SYSTEMATIC HYALURONIC ACID GELS Dosage recommendation for physicians
2 MONOPHASIC NON CROSS-LINKED PRODUCT
amalian balance 3
amalian balance INDICATIONS: - 12 mg/ml, non-cross-linked HA - rejuvenation, vitalizing and hydration of - face - neck - décolleté - hands - touch up after injection with amalian fillers - mesotherapy It s important to know that amalian balance can be injected using a 32 G cannula or a gun which allows a quick and uncomplicated injection into the upper dermis. The best result is obtained with three applications in two-week intervals. The vitalizing effect will approximately last 3 months. 4
forehead fine lines up to 0.5 ml fine nasolabial folds 2 weeks after treatment with amalian I LT active 0.2-0.4 ml per side fine cheek lines 0.5-1 ml per side chin fine lines 0.1-0.2 ml neck fine lines up to 1 ml décolleté fine lines 1-2 ml 5
6 MONOPHASIC SOFT CROSS-LINKED PRODUCT LINE
amalian LT smoothline amalian I LT active amalian II LT intense amalian LT beauty lips 7
amalian LT smoothline INDICATIONS: - 8 mg/ml, cross-linked HA - fine lines - forehead lines - glabella - crow s feet - vertical lip lines - perioral lines - vermilion border - tear trough - touch up after treatment with amalian I LT active or II LT intense It s important to know that amalian LT smoothline is injected into the upper to middle layer of skin. Cannula size: 30 G For tear troughs subcuteanous* injections are placed outside the orbital area. * amalian devices have been clinically tested and approved for intradermal applications only. 8
acne scars (touch up after treatment with amalian I LT active or II LT intense) 0.2 ml / scar forehead lines 0.3-0.7 ml glabella 0.1-0.3 ml very superficial injection! crow s feet 0.3-0.5 ml tear trough 0.5-1 ml per side fine nasolabial wrinkles (2 weeks after treatment with amalian I LT active or II LT intense) 0.3-0.5 ml each side cheek lines 0.5-1 ml per side vermilion border 0.3-0.5 ml per lip vertical lip lines 0.5-1 ml (depending on the number of wrinkles) chin 0.3-0.5 ml per wrinkle (depending on the length) 9
amalian I LT active INDICATIONS: - 16 mg/ml, cross-linked HA - moderate lines and wrinkles - forehead lines - perioral lines, periorbital lines - vermilion border - gentle lip augmentation It s important to know that amalian I LT active is injected into the upper to middle layer of skin. Cannula size: 30 G amalian I LT active is optimal for gentle lip augmentation and correction of the vermilion border. 10
acne scars 0.2 ml / scar forehead lines 0.3-0.7 ml crow s feet 0.3-0.5 ml fine nasolabial wrinkles 0.3-0.5 ml each side cheek lines 0.5-1 ml per side vermilion border 0.3-0.5 ml per lip vertical lip lines 0.5-1 ml (depending on the number of wrinkles) chin 0.3-0.5 ml per wrinkle (depending on the length) lip augmentation 0.5 ml per lip 11
amalian II LT intense INDICATIONS: - 24 mg/ml, cross-linked HA - medium to deep wrinkles - nasolabial - oral commissures - chin - perioral - acne scars - contraindicated in forehead and glabella - vermilion border - stronger lip augmentation - nose bridge augmentation It s important to know that amalian II LT intense is injected into the middle or deep dermis. amalian II LT intense is optimal for moderate to stronger lip augmentation. Cannula size: 27 G For augmentation of the nose bridge it is necessary to inject very deeply. The best result is obtained by using small quantities and with a following touch up 14 days later. 12
acne scars (deep) 0.1 ml each 0.5-1 ml max. per side 2 sessions are recommended nose bridge augmentation max. 0.5-1 ml in one session do not overdose! nasolabial folds (II-III) 0.5 ml per side nasolabial folds (IV) 0.3-0.5 ml per side (for touch up after treatment with amalian III expert volume) oral commissures (II-IV) 0.3-0.5 ml per side lip augmentation 0.5 ml per lip chin fold 0.3-0.5 ml 13
amalian LT beauty lips INDICATIONS: - 22 mg/ml, cross-linked HA - lip augmentation - vermilion border It s important to know that amalian beauty lips LT is a new monophasic formulation for stronger tissue augmentation of the lips. Its superior performance is achieved by implanting five small volume depots along the lip. If the patient wishes, a touch up treatment may be given at the follow up examination. A common reaction after lip augmentation may be a moderate swelling of the injected tissue. In most cases, this will recede over the next 2 days. The achieved augmentation result may last for 6 months and longer. Cannula size: 27G, 30G 14
lip augmentation 0.4-0.5 ml vermilion border 0.2-0.5 ml 15
16 BIPHASIC HIGHLY CROSS-LINKED PRODUCT LINE
amalian I expert premium amalian II expert effect amalian III expert volume amalian lips expert 17
amalian I expert premium INDICATIONS: - 8,4 mg/ml, highly cross-linked HA - fine lines and wrinkles - Injected into the upper to mid dermis It s important to know that amalian I expert premium is suitable for injection into superficial lines, and delicate indications (like glabella) it can be used as a touch-up option after treatment with amalian II expert effect compared to amalian I LT active, amalian I expert premium is on principial injected in lower doses. Cannula size: 30 G 18
acne scars (as touch-up after treatment with amalian II expert effect), 0.2 ml per scar on entire face glabella, 0.1-0.5 ml very superficial forehead fine lines 0.3-1 ml crow s feet 0.3-0.5 ml, per side cheeks 0.5-1 ml, per side fine nasolabial lines and also two weeks after treatment with amalian II expert effect 0.3-0.5 ml, per side vermilion border 0.3-0.5 ml, per lip (upper/lower) perioral fine lines 0.5-1 ml upper lip chin fine lines 0.3-0.5 ml depends on the length neck fine lines, 0.5-1 ml, per line 19
amalian II expert effect INDICATIONS: - 24 mg/ml HA - moderate to deep wrinkles and folds - Injected into the middle to deep dermis It s important to know that it is recommended to use amalian II expert effect for lines of grade II and III you should inject the product sparingly, and prefer a touch-up session instead of a one-time procedure amalian II expert effect is contraindicated in glabella it is not recommended to use amalian II expert effect for lip augmentation slow and controlled deep injection reduces the risk of delayed swelling at 24 hours after the injection when injecting in the nasal bridge the product shall be injected as deeply as possible but above the muscle and nose bone. Droplet injection technique may be used Cannula size: 27 G 20
acne scars (deep) 0.1 ml per cavity 0.5-1 ml in total per side Recommended to perform in 2 sessions bridge of the nose augmentation 0.5-1 ml in one session do not overdose! nasolabial folds (IV) 0.3-0.5 ml per side (as touch up after treatment with amalian III expert effect) nasolabial folds (II-III) 0.5 ml each side oral commissures (II-IV) 0.3-0.5 ml per side moderate chin lines 0.3-0.5 ml each wrinkle (depends on length) 21
amalian III expert volume INDICATIONS: - 24 mg/ml, cross-linked HA - deep folds - volume defect, i.e. cheek - face deformation - liquid lifting - lipoatrophy - scars It s important to know that amalian III expert volume is applied into deep dermis or subcutis*. Cannula size: 27 G * amalian devices have been clinically tested and approved for intradermal applications only. 22
nose bridge augmentation 0.2-0.5 ml cheekbone augmentation 0.5-1 ml per side do not overdose! nasolabial folds (IV) 0.5-0.7 ml per side cheek augmentation 0.5-1 ml per side chin augmentation 0.5-1 ml (amount depending on the strength of defect) mandibular line (chin / jaw contour) 0.5-1 ml per side 23
amalian lips expert INDICATIONS: - 24 mg/ml HA - strong lip augmentation It s important to know that it is recommended to inject lips in two sessions: first enhancement of the lip volume, and in a touch-up session the vermilion border it is recommended not to exceed a total of 1ml a session for upper and lower lip together you should use as few needle insertion points as possible to prevent bleeding and erythema Cannula size: 27G needles are supplied with the package but, if preferred, a 30G needle may be used 24
upper lip volume 0.2-0.5 ml Vermilion border to be injected at touch up visit vermilion border 0.2-0.5 ml Indicated for perioral fine lines that extent to the red lip area lower lip volume 0.2-0.5 ml Vermilion border to be injected at touch up visit 25
TIPS & Tricks Take the time to discuss with the patient his or her expectations and wishes before the treatment, and inform the patient about the different possibilities of a treatment. Discuss the result after treatment, in order to review the effect of the treatment if the result meet the expectation of the patient. Make sure the patient has completed the declaration of health status (medical history) in order to avoid any unnecessary risks. In case of a beginning flue do not inject - the risk of an immunological reaction is too high. Make sure that the patient has signed the consent form and information sheet, before you start the treatment. Ask the patient for possible illness like influenza, within the last 14 days and refuse the treatment in case of a positive answer, thus to avoid immunological reactions. If a lip augmentation should be done ask for propensity for herpes. In case of positive affirmation we recommend an oral antiviral prophylaxis (one tablet at treatment day), alternatively an antiviral lip ointment used for one week. 26
Take before and after photos in an upright position from the front and the side. It will help the patient to better assess the improvement after the treatment. Take the pictures before using anesthesia, since this may affect the appearance of the injection area. Follow the lines and wrinkles, and inject the material along them while retracting the needle. Use simple and gentle injection techniques, and inject slowly. Make an injection plan, select the suitable product and decide on the volume you want to use before you begin the treatment. Using anesthesia either by injection or by topical cream is highly recommended, to ensure patient comfort during the treatment and positive experience after. It is recommended to use anesthesia without adrenaline, to prevent any potential arrhythmia beat. Sitting the patient in an upright position will help you assess the wrinkles correctly, with the natural effect of gravity. Please be aware that after having used anesthesia injection the treated area can be swollen and the wrinkles look different. Soft massage of the injected area can provide a better result, as it improves the distribution of the material in the tissue. 27
S & V Technologies AG Neuendorfstraße 20 a 16761 Hennigsdorf Germany Tel. +49 (0) 3302-202-7900 Fax +49 (0) 3302-202-7905 info@skin-vision.eu www.skin-vision.eu November 2012