4^th International Conference and Expo on Cosmetology & Trichology June 22-24, 2015 Philadelphia, USA

Seong Ho Jeong has completed his PhD from Korea University and Postdoctoral studies from Korea University School of Medicine. He is a Professor of department of plastic surgery, Korea University Guro Hospital. He has published more than 20 papers in reputed journals.

The purpose of this study was to assess the appropriateness of the clinical indications for the various reconstructive methods for burn alopecia and suggest an algorithm for individualized reconstruction. A review of 83 patients who underwent reconstruction for burn alopecia was conducted. Demographics, associated injuries, preoperative findings, surgical techniques, and postoperative complications were collected. From these data, we classified reconstructive methods based on the area, the scar quality, and the location of the burn alopecia, and investigated the clinical outcomes. Reconstructive methods included hair grafting (n=13), scalp reduction (n=21), scalp extension (n=14), and scalp expansion (n=37). Hair grafting was mainly performed for reconstruction of small, good-quality burn alopecia located in the frontal or parietal area. Scalp reduction was primarily used in small or medium burn alopecia in which scar quality was good or moderate. Scalp extension was mainly performed for reconstruction of medium and moderate-quality burn alopecia; scalp extension was particularly successful in the vertex region. Scalp expansion was the reconstructive procedure of choice for large, poor-quality burn alopecia. Twenty-eight (33.7%) patients experienced surgical complications and most of the complications were related to alloplastic implants used in scalp extension and expansion. The reconstructive method should be tailored to the conditions of the burn alopecia. Because scalp extension and expansion are associated with a high rate of complications, the authors recommend the use of these methods for large, poor-quality burn alopecia. On the other hand, hair grafting and scalp reduction are more appropriate treatment options for relatively small, good-quality burn alopecia.

Background: Scars in hair bearing scalp present unique challenges. While scar revision is the main tool in the reconstructive surgeon’s armamentarium, at times it may have either contributed to the scar problem or may not be an ideal choice. Hair transplantation offers an alternative in select cases. A review of 12 repair cases is presented with discussion of specific nuances particular to graft placement into scar tissue. Materials and Methods: Review of 12 cases of hair transplantation to repair scars in hair bearing scalp in patients with at least 1 year follow up. Results: All 12 patients had good to excellent coverage of their scars with hair transplantation using follicular unit harvest by either strip or FUE. In 3 patients, particularly dense and fibrous parts of the treated scar showed less growth but still a significant growth yield. Full growth often required 15 months. Discussion: In this series, both strip and FUE graft harvest was utilized. In both techniques, minimal trimming of subcutaneous tissue was performed so that the follicular unit was transplanted with slightly more surrounding tissue than for a standard hairline case. Recipient slits were therefore made slightly wider, averaging 1.25mm and minimal pressure was used in graft placement. Conclusion: In patients with scars in hair bearing scalp, hair transplantation offers an alternative to surgical scar excision. Careful harvest and placement of slightly thicker grafts into properly created recipient slits yields consistent and cosmetically pleasing results.

Rajaram Samant Crowned “Entrepreneur of the Year for three consecutive years 2012, 2013 & 2014” amongst several other prestigious awards, he is the Founder and CEO of Akumentis Healthcare Ltd, which is the fastest growing company in India. After graduating from the Grant Medical College, Mumbai, India, he did his MBA from Indian Institute of Management- Kolkata (IIM-C). His company received Emerging company of the year award in 2013 & All India Achievers Foundation crowned him as emerging leader of 2013. He posses special interest in research in trichology & skin lightening

Background: Hyperpigmentary disorders, commonly melasma and post-inflammatory hyperpigmentation (PIH), cause emotional stress to the patients decreasing their quality of life. Current topical formulations have drawbacks related to side effects and lack of demonstrated efficacy. New and improved formulations are needed for the treatment of hyperpigmentation.
Objective: To evaluate the efficacy & safety of Happyglowâ„¢, a new skin lightening product for the treatment of melasma.
Methods: Forty-five women with melasma enrolled and were advised to apply Happyglowâ„¢ cream twice daily for a period of 12 weeks. Happyglowâ„¢ is a proprietary formulation containing white curcumin, pterostillbene and other agents. Patients were evaluated at 6 weeks and 12 weeks for efficacy and safety.
Results:The proprietary skin lightening product improved facial hyperpigmentation under ambient light and Wood's lamp examination. Patients showed a significant decline in Melasma Area and Severity Index (MASI) readings (Baseline: 15.61 and Post-treatment: 7.58). Using patient assessment ratings, 89% were extremely satisfied or satisfied with the result. None of the subjects discontinued the therapy due to treatment related side effects.
Conclusions: Happyglowâ„¢ cream is a new effective and safe formulation in the treatment of melasma. This formulation may also be effective in post-inflammatory hyperpigmentation conditions.

Diana Proshutinskaia, Ph.D, MD. She is a leading researcher of department of dermatology. She has published 30 papers in reputed journals. She is a member of EADV, ESPD Vladimir Volnukhin, Ph.D, MD. He is a leading researcher of department of dermatology. He has published 80 papers in reputed journals. He is a member of EADV.

There is a view of the impossibility of recovery of skin pigmentation in the long-existing vitiligo lesions. We studied efficacy of UVB phototherapy in long-existing vitiligo. The 80 patients enrolled in the study had non-segmental vitiligo with duration of disease from 4 month to 42 years. The 64 patients underwent Narrowband UVB phototherapy (311 nm) in the cabin Waldmann UV 7001K (Germany), 16 patients - ultraviolet excimer laser irradiation with a wavelength of 308 nm (XTRAC XL PLUS, PhotoMedex Inc, USA). Median number of procedures per course was 54. Analysis of treatment results showed the efficacy of phototherapy in long-existing vitiligo. In patients with duration of disease less 10 years (n=54) the average percentage of repigmentation in lesions after a course of phototherapy was 46,4%, in patients with duration of disease 10-20 years (n=15) - 26,9%, in patients with duration of disease more than 20 years (n=11) - 36,8%. The correlation analysis in the general group (n=80) revealed weak inverse correlation of percentage of skin repigmentation and disease duration (Kendall tau rank correlation coefficient is -0,15). Three of the 11 patients with duration of disease more than 20 years after treatment had the percentage of skin repigmentation more 70% in vitiligo lesions, four patients – from 30 to 50%, four patients – less 15%. The patient with duration of disease 42 year showed percentage of repigmentation 30%. The findings suggest the ability of UVB phototherapy to stimulate repigmentation in vitiligo patients with long duration of disease, including more than 40 years.

Magda Rosa Ramos da Cruz is graduated in Nutrition from the Federal University of Paraná (1999) and Masters of Technology in Health at the Pontifical Catholic University of Paraná (2006). She is a nutritionist's Center for Advanced Paraná Videolaparoscopy (CEVIP), Specialization course coordinator in Nutrition Functional Medicine and Herbal Medicine and professor of nutrition course of PUCPR. Has experience in the area of Nutrition, with emphasis on Morbid Obesity, acting on the following topics: morbid obesity, bariatric surgery, functional nutrition and herbal medicine.

Obesity rates have increased in recent decades, with the estimate that 78.6 million American adults are obesos (CDC, 2014). In Brazil, data show that 50.8% of the population is overweight and 17.5% obesidade (VIGITEL, 2013). Concomitant the obesity epidemic, there was the rise of bariatric surgery, and gastroplasty intestinal bypass in Roux-en-Y, the surgical technique more utilizada (SBCBM, 2014). This study aims to determine the prevalence of hair loss during the first year of post-bariatric surgery. This is a retrospective, observational study from the collection of data from medical records of patients in a private clinic in Brazil. The sample consisted of 146 patients, 133 (91.2%) women and 13 men (8.9%) with a mean age of 39 ± 10.7, undergoing gastroplasty. 3 and 6 months after surgery, the prevalence of patients with hair loss was similar, 51 (34.9%) and 52 (35.6%), respectively. While at 1 year postoperatively, a significant reduction was observed, only 14 (9.6%) of the patients had this symptom. These findings may be related to dietary changes that occur in the first months of surgery because during the first three months, the energy content of the diet does not exceed 800 kcal/day. Only after 6 months, the reservoir volume increases, allowing a higher intake. The power postoperative should follow the dietary recommendations of the food pyramid adapted to surgery bariátrica (MOIZE et al, 2010), with balance between macro and micronutrients from food and nutritional supplements to compensate for nutrient deficiency caused by surgery avoiding excessive hair loss.

Magda Rosa Ramos da Cruz is graduated in Nutrition from the Federal University of Paraná (1999) and Masters of Technology in Health at the Pontifical Catholic University of Paraná (2006). She is a nutritionist's Center for Advanced Paraná Videolaparoscopy (CEVIP), Specialization course coordinator in Nutrition Functional Medicine and Herbal Medicine and professor of nutrition course of PUCPR. Has experience in the area of Nutrition, with emphasis on Morbid Obesity, acting on the following topics: morbid obesity, bariatric surgery, functional nutrition and herbal medicine.

The macro and micronutrients deficiency contribute to the appearance of clinical signs (PEDROSA, 2009). This study aims to quantify the protein, zinc and selenium intake from food, in one year of postoperativeY-en-Roux Gastric Bypass. The sample consisted of 95 patients, 84 (88.4%) women and 11 men (11.6%) with a mean age of 46 (20 to 64) years. Three months after surgery (n = 92), the intake of protein, zinc and selenium were: 43.4 ± 12.2g/day, 7.97 ± 3 mcg/day, 8.06 (0 to 32.24) mg/day, respectively. In six months (n = 88), the values were: 48.13 (20.87 to 113.61) g/day of protein, 10.59 (0.21 to 21.30) mg/day of zinc and 3.57 (0 to 38.66) mcg/day of selenium intake. In twelve months (n = 95), the intake was 51.28 ± 13.92g/day of protein, 9.61 (1.83 to 15.18) mg/day of zinc and 5.58 (0 to 28.96) mcg/day of selenium. As regards protein intake, was lower than the recommendation (min 60 g/day). The consumption of zinc and selenium varied in the three periods. With 12 months of zinc consumption was adequate (6.8 to 9.4 mg/day). However, the selenium intake was below the recommendations set (45 mcg/day). It is concluded that after surgery, in addition to balanced diet orientation, should be encouraged use of protein supplements, vitamins and minerals.

Dr. Sameera Irfan is a Consultant Oculoplastics Surgeon & Strabismologist, in Mughal Eye Trust Hospital, Lahore, Pakistan. She completed her M.B.B.S from Fatima Jinnah Medical College, Lahore, Pakistan and she is a gold medalist in ophthalmology. She is an active member of various societies like, Royal College of Ophthalmologists, Royal College of Surgeons, Ophthalmological Society of Pakistan, Pakistan Oculoplastic Association, Pakistan Association of Pediatric Ophthalmology, All India Ophthalmological Society, Oculoplastic Association of India.

Introduction: Benign Essential Blepharospasm causes a lot of ocular morbidity. A new surgical technique is being introduced to offer these patients a permanent relief. This study was conducted to assess how efficient and safe this technique is to relieve blepharospasm in such cases permanently. Materials and Methods: This is a prospective clinical, interventional study conducted at the oculoplastics department of a tertiary care centre. A total of 25 consecutive cases (50 eyes) were included in the study, conducted from Jan 2012 to Dec 2014. There were 19 females and 6 males between the ages 28-66 years (mean age 52 years). They were referred to the oculoplastics clinic because of their inability to keep their eyes open and frequent blinking. After a thorough history, a complete ophthalmological examination was carried out by a single examiner (SI). Any associated causes of ocular irritation like dry eyes, meibomitis and blepahritis were first treated with lid hygiene, lubricants, and tetracycline eye ointment massaged into the lid margins and wearing tinted glasses. After one month of this therapy, a limited orbicularis myectomy of both the upper and lower lids was performed under local anesthesia by a single surgeon. All cases were followed up after 1 week, one month, 3 months, 6 months and 1 year. The patients were asked about subjective improvement while the presence and extent of spasms was also noted objectively. Any complications like lid edema, lagophthalmos, and corneal exposure was also noted. Results: A total of 25 consecutive cases (50 eyes) were included in the study, with 19 females and 6 males between the ages 28-66 years (mean age 52 years). A positive family history was present in only 3 cases (12%), the rest were all sporadic. After treating or removing the triggering factors and a meticulous control of their diabetes and hypertension, all patients underwent a limited orbicularis myectomy of all 4 eyelids simultaneously, under local anesthesia by a single surgeon. After the first post-operative dressing, ecchymosis of lower lids was noted in 13 cases (52%); a slight lid swelling at the lateral lid margin was present only in 3 cases (12%). No lad lag, lid asymmetry or corneal exposure was noted in any case. The patient satisfaction was 100%. Conclusion: Limited orbicularis myectomy by this procedure was found to be effective in providing a long-term relief of spasms and was not associated with any complications. However, proper patient selection and treatment of triggering factors pre-operatively is mandatory.

1. Purpose Facial laceration is one of the most common traumas in outpatient plastic surgery. Early postoperative fractional laser treatment has been used to reduce scarring in many institutions, but the most effective energy parameters have not yet been established. This study sought to determine effective parameters in the treatment of facial laceration scars. 2. Methods From September 2012 to September 2013, 57 patients were enrolled according to the study. To compare the low and high fluence parameters of 1,550-nm fractional erbium-glass laser treatment, we virtually divided the scar of each individual patient in half, and each half was treated with a high and low fluence setting, respectively. A total of four treatment sessions were performed at one-month intervals using the same parameters and clinical photographs were taken at every visit. 3. Results Results were assessed using the Vancouver Scar Scale(VSS) and global assessment of the two portions of each individual scar. Final evaluation revealed that the portions treated with high fluence parameter showed greater difference compared to pre-treatment VSS scores and global assessment values, indicating favorable cosmetic results. 4. Conclusion Laser therapy is a promising method of scar treatment. Our institution compared the effects of high fluence and low fluence 1,550-nm fractional erbium-glass laser treatment for facial scarring in the early postoperative period and revealed that the high fluence parameter was more effective for scar management. Future studies should investigate the optimal number of sessions or protocols for scars in different locations.

Dr. Sameera Irfan is a Consultant Oculoplastics Surgeon & Strabismologist, in Mughal Eye Trust Hospital, Lahore, Pakistan. She completed her M.B.B.S from Fatima Jinnah Medical College, Lahore, Pakistan and she is a gold medalist in ophthalmology. She is an active member of various societies like, Royal College of Ophthalmologists, Royal College of Surgeons, Ophthalmological Society of Pakistan, Pakistan Oculoplastic Association, Pakistan Association of Pediatric Ophthalmology, All India Ophthalmological Society, Oculoplastic Association of India.

Introduction: There are many surgical techniques to correct involutional entropion, but they either lead to over-correction or recurrence. A new surgical technique is described here that takes care of both these problems. Materials & Methods: In a prospective study done at an Oculoplastic unit, 25 consecutive cases of involutional entropion with no remarkable horizontal lid laxity were included. There were 16 primary cases and 9 recurrent. The mean age of patients was 67.5+/-7.4 yrs. (S.D) with a range of 56 - 78 yrs. All were operated by a single surgeon (SI) using the procedure described below. They were reviewed at 1 week, 6 weeks and 1year postoperatively. The position of lower lid was recorded at each visit. Surgical technique: Under local anesthetic infiltration, skin incision was made 4 mm below the lash line, extending from lower punctum to lateral canthus. Orbicularis muscle was split; inferior orbital septum was divided to expose lower lid retractor complex. It was opposed to the lower border of tarsal plate by two 6/0 vicryl sutures tied in slipknots kept outside the skin wound. The skin was closed with continuous vicryl suture. The next morning, if over-correction noted, the knots were opened, the lid was gently massaged upwards; this loosened the sutures and the overcorrection was un-done. The sutures were tied and ends cut short. Results: Out of 25 cases, 9 (36%) needed correction. On repeat follow-up, none of the patients developed recurrence or over correction. Conclusion: This is a simple technique, easy to learn, avoids recurrence and overcorrection

Magda Rosa Ramos da Cruz is graduated in Nutrition from the Federal University of Paraná (1999) and Masters of Technology in Health at the Pontifical Catholic University of Paraná (2006). She is a nutritionist's Center for Advanced Paraná Videolaparoscopy (CEVIP), Specialization course coordinator in Nutrition Functional Medicine and Herbal Medicine and professor of nutrition course of PUCPR. Has experience in the area of Nutrition, with emphasis on Morbid Obesity, acting on the following topics: morbid obesity, bariatric surgery, functional nutrition and herbal medicine.

The incidence of hair loss at six months post-bariatric surgery is high and is associated with rapid weight loss, protein deficiency and lack of vitamins and minerais1. The aim of this study is to describe the nutritional status of patients with hair loss at six months of surgery. This is an observational-retrospective study, conducted through data collection from medical records of patients in a Private Clinic in Brazil. The sample consisted of 35 patients at 6 months after surgery, 30 women and 5 men, undergoing gastroplasty. The mean BMI was 28.2 kg/m2 ± 3.6 and the percentage of excess weight loss (%EWL) was 82.8% ± 26.5, it was being considered higher than expected for the time of surgery (50% or more of EWL%2). The caloric intake average was 991.9 kcal/day ± 212.4 and 25 (71.4%) of the patients used multivitamin. The average consumption of carbohydrate portions, protein sources, fruits and vegetables were 3.5 ± 1.5, 4 ± 1.42, 1.6 ± 1.2 and 1.76 ± 1 04, respectively. The average amount of protein intake was 50.7g/day ± 12.4, and 28 (80%) of the patients had protein intake less than ideal for the current weight. Based on the food pyramid adapted to bariatric surgery patients3, the portions of protein, fruits and vegetables were at the lower of the recommended. From this study, we identified the low intake of protein, fruits and vegetables, as well as non-adherence to multivitamin supplement and excessive weight loss as risk factors for hair loss after bariatric surgery.

Magda Rosa Ramos da Cruz is graduated in Nutrition from the Federal University of Paraná (1999) and Masters of Technology in Health at the Pontifical Catholic University of Paraná (2006). She is a nutritionist's Center for Advanced Paraná Videolaparoscopy (CEVIP), Specialization course coordinator in Nutrition Functional Medicine and Herbal Medicine and professor of nutrition course of PUCPR. Has experience in the area of Nutrition, with emphasis on Morbid Obesity, acting on the following topics: morbid obesity, bariatric surgery, functional nutrition and herbal medicine

Bariatric surgery is an effective intervention in the treatment of obesity, but lifestyle and diet should be monitored after this procedure to ensure success. The American Society for Metabolic and Bariatric Surgery established dietary recommendations to guarantee health maintenance, preserve lost weight, and avoid the occurrence of nutritional deficiencies. These guidelines are outlined in a nutritional pyramid made for patients in the late postoperative bariatric surgery phase. The purpose of the current study is to evaluate the life habits and diet quality of patients who have undergone bariatric surgery based on the specific food pyramid. Retrospective data analysis was performed using medical records of patients who had been followed for at least 6 months after bariatric surgery. The following data were collected from patient records: age, gender, education level, BMI, percentage of excess weight loss relative to the time of surgery, frequency of physical activity, use of nutritional supplements, usual dietary intake history, and fluid intake. Results were analyzed using descriptive statistics. We evaluated 172 patients records. In this study, there was a low prevalence of physical activity, use of vitamin-mineral supplements, and water intake. There also was low consumption of protein, fruit, vegetables, and vegetable oils. In addition, intake of carbohydrates, sugars, and fats were higher than the recommendations established by the pyramid. Results indicate that patients who have undergone bariatric surgery have an inadequate diet according to food evaluation with the specific pyramid. In the long term, this may lead to weight gain and vitamin and mineral deficiencies.