REJUVENATION OF THE AGING FACE

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PREFACE

I felt in love of facial endoscopic procedure for rejuvenation when, at the end of 90’s, I had the opportunity and honor to meet Nicanor Isse in Los Angeles; he taught me the basis of endoscopic technique for facial rejuvenation and I had great time with him. He was not only a great teacher but a great friend.
Since beginning of the 2000 I have been performing more than 500 of endoscopic facial rejuvenation procedures.
I’m deeply convinced that in our 45-55 yrs old patients, the center of the face is the more involved area in facial aging; the endoscopic procedure addresses to reposition the tissue in the center of the face, not pulling the skin laterally but repositioning the tissue following vertical vectors by a minimal incisions procedure.
In the 2013, I and my colleague and friend F.P. Bernardini published my technique M.I.V.E.L. (Minimal incisions Vertical Endoscopic Lifting) on OPRS (Ophtalmic Plastic and Reconstructive Surgery).
The descent of tissue is only one of the factors involved in the facial aging; the other two most important factors are loss of volume and skin aging: since the 2004, I have been performing fat graft in all my facial rejuvenation procedures and it improved both the volume of the face and the quality of the skin. In the last 6 years I changed my technique of fat grafting aiming to increase the benefit of the ADSC in order to achieve not only a volume restoration but also a tissue regeneration.
In the 2015 we published my technique S.E.F.F.I. (Superficial Enhanced Fluid Fat Injection) on ASJ (Aesthetic Surgery Journal).
In conclusion the three main factors involved in facial aging are: descent of tissue, loss of volume and skin aging hence. The facial rejuvenation procedure have to Repositioning tissue, Restoring volume and Regenerate the skin, in one word R3 REJUVENATION.
MIVEL and SEFFI are the two techniques addresses to R3 REJUVENATION.
This book is dedicated to young surgeons: facial rejuvenation is one of the most challenging procedure in aesthetic surgery; for many years it has been taught as a very invasive procedure, with long scars, wide dissection and prerogative of only experienced surgeons. I wish to say to young surgeons that it is not true: facial rejuvenation is for smart surgeons who can think out of the box and evaluating the harmony of the face and use the best and less invasive technique to achieve the best result for their patients.
The significant problems we have cannot be solved at the same level of thinking with which we created them.” Albert Einstein
Alessandro GENNAI, MD.

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INDEX

REJUVENATION of THE AGING FACE

(132 pages / 18 videos)

1. INTRODUCTION
1.1 Our philosophy of facial rejuvenation
1.2 The center of the face: the periocular and perioral aesthetic units
1.3 Anatomical basis
2. M.I.V.E.L. Minimal Incisions Vertical Endoscopic Lifting PROCEDURE
2.1 Surgical instruments
2.2 Preparatory marking and external anatomical landmarks
2.3 Infiltration
2.4 Endoscopic dissection
2.5 Fixation
3. S.E.F.F.I. Superficial Enhanced Fluid Fat Injection
3.1 The Philosophy
3.2 Histological Evidence
4. S.E.F.F.I. PROCEDURE
4.1 Instruments and Preparation
4.2 S.E.F.F. Injection
4.3 Vascular consideration
5. RESULTS
6. REFERENCES

About Bertrand LACOTTE

Dr. Bertrand Lacotte is a French board certified plastic surgeon based in the Caribbean since 1992. He was trained in Plastic and Reconstructive Surgery and microsurgery at the Free University of Brussels in Belgium. He was a pupil of Claude LASSUS and Madeleine LEJOUR. He is currently working in Centre Hospitalier Louise Constant Fleming in St Martin...

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