The AMWC International Anti-Aging Medicine Congress is one of the premier events in aesthetic medicine. Every year experts from all over the world come to Monaco to get the latest and most relevant knowledge in the industry. On April 4-7, the 16th AWMC Congress took place, during which estet-portal.com journalists managed to communicate with the world's best experts. Doctor of Medicine, professor, specialist in minimally invasive interventions and injectable cosmetology Ilya Meskhi also shared his personal experience. What drugs does the doctor choose, and why does he prefer to inject them in large quantities – read in the exclusive interview.
What procedures does Ilya Meskhi prefer to perform on his patients
Despite the fact that Dr. Meskhi's specialty – surgical oncology, he loves to work with skin quality (ed. – Ilya Meskhi international expert of Hyalual).
You work a lot in aesthetic medicine. Tell us, what do you like to start working with patients with?
I like to start my work with patients with an assessment of the overall condition of the face. Most of the time I work on the face, starting with improving the quality of the skin, and ending with volumization and sometimes lifting. I also love threadlifting, but I don't use it always and everywhere.
Is this surprising because you are a surgeon but prefer minimally invasive techniques?
Where a lift needs to be done, it should be done, and I'm all for it. But sometimes lifting is done where you can achieve better results simply by restoring volumes, and I do not agree with this.
How important is skin quality to a patient's appearance?
For me, the quality of the skin is as important as, for example, the contour of the face. This can be compared with asphalt: if the soil has subsided, then cracks appear on the asphalt, and if we restore the soil – cracks will still remain, and they need to be repaired.
Leather quality – this is very important and that's why I don't like botulinum toxins as such, because they don't work on the quality of the skin, but only temporarily block muscle activity.
I like to fight wrinkles, treating them, not temporary restoration.
Drugs that Ilya Meskhi uses in his practice
The doctor prefers to work with evidence-based products, namely pure hyaluronic acid, or its combination with succinic acid.
What drugs do you currently use in your practice?
At the moment for me the only drug of choice – it is pure hyaluronic acid, or hyaluronic acid combined with succinic acid, as they both have medical evidence of safety and effectiveness. All other drugs with impurities of various peptides, nucleotides, vitamins, and so on, are unacceptable for me.
Why such categoricalness?
Categoricalness comes from evidence-based medicine. It has not been proven that parenteral, namely intradermal administration of certain substances that have not been fully investigated, causes a positive effect, and they are not toxic, not autoimmune, and so on. That is, there is no evidence base. As soon as she appears – I will gladly take any medication.
Amount of drug administered and complications: is there a link
Ilya Meskhi prefers to inject drugs in fairly large quantities. Do his patients have complications related to this?
What are the most common challenges you face in your work?
Fortunately, while they passed me, but I am always ready for the most terrible complications, that is, for ischemia or hypercorrection, since I am a fan of the introduction of drugs in large quantities. And although so far I have not encountered complications, this does not mean that I am immune from this. No one is immune from complications.
What is the maximum amount of the drug, in your opinion, it is advisable to inject in one procedure?
A very interesting question, which, unfortunately, has no evidence base in medicine. At AMWC 2018, I noticed that many speakers are in favor of reducing the amount of drug injected into different areas so that the procedure is safer. But if you look at this issue from a surgical or anatomical point of view – small amounts sometimes do not solve anything, because we have much more tissue loss than an injection of 0.1 ml of the drug per point can replace. Therefore, to be honest, I do not count the amount of the injected drug or syringes, and I inject up to 6 ml.
Today, the introduction of up to 20 syringes of the drug into one zone is relevant. But negative consequences occur not only at the time of injection, & nbsp; Or maybe delayed?
That's exactly right, I don't inject 20 syringes into one area and to be honest I've never heard of that. Of course, hyaluronic acid in good preparations today is recombinant and pure, but we still do not know all its end effects, and what it leaves after resorption. Therefore, the introduction of such a large amount of the drug is, of course, unacceptable.
Maybe it makes sense not to inject such a large amount of the drug, but to redirect the patient to a plastic surgeon?
Very agree. Surgery has taken a backseat in recent years. There is an opinion that everything can be solved either with threads or fillers. But so far, it is surgery that occupies 70% of this niche, and it should occupy it, because there are moments that cannot be solved either by volumization or threads.
Gradually, surgery will probably fade into the background, but we still have to get to that point.
Therefore, if cosmetologists deal with the skin, which a surgeon cannot do, it will be great, especially since such an industry as molecular biology is developing now, and there are many good drugs.
What does the congress in Monaco mean to you?
Congress in Monaco – this is an opportunity for me personally to learn something new from manufacturers, and to a lesser extent – from reports. This congress is interesting for me as a surgeon, from the point of view of anatomy, so I go to more anatomical reports. I have my favorite experts, and it's the speakers that I will always listen to. All the other speakers are also doing a very good job, as they focus more on not harming the patient, which is very helpful. Therefore, I recommend that all doctors come to the annual AMWC congress in Monaco!
Note that Ilya Meskhi is an international expert of Hyalual.
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