StOff, Md
Geneva in September. As the program is fur- John PEREIRA, Md
Manu SOOd, MS, MCh(Plast),
ther structured and developed, information ISAPS News is not responsible for facts as presented by filippos PAPAthEOdORAKIS, Md
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cific diagnosis and treatment of individual cases and is not ration. We recognize that on-the-ground assis- Csaba MOLNAR, Md
Steven COhEN, Md
intended for use by the layperson. The International Society hootan dANEShMANd, Md
tance in disaster zones is not for everyone. of Aesthetic Plastic Surgery, Inc. (ISAPS), the editors, con- Paul C. hOBAR, Md
tributors, have as much as possible, taken care to ensure Thus the ISAPS-LEAP Strike Force will look Srikanth GARIKAPARthI, Md
that the information published in this newsletter is accurate dennis J. hURWItz, Md
and up to date. However, readers are strongly advised to for those ISAPS members with reconstructive david REAth, Md
Cutting Edge.5x8.5_ISAPS.v2.indd 1 confirm that the information complies with the latest leg- Ebrahim hAtAMIPOUR, Md
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surgical skills and a willingness to help when islation and standards of practice. ISAPS, the editors, the daryush NAdERI, Md
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opinions expressed in this newsletter. Copyright 2012 by homayon zEhtAB, Md
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the International Society of Aesthetic Plastic Surgery, Inc. All rights reserved. Contents may not be reproduced in whole *Associate Member (Candidate)
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The ISAPS-LEAP Strike Force will respond in global crises. ISAPS News Volume 6 • Number 1 January – March 2012

Source: http://www.aesthetische-chirurgie.ch/docs/260612-105555_doc_de.pdf

Powerpoint presentation

For BROCK BIOLOGY OF MICROORGANISMS, THIRTEENTH EDITION Michael T. Madigan, John M. Martinko, David A. Stahl, David P. Clark Chapter 26 Microbial Growth Lectures by John ZamoraMiddle Tennessee State University © 2012 Pearson Education, Inc. Microbial Growth Control • Sterilization – The killing or removal of all viable organisms

Toxicity research report final-

Fireweed Toxicity Facts and Steven M Colegate BSc(Hons), PhD Photos: Forest&Kim Starr Fireweed Toxicity Facts and Perspectives Executive Summary • HPLC-MS analysis of fireweed collected in the Bega Valley (NSW) in the spring of 2006 and 2008 showed the presence of dehydropyrrolizidine alkaloid esters at levels up to about 220 milligrams per kilogram of plant.