Priscilla Yong

Document Sample
Priscilla Yong Powered By Docstoc
                                                          ISSN 1978-4260

 THE AESTHETIC SIDE OF MEDICINE                    VOL. 1 No. 2 November 2007

Guna Cocktail
Homeopathic Remedies

Dr. Alain Gondinet
"The Science of Meso-Pain"

Upcoming Stemcell Workshop
By Prof. Dr. Leow Chong Ngan

Penetrates Deeper,
Works Even Better
MTS Roller System

Prof. DR. Dr. Walujo Soerjodibroto, SpGK
Mesotherapy as a Part of
Obesity Nutrition Therapy                  Priscilla Yong
                                                       AESTHEDICA               1
Aesthetic Medicine Training                                         IMMA (Indonesian Medical Mesotherapy Association) is the
                                                                                              first Mesotherapy Education Center
                                                                     in Indonesia. IMMA Training present to gives alternative on
                                                                                     skin, face, and body health and beauty care

    Why IMMA Training?
       » Certificated
       » Accredited by Lembaga Nasional (DIKMENTI)
       » Professional Trainer & Up-to-date Curricullum
       » Hands on (direct action to the patient)
       » Comfortable training & practice room
       » Modern and high technology beauty products and tools

    Training Program
       » Basic Mesotherapy
       » Advanced Mesotherapy
       » Chemical Peeling with Easy TCA
       » Botulinum Toxin Type A-Mesobotox & Botox
       » Aptos Model
       » Filler

    New Program!

Cosmetic training by Medica Persada
Beauty and spa training by IMMA
Do you need highly skilled well-trained beauty theraphist staffs?

Medica Persada as Indonesian aesthetic training center pioneer
would like to hold an education program about how to choose safe
and high quality cosmetic products and also how to use it with an
update style. Our mission is to improve beauty and make up
knowledge and skill so that Indonesian women can be seen as
healthy and stylish ladies. We also would like to give knowledge
about safe and healthy cosmetics since a lot of products in market
contain toxic agents that can harm people.

Supported by professional teachers with education background,
Medica Persada Aesthetic Training Center is optimist that this
training will be useful for all who concern about appearance and

We also would like to hold beauty training for beauty care provider.
Since there are many misperceptions and mistakes done in beauty
services held by nonmedical workers, IMMA will hold beauty and
medical spa training starting December 2008. This training is                              For more information
conducted for spa or beauty salon owners or practitioners, nurses,                         & registration please contact:
physiotherapists and pharmacists. After 1 week training,
                                                                                           Mrs. Ati & Mr. Eko
all participant can practice the right way to perform many beauty                          IMMA (Indonesian Medical Mesotherapy Association)
services. Enhancement of the service quality will not only improve                         Jl. Kramat VI/13, Jakarta Pusat 10430, Indonesia
their ability, but also their customer’s satisfaction.                                     Tel: +62-21-390-9333/7077-1331/391-7373
                                                                                           Fax: +62-21-390-9333/391-7373/386-6811
                                                                                            THE AESTHETIC SIDE OF MEDICINE

                                                                                            Dr. Ratna H. Purwoko, Sp.KK

                                                                                            Editor in Chief
                                                                                            Dr. Reza Y. Purwoko, Sp.KK

                                                        From The Editor                     WHO’S INSIDE

                                                                                            Anju Siahaan
At first, in this wonderful opportunity I would like to say Taqoballahu minna wa minkum
Minal Aidzin walfaidzin, Happy Ied Mubarak to all readers of Aesthedica.                    EDITOR
                                                                                            Dr. Elizabeth Yasmine
                                                                                            Dr. Mirna Praptini Nurasri
In this second edition of Aesthedica, the Aesthetic Side of Medicine Magazine, the Man-
agement and Editorial Board wish to you our sincere hope that you will find all useful      REPORTER
                                                                                            Diah Martina
sources of information and innovation about Aesthetic Medicine in English.
                                                                                            ART, DESIGN & PRODUCTION
This issue contains reports from interviews with Aptos Trainers, Aesthetic Specialists,     Aiko Urfia Rakhmi
and Aesthetic Models and as an added value for readers; we present a report about
mesolipo by Prof. Walujo Soerdjodibroto throughout his years of experiences.                ADVERTISING AND MARKETING
But off course in its infancy a magazine is normally far from being perfect, and we real-   Abdul Ruhadi
ize that Aethedica is not an exception.                                                     Ade Nurbaeti
                                                                                            Hery Agus Santoso
                                                                                            Meryah Meliala
Even thought we really welcome any constructive advices and we invite you hereby to         Lucia Trisnawati
be a contributor for articles or any publication on exclusive issue and ideas related to    Resti

Aesthetic medicine.
May the Almighty God bless this modest yet useful endeavor which provide a practical        Nurnarisasi
vehicle for Beauty Skin Centers, Physicians, Aesthetic Specialist and all stakeholders in
                                                                                            SALES AND DISTRIBUTION
Aesthetic Medicine in Indonesia and beyond share their innovations and passion to all       Indar
Aesthetic Community.                                                                        Triyanto

                                                                                            PRINTED AND PUBLISHED BY:
Dr. Ratna H. Purwoko, Sp.KK                                                                 IMMA

                                                                                            CONTACT ADDRESS
                                                                                            Kramat VI No.13
                                                                                            Jakarta Pusat 10430
                                                                                            Tel: (+62)21 70771331
                                                                                            Fax: (+62)21 3909333, (+62)21 3917373
                                                                                            Account No. 6340 169 831
                                                                                            a.n. Mery Tay

                                                                                                               AESTHEDICA           3
                        Aesthedica November 2007

    cover story
    05 Beautiful lady by nature, healthy woman by lifestyle.
       We proudly introduce you to Mrs. Priscilla Yong.

    special feature
    06 Penetrates deeper, works even microneedle system.
       Another breakthrough is the

          People had made pricky device to create multiple
          trauma on skin so that applied drug can penetrate

    the profile
    12 Dr. Alain of mesogel and pioneer in mesotherapy for


    case report
    15 Alopeciahave shown that people underwent hair loss

         can experience psychological stress and disturb their
         perception as self and weaken confidence.

    25 Mesolipo can be used from the beginning if the
         problem was only overweight and not obesity.

    ask the reference
    17 Acthyderm allows a simple, rapid, and effective
       transdermal therapy, providing surprising results
         without surgery or injections.

    event update
    34 Aesthetic Seminar, Cosmobeaute Indonesia.

    GET YOUR OWN DEVICE NOW!                        28
    MONTHLY HIGHLIGHT                               35

Cover Story

       Pri scill a Y on g:
          Ca n you gu ess my age?
   B   eautiful lady by nature, healthy woman
                                                by lifestyle.
       We proudly introduce you to Mrs. Priscilla
  First time Aesthedica met this beautiful
                                            lady, we are so amazed by
  her hospitality. With her gorgeous smile
                                           , she gave us a slight look at a
  dimple on her right cheek.

  • Good afternoon, Mrs. Yong. How are
  Oh, never been better! Please call me Prisc

  • How do you keep your body figure, Pris?
  Just like any other woman, a proper diet
                                               of course.

  • And how do you do your diet?
  To be slim and fit like me, you don't have
                                             to torture
  yourself with eating almost nothing. I still
  enough carbohydrate. Well, it's not every
 day that I eat rice. Sometime I eat bread
 or noodle, in a small portion, of course.
                                                       give s me
 I also prefer fish than red meat. I eat          me sotreat me nt
 a lot of fruits, vegetable, and also
 some vitamins. Do you know how to
                                                and MTS rolle r, also
 consume vegetable in large portions?           give s me slim min g
 You can make vegetable and fruit juice
 with an extractor! My favourite is cai
                                                   crea m for my        With her healthy life style and her cons
                                                                                                                 istency in
                                                                       taking care of her skin, no wonder she
 sim, pineapple, and watermelon. And one              tu mm y."       woman in her late twen
                                                                                                              looked like a
 more important thing. No snacking! That'                                                             ties. We were so surprised when
                                          s                                 she showed us pictures of her daughters
 the key of any successful diet,                                                                                     . Looking at her,
                                                                         nobody would ever guess that she alrea
 I guess.                                                                                                       dy has 2 children,

                                                                         These are some pictures of my sweet daug
 • What about your skin treatment?                                                                                 hters. Here is Givela
                                                                         (14) and Ghania (11). Ghania often sings
 For my face, I give trust to dr. Reza. He                                                                        in some public occa-
                                            gave me mesotreatment        sions. Maybe she will follow her moth
 and MTS roller. Indeed, many of my friend                                                                      er's footsteps to be a
                                               s told me that my skin    public figure one day.
glows brighter since dr.Reza handled me.
                                             Mm.. it's not for promo-
tion that I speak like this. You can ask my
                                            friends yourself. He also    Well, keep up the good work, Priscilla. Your
gives me slimming cream for my tumm                                                                                   healthy lifestyle is a
                                            y. Sometime if I felt like   very good example for Aesthedica reade
I eat too much, I put stagen overnight.                                                                            rs. As an actress, pho-
                                          With so, I wake up with a      tomodel, property dealer, and also a moth
fresher feeling in my tummy.                                                                                           er of two, you are
                                                                         truly gorgeous! ( YA S M I N E ) +

                                                                                                                      AESTHEDICA               5
    Special Feature

                     Penetrates De
                       Works Even Better
                       Dr. Elizabeth Yasmine

    M     any transdermal drugs are in-                                     then, many injection methods are used, such as epidermic, multi
                                                                            pricking, and point per point. Each has its own advantages and
          vented to give certain results.                                   indications.2
    But behind those drug inventions,
    many equipment and methods are                                          Another evolution in me-
                                                                            sotherapy is the micro-me-
    also invented to give way to drugs                                      sotherapy. Unlike general
    so that they can penetrate deeper,                                      practice of mesotherapy
    hence work even better.                                                 that uses 4 mm-length nee-
                                                                            dle into the deep layer of
                                                                            the epidermis, micro-me-
    Transdermal drug delivery is based on the absorption of drug            sotherapy uses an ultra
    into the skin after topical application. But the application of med-    thin needle of 23 G x 2 mm
    ical or cosmetic products on skin is always affected by the stra-       and allows injection in the
    tum corneum which acts as barrier and constitutes a strong elec-        superficial layer of the der-
    trical impedance. However, the lipophilic nature of the stratum         mis (papillary layer). This
    corneum in particular mean that the useful transport of charged         technique is able to reduce
    and/or highly polar drugs requires an effective enhancement             the undesirable effects and
    strategy. 1
                                                                            risks of the traditional me-
                                                                            sotherapy such as, break-
    Transdermal delivery system not only have to provide drug to            ing the small veins and
    the skin under stable conditions and in a form convenient to pa-        small arteries, damage of
    tient, but also serve to locally increase the permeability of skin to   the deep dermis, and pain-
    larger, charged, or hydrophilic drug molecules while minimizing         ful injections due to super-
    irritation.1                                                            ficial nerves.2

    The most common method is to spread cream on the skin. De-              The development of mesogun was a major breakthrough to re-
    pending on the substance, the penetration is very different. Un-        duce the pain and to inject drugs at the same depth. Many me-
    fortunately, most of the cosmetic substances cannot penetrate           soguns are now available with many helpful features, such as
    the skin.2                                                              skin stabilizer, deep injections, no leakage between injections,
                                                                            and many more.2
    Mesotherapy was once developed by Michael Pistor by admit-
    ting drugs to epidermis with needles. It goes directly to the tar-      Another breakthrough was the microneedle system. People
    get cells, hence works better that just topical application. Since      had made pricky device to create multiple trauma on skin so

 that drug applied can penetrate deeper. The first generation of      collagen induction.2,4 Using MTS, the epidermis remain intact
 this device has uneven needle length and uneven distance be-         because the microprick channels created by the device will be
 tween needles. And now, Microneedle Therapy System (MTS) is          closed within hours. This is an advantage of the MTS, that we do
                                     available with microneedle       not need to damage epidermis to induce collagen production.
                                       roller. Each roller has 200    These channels also act as new transcelular route for drug to
                                       micro needles and this         go through, hence it will improve the penetration of therapeutic
                                       system    offers   different   active ingredients applied.2,3,5
                                       needle length for different
                                       purposes. For home care,       A clinical studies conducted in South Korea have shown that
                                       it is advised to use 0,2 mm    MTS rollers are more effective in increasing the thickness of the
                                       while professionals use        skin than IPL and just as effective as ablative treatments, such as
                                       0,5 mm to 2,0 mm.2,3           chemical peel, dermabrasion, laser resurfacing, and non abla-
                                                                      tive machine based treatments such as CO2 laser, Fraxel, and
                                       After drug have been ap-       Thermage.6
                                       plied, the device should
                                       be rolled horizontal, ver-     “Doctors may try the roller on half their face, or their hand. They
                                       tical, and diagonal. The                                                       ”
                                                                      will see the difference with the other half then. Purwoko said,
                                       end points are erythema        very convinced and satisfied with the result he experienced
                                       and small puntate bleed-       himself. Purwoko does not feel the need to invest on expensive
                                       ing. The bleeding are so       machine such as laser or others high-cost devices. Instead, he
                                       small, it will stop without    prefers to stock MTS Roller which gives the same or even better
                                       any effort, said dr. Reza Y.   results but has a lower price. Hence, the cost bore by patients is
                                       Purwoko, Sp.KK.                also lower.
                                       MTS roller is a high qual-
                                      ity roller, which has sharp
 and rustproof needles, has uniform length thickness and spaces       No Needles Needed
 apart, and the needles will not come off. Micro channels created     Some patients afraid of the painful procedure of mesotherapy,
 by the roller have equal sizes and depths.2,3 This is why USA        although mesogun was created to minimize the pain. Transder-
 Food Drug Administration (FDA) have approved MTS roller in-          mal delivery systems can be enhanced with occlusive adhesive
 stead of other rollers. Some of other rollers are actually get the   plaster. People might be already familiar with nicotine or hor-
 approval from their local countries such as Korean FDA, China        monal patch.
 FDA, etc.2,3
                                                                      Not quite satisfied with the passive transport as plaster, people
 The micro injury created by the roller will promote healing and      try to invent the active transport system using ultrasonic or ion-

                                                                                                                      AESTHEDICA            7
    Special Feature

    U    sing MTS, the epidermis remain intact because the microprick channels
         created by the device will be closed within hours. This is an advantage
    of the MTS, that we do not need to damage epidermis to induce collagen

                                                                         ideal driving force that favors the transdermal passage of the
                                                                         marked substance. Hence, mesoporation is an effective method
                                                                         for transdermal ionized and neutral drugs.1

                                                                         The electroporation impulses lead to a temporary reorgani-
                                                                         zation of the cellular membrane allowing the creation of new
                                                                         channels through cells and the cellular membrane,the Elec-
                                                                         tropores, which facilitates the flow of water- and non water-sol-
                                                                         uble molecules. Due to the shape of the electropores created by
                                                                         Acthyderm, neutral and undissociated molecules can also be
                                                                         transported into the cells.2   ( YA S M I N E & M I R N A )   +

    tophoresis. Iontophoresis enhances drug delivery by electrore-       References
    pulsion, electro-osmosis, and electrically induced skin perme-       1. Amitrano C, Cappelletti R, Torre R. New trends in drug
    ability changes. But the depth of drug penetration has not been         deliver y systems: mesoporation, a novel technique.
    able to compete mesotherapy injections.3                                American Journal of Mesotherapy, 2006.
                                                                         2. Pur woko RY. Increasing Topical Product Penetration.
    Then people used electroporation, a stem method from ionto-             Pertemuan Ilmiah Tahunan Perkumpulan Dokter Spesialis
    phoresis. Unlike iontophoresis, electroporation can channel-in          Kulit dan Kelamin XI Surabaya. 2007.
    positive, negative, and neutral molecules by creating new chan-      3. Microneedle therapy system. Cited from http://www.
    nels through the cells and the cell-membrane.1,2               on October 10th 2007.
    A research was conducted to compare the penetration of radio-        4. Greco JF. Micro needling and injecting platelet rich plasma
    active-labelled substances by using iontophoresis and mesopo-           to enhance collagen synthesis and skin tightening. 2006
    ration by Achtyderm. The research concluded that iontophore-         5. Joon KB. Microneedle therapy system. 2006
    sis is minimally efficient in transdermal transportation of the      6. Moon HS, Kim SE, Ko DS, Lee AY. Collagen induction
    marked substance administered. Mesoporation delivers 99% of             therapy in mouse (IPL vs micro-needling). 2006
    mesotherapy formulation at the depth of centimeter and ap-           7. Schied G. A different kind of mesotherapy. American
    proximately 65% at the depth of 6 centimeters, while traditional        Journal of Mesotherapy, 2005.
    iontophoresis delivers only about 10% of the product at the
                                                                         8. Dobradin A. Mesoporation – a new addition to
    depth of 1 cm.1,8                                                       mesotherapy and no-needle drug deliver y. American
                                                                            Journal of Mesotherapy, 2007.
    This result may be related to the lipophilic nature of the stra-
    tum corneum which is an electrical impedance. Mesoporation
    improves migration of the radioactive compound under the
    effect of the electrical field and the electric roll-on creates an

MTS Roller

                         There are THREE major advantages
                         for using MTS Roller:

                                       MTS Rollers are revolutionary. They do the same job that                            100
                                                                                                                                   Moisture Absorption
                                       lasers and other ablative methods by increasing                                             into the skin
                                       the production of collagen with minimal damage to the
                                       protective layer of the skin.

                                                      MTS Rollers are effective. In fact, just as effective                 60
                                                      as lasers, IPL, Thermage and other ‘machine-based’
                                                                                                                                              Up to 3000% of
                                                      treatments, but at a fraction of the cost
                                                      to practitioners and patients.

                                                   MTS Rollers are safe. “Non-surgical and non-                             20
                                                   ablative” means more ‘forgiving’ and skin-friendly
                                                   treatments. Patients experience little or no pain,                                  Mosturizer

                                                   downtime, and risk for complications.                                      0
                                                                                                                                        0.03-1%       1-5%         3-20%      75-85%
         Burning Scar Treatment

                                                                           TYPE                  PRODUCT          LENGTH          METHODS

                     Before                                                Personal Use          CR2              0.2mm           Skin restoration
                                                                                                 CR3              0.3mm           Improve Alopecia
                                                                                                                                  Homecare Therapy
                                                                     CR3                                                          Drug delivery
                                                                           Clinical Use          CR5              0.5mm           Skin Whitening,
                                                                                                                                  Improve skin pigmentation,
                                                                                                                                  Improve wrinkle (eye area),
                   After 2 weeks
                                                                                                                                  Improve Alopecia,
                                                                                                                                  Collagen Induction,
                                                                     CR5                                                          Drug Delivery
                                                                           Medical Use           CR10             1.0mm           Improve wrinkle,
                                                                                                 CR20             2.0mm           Collagen induction,
                                                                                                 CR30             3.0mm           Improve skin scar,
               After 1 month                                                                                                      Cellulite treatment,
                                                                                                                                  Skin thickness,
                   Alopecia                                                                                                       Face firming,
                                                                                                                                  Face body lifting

          Before           After 6 weeks
                                                     1.    Clinical Study: MTS (Microneedle Therapy System), 5-Month Study; Dr KB Joon, Department of Dermatology,
             Acne Treatment                                Dongguk University, S. Korea (2006).
                                                     2.    Collagen Induction Therapy Comparison (IPL vs Micro-Needling); Drs HS Moon, SE Kim, DS Ko, AY Lee, Dep. of
                                                           Dermatology, Eulji University School of Medicine and Dongguk University, S. Korea (2006).
                                                     3.    Product Comparison Study (MTS Roller vs Dermaroller); manufacturer’s shelf-life and usage study, including
                                                           known references on materials and usage.

          Before               After

                                                                                                                                                       AESTHEDICA                      9

     As simple as that!
     Dr. Mirna Nurasri Praptini

     A    lthough full sets of MTS Roller can only be bought by
          medical personnels and certified therapists, any profes-
     sional beauty practitioners can in fact learn how to use MTS
                                                                           used if you want to enhance the drug penetration. Cleanse the
                                                                           treated area with a sponge after anesthesia is confirmed. Topical
                                                                           anesthetics that usually used are those that contain benzocaine
     Roller in only two hours. Patients can also bring their personal      (20%), lidocaine (4%), tetracaine (2%) and pramoxine HCI (1%).
     MTS Roller home and use it by themselves after being taught
     by their therapists. By using the equipment at home, the cost of      The next step is to 3) apply solution #1. Clinical studies conduct-
     therapy will be lower and the result will be better and sooner to     ed by Dr. B.J. Kim showed that ‘double’ applications increase
     be seen. The best result can be seen after 6 months of only one       efficacy of the treatment modality. Step 4) is using the roller.
     per month visit to the clinic.                                        The treatment area should be divided into subdivisions before
                                                                           applying the treatment roller (CR5, CR10, CR20 and/or CR30)
     To treat one patient it is needed a wash, one treatment roller        with the similar pressure on the skin, vertically, horizontally and
     (MTS Roller model CR5 and up), a topical anesthetic (e.g.,            diagonally. Don’t change course while rolling and don’t apply
     benzocaine, lidocaine, tetracaine, pramoxine HCI), two topical        pressure too much.
     aesthetical ingredients(e.g., peptide, retinol, collagen), a sooth-
     ing mask, moisturizer and sun block (SPF 30). To applicate the
     anesthetic, clinicians may also use another model of MTS Roller
     which is model CR2. Other options include ultrasound, Ionto,
     topical skin nutrients, and microdermabrasion to smooth the                                  Figure 2. Roller Direction
     skin and achieve better result.
                                                                           After that we 5) apply solution #2 as much as it takes to the
     Procedure to Use MTS Roller for Clinicians                            treated area. Ultrasound can be administer to the treated area
     MTS Roller application consists of 7 steps that take approxi-         to enhance serum absorption. The step after that is 6) relaxation
     mately 20-30 minutes.                                                 when we apply a mask pack or other soothing application for
                                                                           relaxation. The last step is 7) postcare or completion. In this step
                                                                           we can give nutrition, moisturizer and sunblocks.

                                                                           Cleaning MTS Roller
                                                                           MTS Roller can stand multiple contacts with “cold sterilization”
                                                                           agents such as germicides (phenol, ethyl alcohol), Cidex™ (glu-
                    Figure 1. Steps using MTS Roller for Clinicians        taraldehyde), and common ultrasound cleaning devices. Rinse
                                                                           rollers thoroughly and return to its protective case after drying.
     The first step is 1) preparation where we thoroughly cleanse the
     application area then 2) applying local anesthetic as needed –        Storing MTS Roller
     recommended for CR5, CR10, CR20, and CR30. The CR2 can be             The MTS Roller came with a protective case and sealed in a ster-

ilized pouch. After each use (and cleaning) return the MTS Roller      ment area(s) into subdivisions, for instance the forehead, nose,
back to the protective case. Always treat the MTS Roller gently        cheeks, mouth, and neck area. Apply MTS-Roller with the same
and avoid any contact with hard objects or surfaces. All rollers       amount of pressure on the skin. Roll the same areas vertically,
that have been dropped should be discarded and keep rollers            horizontally and diagonally.
out of reach of children.
                                                                       Step 3) is active ingredients application such as peptides or vita-
Indications                                                            min A, C, E and betacarotene. Allow a few minutes for the appli-
Basically MTS Roller can be used with any kinds of serum or            cations to be absorbed to firm and tone skin. Step 4) Protection,
cream to enhance the penetration of ingredients but MTS come           additional nutrition, moisturizing and sunblocks management is
with its own lines of therapy. Various clinical studies have been      recommended. The last step is to 5) clean roller and return it to
conducted to treat scars, wrinkles, large pores, hyperpigmenta-        its protective case.
tion, stretchmarks and alopecia.
                                                                       The treatment should be repeated between two to seven times
Contraindications                                                      a week. Should the skin feel sensitive after a treatment, it is ad-
Do not use MTS Roller on irritated skin, infected skin, fungal skin    vised not to use the instrument again until the skin feels com-
infections, active acne, rosacea, eczema, psoriasis, severe solar      fortable. The tiny holes, formed from the use of the treatment,
keratosis, raised moles and/or warts, and/or any open wounds           in the epidermal layer seal naturally within a day. The more fre-
or sores.                                                              quent the treatment, the better the result. At the beginning it is
                                                                       better to use the MTS Roller at bedtime every second day until
Side Effects                                                           skin becomes accustomed to the roller. After the second or third
No side effects from using MTS Roller when used as directed            week you may roll daily if you think it is necessary. Do not use
under the advice or supervision of a trained skin care profes-         the MTS Roller vigorously or more than once daily unless pre-
sional are shown by clinical studies. The recorded side effects        scribed by a professional skin care specialist.
are infections when were done in nonsterile places. Serums,
creams and/or any other cosmeceutical topical can only be used         Cleaning MTS Roller at Home
under supervision of a trained skin care professional.                 You may use denture tablets dissolved in water to clean the
                                                                       MTS Roller. Denture tables are enzyme cleansers and enzymes
Procedure to Use MTS Roller at Home                                    take off fat as well as reduce bacteria. While not as effective,
To achieve better and faster result, it is recommended that the        alcohol (isopropyl) can also be used. Consult a pharmacist for
patient use a personal MTS Roller model CR2 or CR3 for applica-        the best advice for a sterilization solution. Open the cleaning
tion of vitamin solutions and moisturizer with sun block proper-       tray and place the white cleaning pad in the larger half of the
ties. Please remember to give proper instruction to patients on        tray. Fill the cleaning tray with sterilization solution and roll the
how to use their personal roller. Usually the treatment time take      roller into the pad with medium pressure. Leave the MTS Roller
time from 5 to 10 minutes depending on the size of the area,           in the cleaning solution for about 15 to 30 minutes – ensure that
given two to three times a week. Advise the patient to stop and        the roller drum is constantly wet with the cleaning solution. Af-
call if they experience sudden and prolonged irritation in the         ter cleaning, rinse with tap water and return the roller to the
treatment area.                                                        protective case and allow it to air dry. Replace the case lid until
                                                                       the next use. q

                                                                                              Tips from the expert:
                                                                           When applying anesthetic cream before using the
                                                                           roller, for example BLT mesomedica anesthetic cream,
                  Figure 3. Steps using MTS Roller at Home                 don’t forget to cover the skin with thin plastics for 15
                                                                           minutes to maximize cream penetration. Patient will
                                                                           feel less pain and more comfortable during proce-
Step 1) is for cleansing and boosting. Firstly clean the skin, rinse
                                                                           dures. And never forget to inform patient about the
thoroughly and dry with towel, after that applying topical so-             possible side effect of thickness sensation and non-
lution such as vitamin C or MTS VItaPep Serum for the maxi-                sensoric of the lips. (Dr. Reza Y. Purwoko)
mum MTS effect. The next step is 2) MTS Roller, divide the treat-

                                                                                                                         AESTHEDICA            11
     The Profile

                                Dream of A
                                Better Tomorrow
                                Alain Gondinet, MD

     O    n October 27th 2007, our correspondent Mirna Nurasri had
          an opportunity to interview a world renowned doctor in
     mesotherapy, doctor Alain Gondinet, in the middle of his visit to
                                                                         When you meet a doctor, in a minute you (the doctor) can know
                                                                         everything about the patient because he (patient) wants to tell
                                                                         the doctor everything. This is the only job in the world that make
     Jakarta. In this rare piece their conversation ranging from book    it possible for people to trust you. And when I go around the
     publication plan, Indonesian attentive doctors to his prediction    world I meet many people and I have many good friends along
     of cancer among urban citizen.                                      the way. It is very interesting. And the second reason that in this
                                                                         world you have goals. My goal, other than to succeed, is I also
     What do you still want to reach in your career?                     want to transmit knowledge. And in this profession I can share
     I want to introduce antioxidative mesotherapy to the world be-      my knowledge to many people.
     cause it has not only aesthetic purpose but also in reducing pain
     in rheumatology. with specifis coctails of medicine, vitamin and    Many cosmetic practitioners and patients are overdoing their
     organic silicon. I also want to find an antioxidative society and   treatments, do you have something to say about this?
     to teach more students.                                             When we do treatment, laser, etc, we have to think about the
                                                                         consequences of medical device, think about oxidative stress
     What is your best experience with a patient?                        these treatments produce because free radicals are the cause
     It is when a long time a go, a patient came with an ambulance       of many diseases. After doing a stressful therapy you have to
     having a kind of sciatica and came home with his feet.              give an antioxidative therapy, with antioxidative mesotherapy
                                                                         and antioxidants. And the other thing is to train the mentality of
     And the worst?                                                      doctors that our body needs natural treatment.
     To do something wrong to patients, to misdiagnose a patient.
                                                                         What beauty means to you as a doctor who practice in beauty
     Do you think the pain management with mesotherapy is al-            business?
     ready the best pain (rheumatological                                                               I think the thing is to say no when
     related) therapy available?                                                                        the treatment is too much. Asia
     Mesotherapy is very efficient in spe-                                                              and Europe have different con-
     cific pain such as in rheumatology but                                                             cept of beauty and doctors have
     of course it is not efficient for cancer                                                           to know when they’re giving
     pain. And yes, I think mesotherapy in                                                              too much treatments to patients
     rheumatological pain is one of the best                                                            and they have to think about the
     therapy. Also because I’ve practiced it                                                            health of the patients. In Asia peo-
     myself to more than 1500 patients.                                                                 ple have higher treshold of pain
                                                                                                        and agreeing easier to what their
     Have you ever tried it to yourself?                                                                doctors suggesting. In Europe,
     Yes. Because I hate to take pills,                                                                 patients ask many questions.
     I hate drugs.
     In your very often trip around the                                                                 So what do you think about the
     world, what make you keep going?                                                                   future of beauty?

The market ? It’s increasing. For example, there are more than
100 companies in the world producing filler. It’s incredible. So          This is your first trip to Indonesia?
the market is very very increasing. Five years ago there are only         Yes, and what amazed me is the doctors here are very enthusi-
a few companies producing filler, only one.                               astic and eager to learn, it’s different from in Europe. Indonesia
                                                                          is very interesting. I can feel the hospitality. It’s the same across
Including your company?                                                   Asia but it’s different here. Of course it’s different than in Santo
No. No more company because now it’s too late for me. I prefer            Domingo, where everybody is singing.
to act and work as a consultant which is better.
                                                                          My last question is personal question. It’s an usual question in
First, you started as a nutritionist, why switch to mesothera-            Indonesia, can you..?
py?                                                                       You mean my status? (Laughing) I’m married and have a 22-
Because in my first practice, I have found that nutrition alone           year-old son studying in Westminter and he wants to be a spe-
is not sufficient. One of my teacher in Necker-Enfants Malades            cialist in data system. I have two cats. I love martial arts, karate.
taught me about mesotherapy, the classical one. And after this            I swim, competition swimming. I did a lot of sports, horse riding
lecture I though it’s not possible to practice without mesothera-         and everything. What more do you want to know ? Give me a
py. The beginning was 5 years after I started my practice I knew          million dollar.. just kidding.
about mesotherapy then I took lessons, I tried and (the result
was) succesfull. Twenty seven years ago mesotherapy was not
only for beauty but of course for pain. At that time, mesolift
wasn’t even exist and wasn’t thinkable. I also learn about the
work (of mesotherapy), magnetic field of the body, which later
brought me to pollution, chemical pollution. It’s all the same,
free radicals. In lessons, in France, we have to talk not only              1950   Birth in Paris
about meso, but also about nutrition, pollution, macronutrition             1975   Graduated as a medical doctor (MD) in Necker-Enfants Malades
and many things that can help patients. But the food in Europe                     Paris, France
is different with the food you have in Asia.                                1981   Graduated in Mesotherapy from Necker Hospital in Paris, France
                                                                            1981   Member of the French Society of Mesotherapy
                                                                            1986   Graduated in Nutritional Medicine from Saint Michel Hospital in
So you combine mesotherapy with nutrition?
                                                                                   Paris, France
Sometimes I use it alone sometimes I combine with nutrition                 1986   Founder of Bionuclea (cosmetic company), inventor of Mesogel
and antioxydants.                                                           2002   Registered in London, UK (private practice in Mesotherapy and

Do you have any message for practitioners and patients in In-               2003   Cofounder of Antioxydative Meso Therapy concept with Dr André
                                                                                   Dallo Bourguignon
                                                                            2004   Antioxydative Mesotherapy trainings in France
I think the patients in town will be suffering very shortly to pol-         2005   Speaker on Mesoplus Therapy at the World International Congress
lutants and there’re going to be more cancer, more stress. The                     on Antiaging in Monte Carlo, Monaco
traffic is incredible, lot of big cars. It’s the mentality. If you have     2005   Speaker at the 6th ICOS in Istambul
big cars the mentality is different. I don’t know about the village         2005   Trainings in Luxor centre in Almaaty, Kazakhstan
                                                                            2005   2-day training in London, UK
but I think we have the same problem in the city. They eat Ameri-
                                                                            2005   Speaker in Congrès International de Médecine Esthétique, Paris
can food so we will have obesity, we will have cancer.
                                                                            2005   Workshop and speaker on Antioxidative Mesolift, Dermoesthetic
                                                                                   Congress in Bratislava, Slovakia
Where can I read about the antioxidative mesotherapy?                       2006   Workshop Antioxidative Mesolift in Dermaparty congress (Smok-
It will be published in a shortwhile, I hope. The book will be                     ovec Slovakia)

about the foundation of mesotherapy that many doctors don’t                 2007   Trainings of Antioxidative Mesolift for doctors during Antiaging
                                                                                   congress in Monaco (March)
know. And not only for beauty because pain therapy is (also)
                                                                            2007   Trainings for Middle East doctors in Cairo
very important.                                                             2007   Course in Hopital Tarnier (Diploma for injections technics) in Paris
                                                                            2007   Speaker on Mesolift to RIDES assiociation in Bendor (France)
Will this information will be available in the internet ? Because           2007   Speaker at the 7th ICOS in Istambul (workshop)
if you want many people to know about this knowledge you’ve                 2007   Paris Communication and workshop at the 9th ESCAD congress
                                                                                   (The Mitochondrion: the real aim of the Mesotherapy ?)
got to make it available in the internet?
Of course. But after the course.

                                                                                                                                  AESTHEDICA              13
Case Report

Case Report of Mesoalopecia
Dr. Regine Rina & Dr. Reza Y. Purwoko, Sp.KK

A   24 years old female consulted a physician for suddenly
    having a localized hair loss one week before. She told the
doctor that she has always used good quality products for her
hair. Her history told no similar symptoms in family, no autoim-
mune diseases, and no atopy.

Physical findings are patchy hair loss with follicular opening,
normal skin of the scalp, smooth, slightly erythematous. There
is no visible signs of inflammation, no scarring and no atrophy.
The hair pull test was positive at the peripheral of the patch. The
exclamation point hairs and nails abnormalities were not found.
She was diagnosed as alopecia areata.

The psysician treated her with intradermal injection of Triam-
cinolone acetonide 10 mg/mL 0,1mL (using 1mL syringe and              self and weaken confidence. These implications have helped to
Mesalyse 32-gauge), followed by point per point superficial           build a multibillion dollars business around the globe. In Amer-
intradermal and nappage intraepidermal injection of mesoalo-          ica alone, 25 billion dollars were spent in this industry every
pecia therapies. A combination of intralesional corticosteroid        year. It’s no wonder then if many claims have arisen to state that
with mesoalopesia were given every 2 weeks for five times. The        various products can be used to treat alopecia or baldness. Food
cocktail of mesoalopecia consists of Minoxidil, Biotin,and Dex-       and Drug Administration can’t ban these false products because
panthenol.                                                            yet no harm were done. So it lies to true scientists and genuine
                                                                      practitioners the responsibility to give proper explanation and
For home treatment the psysician gave her topical Minoxidil           care to patients. From treatments available, mesoalopecia has
2%, to be applied twice daily just on the affected area. And oral     shown as one new hope in giving better nonsurgical therapy for
supplements for nutrifying the growth of hair, once a day.            alopecia, in this case report, alopecia areata (AA).

The initial regrowth was seen in 4 weeks. There were several          Definiton
hair shafts approximately 5 mm of length and several vellus           AA is a nonscarring type of alopecia that presents as a localized
hair of the patch. At further treatments, the hair regrowth was       loss of hair, round or oval shaped (patchy hair loss). AA can af-
significantly increased, either normal hair shafts or vellus hair.    fect any hair-bearing areas. The most common presenting site is
Afterwards we treated her only with mesoalopecia. At her last         the scalp, but other areas such as the eyebrows and the beard
treatment, the hair regrowth was seen in almost all of the af-        areas may demonstrate hair loss with or without scalp involve-
fected areas (more than half of the area) with a predominantly        ment. There are several other patterns of hair loss that may be
appearance of normal hair shafts. The mesotherapy was contin-         seen in AA. Alopecia totalis (AT) refers to the total absence of
ued once a month and daily home treatment was continued too,          scalp hair and alopecia universalis (AU) is complete loss of all
as a maintenance therapy.                                             body hair.

Introduction                                                          Epidemiology
Studies have shown that people underwent hair loss can ex-            Prevalence of AA in the US general population is 0,1-0,2% and
perience psychological stress and disturb their perception as         worldwide prevalence of AA is similar as in the US. All races and

                                                                                                                     AESTHEDICA            15
     Case Report

            s             tudies have shown that people underwent hair loss can expe
                          psychological stress and disturb their perception as self an

     both sex are affected equally by AA. AA can occur at any age
     from birth to the late decades of life. Peak incidence appears to
                                                                           of patients and most commonly seen in patients with severe
                                                                           forms of AA.5
     occur at age 15-29 years. As many as 44% of patients with AA
     have onset at younger than 20 years, and onset in patients older      Precipitating factors can be found in 15,1% of patients with AA.
     than 40 years is seen in fewer than 30%.5                             Major life events, febrile illnesses, drugs, pregnancy, trauma,
                                                                           and other events had been reported, but no clear conclusions
     Pathophysiology                                                       can be drawn. Despite these findings, most patients with AA fail
     The pathophysiology of alopecia areata remains unknown.               to report a triggering factor preceding episodes of hair loss.5
     Many evidences support the hypothesis that AA is an autoim-
     mune condition. The process appears to be a T-cell mediated,          Diagnosis
     but antibodies directed to hair follicle structures have also been    Diagnosis usually can be made on clinical grounds; a scalp
     found in AA patients. Antibodies to anagen phase hair follicles       biopsy was seldomly needed, but can be helpful when clini-
     were found in as many as 90% of AA patients compared to fewer         cal diagnosis less certain. The most characteristic feature is a
     than 37% of control subjects.1,5 The outer root sheath is the         peribulbar infiltration, which was described as appearing similar
     structure targeted most frequently, followed by the inner root        to a swarm of bees. The infiltration was often spared and usually
     sheath, the matrix, and the hair shaft.5 As a results, the growth     involves only few affected hairs in biopsy specimen.
     of the hair is impaired and the shaft is subsequently narrowed
     and tends to break off at the skin surface. The hair loss is poten-   A significant decrease in terminal hairs is associated with an
     tially reversible because the inflammatory process spares the         increase in velllus hairs, with a ratio of 1, 1:1 (normal is 7:1).
     stemcell rich bulge area.3                                            Other helpful findings include pigment incontinences in hair
                                                                           bulbs and follicular stellae. A shift occurs in the anagen-telogen
     Clinical Features                                                     ratio, which is not specific. The normal anagen-telogen ratio is
     AA is often asymptomatic, but some patients (14%) experience          approximately 90% to 10%; in AA 73% of hairs were found to be
     burning sensations or pruritus in the affected area.5 Likely, it      in the anagen and 27% in the telogen.5
     was noticed by friends or hairdressers. The absence of clinical
     signs of inflammation is remarkable because histopatologically        Differential Diagnosis
     there are always inflammatory infiltrations around hair follicles     The other problems to be considered include trichotillomania
     in active lesions. The scalp appears normal in AA, with follicular    (unusual shapes and sizes), tinea capitis (erythema, scalling,
     openings, no scarring and no atrophy. The presence of smooth          and crusting locally on the scalp), scarring alopecia and post-
     slightly erythematous (peach color) or normal-colored alopecic        traumatic alopecia (the absence of follicular ostia or some de-
     is characteristic.
                                                                           gree of atrophy) and telogen effluvium (mimicking diffuse pa-
                                                                           tern of AA).
     The presence of “exclamation point” hairs, particularly at the
     periphery of affected areas, is pathognomonic but that is not         Treatments
     always found. These short broken hairs, whose distal ends are         Treatments are used to be believed to stimulate hair growth,
     broader than the proximal ends, illustrate their inherent sequent     but no evidence exists that they influence the ultimate natural
     of events: follicular damages in anagen and then a rapid trans-       course of disease. The most common therapies include corti-
     formation to telogen. A positive pull test at the margins of the      costeroid injections, corticosteroid creams, minoxidil, anthralin,
     patch usually indicates that the disease is active, and further       topical immunotherapy, and phototherapy. The choice of agents
     hair loss can be expected.                                            depends on patient’s age (children do not always tolerate ad-
                                                                           verse effects), extent of conditions, and the patient’s personal
     Nail abnormalities can be seen in patients with AA. Pitting is the    preferences.
     most common finding. Nail involvement was found in 6,8-49,4%

d weaken

   For adults with less than 50% scalp in-
   volvement, the first option usually is an
   intralesional corticosteroid, followed
   by corticosteroid cream, minoxidil, and
   anthralin. For adults with more than
   50% scalp involvement, topical immu-
   notherapies and phototherapies are
   additional options.                                           First Condition                            After 10 Weeks of Treatment

                                                                               Both systemic and topical psoralen plus UV-A (PUVA) thera-
   Intralesional steroid (Triamcinolone 2,5-5 mg/mL) is the first line
                                                                               pies have been used. The initial response rate varied from
   treatment in localized patches. In a study including 84 patients, re-
                                                                               20-73%. The relapse rate is high (50-88%). Most patient re-
   growth on treated areas was present in 92% of patients with patchy
                                                                               lapse within few months after treatment stopped. Adverse
   AA and 61% of AT. Regrowth usually was seen within 4-6 weeks in
                                                                               effects include burning and possibly an increased risk of skin
   responsive patients.5 Less than 0,1 mL was injected intradermally
   per site using 30-gauge needle, and injections were given to cover
   the affected areas (approximately 1 cm between injection sites) for
                                                                               Topical immunotherapy is defined as the induction and peri-
   maximum volume of 2-3 mL. Injections are administered every 4-6
                                                                               odic elicitation of an allergic contact dermatitis by topical ap-
   weeks3,4,5 Adverse effects mostly include pain during injection
                                                                               plication of potent contact allergens. Commonly used agents
   and minimal transient atrophy (10%). The atrophy rarely can be se-
                                                                               are diphencyprone (DPCP) and squaric acid dibuthylester
   vere and permanent.5
                                                                               (SADBE). Treatments are provided weekly. The patient is first
                                                                               sensitized directly on the scalp with 2% concentration on a
   Few studies have been performed regarding the efficacy of topical
                                                                               small area (2x2 cm2), the following week a low concentration
   steroids, and their usefulness remains under debate. Fluomcino-
                                                                               (0,0001%) is applied. Then, the concentration is increased
   lone acetonide cream 0,2% or Betamethasone dipropionate cream
                                                                               slowly every week as needed until a mild, tolerable allergic
   0.05% twice daily induced a satisfactory response in 61% patients;
                                                                               contact dermatitis is elicited. The median time to achieve sig-
   children younger than 10 years responded better.3,5 Rates of re-
                                                                               nificant regrowth was 12,2 months. Some patients showed
   growth vary greatly (27-89%).5
                                                                               regrowth after 18 months. The relapse rate after reaching sig-
                                                                               nificant regrowth was 62,6%. Most studies have a success
   Minoxidil appears to be an effective treatment of AA in patients
                                                                               rate of 30-50%.3,5 Adverse effects include cervical lymph-
   with extensive disease (50-99% hair loss). Response rates in that
                                                                               adenopathy and pigment changes. The mechanism of action
   group vary from 8-45%. The 5% solution appears to be more effec-
                                                                               is unknown; may be antigenic competition. q
   tive. No more than 25 drops are applied twice daily regardless of
   the extent of the affected area. Initial regrowth can be seen within            References
   12 weeks, but continued application is needed to achieve cos-                                             ,
                                                                                   1. Allan BF Jr, Steven RF Aaron SK, Beth DC. 20 Common
   metically acceptable regrowth. Minoxidil is usually well tolerated.                problems in dermatology 2000;18: 256-61
                                                                                   2. Thomas BF Richard AJ, Klaus W, Dick S. Color atlas & synopsis
   Adverse effects include local dryness or irritation (7%) and facial                of clinical dermatology, common and serious diseases, fourth
   hypertrichosis (5%). The exact mechanism of actions remains un-                    edition 2001; 27: 928-31
   clear. It most likely has a direct mitogenic effect on epidermal cells,         3. Francisco AK, Francisco JA. Dermatology just the facts 2003;
   both in vitro and in vivo.5                                                                  ,
                                                                                   4. Irwin MF Arthur ZE, Klaus W, K Frank A, Lowell AG, Stephen IK.
                                                                                      Volume I Fitzpatrick’s dermatology in general medicine, sixth
   The efficacy studies of anthralin unfortunately were uncontrolled.                 edition 2003; 10: 641-3
                                                                                   5. Chantal B, Harvey L, Jerry S. Alopecia areata 2006.
   A 2004 study showed no benefit. Other studies showed a response
                                                                                   6. The National Institute of Arthritis and Musculoskeletal and Skin
   rate of 20-75% for patchy AA and 25% for AT.5                                      Diseases. Questions and answer about alopecia areata.

                                                                                                                                   AESTHEDICA            17
                                   Sebelum Perawatan        Masa Perawatan                      Setelah Perawatan

                                                       For training purposes we have worked out a model of an aging face made of special
                                                       material and resembling a human face - with pronounced "wrinkles" and "folds", "soft
                                                       tissue ptosis". This model will help a doctor to practice various manipulations and
     From the beginning of the 1998,                   operations and to acquire experience.
     the scientists, inventors and plas-
     tic surgeons from Moscow, father                  The APTOS Model will help our colleagues to master not only our new techniques but
     and son, Marlen and George Sula-                  also other operations and manipulations (correct injection of various gels, medicines,
     manidze, having large experience
     of rejuvenation operations, such is
     face lifting, and wishing to make
                                                       For long-lasting, yet minimally invasive lifting of the skin and subcutaneous tissue of
     the operations as easy for the pa-                the face, neck, breasts, brachial inner surface and buttocks with small (up to 1 cm) inci-
     tients as possible, without post-                 sions.
     operative hems, pains, different
     complications and nonsuccessful                   Such lifting is performed with the help of the APTOS Needle, a unique device which
                                                       makes it possible to suture soft tissue with small stitches just subcutaneously without
     results, invented new technologies
                                                       the suture thread emerging on the skin surface.
     and methods for such operations
     and manipulations. These methods                  As though an invisible surgeon under the skin is suturing the flabby tissues grouping
     have developed the possibilities of               them in the required places in order to impart them elasticity and create new contours
     the aesthetic and plastic surgery.                of the skin with no scars left.

The Journal

 Soft Tissue Augmentation :

Use of Hyaluronic Acid
as Dermal Filler
THE HISTORY OF HYALURONIC ACID                                        correction of wrinkles. If anesthesia was required a topical anes-
Karl Meyer and his John Palmer isolated a chemical substance          thetic cream is applied to the area under occlusion at least one
from the vitreous jelly of cow's eyes in 1934. The name hy-           hour prior to the treatment.
aluronic acid was derived from hyaloid (vitreous) and uronic
acid. The identical structure of hyaluronic acid in all species and   Techniques of injection
tissues makes it to use as a biomaterial in health and medicine.      1.   Linear threading technique: the full length of the needle is
Hyaluronic acid is present in many places in the human body.               inserted in the middle of the wrinkle and the substance is
It gives volume to the skin, shape to the eyes and elasticity to           injected while pulling the needle slowly backwards so that
the joints.                                                                the threads of the gel are placed lengthwise in the wrinkle.
                                                                      2.   Serial puncture technique: multiple injections are placed se-
PRODUCTS OF HYALURONIC ACID                                                rially along the length of the treated wrinkle/fold. It is made
The older products of hyaluronic acid are ranging from animal              closely together so that it merges into a smooth continuous
to nonanimal source and allergic prone to hypoallergenic prod-             line which lifts the wrinkle.
ucts. The major disadvantage of the common hyaluronic prod-           3.   Fan technique: the needle is inserted at the periphery of the
ucts was the need to be mixed with a chemical thinner before               area to be treated as when using the linear threading tech-
usage due to the increment of free radicals. Some products                 nique. After injecting one line the direction of the needle is
now available in the market are free of this need, for example             changed and injected as before along a new line.
Visagel.                                                              4.   Cross hatching technique: the needle is inserted at the pe-
                                                                           riphery of the area intended to be augmented and injected
INDICATIONS AND CONTRAINDICATIONS OF                                       as when using the linear threading technique. The needle
DERMAL FILLERS                                                             is withdrawn from the skin and inserted 5-10 nm adjacent
Indications: depressed scars: postsurgical, traumatic, postacne            to the first puncture site and injected in the same way. This
or other diseases, wrinkles and folds, lip sculpting, enhance-             procedure can then be repeated at right angles to the origi-
ment of facial contour, periocular melanoses and sunken eyes.              nal lines.
Contraindications: keloidal tendency, hypersensitivity to prod-
ucts as demonstrated by positive skin testing, unrealistic expec-     Successful treatment
tations.                                                              Where to inject is the key to successful treatment. For best re-
                                                                      sults the products should be injected within the product recom-
PROCEDURE                                                             mended tissue depth.
A detailed clinical examination and history taking and counsel-
ing of expectations and limitations of the product are essential.     Posttreatment care
A preoperative photograph and written informed consent are            The area should not be touched for 6 hours after the injection,
recommended. No anesthesia is necessary when injecting for            and should not be exposed to extreme heat or cold. Touch up

                                                                                                                      AESTHEDICA             19
         F  iller is a practical and instant solution relatively free of
            side effects for patients who wish to look young without
         undergoing major surgical procedures.

     treatment can be given after 2-4 weeks if necessary.

     Erythema, swelling, pain, itching, discoloration and tenderness
     at the implant site. Resolution is spontaneous within one or
     two days. Substance related adverse effects such as swelling
     and induration are rare (less than 1 in 2000 treatments). A short
     course of oral steroids or intralesional hyaluronidase may be

     Filler is a practical and instant solution relatively free of side
     effects for patients who wish to look young without undergo-         and augmenting lips and lip contours. It is injected into the mid
     ing major surgical procedures. However the effects of fillers        or deep dermis by linear withdrawal technique (tunnel or criss-
     like hyaluronic acid are temporary and injections need to be         cross-technique), by serial puncture technique or by a combina-
     repeated once in 6-10 months.                                        tion of these techniques.

     REFERENCES                                                           Visagel contains less then 0,15 µg/ml protein which came from
     Vedamurthy M. Soft tissue augmentation - Use of hyaluron-            the hyaluronic acid as raw material. The endotoxin level of it is
     ic acid as dermal filler. Indian J Dermatol Venereol Leprol          less then 20 EU/ml product and the divinylsulfon level of Visagel
     2004;70:383-7.                                                       is 0,0004 mg/ml product. The results of the biocompatibility tests
                                                                          show clearly, that there is no adverse effect. For product release
     A NEW HYALURONAN: VISAGEL                                            a cytotoxicity test was done for each lot in order to verify the
     Visagel is a new hyaluronan product made with help of Visalink       biological effect of the cross linking reagent.
     technology. The technology is the only one in the world that         Visagel guarantees a sterility assurance level of ≤ 10-6 and a bio-
     ensures complete crosslink of hyaluronan. Thus make Visagel          compatibility that meets the requirements of international stan-
     able to be an outstanding elastic material and the only hyaluro-     dard ISO 10993-1.
     nan product that doesn’t need thinning agent when used. It is
     made from the purest and highest quality hyaluronan material         A word about Visagel from doctor Alain Gondinet after giving
     and therefore requires no allergy test before administration.        a course of Visagel filler, “Visagel is pure, 100% pure. This is a
     The end result is natural and lasts longer than another product.     natural product. It is soft, elastic, and easy to use and of course
     In comparison with another hyaluronan, the use of Visagel is         it is cheaper than the other. It can be used for deep wrinkle, shap-
     cheaper because it has higher performance and longer lasting         ing the nose, glabella, no superficial wrinkle. It is invented by a
     result.                                                              German company and they have studied it for three years. The
                                                                          study is very interesting because it has no reaction, no side ef-
     Visagel is indicated for treating medium and deep cutaneous          fect because it is very pure and contains no other chemical agent
     depressions such as wrinkles, folds and other defects, restor-       in it. So it is easy and safe to use by doctors. So it is soft, easy,
     ing or creating volume in facial contours (cheekbones, chin)                 .
                                                                          and safe” q


                                  Ahead With
                                  Stem Cells
                                   Stem cell therapy will keep progressing and the world is waiting for
                                   animal stem cells that can be used in human.

S    everal years ago, stem cell therapy seems so far away and            won’t be denaturated even in room temperature.
     unreachable. But recently, stem cell is becoming the latest     •	   Stem cell therapy awaited revolution is how to increase the
trend in aesthetic and blood related diseases. And the therapy is         productivity of stem cell. The ways that have been tried in-
real and already available in the market. Knowing the latest in-          clude growth factor and platinum wire. Platinum wire can
vention is crucial if we want to know what’s right and what’s just        produce infrared that can penetrate body up to 15 cm.
bogus. Here are several facts that we’ve compiled from around        •	   This therapy is still expensive, ranging from USD 7,000 for
the world.                                                                animal stem cell to USD 20,000 for human stem cell cancer
•	   Nowadays, single layer stem cell is more popular than mul-           therapy.
     tiple one. Single layer stem cell can be found in thymus,
     embryo, placenta and serum. The famous serum type is the        Stem cell therapy will keep progressing and the world is waiting
     popular cord blood or umbilical cell that are being kept in     for animal stem cells that can be used in human. q
     cord banks (Kalbe Farme in Indonesia)
•	   Recent foundings in stem cell therapy:
     1. When an old rat was transplanted with a young thymus
        rat, everything in the old rat become younger. Thymus is          Excerps from Lecture of Prof. Dr. Leow Chong Ngan:
        found to have a good antiaging effect, though actually
        thymus is an immune organ.                                        THE AGEING PROCESS CANNOT BE PREVENTED
     2. Embryo is said to be able to protect DNAs, for example            BUT YOUTHFULLNESS CAN BE REGAINED
        to protect people from mutation and injury in nuclear
        facilities. Embryo is also said to be a new anticancer            Stem cell products are available from Switzerland’s
        hope.                                                             company EroCell. The stem cells are extracted from
     3. Placenta is said to have excellent aesthetic purposes, for        bovine thymus, placenta, embryo and serum. EroCell
        example in hormonal treatment. And serum (cord cell)              placenta are indicated for promoting blood circulation in
        is proven to cure almost anything related to blood, for           wound healing, climacteric disturbances, early ageing,
        example curing anemia aplastic, leukemia and diseases             while EroCell serum for ulcer, myocardial infarction and
        of vessels and hearts.                                            cerebral circulatory disorders. EroCell embryonal can be
                                                                          given for aging related diseases such as chronic urethri-
     4. Fetal preputium stem cells can produced sizable epider-
                                                                          tis and prostatitis, regeneration of connective tissue and
                                                                          psycho-physiological weaknesses such as insomnia, lack
     5. In patient with parkinson, with the right stem cell thera-
                                                                          of concentration and other mental performances.
        py, tremor can subside in three days. Stem cell can also
        be used for spinal cord injury.
                                                                          These products can be given directly to the skin or
•	   Stem cell use depends on patient’s need. For aesthetic prob-         orally, intravenous, intramuscular, intracutaneous or
     lem, placenta was used as a main therapy and if patients are         subcutaneous, depend on consultation. EroCell is given
     healthy, all kinds of stem cells can be used in combination.         two to three times weekly with a total of 24-36 doses for
•	   A method known as “completeness” is when hundreds of                 a cycle of treatment.
     each type of stem cell is used to get the best result. This
     method is popular because being so small in peptide size, it

                                                                                                                    AESTHEDICA           21

            Homeopathic Aquapu

                 Localised adiposity
                 OMEOFORMULA 1

                 Administered using microinjections (0.2-0.3 mL) into the affected area and,
                 possibly, via some simple acupuncture points, such as stomach 37, stomach
                 40, stomach 44, large-intestine 11, spleen-pancreas 6, and gall-bladder 23.

                 Tissue tone treatment
                 OMEOFORMULA 3
                 Used for:
                 •	   Skin slackening and tissue revitalisation
                 •	   Bio lifting of large areas of the body
                 •	   Firming of the gluteus muscles.
                 •	   Administered using collagen needle (13 mm 30 G) and mesotherapy
                      needle (4 mm 27 G).
                 •	   For firming gluteus muscle, infiltrate to the following areas:
                      1. From the centre of the gluteus muscle proceed with 4 injection lines,
                        in a sunburst shape (superiorly, inferiorly, towards the medial side,
                        towards the lateral side).
                      2. Along the subgluteal furrow.

uncture Technique

          OMEOFORMULA 2
          •	   Used in oedematous-fibrosclerotic lipodistropy or cellulite. It can be
               used saddlebags, root of the thigh, knees, and arms.
          •	   Administered using microinjections (0.2-0.3 mL) via some acupuncture
               points such as spleen-pancreas 6, spleen-pancreas 9, spleen-pancreas
               10, and liver 11.

          Breast toning
          OMEOFORMULA 4
          •	   Administered using small inoculation wheals (0.2-0.3 mL).
          •	   Infiltrate the following areas:
               1. From the clavicle down along the breast muscle with 3 parallel
                 injection linjes.
               2. From the areola go on with 4 injection lines radially (in the upper
                 part, in the lower part, towards the medial side, towards the lateral
               3. In the area below the breast, along its insertion on the thorax.

                                                                        AESTHEDICA       23
      Case Report

     Mesotherapy as a Part of
                            Obesity Nutrition T
                                                                         to have high threshold of hypnosis (hard to fall under influ-
                                                                         ence). Sometimes, hypnotherapy should be administer re-

     O    besity is one of new arising degenerative disorders in
          urban areas. The treatment remains as one of the great-
     est obstacles in the world of therapeutic medicine due to
                                                                         peatedly to achieve an optimal result.

                                                                         Several nutritionists are developing “nutritional hypnother-
     the many factors comprising the disease. Nutrition is one of
                                                                         apy” science that dealt with the unconcious mind of patients
     important factors in preventing and curing obesity. The way
                                                                         in order to make them want to eat the healthy food uncon-
     people eat describe who they are and changing it can be a
     gigantic hindrance. Because of bad nutrition, obesity treat-
     ment seems to face failure, often more than less.
                                                                         Other advantage with hypnotherapy is patient can be made
                                                                         in relaxed condition, ‘fearless’ and feel no pain when he/she
                                                                         is injected without prior anasthetic.
     The city life brings a whole new way of life, one of it is a cus-
     tom to eat for living and no the other way around. The food
                                                                         MESOTHERAPY AND NUTRITION THERAPY
     this new life brings is high in simple carbohydrates, sugar,
                                                                         Obesity should be treated to prevent further complications
     dan fat. Uncontrollable eating behaviour will make people
                                                                         such as diabetes, cardiovascular diseases, early aging, can-
     gain excessive weight, obesity, and all degenerative compli-
                                                                         cer etc. It is also being treated for aesthetic factor. Meso-
     cations cause by it.
                                                                         therapy can be very useful to delay tissue early ageing and
                                                                         improve patients appeareance with its mesolipo.2
     Studies have shown that people find it hard to stop eating
     good food no matter how bad. What is needed is a high self
                                                                         Below are case reports of obesity that were treated by nutri-
     control while obese people usually show low discipline when
                                                                         tion alone or combined with mesolipo.
     facing food temptation. Diet consultation which is made to
                                                                         Case 1:
     give examples of healthy food to reduce weight often failed.
                                                                         Male, 30 year old, single, height 175.0 cm, weight 131.5 kg,
     The main reason of this failure is the assumption that when
                                                                         BMI 42.9 kg/m2, total body fat 61.9 kg (Imron, Bioelectric Im-
     people know how to eat right they’ll do it right away. Actu-
                                                                         pendance), belly diameter 128.0 cm (Figure 1A, 1B).
     ally, those two things are very different. Although patients
     have known what healthy foods are their heads keep craving
                                                                         The treatment started with a conventional diet consultation
     for unhealthy foods.
                                                                         which taught how to choose low caloric food. When the re-
                                                                         sult seemed unsatisfactory, the therapy was changed to hyp-
     The most important thing to remember in therapy is to
                                                                         notherapy and patient was given suggestion to resist high
     change people mind set that if they eat right they can and
                                                                         caloric food.
     will lose weight. Hypnotherapy is one of effective methods
     to change this mind set with only 5% of patients showing
                                                                         Other therapies that were given included individual low

Therapy                                                    Prof. DR. Dr. Walujo Soerjodibroto, SpGK
                                                                    Department of Clinical Nutrition
                                                                                 Faculty of Medicine
                                                                             University of Indonesia

 dose sibutramin once daily, aquapuncture to abdominal wall
 to fasten the feel of fullness, and exercise in the form of walk-
 ing 1 hour a day. Patient didn’t do the work ups.

 After diet consultation was changed to once a week hypno-
 therapy, patient gradually started working ups, from walk-
 ing to running. In latter days patient was given mesolipo in
 stomach, upper limb and wing areas. (cocktail combinations
 of : Phosphatidylcholine, Organic Silicium, Centellasial, L-
 Carnitine, Dermaproc). Oral medication was tappered off
 when hypnotherapy had shown to be a promising result.
 Therapy was conducted in 3 years period and at the end of
 program the weight had reduced to 83.2 kg, BMI 27,2 kg/m2,
 total body fat 27,3 kg (Imron, Bioelectric Impendance), belly                                         after 3.5 months
 diameter 86.2 cm (Figure 2). There were no complains from
 patient and significant complications. Patient has married,
 work, and live in other province.                                                                 after 5 months
 Case 2:
 Male, 21 year old, single, height 171.0 cm, weight 87.6 kg, BMI
 30.0 kg/m2, total body fat 25.6 kg (Imron, Bioelectric Impen-                                 after 3.5 months
 dance), belly diameter 93.8 cm. Patient was used to consume
 slimming medication that made him urinate more often and
 diarrhea and when we first met him, he was still obese with                                   after 5 months
 a very flabby abdominal wall (Figure 3).                                                        before
 This patient was given once a week hypnotherapy to make
 him eat low caloric and enough protein food. Patient under-
 went mesolipo once a week in abdominal stomach and was
                                                                                                 after 3.5 months
 recommended to exercise, at least one hour walking a day. At
 first, patient was given low dose sibutramin every morning
 and was tappered off when hypnotherapy kicked off. Meso-                                        after 5 months
 therapy treatment is administered twice a week at abdominal
 area (Dermaheal-LL, with Dermaproc or Xylocain).

                                                                                                                  AESTHEDICA   25
     O     besity should be treated to prevent further complications such
           as diabetes, cardiovascular diseases, early aging, cancer etc. It
     is also being treated for aesthetic factor. Mesotherapy can be very
     useful to delay tissue early ageing and improve patients appeareance
     with its mesolipo.

     The treatment lasted for 5 months and at the end of it his      Bioelectric Impendance), waist diameter 70.8 cm, and bel-
     weight was 82.0 kg, BMI 28.1 kg/m2, total body fat 22.3 kg      ly diameter 74.2 cm (Figure 6). No complains were made
     (Imron, Bioelectric Impendance), belly diameter 81.2 cm (Fig-   during teatment.
     ure 4B). The other interesting part was the improvement of
     renal function, from CCT 65,2 cc/min to 82,2 cc/min.            CONCLUSION
                                                                     The target of obesity treatment is to change the way patients
     This patient was given once a week hypnotherapy to              eat. This change needs to be permanent because when pa-
     make him eat low caloric and enough protein food. Pa-           tients only depend on medication, weight will return or even
     tient underwent mesolipo once a week in abdominal               increase (yoyo effect).
     stomach and was recommended to exercise, at least one
     hour walking a day. At first, patient was given low dose        There are many ways to change eating behaviour. Writer’s
     sibutramin every morning and was tappered off when              experience showed at first safe oral medication can be used
     hypnotherapy kicked off.                                        (nonlaxatives and nondiuresis) concordantly with hypno-
                                                                     therapy and exercise. Medication therapy was tappered off
     The treatment lasted for 5 months and at the end of it his      when hypnotherapy has shown result. Acupuncture or aqua-
     weight was 82.0 kg, BMI 28.1 kg/m2, total body fat 22.3 kg      puncture also helped and mesotherapy (mesolipo) can be
     (Imron, Bioelectric Impendance), belly diameter 81.2 cm         done as latter treatment. Mesotherapy can be used from the
     (Figure 4B). The other interesting part was the improve-        beginning if the problem was only overweight and not obe-
     ment of renal function, from CCT 65,2 cc/min to 82,2 cc/        sity. The main problem of mesotherapy is the price that is
     min.                                                            relatively expensive.

     Case 3:
     Female, 27 year old, single, height 160.0 cm, weight 70.1
     kg, BMI 27.3 kg/m2, total body fat 18.6 kg (Imron, Bio-         Reference
     electric Impendance), waist diameter 79.1 cm, and belly         1.   Stradling J, Roberts D, Wilson A & Lovelock F (1998).
     diameter 80.8 cm. Patient received hypnotherapy and                  Controlled trial of hypnotherapy for weight loss in pa-
     aquapuncture once a week. At the latter time, aquapunc-              tients, Int J Obesity, Vol 22, No 3, Page 278-281.
     ture was changed to mesotherapy once every two weeks.
                                                                     2.   Wikipedia (2007). Mesotherapy.
     (Phosphatidylcholine, Organic Silicium, L-Carnitine, Der-
     maproc) Patient was asked to walk one hour every day
     (Figure 5).

     This program lasted for 4 months and the final weight
     was 57.2 kg, BMI 22.3 kg/m2, total body fat 15.0 kg (Imron,


      A Multi-tallented Cosmetologist

                                 E    xperience is not only the best
                                      teacher for Rubin C. Jusuf S.Pd,
                                 but also a key for a better success
                                                                         Rubin Cosmeceutical provide the most complete products rang-
                                                                         ing from skin & body therapeutic care (day/night cream, sun
                                                                         block cream/gel, bleaching cream, AHA cream, toners, facial
                                 in designing and formulating high-      wash/cleanser, botu-like products, L-Ascorbic Acid serum, anti
                                 ly qualified cosmeceutical –a blend     irritant cream, anti aging cream, acne lotion/cream/gel, founda-
                                 of cosmetics and pharmaceutical-        tion, two way cake, loose powder, massage cream, face mask,
                                 products named Rubin Cosme-             etc), lip care and hair care (shampoo, conditioner, cream bath,
                                 ceuticals, a patented brand image       hair tonic, hair growth serum, etc).
                                 trusted by beauty medicine exper-
                                 tise and practitioners in Indonesia.    ”Various test are done prior to marketing, such as Safety Test to
                                                                         prove products’ safety and adverse effect, Efficacy Test to know
     Having acne problems on his face for more than 10 years dur-        its’ effectiveness and Clinical Test to test the product under der-
     ing his adolescence, young Rubin tried many ways to solve his                               ”
                                                                         matologists’ supervision, said Rubin.
     problems and promised to help other people who have the same
     problems if he succeeded. He finally succeeded in controlling       Rubin has already known for his credible innovation and quali-
     his problems and became more driven in studying cosmetics           fied products which often become a standard and gain compli-
     and formulation technique supported by research and develop-        ments. ”I combine science, art, and technology to produce the
     ment team composed of pharmacists, chemists and dermatolo-          best and competitive product” said Rubin who also manage PT
     gists, by combining medical, cosmetics, and aesthetic medicine.     Sarana Estetika Industri.
     ”This is my biggest satisfaction” said Rubin who is also a source
     person for applicative cosmetology and formulation for profes-      ”I put my trust on Rubin for his special and different work. Rubin
     sionals. He is chosen and trusted by more than 300 aesthetic                                  ”
                                                                         is a reflection of success, said Harijani, MSc, one of his steady
     medical practitioners from Indonesia and all over the world such    customer.
     as Singapore, Malaysia and Brunei Darussalam. They come to
     Indonesia for learning with Rubin directly and intensively.

                                                                         PT. Sarana Estetika Industri
                                                                         Phone. (021) 581 6455, 581 9233
                                                                         Fax. (021) 581 9233


     New Generation Retinoid:

     New Treatment of Acne Vulgaris
     With Adapalen
                                                                                        Tretinoin was the first retinoid used in the treat-
                                                                                        ment acne. It is generally effective and widely
                                                                                        used but when used, dryness of the affected
                                                                                        skin may occur. More sensitive patients may
                                                                                        also experience redness, scaling, itching, and
                                                                                        burning. Now there is a new generation retin-
                                                                                        oid with minimal irritation : ADAPALENE.

                                                                                        Adapalene is a retinoid agent indicated for the
                                                                                        topical treatment of acne vulgaris. In clinical
                                                                                        trial, 0.1% adapalene gel has proved to be ef-
                                                                                        fective in this indication and was as effective
                                                                                        as 0.025% tretinoin gel, 0.1% tretinoin micro-
                                                                                        sphere gel, 0.05% tertinoin cream and 0.1%
                                                                                        tazarotene gel once every two days. It can be
                                                                                        used alone in mild acne or in combination with
                                                                                        antimicrobials in inflammatory acne and has
                                                                                      proved efficacious as maintenance treatment.

A    cne is a chronic inflammatory disorder of the pilosebaceous
     unit that affects almost everyone at some stage between
the ages 12 and 24 years. It is related to neither hygiene nor diet,
                                                                       Adapalene has rapid onset of action and particularly favourable
                                                                       tolerability profile compared with other retinoids, It has a unique
                                                                       chemical structure 3 aromatic rings that make it more stable to
though there appears to be a genetic predisposition in severe          light and adamanthyl structure that has less irritation effect.
cases. It is a multifactorial disease, the main pathophysiologi-       These attributes can potentially promote patient compliance, an
cal factors that influence the development of acne are excessive       important factor in treatment success. Adapalene is therefore
sebum secretion, abnormal keratinisation and desquamation of           assured of a role in the first-line treatment of acne vulgaris.
sebaceous follicle epithellium ( comedogenesis ), proliferation
of propioninacterium acnes in the pilosebaseceous duct and
inflammation.                                                          Reff:
                                                                       Waugh J, Noble S and J.Scott : Adapalene : A Review of its use in
Treatment of acne address the various factor responsible for it .      the treatment of acbe vulgaris, Drugs 2004,64(13):(1465-1478)
They include estrogens and antiandrogen to reduce the impact
of androgen, antibacterial agent to reduce P acnes colonization
of the pilosebaceous unit, and retinoids to reduce hyperprolifer-
ation and keratosis of ductal corneocytes. Choice of treatment is
dependent on the type and severity of the disorder. If the acne
is mainly comedonal, retinoid are the first line treatmen. In the
case of inflammatory acne, topical and / or systemic antimicro-
bial agents may be used in addition to retinoid. In cases that fail
to respond to such treatment, oral isotretinoin may be used.

                                                                                                                       AESTHEDICA             29

                                                     Look Charming with Acanthe
                                                     W      omen and beauty are inseparable. Physical appearance is one of the most im-
                                                            portant things for women. Various cosmetics are therefore being produced to
                                                     satisfy women’s need. One of it is ACANTHE-Naturally Effective, a product made from
                                                     natural compositions proven effective to treat skin naturally. ACANTHE was brought
                                                     from Spain and distributed to Indonesia by PT FERRON PHARMACEUTICALS. Today,
                                                     ACANTHE has 8 products:

     Acanthe Anti Wrinkle Flash                                                Acanthe Caviar Eye Gel
     ACANTHE ANTI WRINKLE FLASH is a formula made especially                    This formula is designed especially for sensitive areas around the
     for wrinkles around the eyes. It is made from the mixture of mel-          eyes. ACANTHE CAVIAR EYE GEL is caviar extracts proven effec-
     hydran, laricryl, vitacell, and terminalia herbs. Melhydran acts by        tive in dealing stress and tired skin and kantung mata. The active
     moisten soft skin around the eyes, larycril acts not only moisten          ingredients work properly and effectively on that areas so the skin
     the skin but also help to reduce pores, refresh and tighten skin. Vi-      is prevented from aging, and become soft, tight, and moist. Use
     tacell acts by stimulating skin cells metabolism and regeneration.         this eye gel during the night, when the regeneration is more in-
     Terminalia, in the other hand, is useful for its effect on improving       tensive.
     skin elasticity.

                                                                               Acanthe Sebum Regulating
     Acanthe Anti-Wrinkle Treatment                                             To overcome oily skin problems ACANTHE SEBUM REGULATING
     ACANTHE ANTI-WRINKLETREATMENT is made from several com-                    came as a solution. This product is beneficial to tighten pores,
     positions. One of it is Lactococcus Permet which moisturizes outer         reduce sebum on skin, and refresh your skin. ACANTHE SEBUM
     skin and sun blocks. Other component is hibiscus which acts in re-         REGULATING composed of amino acid, peptides, and zinc com-
     vitalizing skin cells, anti free radicals, gives nutrition to epidermal    plexes, all of which act as a seboregulator, laricryl as a pore mini-
     cells. Another one is Glicine Soja Protein known not only by it anti       mizer and freshener, and vitacell as a skin revitalize and regenera-
     wrinkle effect but also tightens, improves, and protects skin. The         tor. Use it twice a day during morning and evening.
     last composition is fomes officinalis which cleanses, tightens, and
     moistens the skin. Apply ACANTHE ANTI-WRINKLE TREATMENT
     on the face which has wrinkle and aging signs. Regular use im-            Acanthe Lightening Cream
     prove wrinkle, prevent and delay new wrinkle formation. The best
     result will be seen after three weeks application.                         The same as ACANTHE LIGHTENING GEL, ACANTHE LIGHTEN-
                                                                                ING CREAM makes skin looks lighter and treats hyperpigmented
                                                                                areas. Its active ingredients are Ferulic acid, Waltheria Indica,
                                                                                Citric Acid, and Gluconic Acid which give melanin control effect,
     Acanthe BTX-like Cream                                                     while the other ensure a fast absorption. Regular use will prevent
     Wrinkle often formed from someone mimic habit such as vertical             melanin synthesis. Apply lightening cream during morning and
     line between, eyes, horizontal line on forehead or line on mouth           evening. For single spot, apply directly onto the area. The best re-
     side. To resolve it, ACANTHE launch BTX-LIKE CREAM. This is s              sult will be seen after two months application.
     new generation formula with active ingredients obtained from
     hibiscus flower seeds extract called hydrolyzed hibiscus extract.
     This formula works by preventing wrinkle, reduce musle contrac-           Acanthe Lightening Gel
     tion so that expression line formation reduced. Beside, ACANTHE
     BTX-LIKE CREAM also composed of vitamin E which acts on nutri-             Acanthe lightening gel is formulated to lighten the skin, especially
     tioning your skin, fights against biological aging, and relaxes skin.      for hyperpigmented area. Ferulic Acid and Waltheria Indica are the
     Apply ACANTHE BTX-LIKE CREAM twice a day during morning                    active ingredients which have melanin control, depigmentation
     and night into clean and dry skin with gentle massage on face and          and tyrosinase inhibition effects. While Citric Acid induces epider-
     neck where expression lines easily occur                                   mal desquamation, and Gluconic Acid has Cu2+ chelating activity
                                                                                in melanocytes. Regular use will reduce spot pigmented skin and
                                                                                makes it lighter. Apply ACANTHE lightening gel during morning
                                                                                and evening. For single spot, apply directly into exposed area.
     Acanthe Anti-Irritation                                                    The best result will be gained after two months application. This
     ACANTHE ANTI-IRRITATION is made from mixed purified Com-                   product is best recommended for oily skin.
     frey, Licorice, Burdock, and Cassia Augustifolia roots. This combi-
     nation formula designed to overcome irritation and stress on the          ACANTHE-Naturally Effective is distributed by PT FERRON PAR
     skin. ACANTHE ANTI-IRRITATION helps prevent skin damage and               PHARMACEUTICALS in the end of 2006 and for further informa-
     also improve and prevent irritation while soften and relax skin.          tion please contact PT. Ferron 021-7884-3633 (Kustanto)


     What's New In Light Therapy
     Improved Precision Yields Results

     The World's Most Sophisticated, Expandable Platform for Aes-         act and calculated pre-sets, all the parameters are adjustable so
     thetic Treatment Technologies                                        it offers flexibility too. The operator can create a more selective
                                                                          treatment for each
                                                                          individual case.

     L   umenis released its 4th Generation IPL technology two years
         ago, called Lumenis One. This is the most advanced IPL re-
     leased so far. The Optimal Pulse Technology (OPT) means that
                                                                          Lumenis One tech-
                                                                          nology has been
                                                                          approved by FDA in
     the machine delivers very precise energy. The OPT light delivery
                                                                          the USA and listed
     is more controlled and the energy level can be adjusted to suit
                                                                          in TGA in Australia.
     the individual skin type and condition. This makes it safer than
                                                                          This proofs its high
     earlier machines, and gives very predictable results.                                              before and after IPL treatment for hair reduction using
                                                                          level of safety.                        the Lumenis I in US clinical trials.

     Lumenis One can be used to
                                                                          Representing        the
     treat a variety of skin condition,    ‘The OPT light delivery
                                                                          industry’s         only
     from reducing the appearance          is more controlled and
                                                                          4th generation of
     of fine lines and wrinkles to        the energy level can be
                                                                          IPL, Lumenis One
     the fading of pigmented birth-       adjusted to suit the indi-
                                                                          unites 4 gold stan-
     marks, even port wine stains.            vidual skin type’
                                                                          dard      technologies
     While it is most usually used to                                                               before and after IPL treatment of age spots using the Lumenis I
                                                                          on one platform :
                                                                                                                           in US clinical trials.
     treat all forms of pigmentation, OPT also offers improvement in
                                                                          The IPL for skin
     rosacea, vascular lesion and capillaries. In regards to rosacea,
     some patients experienced prolonged facial flushing and, this
                                                                          and treating vascu-
     is the only machine that has high rate of success in treating this
                                                                          lar and pigmented
     condition. The texture of the skin is also improved. It reduces
                                                                          lesions, the Light-
     the appearance of fine lines and wrinkles, reduces pore size and
                                                                          sheer diode laser
     evens out skin tone and colour.
                                                                          for        permanent
                                                                          hair reduction, the           before and after IPL treatment of actinic keratosis and
     The technology works by optimizing the wavelength so that the                                    hyperpigmentation using the Lumenis I in US clinical trials.
                                                                          Multi-Spot Nd:Yag
     energy is absorbed only by the unwanted melanin, raising the
                                                                          for    treating     leg
     temperature and causing the pigment to break up without dam-
                                                                          veins and deeper vascular lesions, and the Aluma with FACES
     age to the surrounding tissue.
                                                                          (RF) technology for the treatment of wrinkles, fine lines and skin
     Lumenis One system is faster than previous models. ‘With older
     machines, the operator would take 30 to 40 minutes to treat the
                                                                          The system’s key features is the OPT, integrated contact cooling
     whole face. With OPT, it takes only 10 minutes. For photo
                                                                          system, numerous presets, easy custom settings, and an intui-
     rejuvenation, patients, used to need five or six treatments,
                                                                          tive touchscreen software interface. These features enables phy-
     with OPT the same results can be achieved in just two or three
                                                                          sicians to provide increased patient comfort, faster treatments,
                                                                          and easily tracked patient information. It also has an internal
                                                                          database for maintaining patient records and adding treatment
     The machine’s accuracy also gives improved results. There is
                                                                          notes and clinical indicators. q
     less scatter, even with large pigmentation spots, and the treat-
     ment is therefore more effective. While the machine has very ex-

     Ask The Reference

     Dear Dr. Reza,

     I have heard a lot about Acthyderm, but I am still not sure about
     its usage. Do you use Acthyderm for your patients? Are they
     satisfy with the result? Thank you.
                                                                  &                            Anaesthe

     Dr. Rita, Surabaya

     The straight answer for your first question is YES. I use
     Acthyderm to treat my patients. Acthyderm is a device to
     utilize skin electroporation of for transdermal vehiculation of
     pharmaceutical and cosmetic products. This device is used with
     mesoporation, a noninvasive technique of transdermal drug

     Acthyderm allows a simple, rapid, and effective transdermal
     therapy, providing surprising results without surgery or            very satisfied with the result. And I agree with her, my patients
     injections. It is used for many dermatologic cases such as          are also amazed with the effect. I hope this short information is
     mesomelasma, mesoglow, mesolift, mesoacne, mesostretch              quite helpful for you. For more information about Acthyderm,
     mark, mesoalopecia, mesolipo, chubby cheek, double chin,            you can contact us.
     sagging arms, breast treatment, and many more. Besides
     mesotherapy procedure, acthyderm is also used for local             Warm regards,
     anaesthesia for minor procedure using lidocain or emla.             Dr. Reza
     The effect is directly seen for most cases. For mesomelasma,
     mesoacne, and mesolipo, it might need 2 or 3 times treatment
     for the effect to be seen.

     Acthyderm was launched at 2001 and since then it has been
     used in over 20 countries, including Indonesia. Prof dr. Diana
     Yusuf, Sp.KK in Medan also uses Acthyderm for her patients.
     She said that so far, the effects are so amazing and patients are

etic Cream for MTS                                                                                                           Dr. Reza Y. Purwoko, Sp.KK


  Dear Dr. Reza,

  I used MTS Roller 1 mm to treat acne scar on my patient's face
  and she was satisfied. The problem is she felt pain when I rolled
  her face. According to your experience, what is your sugges-
                                                                         Since BLT cream creates a layer on skin, you need to wash pa-
  tion to reduce the pain? What kind of medication do you use
                                                                         tient’s face with normal saline after each use. Wash your hands
  with MTS roller? Is it different with medication used with me-
                                                                         well also.

                                                                         Drugs used with MTS roller and mesotherapy are actually the
                                                                         same. You can read the cocktail in Aesthedica magazine first edi-
  Dr. Riswan, Papua
                                                                         tion. In mesotherapy, we use needle and drugs will be inserted
                                                                         with injection. With MTS roller, we apply the medication first
                                                                         then we create microinjury for that medication. It is like we are
  Answer                                                                 pouring the medication to skin. It is better that we use creamy/
                                                                         jelly-like medicines instead of a liquid mesomedication as it will
                                                                         not evaporate easier than the liquid one. We get this thicker me-
  Dear Dr. Riswan,
                                                                         somedication by mixing the mesococktail with a nonreticulated
                                                                         hyaluronic acid (Hyalift or Hyaluronic Acid Mesomedica) meso-
  MTS roller indeed can cause pain. You can use anesthetic cream
                                                                         product, Idabae, or other products.
  such as lidocaine 1% cream or other cream. But in my experi-
  ence, BLT cream gives better result. BLT cream contains 3 active
                                                                         Sincerely yours, ,
  ingredients : Benzocaine 20%, Lidocaine 6%, and Tetracaine 4%.
                                                                         Dr. Reza
  Before starting the treatment, you can apply BLT cream all over
  the face and roll the MTS until the anesthetic cream is absorbed
  well. Then wrap the patient’s face with plastic wrap for about
  10-20 minutes. The patient will feel the numb sensation, includ-
  ing his/ her mouth (will feel a little swollen). Don’t forget to put
  holes on the wrap for nose and mouth to breath. After that, you
  can start apply medication to patient’s face and use MTS Roller        If you have any problems or questions related to aesthetic
  once again. With BLT cream applied before, patient won't feel          medicine, you can e-mail us at:,
  any pain again.                                                        fax us at : (+62)21 3909333/3917373
                                                                         or send us postmail to: Jl. Kramat VI No. 13. Jakarta Pusat, 10430.

                                                                                                                                     AESTHEDICA           35
                                          get              your own device                          now!
      • Automatic
        Automotically adjusted syringe                                                                     Pneumatic power
        pressure depending on the                                             • Painless                      The pneumatic allows faster injection
        viscosity of the product          • Economic                            Sterile Viewfinder:
                                           No product wastage                   No tremble = No pain          as well as faster needle movement.

                                                                 Separate needle
                                                                 reduces impact                        No dripping or waste of medicatio
                                                                                                         In the U225 the dripping in betw
                                                                                                         injectio ns has been reduced to zero.

                                                                                                             Needle syringe separation
     • Precise                                                                                                   This provides added stability and
      Injection speed and frequency                                                                              less vibration while injecting.
      electronically controlled

                                                                   • Product Delivery
                                                                       Fully variable:                 Depth adjustment
                                                                                                                                       a dial, shows
                                                                       Drop by drop or continuous      Depth is easily adjustable with
     • Light weight                           • Flexible                                                                                 cted.
      Less than 500g                            Adjustment of needle                                   the user the injection depth sele
                                                penetration depth
                                                from 0 to 10 mm

     U225 is the most sophisticated mesotherapy                                  •	    Celugel: heat-conducting anticellulite active gel based on high-
                                                                                       concentrate biorubina liposomes.
     injector curently available on the market.
                                                                                 •	    Redugel: active reducing and anti-obesity gel. It contains caf-
     It is fully automatic, powered by pneumatic                                       feine and ivy extract.
     pressure generated by an air compressor.                                    •	    Firmgel: firming gel containing horsetail herb and ginkgo bi-

           ome devices and drugs used for mesotherapy are usually                Therma G-Plus
           high in price. Understanding this, Medica Persada in co-              Therma G-Plus is a multi-function device with dual radio frequency
           operation with ADIRA finance offer installment payment                system. The radio frequency used affects ion of the molecule forming
     program for doctors or other health professional who desires to             biologic tissue. The high frequency energy that has been converted
     own their own devices.                                                      into biothermal energy increases tissue’s temperature, promotes ac-
                                                                                 tivation of cellulation and improves lymph drainage.
     We offer you three interesting program: free interest payment,
     reasonable interest payment, and first-installment free. You can            This device can be used for:
     choose any program up to 24 months duration.                                •	   Reducing body fat
                                                                                 •	   Increasing mesotherapy treatment effectiveness
     Here are some product lists that you can buy with installment               •	   Skin rejuvenation
     system. All you need is to give your complete data and purchas-             •	   Acne and flecks control
     ing list to Meso Medica. The process is so easy and you can get             •	   Wrinkle control
     your own device in no time.                                                 •	   Pain reducing
                                                                                 •	   Promoting hair growth by giving an impulsion to the hair fol-
     No need to hesitate now. Pick up your phone and contact us.                      licle
     Alamat, nomer telpon, fax, dan email.                                       •	   Strengthening weak and thin hairs
                                                                                 •	   Erectile dysfunction
     Boks                                                                        •	   Urinary incontinence

     Thermojet                                                                   iPULSE
     Thermojet is a thermolipolysis appliance that creates tailor-made           iPULSE is a unique device for hair removal and skincare. It works
     treatment to each client. It uses infrared waves at 8,000 Ang-              through patented way of delivering micro-pulses of intense light.
     stroms and the radiation stimulates the metabolism of the adipo-            This product is able to deliver light energy efficiently at lower cost. It
     cytes and improving circulation. The infra-red energy increases             is also able to treat larger skin areas in considerably less time.
     body temperature and stimulates body’s chemical and metabolic
     reactions. This will cause fat to dissolve.                                 This device can be used for various skin treatments, such as remov-
                                                                                 ing age spots, lesions, uneven pigmentation and thread veins, acne
     This device can be used with:                                               treatment, and wrinkel reduction. All of that can be achieved with
                                                                                 swift and remarkable results.

 Event Update

Indonesia 2007
  Held in Raflesia Grand Ballroom and Balai Kartini Exhibition Center, September 7-10 2007, Cosmobeaute Seminar Program is the
  2nd Indonesia International Exhibition & Conference on Cosmetics, Hair, Beauty & Spa. This event was considered as one of the
  biggest event in beauty industry. Attended by 6.254 participants, this events has also increase its number of contributing exhibitors
  amount to 260 companies from 25 countries. One of the key speaker in this event was Prof. Yongji Chung, PhD. from PT Aslanindo
  Suksestama talking about ‘Fight Against Aging Process with Growth Factors & Peptides Complex’. There were also a demonstration
  of New Magic Beauty Plus by Ms. Songja Park (Product Manager of Hwajin Cosmetics-Korea) and a seminar and hair show by Rudy
  Hadisuwarno’s Artist Team. Even until the last day, the participants didn’t seem loosing their interest on the exhibitions and confer-
  ence held.

a Better Way to Remain Young!
  As time goes by, various physiological changes happened to our body. These include natu-
  ral cutaneous aging such as development of wrinkles, skin thinning, colour changes, he-
  liodermy, and pigmentary disorders. Antioxidative therapy is one way to stop this process
  as mentioned by dr. Alain Gondinet at a workshop held on 26-27 Oktober 2007. Organic
  silicon or Silanol is one of the anti free radicals which helps against aging process. In
  this workshop was launched Conjonctyl®, a Silanol containing hydrocarbon group and
  hydroxyl radicals, both necessary to reach the greatest bioavailability on the body. Unlike
  mineral silicon, Silanol has at minimum one atom of carbon linked to one hydrogen (Si-C).
  Its’ hydrogen bounds unite the -OH functions to those of the salicylate ensuring the stabil-
  ity of the product in aqueous solution. As a structure and components of the connective
  tissue extra cellular matrix Silanol works by biosynthesize collagen from a fibroblast. This
  workshop was held from 8 to 2 AM and attended by 30 physicians.
                                                                                                                   AESTHEDICA              37
      Event Update

                              acaranya ibarra

     MSG damages saraf otak
     Narcotics is widely known can cause extreme                           Nuricafe
     damage for brain, there is another substance
     cause damage for human being, that substance            •	   Provide healthy food menu, without
     calls Monosodium Glutamate (MSG) – food spice                MSG
     which is known in Indonesia as “vetsin or “micin”   .   •	   Nutritionist consultation by dr. Diana Su-
     The trade mark varies in market; all of them is pure         nardi
     “chemical substance”   .                                •	   Open 9am – 10pm
     Researches by experts from all over the world show      •	   International standard of cooks
     that MSG can damage children brain. During their
     growth period, it damage children neuron system         We also provide meeting package for 10 per-
     so they have difficulties-emotionally & during their    son’s minimum order
     study Evidence Based Medicine also proved that
                                                             You deserve free facilities of :
     this chemical substance can damage part of brain
                                                             Room rental
     that controls the hormone permanently. Further-
                                                             Multimedia Projector
     more it can cause endocrine syndrome. For adult,
     all chemical substance that calls excitotoxin is very
                                                             Sound System
     bad. It caused epidermy disease such ad Parkin-
     son, Huntington, ALS, Alzheimer etc.                    Contact Person :
     Not all know that excitotoxin in food spice cause       Didin Kuswara
     risks for people who suffer from diabetes, stroke,      erpour Nutricafe
     brain injury, tumor, meningitis research show hat       Oasis Mitra Sarana Apartment Tower C lobby Level
     chemical substance can damage the brain function        Jl. Kalilio No. 155-157 Senen Raya Jakarta Pusat
     he effect can not be cured for children.                Telp./ Fax (021) 3524334


MONTHLY Highlights
October                                                         January
 22       Grand Launching érpour Kalimalang
 venue:   Komplek Pusbinal PU Blok B No. 1A                      14—19   Training IMMA
          Jl. Inspeksi Saluran Kalimalang                        21—26   Training IMMA
 28       Business Opportunity Launching
          érpour med-spa, skin and mesotherapy center
          for sub distributor                                   February
 venue:   érpour nutricafe, OASIS Mitra Sarana Apartement
          Tower C Lobby Level                                    11—16   Training IMMA Jakarta
          Jl. Kalilo No. 155-157 Jakarta Pusat                   25—1    Training IMMA Jakarta

 5—10     Training IMMA
 10       Mesotherapy Workshop
          Speaker: Dr. Ibarra, Philipine
          Aesthetic Medicine and Pain Management
 venue:   érpour nutricafe, OASIS Mitra Sarana Apartement
          Tower C Lobby Level
          Jl. Kalilo No. 155-157 Jakarta Pusat
 19—24    Training IMMA

 23—25    PERDESTI
          International Symposium and Exhibition in
          Aesthetic Medicine
 venue:   The Ritz Carlton Grand Ballroom Pacific Place, SCBD
 25       Aptos Hands on Training
 venue:   érpour nutricafe, OASIS Mitra Sarana Apartement
          Tower C Lobby Level
          Jl. Kalilo No. 155-157 Jakarta Pusat

 3—8      Training IMMA
 7--8     ICAAM ASIA
                                Revital - Celluform - An Anti-Aging Blow of Wellness
          Intercontinental Conference On Anti-Aging &
          Preventive Medicine
                            Innovative formula with phosphatidylcholine and N-acetyl
 venue:   Everbright Convention & Exhibition Centre the absorption of the adipose stores giving
                            cysteine that promotes
 10—15    Training IMMA         the skin a smoother aspect.

                                Recommended in case of "orange peel" skin.

                                                                                                  AESTHEDICA   39
                          Full Face Peeling                                 Lip & Eyelid + Easy TCA                           Chemo-abrasion (Easy TCA) +
                                                                                                                       Blending Bleaching Cream + Purifying Cream

                               ONEskinONE peelings & cosmeceutics
                                               Skin Tech has perfected a range of peelings adapted for all skin types

                         ONLY TOUCH PEEL                                                                            EASY PHYTIC SOLUTION
                    [ A DEEP LOCAL TREATMENT ]                                                 A surface peeling with a progressive action for patients who do not want re-
Recommended for marks deeply ingrained in the hands or face.                                   moval. It makes the complexion uniform and gives a tensor effect. Treatment
                                                                                               to be repeated once or twice a week. Social life is not affected.
                       [ A TRUE REJUVENATOR ]                                                                              EASY TCA
It regenerates the entire structure of the skin. The rejuvenating effect is such                              [ A GOOD APPEARANCE REDISCOVERED ]
that it can give you five or ten years. It stimulates the making of collagen. This             Recommended for the treatment of acne marks and scars, it also gives a spark
peeling involves an interuption of your social life for about five days.                       to tired skin. It is painless and to be repeated four times (once a week). With no
                                                                                               interruption to your working life it must done at lunch time.
                              Lip & Eyelid
              [ A REJUVENATOR FOR EYES & LIPS ]
Intended to correct deep wrinkles. Expect an interruption to your social life                  Your Doctor will help in the choice of peeling that is suitable for you according to
of around 8 days.                                                                              the state of your skin and result desired.

                         Textbook of Chemical Peels Superficial, Medium and Deep Peels in Cosmetic Practice
                         Philippe Deprez

                         This book is the definitive reference for all engaged in chemical peels in cosmetic practice, based on one authors extensive experience
                         in research, practice and teaching. It contains the result of over 15 years of work with peels and covers all types of treatment and all
                         types of peel, paying attention to science underlying their use, as well as to preparation, application and potential complications

                         Available Certified and Accredited Peeling Training for advance
                         Including Hands On
                         By Indonesian Medical Mesotherapy Association (IMMA)

Shared By: