Medical Gluteoplasty by Chemical Myoplasty

contribution:

Scarless Immediate Isovolumetric Gluteoplasty by Chemical Myoplasty ( ENDOPEEL)

Alain.TENENBAUM,Mauro TIZIANI

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Abstract

Objectives:

Physicians will learn that with minimum material, low investment,with some techniques called Endopeel completely different  than what exist actually on the market,are an alternative or an additional request to/after surgery  proposed to reshape the gluteal area, allowing to lift, tighten or widen and project  at same moment in 3D the butts. Figure1

Those techniques can be proposed to patients who wish to get a gluteoplasty, to patients who are not candidates for a surgical gluteoplasty, to patients who refuse threads and/or sutures, to patients who refuse fillers,to surgeons who wish to complete their surgical procedure of gluteoplasty with a medical method avoiding the surgical look of any prosthesis at the gluteal contraction. Figure2

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

• THE IMMEDIATE EFFECT,
• THE ABSENCE OF SCAR,
• THE ABSENCE OF DOWN TIME,
• THE ABSENCE OF SOCIAL EVICTION
• THE ABSENCE OF PAIN DURING AND AFTER THE PROCEDURE
• THE ABSENCE OF IRREVERSIBLE COMPLICATIONS (SIDE EFFECTS IF THEY DO EXIST HAVE A SHORT TIME DURATION AND RESOLVE FROM THEMSELVES)

Summary :

The immediate butts lift  realized by isovolumetric gluteoplasty by chemical myoplasty, myopexy and myotension ( so called Endopeel) is a new weapon for plastic surgeons, to propose to their patients .

The techniques Endopeel consider each muscular unit like a viscoelastic elastomere which can be deformed in 3D applying vectors normal to the muscular plan and tensors parallel to the muscular plan choosing the direction and the sense of the movement to get a deformation.

MAIN TEXT

• Introduction
  
  Instead of using fillers to add volume to the butts, we have preferred to use a 3D isovolumetric repositioning of the muscles , by tightening or widening the butts, lifting them and projecting them.The isovolumetric projection of the butts is logic at the difference of adding volume with fillers, regarding the laws of the gravitation in Physics ( adding volume lead to more weight which has tendence to fall down) .
  
  Patients’ selection 
  All patients who desire a surgical or non-surgical gluteoplasty can be candidates, as those not being candidates for any kind of filler (the fillers are too often sources of complications like granulomas, necrosis, migration, nodules etc.) Figure3
• Best indication is not fatty gluteal area, sagging down .
• Our criters of exclusion: pregnant women, subjects under 18 years, patients using recently steroid anabolisants, patients with severe allergy to arachides, patients with prosthesis placed too much superficial.Figure4

Indications

• Gluteal Projection Figure5
• Butts Tightening Figure6
• Gluteopexy or Butts Lift Figure7
• Hardening the gluteal area
• Gluteal Atrophy Figure7
• Gluteal Stretch Marks Figure8
• Correction post Lipoplasty Figure9
• Reshaping Sporty Butts for males Figure10 and females
• Fashion Butts Figure11
• Butts in case of inferior member asymetry
• Banana Fold Lift or Infragluteal Fold Lift
• Post Surgery after Gluteal Prosthesis( only if the prosthesis is deep or has a inter muscular position)

Contra Indications

• Patients using Anabolisants ( in such case it s better to make the procedure 3 months after stopping anabolisants)
• Fatty Butts
• Pregnant Women
• Breast Feeding Women
• Patients with severe allergy to Arachides
• Patients with Prosthesis placed too superficial

Benefits and Advantages-Results
The gluteopexy effect is immediate and is perfectly visible 30 minutes after the end of the treatment with a maximum result 3 days after the procedure. 

• The gluteopexy 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 as percussion.
• These same parameters are taken again to evaluate the duration of the results objectively 
• In the field of safety, so far and since 19 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 main complications are only transitory, like ecchymosis. 
• The report/ratio benefit cost of the treatment is accepted in the large majority of the cases.

 Effect Duration

• 1st procedure : 1 month
• 2 nd procedure : 3 months
• 3 rd procedure : 6 months and after each 6 months this procedure needs to be done.
• We have many different protocols.

Material and Methods

The chemical patented mixture used for injection is made of carbolic acid and arachidonic acid.

The material to be used is the following :
- The magistral preparation like specific and patented oily acid carbolic formula Tenenbaum

- Syringes 1 ml luer lock

- Flexible needles for the body 25 or 27g

- 1 needle 18g to aspire the solution of oily carbolic acid

The technique known as standard treats: the whole gluteal area on all sides, the banana fold, eventually the areas under the banana fold as the area above the trochanteric line.
Areas of, love handles, can be treated as well if there is no fat excess. In case of fat excess a prior lipoplasty should be done and Endopeel technique can follow 1 month after the lipoplasty procedure.

The basic technique consists in injecting in subcutaneous perpendicular to the plan of the muscles 0.10 ml of oily acid carbolic each 4cm2 and same in the perpendicular plan to the precedent following the direction and the sense to obtain the wished lifting effect

Figure12

Side Effects and Complications

• Worst Complications are in relation with a dangerous copy of the original product using for ex hydroxybenzene . Those complications have led to death by extensive necrosis, infections, septicemia, fat embol and so on. Read more 
• Bad technique or bad indication lead mostly to no results
• Allergy to peanut is mostly seen with face procedures and is extremely rare with body indications.
• Ecchymosis are frequent with a max duration of 1 week
• Some papulas may appear because of the reaction to the Zn material of the needle used for injection and also because of the pens used for the marking . Such papulas disappear mostly from themselves after 3 days to max 1 week.
• Broken needles may appear if the MD doesnt change them ( patients pain, hard needle, curved needle) and doesnt select flexible needles

Conclusion
Until now, the concept of Gluteoplasty was based only on volume augmentation concept, without taking care of the gluteopexy. 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 gluteopexy with a handing-over in tension of tissues with tightening effect like the Endopeel techniques give a better shape of the gluteal area, project a nice convexity of the new gluteal shape , which is tighten too , with redraping of the oranges skin dued to cellulitis ( which gets the, iron effect, with Endopeel ). Also the eventual stretch marks will only optically disappear, being as well redraped through the, iron effect, of Endopeel.  

Keywords: endopeel,chemical myoplasty, chemical myopexy,retensado cutaneo,medical gluteoplasty,butts reshaping,gluteopexy,muscular repositioning.

References

Legend to Figures

Figure 1 : Endopeel is an isovolumetric medical myoplasty .On this 36 years old male, just the left butts has been treated and here is the result 30 minutes after procedure. It is easy to see the lifting effect ( myopexy), the tightening effect and the projection effect ( without any volume augmentation) .Endopeel techniques ( isovolumetric) is completely different of fillers ( adding volume)

Figure 2:  The surgical look of prosthesis at contraction

Figure 3:   Migration of PAAG Filler after 5 years

Figure 4: An implant placed too superficially is a contra indication for Endopeel

Figure 5:  Indication : Gluteal Projection –Female Vietnamese Patient-Results after 3 days

Figure 6: Indication: Butts Tightening- Left Butt treated on a 30 years old male-Result after 15 minutes. The tightening effect measures 4 cm

Figure 7: Left Gluteopexy on a 45 years old male- Result after 30 minutes.

The gluteal muscles were atrophied after a long decubitus post accident which immobilizes the patient.

Figure 8: Endopeel improves the optical effect of gluteal stretch marks without treating the stretch marks .

Right Gluteus treated on a thai male patient 30 years old, who had lost 30 kg in 5 months after a diet

( initial weight was 100kg). Result after 30 minutes

Figure9: Correction post lipoplasty- Left Butt has been treated , 6 months after lipoplasty with fat grafting .

Result after 30 minutes on a 36 years old brazilian female.

Figure10: Left Butts treated on a male Brazilian soccer of 23 years old.

Soccers run so much that they increase quickly the gluteal mass and volume, too heavy for their well shaped defined body. That s why they are asking to reshape and lift their butts .Result after 30 minutes.

Figure11: Fashion Butts on a 18 years Cambodian male

Figure12 Vectors and Tensors

References

1. Tenenbaum A (2009) La tecnica Endopeel- La medicina estetica-A.Redaelli, EEAFlorence.
2. Dewandre L,Tenenbaum A (2011) The Chemistry of Peels (2nd edn), Saunders Elsevier.
3. Tenenbaum A (2013) Medical Facelifts by Chemical Myoplasty, Myotension and Myopexy (Endopeel Techniques or Muscular SMAS Repositioning). Anaplastology 2: 116. doi: 10.4172/2161-1173.1000116

Legal Aspects

  From 07-2019, only one industrial pharmacy  in whole EU can deliver the product upon medical receipt as magistral preparation only to qualified MD belonging to the board certified      endopeel users .