Abstract: Pectoroplasty by chemical myoplasty and myopexy

Authors: 

1. Alain TENENBAUM, M.D; Ph.D; D.Sc-Facial Plastic Surgeon   

2. Mauro TIZIANI,Molecular Biologist.

What delegates will learn/take away from this presentation:

Delegates will learn with safe techniques an alternative to surgery here proposed to reshape male body , giving more appearance to existing muscles or more projection to the hidden muscles .

Movies and/or live demo shown in this presentation will proove the scarless immediate chemical isovolumetric myoplasty applied to male or female pectoroplasty.

 

 Introduction

The immediate chemical and medical Pectoroplasty  is a new weapon for dermatologists, plastic surgeons by using the techniques called Endopeel, which have like mechanism of  action a myotension, an isovolumetric  myoplasty and myopexy which  duration does not exceed 6 months.

Objectives

These techniques can be proposed to patients who wish to get a pectoroplasty, to patients who are not candidates for a surgical Pectoroplasty, to patients which refuse fillers ( It is known that most fillers in this area look obvious and lead to many complications.), threads ( more invasive, painful with less effects) 

The advantages of these techniques are important for the patients,because of

• the immediate effect,

• the absence of scar,

• the absence of down time,

• the absence of social eviction,

• as the transitory SHORT TIME complications which are limited only to ecchymosis.

Patients’ selection

• All patients who desire a surgical or non-surgical pectoroplasty can be candidates, as those not being candidate for any kind of filler (the fillers are too often sources of complications like granulomas, necrosis, migration, nodules etc.) . 
• Our criters of exclusion: Alcoholic patients, smokers, subjects under 18 years,patients using recently steroid anabolisants as gynecomasty, gigantomasty, breast cancer, breast feeding ,antecedents of pneumothrorax ...

Benefits and Advantages-Results

• The pectoroplasty effect is immediate and is perfectly visible 30 minutes after the end of the treatment with a maximum result 2 to 3 days after the procedure. 
• The pectoroplasty effect is early and will be relayed by the late peeling effect, specific to the techniques Endopeel.
• The treatment can be ineffective in 8% of the cases (bad technique). 
• The effectiveness of this treatment increases with the number or the repetition of the procedures because the basic muscular tone will be thus increasingly high on the scale of the tension of this last 
• It is easy to prove objectively the effectiveness of this treatment by treating for example only one side only on the same patient and by making a comparison between the treated side and the controlateral untreated one by pure visual inspection, or by photographic images, or by using points of reference. Results can be not only appreciated by inspection but also by palpation.
• These same parameters are taken again to evaluate the duration of the results objectively 
• The procedure is made comfortable for the pusillanimous patients thanks to the special anesthetic gel applied before the Endopeel procedure and giving satisfaction of painless technique to each patient, because the protocol can be adapted perfectly according to the timetable of the patient and also according to his social requirements 
• In the field of safety, so far and since 23 years these techniques started to be used, no legal procedure against a physician using the techniques Endopeel was announced and/or indexed to our knowledge. The only complications met are only transitory, like ecchymosis. 
• The report/ratio benefit cost of the treatment is accepted in the large majority of the cases.

  Techniques -Procedures

• The selection of the patients has been described above. 
• The material to be used is the following:

-                The patented preparation developed by Dr.Alain Tenenbaum & Mauro Tiziani.

-                Syringes 1 ml luer lock

-                Flexible needles for the body 25 or 27g

-                1 needle 18g to aspire the patented sterile solution.

-                An anesthetic specific gel containing lidocaine 23%, tetracaine 7%, using an emollient lipophilic lubricating gel like vector ONLY IF NECESSARY or Propofol IV ONLY IF NECESSARY 

-               A post, Endopeel, cold cream

-                Finally one not alcoholic disinfecting product, gloves and gauzes.

• The technique known as standard treats: the whole pectoral area except the areola as the mammary glandula ( for females).
• The basic technique consists in injecting in subcutaneous perpendicular to the plan of the muscles 0.10 ml of the patented preparation each 1cm2 and same in the perpendicular plan to the precedent following the direction and the sense to obtain the wished lifting effect using a criss-cross-technique.
• Errors: The intra vascular injection of the patented solution cannot be regarded as an error, considering the sclerosing effect of this substance. The injection into the motor plate or any nerve of phenic acid may slow down the speed of nervous conduction for short duration.
• Safety: It is recommended for toxicity reasons not to inject more than 40 ml/ day/ adult patient . In case a patient needs more than 40 ml, this technique can be divided in consecutive days, respecting the maximal dose per day per patient. 

Conclusions

Until now, the concept of Pectoroplasty was based only on volume augmentation concept, without taking care of the shape of the area. With  Endopeel techniques one acts not only on the myotension by preserving the muscular mass and without affecting the muscular contraction but also on the myoplasty and the myopexy .With this fact the indications of the fillers become more restricted and will apply only to the depressions which remain after tissue tension of the selected area. 

Finally chemical pectoroplasty with a handing-over in tension of tissues with tightening effect like the Endopeel techniques give a better shape of the pectoral area, project a nice convexity of the new pectoral shape , 

The technique Endopeel is a new strategic weapon for the Dermatologists and Plastic Surgeons enabling them to complete and/or maintain a Pectoroplasty which is an alternative to the surgery.