MEDWELLNESS - SPECIAL EDITION - IMCAS 2022

YEAR 10 | ISSUE 24 | 2022

Marco

Benedetti

ies Davide Di Maggio Andrea Ortolani

OEO

The most valuable

digital library

Liliana

Abrami

Innovation and intuition: when top range in beauty products is made in Italy + - Seffiller: The Face Rejuvenation - Filler trends for 2022 - Ponytail Thread Lift for Mid-Face - The stem cell revolution in surgery

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Iscrizione al Roc n°23381 aprile 2013 - Poste Italiane S.p.A. - Spedizione in abbonamento postale – D.L. 353/2003 (conv. in L. 27/02/2004 n.46) art. 1, comma 1, C/PE/16/2013 del 30.04.2013

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IMCAS Paris 2022

NEW anatomical and vascular model N.24 | 2022

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GYNAECOLOGY AESTHETIC AND FUNCTIONAL

by Marina Mantovani

oeo digital library: more than 20 digital books and hundred video digital.oeofirenze.com scan the qr for your free trial

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Marco Cover story

Benedetti Liliana

Abrami

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Publisher Strategia Grafica di Cristina Zecca Pescara PI: 01434110688 PEC: strategiagrafica@pec.net

INNOVATION AND INTUITION When top range in beauty products is Made in Italy

General and Administrative Director Cristina Zecca c.zecca@medwellness.it

News e Tecnology

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Editor-in-chief Alessia Addari redazione@medwellness.it

Aestethic Medicine

Graphics Designer Cristina Zecca

14 Ponytail Thread Lift for Mid-Face Rejuvenation 16

The stem cell revolution in surgery

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Filler trends: What to ask your aesthetic doctor

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Skin redensification and dynamic filler for hands care and repair

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Seffiller the face rejuvenation

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Ginecology aesthetic and functional

tories

Health and Medicine 26

Shortening Long Covid

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Effects of Vitamin D on Hashimoto Thyroiditis

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How to reduce Parkinson’s disease symptoms with the help of nutrition

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Marketing and Advertising Director Cristina Zecca marketing@medwellness.it

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Davide OEO di Maggio DIGITAL Andrea LIBRARY Ortolan i

Administration amministrazione@medwellness.it Editorial Office Piazza della Rinascita, 33 65122 Pescara - Italia T +39 085 296 298 Partners to this issue Abrami Liliana , Ashary Ibrahim , Benedetti Marco , Cirri Carlotta, Crobeddu Vittorio, Di Maggio Davide, Di Russo Maria Gabriella Gennai Alessandro, Messaggio Susanna Ortolani Andrea, Quieti Cartledge Raffaella, Russo Mario Photos by: Archivio Stock

Summary

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Aqua Dome Tirol Therme Längenfeld in the heart of the Ötztal Valley

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Fiuggi Palace

YEAR 10 | ISSUE 24 | 2022

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Cover Shakira

Milly Carlucci

Carol Alt

Cristina Chiabotto

Susanna Messaggio

Cover Barbara D’urso

Arianna Ciampoli

Kelly Killoren Bensimon

Samanta Togni

Paola Saluzzi

Sophie Charreteau

5 Gessica Notaro

Elena Sofia Ricci

D. Boschi e A. Calanchi

www.medwelleness.it www.medwelleness.it YEAR 10 | ISSUE 24 | 2022 YEAR 10 | ISSUE 24 | 2022 June - July - August June - July August medicine, Quarterly of -aesthetic Quarterly of aesthetic medicine, well-being and nutrition well-being and nutrition ___________________ ___________________ Editorial Office Editorial Office Piazza della Rinascita, 33 65122 Piazza della Pescara - ItalyRinascita, 33 65122 Italy298 TPescara +39 085-296 T +39 085 296 298 segreteria@medwellness.it segreteria@medwellness.it ______________________ ______________________ Registration to the R.O.C. Registration R.O.C. number 23381toofthe 02/04/2013 number 23381 02/04/2013 Exemption fromofnewspaper Exemption in from newspaper registration registration in07.03.2001 n.62 court: art.16 L. court: art.16 07.03.2001 n.62 MedWellnessL.and Medicine Dossier MedWellness Medicine Dossier are trademarksand registered with the are trademarks registered with the Chamber of Commerce Chamber of Pescara.of AllCommerce rights reserved. of Pescara.

All-rights reserved.

Cristina Zecca Pescara Cristina Zecca - Pescara It is expressly forbidden to reproduce It is expressly forbidden to reproduce even partial texts, graphics, images even partial texts, graphics, imagesin and advertising material contained andnumber. advertising material contained in this All rights reserved. this number. All rights reserved.

Annamaria Acquaviva

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News &

Tecnology PROPERTIES AND SOURCES OF VITAMIN A by: Fondazione Valter Longo Onlus editorial staff Vitamin A is fundamental for the wellbeing of human organism, in which it is present in the form of retinol. In nature, it exists in two forms: carotenoids (of vegetable origin) and retinoids (of animal origin). It is a fat-soluble vitamin that

regulates membrane permeability and tissue elasticity. Moreover, it is essential for the teeth and bones. Scientific evidence demonstrates the anti-oxidant role of vitamin A as antitumor. Its antioxidant power also acts in strengthening the immune system, as well as protecting the cardiovascular system and constitutes an excellent barrier to possible lung infections. _____________________________________

OLIVE OIL, ELIXIR OF LONG LIFE

are reduced: oleic acid helps reduce “bad” ldl cholesterol, and the presence of polyphenols helps increase “good” hdl cholesterol. as a result, the formation of atherosclerotic plaques is minimized, which can obstruct blood vessels and lead to cardiocirculatory problems like stroke or heart attack. oleic acid, polyphenols, and vitamin e contained in evoo, in addition to protecting the arteries from oxidative damage, and atherogenesis, help decrease blood pressure. these observations have been

by: Fondazione Valter Longo Onlus editorial staff The mediterranean diet is often the primary focus of many scientific studies due to its protective effects against various age-related chronic diseases. particularly, a high consumption of olive oil determines these properties. it contains substances that are particularly beneficial for our health, and its pleasant taste makes is tasty and suitable for everyone. accumulates in the liver and is absorbed by the intestine. What vitamin a useful for?

It is fundamental to a healthy eyesight. vitamin A (in the form of retinol) together with its precursors (carotenoids) is one of the components of rhodopsin: a lightsensitive pigment, present on the retina in the rods (organelles capable of capturing light). Retinol, therefore, plays an indispensable role in the mechanism of sight, especially night vision. Furthermore, vitamin A is involved in the regulation of the process of cell growth and differentiation.

For this reason, it is essential in the early years of development, as well as for the wellbeing of tissues and organs. It is good for the skin because, in addition to promoting cellular regeneration, it

OLIVE OIL AND ITS HEALTH BENEITS. The daily consumption of extra-virgin olive oil (evoo) helps to counteract the rise in post-meal blood sugar, especially when consuming foods with a high glycemic index, and for individuals living with type 1 diabetes. oleic acid, found in olive oil, reduces fasting blood sugar and insulin sensitivity, thus also improving blood circulation. This has also been proven in healthy subjects. another beneficial effect of olive oil is closely connected to the prevention of cardiovascular diseases. specifically, the presence of monounsaturated fatty acids can improve the biosynthesis and metabolic process of cholesterol. total cholesterol levels

proven by scientific research.

Other studies point to the protective effects of olive oil, especially evoo, against tumors, as it contains various substances that can trigger the death of cancer cells. for example, oleic acid, squalene, and polyphenols have anti-tumor effects and can prevent the risk of breast and ovarian cancer. the polyphenols found in olive oil can even protect against colorectal cancer. other investigations have linked the intake of evoo and healthy bone density and with protective effects against osteoporosis. furthermore, recent scientific research shows that olive oil

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GUARANTEED MEMORY WITH SLEEP AND GOOD MOOD by: Fondazione Valter Longo Onlus editorial staff A group of psychology researchers from the University of California at Riverside has identified three determinants of so-called “working memory”: age, sleep and mood.

In particular, resting well and keeping a positive mood positively affects this part of memory directly linked to our cognitive performance. The study was published in the Journal of the International Neuropsychological Society (July 2019).

Let’s see the details to understand the connection between the various factors.

WHAT IS WORKING MEMORY The “working memory” is that part of shortterm memory, which holds information temporarily, and then manages it to carry out cognitive activities. This type of memory is also linked to learning and the ability to reason, so it guides us in the actions we carry out every day as a sort

Furthermore, this type of memory is fundamental – as well as for understanding and reasoning – also for intellect, language, the ability to plan actions and solve a problem creatively. To analyze the correlation between working memory versus age, sleep and mood, the researchers separated these three factors, analyzing their different roles and quantifying their effects.

In the past, scientific research had already dealt with analyzing the consequences that the three factors – age, sleep and mood – separately have on memory. In this new study, the American psychologists wanted to statistically isolate the effects of the individual factors considered, related to the quality and quantity of working memory, or what is defined as “memorization capacity”. Specifically, two studies were conducted separately. In the first, the role of sleep and mood were considered, on a group of 110 university students. In the second study, however, the age factor was analyzed in a group of 31 individuals, ranging from 21 to 77 years.

In both cases, participants underwent tests to assess cognitive performance related to working memory.

QUALITY AND MEMORY

QUANTITY

OF

THE

The results of the two studies compared show that the three factors analyzed (age, sleep and mood) have a different role on working memory. In particular, sleep and mood can have quantitative effects.

That is, if you do not rest enough and, in the same way, suffer from a depressed

mood, the amount of information stored decreases and the likelihood of remembering a past event in detail is reduced. In addition, insomnia and low mood, even individually, worsen working memory. Age, on the other hand, affects the quality of memory, meaning that memories (emotions, images, etc.) appear blurry and unclear, like in an old photo faded by time. The various factors, then, are also linked to each other. If you sleep little and badly, your mood lowers, as well as advancing age can be related to depressed moods. Furthermore, this study is further confirmation of the close link between rest and memory. Finally, this new survey highlights how sleep and mood act on memory independently of each other.

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_____________________________________

of navigator. Working memory connects actions, perception and long-term memory, thus allowing us to perform different tasks in our daily life.

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has a protective effect against cognitive decline.

Cover Story Interview

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By Susanna Messaggio

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MEDWELLNESS | FREE PRESS

Marco Benedetti Liliana Abrami

Liliana Abrami and Marco Benedetti, the founders of wellestablished 303Pharma, have not lost sight of their company mission and keep sharing their knowledge and experience in pharmaceuticals. Their company develops solutions for aesthetic medicine, keeping safety parameters to the highest levels.

Lately, they have embarked into a new Made in Italy adventure.

www.303pharma.com

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INNOVATION AND INTUITION

“

Dr Benedetti, what prompted you to invest in this business?

In order to deliver to our clients the wellbeing they deserve, Liliana and I have invested energy and resources to trigger that “revolution in aesthetic medicine” which is giving visible results. We wanted to offer safe answers to what are health needs, but also the recipe to improve our client’s quality of life.

You are exclusive users of Neosilk, the protein of the alpha-1 collagen chain. Can you tell us about its achievement in tissue regeneration and its various applications?

We are licensees of Neosilk®, which is at present our flagship product: it is the alpha1 R-polypeptide chain of collagen, obtained from the cocoon of a silkworm bred in Japan, through an extraction and purification process.

Neosilk® is an innovative substance because it differs from all collagens on the market: almost 100% of the product is biocompatible with the human body. A cruelty-free and completely natural (therefore organic) biological solution.

Quality, ethics and patient care, together with strategic choices have allowed your company to develop both the Italian and international markets. Doctor Abrami can you tell us more about your company’s journey?

We set ourselves up to find exclusive and

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MADE IN ITALY

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WHEN TOP RANGE IN BEAUTY PRODUCTS IS

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Cover Story Interview

# INNOVATION AND INTUITION

unique products. With a sense of foresight, we have allowed 303Pharma to achieve ambitious targets. Our winning strategy, supported by our enthusiasm, was the realization of how useful this new substance could be.

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What is the secret behind your product’s success ?

After launching the Creo line of cosmeceuticals based on Neosilk®, our company has also certified other medical devices intended for different therapeutic areas. 303 Pharma produces Creo R-Mousse for the treatment of all inflammatory conditions of the skin.

Neosilk® naturally stimulates the production of endogenous collagen, giving the skin greater elasticity and tone. The company has also formulated injectable medical devices based on Neosilk®. The bio-replenishing soft filler, Karisma, naturally restores pre-aging skin condition, acting on the rejuvenation of the extracellular matrix of the skin. Neoial HC, a further winning product for visco supplementation in the knee and joints, promotes cartilage regeneration.

The product is an adjunct to the treatment of traumatic or degenerative diseases of the joint structures, therefore useful in case of focal chondropathy, arthrosis and even meniscal pathology. An absolutely innovative solution for the orthopedic sector.

Your research and your products do not only help us humans, but also our four-legged friends. How? We use the same principle for veterinary products, such as a buccal gel, Revogen S, for the treatment of stomatitis and inflammation of the oral cavity of viral origin. The eye drop Regogen Eye, is an adjuvant in the treatment of corneal lesions for pets.

What is new in the nutraceutical sector?

In nutraceuticals we are also studying a new generation of ‘biodynamic’ food supplements, capable of stimulating the synthesis of essential elements for the well-being of our body. The formulations aim to control metabolic disorders and weight, and offer support to aesthetic medicine treatments.

Are your company and products environmentally friendly ?

For a substance such as Neosilk®, which is totally biocompatible, we have developed ‘eco-friendly’ products, such as a thixotropic gel, a liquid that, once stirred and sprayed, arrives ‘fly & stay’ on the application area, for the treatment of chronic ulcers.

Thanks to the work done to date and the results achieved, 303Pharma has been recognized by the manufacturer of Neosilk®, IBL Japan, as the only partner for the development of products containing the substance, for use in the various therapeutic areas.

A recognition that pushes our company towards new frontiers of development, partnership and internationalization of its business model. Today we are a Made in Italy excellence that, in a short time, has become an eco-friendly example for all players in the sector.

Can you tell us more about Neosilk ?

The perfect compatibility of Neosilk® with human tissues, thanks to its monoelic structure, (therefore similar to that of the collagen produced by fibroblasts), makes the substance 100% tolerable for use on the skin. A structure that determines a better and faster synthesis of autologous type I collagen. Neosilk® is a new collagen defined as “recombinant” as it does not come from animals. Extracted from the filament of silkworms fed and raised according to the highest standards in Japan, to obtain a product of the highest quality, Neosilk® collagen is ideal for the rejuvenation of the extra cellular matrix of the dermis, compatible with human tissues. In fact, the purification process that takes place immediately after extraction eliminates any risk of contamination by pathogens and foreign bodies.

Once the cocoon has been woven, the silkworms are not killed and their life cycle is respected.

THE EXCELLENCE OF MADE IN ITALY AT EXPO DUBAI 2020

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Since 303 Pharma’s inception, in 2018, founders Marco Benedetti and Liliana Abrami, have been at the forefront of design and manufacture of regenerative medicine products.

The result of their research is the recombinant protein Neosilk, obtained from the cocoons of a silkworm bred in Japan. “In a sector such as healthcare, which thrives on constant innovation - explains Liliana Abrami co-founder of the company - our laboratories more than others have turned their gaze - and continue to do so - towards the search for ever new solutions”. “Our goal is that of international integration and recognition - continues Marco Benedetti co-founder of 303 Pharma - this is the lever that has led us to be one of the leading companies on the global scene and to participate in the scientific Medical & Healthcare conference in Dubai with the aim of initiating debates and fostering relations with strategic partners and the most important global stakeholders”.

What does the near future hold for such a dynamic and forward-thinking company like yours?

We will be increasingly focused on strategic partnership activities and on the internationalization process that allows us to be present in new commercial scenarios.

To this end, we will take part to the IMCAS congress in Paris 2022, in support of Taumed, and in Dubai Derma with our 303 Pharma stand. We are working on further technicalscientific innovations which, in line with our company philosophy, will offer the market and the end-user, solutions that are always at the forefront of our field.

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Despite the health emergency, which caused understandable travel restrictions and the war in Ukraine that has triggered the destabilization of the global geopolitical balance, Expo 2020 Dubai has exceeded 20 million visitors.

The last universal exhibition, namely Expo 2015 Milan had hosted 22.2 million visitors. Numerous Italian companies have landed in the Emirate city-state. The mission in the United Arab Emirates is that of telling an audience of international investors about Italian excellence. Within the health service sector, the Brescia-based company 303 Pharma was a reference point.

With a consolidated experience in pharmaceuticals, 303 Pharma is known for the design and production of skin products based on the innovative recombinant collagen Neosilk.

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Expo Dubai 2020 is a World Expo, hosted by Dubai in the United Arab Emirates from 1 October 2021 to 31 March 2022.

Originally scheduled for 20 October 2020 to 10 April 2021, it was postponed due to the COVID-19 pandemic.

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Dr Ibrahim Abdulhameed

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ASHARY...

A NAME OF GOLD After graduating from the University

of

Tubingen

in

Germany, Dr Ashary trained with the best-known plastic surgeons in Germany

and

France.

are

His

clinics

located in Jeddah in Saudi Arabia

and

Dubai

in

the

United Arab Emirates. He also visits patients and performs cosmetic surgery in London.

“

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Dr Ashary, the gold standard of cosmetic surgery

Dr Ashary, what are the plastic surgery procedure you perform most often?

The plastic surgery procedure I perform most often are thread lifting facelift and rhinoplasty, which are fast becoming the most popular cosmetic surgeries also for men. I wrote two books about these procedures and I have two specific and unique techniques for rhinoplasty.

What is thread lifting?

A thread lift is a type of procedure wherein sutures are used to produce a subtle but visible “lift” in the skin. Instead of removing the patient’s loose facial skin surgically, the cosmetic surgeon simply suspends it by stitching up portions of it. This has the effect of pulling the skin back slightly and therefore lifting and tightening the face. In addition to being ideal for lifting the skin, threads combat aging in another way: by provoking the body’s “healing response” and causing the body to direct large surges of collagen to treated areas.

This is important because of the vital role collagen plays in the aging process.

What are the advantages of having a thread lift instead of a facelift?

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THREAD LIFT

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ASHARY...

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ASHARY What are the advantages of having a thread lift instead of a facelift?

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RHINOPLASTY The biggest advantage of having a thread lift rather than a facelift is the greatly reduced recovery time associated with thread lifts.

Facelift patients usually need to take one to two weeks off work, too, to heal.

Recovery from a thread lift, on the other hand, is comparatively easy. Thread lifts can be performed under local, rather than general anesthesia, meaning that thread lift patients can drive themselves home and look after themselves immediately after having their procedure.

What are the forms of rhinoplasty surgical technique?

The rhinoplasty can be performed in two forms: Open rhinoplasty: The open rhinoplasty can be done using a transcolumellar incision, which provide wider visibility and accessibility to the interior of the nose to allow full restructure when necessary, although this form of the surgery requires an incision yet there shouldn’t be worries regarding the scars due to the very fine suture material used and the technique of suturing.

Closed rhinoplasty: This technique is differentiated from the open rhinoplasty in the fact that the incision is performed inside the nostrils, and it’s used in patients with less severe cases and when less structural changes are required. The surgical technique and the

“ “ “We believe that beauty most reflect your personality and take your breath away. Therefore we use the most advanced scientific technologies with our sense of Art to achieve a gorgeous look”.

Dr Ibrahim Ashary

type of incision is decided according to the type of treatment needed.

What procedure is the fastest growing in popularity?

Today more women and men want to look and feel better about themselves, which is why body contouring and lipo-sculpture are constantly growing in popularity and becoming the most appreciated cosmetic surgery performed nowadays. SmartLipo is the first and only laser-assisted liposuction system available meeting this need. It provides a revolutionary and minimally invasive procedure for the removal of fat using a high-powered laser to sculpt body contours and tighten skin with less downtime and side-effects.

How does the SmartLipo procedure work?

SmartLipo is a simple procedure: a very small cannula or tube containing the laser fibre is inserted into the skin. The cannula is moved back and forth as the laser’s energy is delivered directly to the fat cells, making them rupture and easy to drain away. In addition, as the laser energy interacts with the dermis it results in skin shrinkage or tightening. Procedure for the removal of fat using a high-powered laser to sculpt body contours and tighten skin with less downtime and side-effects.

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https://drashary.com/en/

Do you rely on machines to perform your surgeries?

I have high tech machineries and instruments but I prefer using my hands, Results with machines are not up to top standards and recovery is much longer. Most of my patients are individuals with a busy and intense life and they cannot wait for 6 months before looking presentable again. For example the specific type of rhinoplasty I perform is scarless, gives natural results and the effects finish fast, so in no time the patient can go back to his/her life.

“

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I dedicate a long time to my patients when they come for a first consultation. I talk to the patients to understand what they need.

I rarely do the same type of operation to two different patients as each individual is unique and desires to achieve his/her own individual results.

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How do you manage to achieve results that respect and reflect the patient’s personality?

Long time, beauty has inspired human being and as the beauty of Plastic surgery has inspired me in many aspects, I have tried to use latest science with art to achieve Harmony and beauty for my patients.

Beauty has to touch you and take your breath away

“

aesthetic medicine

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By Dr Ibrahim Ashary https://www.medicalandresearch.com/

Lift for

Mid-Face Rejuvenation

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Ponytail Thread

The aging process is regarded as a natural biological phenomenon in the human body, leading to atrophy of the soft tissue and loss of tonicity and congenital structural integrity As a minimally invasive facial rejuvenation operation, thread lift has become progressively common globally. The initial excitement was frequently accompanied by disappointment as we learned more about the restricted longevity of minimally invasive procedures and complications arising from different previous suture models.

In this study, we present our experience with the ponytail thread lifting method, which is a combination of classical thread lifting and Dr Ashary’s ponytail modification, that addressed the issue of thread lifting durability based on Patient satisfaction which has been proven to be the predominant factor in determining aesthetic surgery success.

Patients were asked to finish a standardized study instantly after surgery, follow-up and two years after surgery. The questionnaire is an outcome reported by the patient to assess results among patients with midface area facial aesthetics.

Results: After surgery, all patients reported an enhancement in their appearance, and cheek elevation on Follow-up patients was asked about their facial appearance satisfaction, and all patients were pleased with their appearance.

94.29% of patients rated their appearance as natural and all patients reported that they’ve

noticed a positive change in their quality of life.

57.14% reported that people made positive remarks about the operation.

When patients were asked about how many years of favorable effect did the surgery have on their appearance, 40% reported they look 10 years younger, 35.71% reported they look 15 years younger and 24.29% reported they look 20 years younger. 97.17% expressed satisfaction with the choice to undergo surgery two years after the surgery, Only 4.29 % reported they believed their face would look better if they didn’t have a thread lift.

Conclusion The ponytail thread lift technique has proven to be efficient and more durable even two years after surgery, and a great step in the way of preparation for the permanent facelift procedure.

Patients who responded in this study were extremely satisfied with their choice to undergo the procedure.

The aging process is considered to be a natural biological

phenomenon occurring in the human body, resulting in soft tissue atrophy and loss of tonicity and congenital structural integrity. (1) The facial plastic surgeon has several methods available to influence a beneficial shift about the midface.

Comprehension of the anatomy of this area is paramount in rejuvenating the aging midface. The relationship of the malar pad with the zygomaticus major / minor muscles and the SOOF are key aspects to understanding the aging midface, Location and knowledge of the significance of the frontozygomatic ligament, understanding how superficial facial expression muscles use SMAS to form facial fiber links to the dermis that enable midface animation, and, Finally, the investment by SMAS in the midface of the superficial facial expression muscles and the malar pad.

The first anatomical point is that the malar pad overlaps the zygomaticus muscle and the SOOF, The frontozygomatic ligament emerges from a thickening of the SMAS that secures the midface right above the lateral attachment of the zygomaticus muscle. The surgeon must release this ligament to successfully

Before ponytail thread lifting, frontal view

After ponytail thread lifting, frontal view

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rejuvenate the midface during surgery, as the inability to do so will prevent the lateral and superior movement of the malar pad during surgery. The significance of understanding that the superficial facial expression muscles in the midface use the SMAS to attach to the dermis, which makes it possible to animate this region, clarifies why lifting this region in a subperiosteal plane will have little impact on enhancing the depth of the nasolabial fold since lifting in this plane moves all superficial structures around the same, yielding no net alteration of the superficial aging anatomy. (3) Thread lift has become increasingly popular worldwide as a minimally invasive facial rejuvenation procedure. The initial excitement was often followed by disappointment as we learned more about the limited longevity of minimally invasive procedures and complications resulting from various suture designs of the past.

Patient satisfaction has been proven to be the predominant factor in determining aesthetic surgery success.

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aesthetic medicine

18

By Dr Mario Russo

The stem cell revolution in surgery N.24 | 2022

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Bye-bye scalpel

You can obtain the stem cell from a quick and painless liposuction, achieving a double result: using it in the operating room and reducing undesired fat. And you can cryopreserve them too, as a biological insurance policy on your health. Let’s discover how the surgeons can use stem cells to promote your wellbeing.

Every year, thousands of millions of surgeries are performed all over the world. Unfortunately, they do not come without risks.

Incision, excision, manipulation and pain are all sources of stress which has multiple effects on the whole body. Inflammation levels, coagulation and the immune response are all affected. Moreover, specific surgery can be associated with specific risks.

However, the scalpel is not always the only option. Stem cells have already paved new ways to approach surgery in several fields, heading towards regenerative treatments.

«Adipose-Derived Stem Cells (ADSCs) are the basis of the most innovative aesthetic medicine and plastic surgery treatments», says Dr. Mario Russo, an Italian Board Certified Plastic Surgeon, Medical Director at Maison Lutetia Dubai. Dr. Russo is a specialist in Breast, Facial, and Body Surgery, having performed more than 9,000 surgeries, he settled his work on patient safety and on providing the best natural results, and found the ideal approach in stem cell-based treatments.

A case in point: breast volume increase and cancer risk Among procedures that can take advantage of stem cells is a very common plastic surgery: breast volume increase.

Nowadays, breast implants are utilized for both reconstructive and augmentation surgery. Surgeons and patients can choose among several types of implants; the most common in Europe, for example, are textured implants. Unfortunately, these same textured implants are associated with a greater risk of BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma).

BIA-ALCL can take more than 20 years to develop. The standard of care treatment is surgical resection; however, more advanced BIA-ALCL can require other treatments too, such as chemotherapy or radiation therapy.

Fortunately, cancer risk can be avoided by choosing solutions other than breast implants, such as stem cell-based breast augmentation. ADSCs are the best option. They ensure the best results, together with the highest safety levels and the lowest risk of adverse effects. As explained by Dr Russo, «ADSCs come with a double benefit: breast remodelling and excess fat reduction. They can be obtained from the patient’s excess fat – for example, from fat that has accumulated on the abdomen or thighs. Nowadays, we can isolate stem cells from this fat and multiply them in the lab to obtain the number needed for breast augmentation. Once injected, the cells integrate into body tissues, allowing for results that are natural to both the eye and the touch.»

Dr Russo highlights the importance of choosing an ADSC-based treatment instead of the classical fat or Stromal Vascular Fraction (SVF) transplantation. «SVF is obtained by fat centrifugation; it is enriched in adipose stem cells, but it contains undesired components too, such as macrophages. These components are supposed to drive undesired effects, such as fat resorption after transplantation. That is why one should switch from fat or SVF

Not only breast The same approach is suitable for shaping other parts of the body. For example, ADSCs are a valuable option for buttock enhancement without artificial implants. «Both the theory and the practice are the same as for breast augmentation. No permanent implants are utilized, so the risk of associated complication is completely avoided. No surgery with general anaesthesia is required, eliminating medical and intra-operative risks. Results are long-lasting and could be doubled: buttocks are reshaped while the undesired fat on “critical points” is reduced.»

Again, ADSCs are suitable for a completely natural facial lifting without scalpel, allowing for restoring a youthful face with long-lasting results. «The stem cells of the adipose tissue confer to the skin a younger appearance by promoting the production of collagen and elastin. These are the molecules that mark the difference between a child’s and an adult’s skin. By producing it, stem cells not only increase, where necessary, the volume but also improve skin quality.» Other treatments, such as Botox and fillers, can reduce wrinkles, but cannot improve the quality of the epidermis; that is why the combination of these, more traditional, approaches and ADSC treatment can avoid wrinkle-

A simple procedure All of these treatments are based on a simple and painless procedure. «Fat is collected during a quick outpatient liposuction. No hospitalisation is needed, neither in this phase nor for the treatment, which is usually performed under sedation and/or local anaesthesia. Stem cells are extracted and expanded in a GMP-compliant lab, such as the ones of Bioscience Institute, a leading Regenerative Medicine Centre based in Europe (Italy, San Marino) and Middle-East (Dubai). The expansion takes about 2 weeks, after which the cells are added to the patient’s fat from liposuction and injected into the treatment area.»

What is more, remaining ADSCs can be frozen and cryopreserved to warrant the availability of stem cells for other body shaping treatments, or other Regenerative Medicine treatments.

«Stem cell cryopreservation is a biological insurance policy for our health. Autologous stem cell transplantation is devoid of rejection risk, and research is continuously unveiling new stem cell potential in medicine.

That is why missing the opportunity of cryopreserving the cells you obtained by liposuction is missing the opportunity of exploiting their health-safeguarding potential.»

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transplantation to ADSC-based treatments.» Clinicians using this approach reported that the injection of a suitable concentration of ADSCs is not associated with the adverse effects that are frequent with fat or SVF transplantation, in particular with the development of cysts and the death of the injected fat. «This last effect would come with a toll: the reduction of the volume achieved by the injection. In fact, fat or SVF injection are associated with this risk. Instead, ADSCs produce molecules that can give stability to the volumes and that can regenerate the tissues, avoiding, at the same time, the formation of cysts.»

free but otherwise old skin. «Skin texture is improved, the subcutaneous collagen layer is thicker, fine wrinkles and other signs of ageing disappear, and the skin looks overall healthier and fresher.»

Also, stem cell-driven collagen and elastin production can be exploited to replace the fibrotic tissue associated with scars and stretch marks with fresh and smooth skin.

«Stem cells repair damaged skin through the reconstruction of the extracellular matrix. The fibrotic tissue that makes the scar unpleasant from both the aesthetic and the functional point of view is removed, leaving the skin looking healthier, smoother, and glowing, and reducing stretch marks.»

Finally, ADSCs can be utilised in penis enlargement and vaginal rejuvenation treatments, and in hair loss approaches suitable for people who do not need a hair transplantation because still young or in the initial phase of thinning.

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TRENDS What to ask your aesthetic doctor N.24 | 2022

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6 FILLER

by Dr Vittorio Crobeddu

It’s called LIQUID LIFTING or NON-SURGICAL 3D LIFTING and it’s an aesthetic trend that has been establishing itself in recent months overseas and which will be increasingly popular in the near future. It allows you to model facial features using fillers, giving harmony, volume and rejuvenation, without resorting to a scalpel.

“For this procedure, it is necessary to perform the injections in precise sites and to use fillers that are soft and malleable” clarifies Vittorio Crobeddu, dermatologist Isplad and aesthetic doctor. «Among these, is the new BIOHYALUX FILLER. It ensures a great handling and a natural result and causes no swelling after treatment.

This is thanks to the structure and purity of the hyaluronic acid used, which is available in different formulas based on the target area and desired effect ».

And speaking of strategic areas, here are the six filler trends for next year.

Less volume and more shape. The trend for lips is to highlight the natural structure, emphasizing the contours and providing hydration to the tissues.

TEAR TROUGH. Tear trough hollows and under-eye bags make us to look tired.

For this reason, fillers are increasingly requested to tackle the problem. For this procedure, doctors use gels with particular viscoelastic characteristics which are capable of integrating into the delicate periocular tissue.

HEART-SHAPED FACE. This trend is to enhance the cheekbone area while also targeting the temples to widen the upper part of the face. At the same time, injections are performed on the chin to give a greater definition. The result is a slimmer face; less square and weighed down.

RHINOFILLER (non-surgical correction of the nose).

Using a filler can help smooth out the profile of the nose and achieve some tip lift. For those with a very small nose, the overall shape can be accentuated and redefined.

DEFINED LIPS Less volume and more shape. The trend for lips is to highlight the natural structure, emphasizing the contours and providing hydration to the tissues.

PLUMP CHEEKS. Rather than creating volume on the lower part of the face, the target will be accenting around and above the

cheekbones, lifting the face, thus restoring a fuller and more youthful look.

JAWLINE. In recent months, there have been increased requests in the USA to rejuvenate and redefine the chin and the mandibular angle.

But no excessive interventions, just some retouching to give the feeling of a face that still has well-defined contours. « A natural result can be obtained only with a product that has certain characteristics. The injection technique is also very important,” explains Dr. Crobeddu. “Using the cannula, rather than the traditional needle, has many advantages. The cannula causes less discomfort during treatment and has fewer side effects such as bruising and swelling. With the cannula, a greater lifting effect is obtained and the filler can be more evenly distributed, creating a more natural result, without the formation of unwanted accumulation. »

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Skin redensification and for hand care and repair

DYNAMIC FILLER

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By Dr Maria Gabriella Di Russo

Today the demand to fight against skin aging is no longer limited to the usual areas: face, neck and décolleté.

Increasingly sophisticated and demanding women, require care even for unusual areas such as the hands.

Hands are an important business card: with them we cherish, write, express ourselves, explore and touch the world, we use them to make contact with other people.

Every day our hands undergo prolongued stress. They are an area of the body very exposed and constantly subjected to factors that determine a fast and premature aging process compared to the rest of the body.

Skin changes induced by photoaging are added to the changes of biological aging.

Excessive exposure to the sun and cold, such as frequent washing and continuous contact with soaps personal cleansing or household products, and even the most recent use of sanitizers to disinfect hands, lead to alteration of the epidermis. This can result in dryness, wrinkles, loss of volume and elasticity and in addition skin flaking. Roughness to the touch and the frequent thinning of the skin on the back of the hand makes tendons, veins and bones more visible: in other words skin aging.

Ageing must be combated day by day, a daily

commitment to anti-aging prevention. But it is not enough, the hands rejuvenation requires outpatient medical treatments, through a thorough medical examination the Hcp determines the stage of chrono and photo-aging, in order to plan a targeted protocol.

The number of sessions depends on skin condition. In principle it deals with three customized sessions, one per month according to the aging and combined with a homecare cosmeceutical.

The sessions consist in intradermally injection of dermorestructuring and/or dynamic filler, leading to: improved hydration and skin firmness, increase in compactness, as well as increase in elasticity For the dermorestructuring treatment you use a crosslinked hyaluronic acid gel 15mg/ml with dermo-restructuring complex (8 aminoacidic, 3 antioxidants, 2 minerals and 1 vitamin) and/or the hyaluronic acid filler gel: crosslinked with 15 or 23 mg/ml.

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the dermal redensification improves the physiological parameters of the skin

Skin dermorestruction or skin redensification is the basis of antiaging prevention and skin care, is not simply the correction of the single imperfection.

The aim is to improve the quality of the skin and the psychophysical well-being of the patient. The treatment can be carried out both in summer and winter time, its peculiarity is to provide new nourishment in those periods where other treatments are not recommended.

Summer, as well as winter are two periods of the year in which photo-exposure becomes more aggressive and therefore, a good derma-restructuring of the skin in addition to not having any contraindications, it guarantees a deep and long-lasting hydration.

A properly performed skin redensification is an excellent basis for proceeding to subsequent treatments with dynamic fillers.

In this way, to the redensification it is added, thanks to the “dynamic” filler, a reshaping action of the tissue, to correct depressions and small wrinkles.

With the redensification and the dynamic filler there is an immediate and visible increase of the skin luminosity on all skin types and in patients of all ages.

The light is reflected differently from the skin and this is an incontrovertible index that the texture has improved.

To take care every day, morning, and evening, of your skin with appropriate products, which consolidate and strengthen what is done periodically in the clinic, is absolutely essential Dermal redensification improves the physiological parameters of the skin, the aesthetic aspect of the quality of the skin, enhances the preventive action against aging, and its benefits are effective on the treated area.

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Clinically it shows recovery of skin firmness, tone and skin firmness.

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The protocol for the treatment of aging of hands treats and corrects the alterations caused by chrono and photoaging.

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By Dr Alessandro Gennai

Seffiller N.24 | 2022

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THE FACE REJUVENATION The gaze plays a central role in the aesthetics of the face and no facial rejuvenation procedure is complete without its treatment; the aesthetic physician has several possible procedures to choose from when trying to improve this area (botulinum toxin, needling, lasers, wires etc.) but I believe that the restoration of the volume and the regeneration of the tissues play a fundamental role in the rejuvenation of the eyes.

This chapter will explain a fundamental technique for anyone who wants to approach the methods of rejuvenation of the face, and in particular of the eyes. It is just a description of what I do in my daily practice, inspired by some concepts of my own philosophy of rejuvenation of the eyes and, in a broader sense, of the face. It thoroughly covers a few concepts that I tried to share in my talks during conferences organized by me or others, in my lectures, articles, and books that I published.

These concepts are summed up in a few simple points: Rejuvenation is the improvement of mainly the central part of the face; the gaze plays a fundamental role in the beauty and youth of the face. Unfortunately, the most common and widespread technique of rejuvenation of the eyes, the upper and lower blepharoplasty, is a “subtractive” procedure. It removes tissue (skin, adipose tissue, and muscle) and has the opposite effect of a rejuvenation, as it causes a sinking and rounding of the eyes. Moreover,

by extending the concept to the rejuvenation of the face, the common techniques of “skin lifting” also “pull” the skin especially in the lateral part of the face while the “rejuvenation game” is played by reinvigorating and restoring the volumes in the middle part.

Rejuvenation restores tone and volume and regenerates tissues: this is much more effective than “pulling” the skin.

We have to select the least invasive and safer techniques for our patients and avoid “over treatment”, or treatments that are too invasive in relation to the problem to be solved.

The rejuvenation of the gaze is not a transformation: instead, it restores characteristics lost over the years. For this reason, I think it is very important to ask our patients for their photos of 10-20 years earlier: this is extremely useful for our operative program, and it helps the patient understand what objectives we are pursuing. The topic of my chapter is how the aesthetic physician can rejuvenate and regenerate a gaze using the SEFFILLER® technique. This technique allows him to exploit the regenerative potentials of Stromal Vascular Fraction (SVF) and adipose tissue-derived stromal cells (ADSC) in its Aesthetic Medicine clinic.

Stromal Vascular Fraction (SVF) and Adipose Tissue-Derived Stromal Cells (ADSC) Clinical studies have demonstrated the efficacy of the therapies based on autologous grafting of autologous adult mesenchymal stem cells to accelerate healing and regeneration of the skin and mesenchymal tissues as well as to find application

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The adipose tissue-derived stromal cells (ADSC) have their regenerative and immunomodulatory capacity thanks to the paracrine effects caused by trophic factors presenting antifibrotic, antiapoptotic and proangiogenic activity. Moreover, mesenchymal stem cells also have their own regenerative capacity and can promote tissue reparations thanks to their intrinsic ability to transform in mesenchymal and endothelial cells.

Fig. 5.23a

45-year-old patient (Fig. 5.23a) who came to my observation asking for a rejuvenation of the gaze. The patient presented many mimic wrinkles, photoaging, and loss of volumes predominantly in the upper orbital groove with pseudodermatochalasis. My outpatient program provides tissue grafting with SEFFILLER technique and botulinum toxin treatment (Fig. 5.23b).

The picture (Fig. 5.24b) shows the result 6 months after treatment with SEFFILLER.

Fig. 5.24b

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ADSC are able to differentiate into adipocytes, osteocytes, chondrocytes, miocytes, as well as non-mesodermal cells (neuronal, endothelial, epithelial, etc.). They are also able to secrete a number of growth factors, such as VEGF (Vascular Endothelial Growth Factor), HGF (Hepatocyte Growth Factor), FGF-2 (Fibroblast Growth Factor 2) and IGF-1 (Insulin-like Growth Factor 1) which confer a regenerative and angiogenic power. One of the richest tissues in adult mesenchymal stem cells is adipose tissue.

Adult mesenchymal stem cells of adipose origin (adipose tissue-derived stromal cells - ADSC) are now among the most widely used cells in regenerative medicine for their characteristics, such as their ease of availability.

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in the treatment of autoimmune diseases for their immunomodulatory abilities. Adipose tissue-derived stromal cells are pluripotent adult progenitor cell derived from embryonic connective tissue.

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By Carlotta Cirri - Digital.oeofirenze.com

aesthetic and functional N.24 | 2022

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GINECOLOGY Dear Dr Mantovani, how has the relationship between the women and their gynecologist changed in recent years?

The increase in the average life expectancy compared to last century, which in women has gone from 50 to 83/87 years, has resulted in an increase in the focus on all women’s disease, and anything that may improve quality of life. This is because if we do not succeed in having health expectancy match life expectancy, ageing becomes truly unsustainable from a physical point of view as well as from a psychological point of view.

Women in the 21st century are new women, who have experienced the sexual revolution and saw the birth of the new family law, contraception (and with it motherhood as a choice), abortion – they are independent women who work and often have roles that until a few years ago were the exclusive purview of men. These new women experience the changes of their body in a different way compared to the past, and pay more attention to the changes in their genitals, which used to be seen merely as reproductive organs.

The vagina and vulva regain their identity as essential organs for sexual health, and their integrity is fundamental to prevent the genitourinary syndrome so frequent in postmenopause.

However, for many women it is still extremely difficult to deal with these topics, owing to

embarrassment, to modesty, because of the commonplace assumption that menopause embodies the unavoidable progression of life and that it should be endured as a “natural event”. Indeed, only 25% of women report these issues to their gynaecologist, when at least 50% of menopausal women suffer from them, and at least 70% of doctors do not investigate this type of symptoms.

There are still many taboos on sexuality today, especially when the procreation part is no longer relevant and there remains only the playful and relational aspect, and when the role of mother gives way to that of “partner”. Our work is essential because we must ensure women become aware of their changes and accept them, but above all they must know that nowadays, we have all the tools we need to tackle any problem.

It is important to read between the lines what the patients do not say and what we can assume from the medical history and clinical examination, and to deal with issues that we know to be “thorny” with great sensitivity, trying to instil in our patients that self-confidence that tends to decrease over the years.

Your book focuses on different treatments for vulvovaginal improvement and rejuvenation. What are the most interesting methods?

The new methods I use for aesthetic and functional rejuvenation of the female genitalia are all extremely interesting, as they are “flexible” and able to respond to all the needs of women. They are like tailored suits, they must be studied and tested to solve the symptomatological and aesthetic problems that arise with progress of aging. I use from bioidentical hormones of plant origin (personalised in galenic formulations), to vulvovaginal laser, carboxytherapy and

In your book you support the use of mesenchymal stem cells for tissue repair and regeneration. In your opinion, is there any mistrust towards this type of treatment?

The use of homologous mesenchymal stem cells in gynecology is recently application and as everything “new”, it needs time to establish itself.

I can say that the patients that underwent treatment last year they ask to repeat it: this surely is the most important result.

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“

injected hyaluronic acid and finally regenerative medicine with homologous stem cells of mesenchymal origin.

I registered as intellectual property a protocol for the prevention and therapy of vulvovaginal ageing and genitourinary syndrome called L.A.S.C. from the initials of the treatments used (Laser, hyaluronic Acid, homologous mesenchymal Stem cells, Carboxytherapy).

Marina Mantovani is Surgeon, Specialist in Gynaecology and Obstetrics, Vicepresident of A.I.T.A.R. (Italian Regenerative Autologous Therapy Association).

She obtained her degree in Medicine and Surgery in 1979, at the university of Modena and specialised in Obstetrics and Gynaecology from the same university in 1983. In the last 10 years she focused especially on the well- being of menopausal women, seeking to improve their quality of life, at a functional as well as aesthetic level.

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“

Health and Medicine

Shortening

Long Covid Patrick

Holford Author, speaker, researcher and founder of the Institute for Optimum Nutrition

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By Raffaella Quieti Cartledge

Patrick believes that as important as good nutrition, exercise, reducing stress, not smoking and creating a toxin-free environment are – our state of mind and spirit also have an enormous effect on our ability to be healthy and recover health, and this should not be underestimated. He teaches that we are physical, emotional, sensual, intellectual and spiritual beings living on the Earth in a human society, and understanding this connectedness is vital to feel fully alive, awake, connected on all levels and living a purposeful life. He has written and taught extensively about Long Covid Dr Holford, what is the aftermath of the Covid pandemic?

The aftermath of the Covid pandemic has left 1.2 million people with symptoms of ‘Long Covid’ the main ones being shortness of breath, severe fatigue, brain fog, and heart and lung conditions.

According to a Lancet report there is an extended list of 200 symptoms including visual hallucinations, tremors, itchy skin, changes to the menstrual cycle, sexual dysfunction, memory loss, diarrhoea and tinnitus.

Problems with balance can include generalized dizziness (some report feeling “drunk or tipsy” but without having any alcohol), lightheadedness or a floating feeling, vertigo or a spinning sensation, particularly when looking up or down, or lying on your side, a sensation of swaying or rocking when sitting or lying, or after a quick motion, poor balance when standing or changing positions, problems walking in a straight line or in busy areas such as a shopping mall, brain fog and issues with vision such as blurring, doubling, trouble viewing screens or issues with fast moving or busy scenes.

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Much like chronic fatigue syndrome this multi-system disorder is not responding to any particular drug and is very unlikely to.

However, the world of systems-based nutritional therapy is coming up trumps in many respects.

What are the most important supplements to fight Long Covid ?

The obvious place to start are nutrients that, if optimally supplied, speed up recovery and reduce the chances of ever developing Long Covid in the first place.

Vitamin C’s main functions are: strengthening the immune system, fighting infections, making collagen, keeping bones, skin and joints firm and strong. An antioxidant, vit. C also helps detoxifying pollutants and protecting again oxidation.

In high oral doses or given intravenously, Vitamin C has a long history of reducing fatigue. A dozen studies in a variety of non-covid conditions and many cases of people with Long Covid, either having a course of intravenous vitamin C or taking oral vitamin C up to ‘bowel tolerance’ – the level that induces excessively loose bowels – report recovery. Doses were from 6 to 10 grams a day.

Vitamin C’s other critical role in the body is making collagen needed to keep the skin intact, but especially the very thin endothelium, the membrane that separates blood in the arteries and air in the lungs from your insides. Since a persistent viral infection depletes vitamin C this effectively leads towards scurvy if levels become too low for several weeks. As vitamin C makes collagen, the inter cellular ‘glue’, a chronic lack causes breakdown in these tissues, as well as muscles, leading to

shortness of breath, loss of stamina and arterial damage, all of which are being reported in those with long Covid.

Vit C is a powerful antioxidant. Antioxidants are substances that protect cells within the body from damage caused by free radicals. They help to strengthen the body’s ability to fight infections. They also have antiinflammatory, endothelial-restoring, and immune modulating effects, yet the medical profession’s general bias against vitamins means this option is rarely considered.

Vitamin D has anti-viral and antiinflammatory effects. It also helps maintain strong and healthy bones by retaining calcium.

Deficiency signs include joint pain or stiffness, backache, tooth decay, muscle cramps and hair loss.

While it is not exactly clear how Vitamin D helps, getting blood levels up to 100 nmol/l with 3,000 iu a day (or 21,000 iu per week) is associated with less risk of infection, and severe infection. I have not, however, found any compelling evidence yet that it shortens Long Covid.

A component of over 200 enzymes in the body, Zinc is essential for growth, important for healing, controls hormones and aids ability to cope with stress.

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is passionate about good food and healthy eating. Often ahead of the curve, he has been vocally ‘anti-sugar’ for years and has helped to raise awareness of its dangers. He has written a range of cookery books full of tasty, nutrient-rich, sugar-free recipes.

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PATRICK HOLFORD

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Shortening Long Covid Another excellent reducer of inflammation in the lungs is quercetin, the phytonutrient red onions are rich in.

Like vitamin C, it has many beneficial effects relevant to Covid. However, both vitamin C and quercetin have another role to play which may be significant, not only for Long Covid, but also to help modulate adverse post-vaccination effects, mainly reducing the consequences of clotting. Both Covid infection and especially mRNA vaccines may induce increased clotting. This is why the anticlotting agent heparin is sometimes given to critical Covid patients and why some doctors recommend taking a low dose aspirin in the weeks following vaccination, as well as loading up on both vitamin C and D. Both vitamin C and quercetin inhibit abnormal clotting. Vitamin C also helps to recycle quercetin so they are synergistic in relation to Covid and should be used together.

Linus Pauling’s last contribution to science was to show that, when vitamin C levels drop, a process that leads to the thickening of the arteries to protect against endothelial degeneration occurs. This is measured by an increase in lipoproteins.

Blood clots contain regular proteins, while both viruses and vaccinations may increase the presence of spike proteins. Breaking these down is a major target for helping those suffering from Long Covid. A theory that’s gaining ground, proposes that the virus causes release of micro clots which block access of blood to cells leading to oxygen shortage.

One medical approach that’s being trialled is ‘washing the blood’ to remove clots.

What nutrients help fight Long Covid and why ?

While vitamin C and quercetin undoubtedly help, the most interesting remedies are digestive enzymes.

Bromelain is found in pineapple and papain in papaya. Bromelain binds to both spike proteins and helps break them down. It also inhibits the virus from attaching to ACE-2 receptors.

The study “Evaluation of the Effect of Zinc, Quercetin, Bromelain and Vitamin C on COVID-19 Patients”, sponsored by the Saudi Ministry of Health, concludes that quercetin (800 mg), bromelain (165 mg), zinc acetate (50 mg) and ascorbic acid (1 g) once daily were safe for patients infected with SARS-CoV-2 and may prevent poor prognosis.

Another critical factor in many with Long Covid could be faulty methylation (involved in genetic expression).

Homocysteine is an amino acid found in the blood. Elevated levels of homocysteine have been associated with narrowing and hardening of the arteries.

A faulty methylation is indicated by high plasma homocysteine levels, often driven by poor B12 absorption or folate deficiency (think greens and beans). Many of the symptoms being reported also occur in those deficient in vitamin B12. Raised homocysteine directly correlates with a degree of lung damage.

Therefore, testing a person’s homocysteine and B12 status is a must for anyone with long Covid but it is rarely done. I would, however, start with the basics – vitamins C, D, zinc, quercetin and bromelain and move onto homocysteine and B12 testing if this doesn’t provide significant improvement within a week.

Improvement can be spectacular and quick, as one of my patients case illustrates: Karen described her physical fitness as less than 50% post-Covid, and had to stop every 50 metres when walking to catch her breath. She took a double dose (x6) of a supplement containing quercetin, bromelain and vitamin C, with additional high dose vitamin C and zinc to bowel tolerance, plus 21,000iu of vitamin D. “Two days later I did a one-hour hill work achieving 95% of my usual fitness.”

However, if considerable lung damage has occurred it can take a month or two to see big improvements as lung and muscle tissue takes time to repair.

THE SPIKE PROTEIN is a glycoprotein that protrudes from the envelope of some viruses (such as coronavirus) and facilitates entry into a host cell by binding to a receptor on the surface of a host cell followed by fusion of the viral and host cell membranes.

Like a key in a lock, these spike proteins fuse to receptors on the surface of cells, allowing the virus’s genetic code to invade the host cell, take over its machinery and replicate.

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Effects of vitamin D and vitamin B12

Thyroiditis

“

By Raffaella Quieti Cartledge

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on Hashimoto

A 2019 study investigated levels of vit.D and vit.B12 in patients with autoimmune hypothyroidism and evaluated their correlation with anti-TPO antibodies.

Hashimoto thyroiditis (HT) is the most common cause of hypothyroidism, a disease caused by inadequate synthesis and/or release of thyroid hormones.

In these patients, hypothyroidism is accompanied by the presence of autoantibodies. It is more common in the 30- to 50-year-old age group and is 4–10 times more common in women than in men.

Environmental (30%) and genetic (70%) factors influence the genesis of HT. The possible environmental factors are smoking, alcohol, dietary iodine, stress, selenium, vitamin D (vit.D) deficiency, bacterial and viral infections, pregnancy, and drugs.

The main function of vit.D is to achieve calcium and phosphorus balance with bone metabolism. In recent years, however, vit.D has been reported to have a role in the formation of autoimmune diseases, heart diseases, cancer, inflammatory bowel diseases, diabetes, and rheumatologic diseases, as well as its effects on bone

metabolism.

In addition, it is thought that vit.D may play a role in the regulation of the immune system because vit.D receptors are detected on cells of the immune system. In some studies, a relationship between vit.D deficiency and autoimmune thyroid diseases such as HT and Grave’s disease has been reported, and impaired vit.D signalling has been reported in thyroid cancers.

Many autoimmune diseases, such as pernicious anaemia, myasthenia gravis, celiac disease, type 1 diabetes mellitus, autoimmune liver diseases, multiple sclerosis, Addison’s disease, rheumatoid arthritis, and systemic lupus erythematosus, may accompany HT. Vitamin B12 deficiency has been reported frequently in autoimmune thyroid patients. This association is probably due to impaired absorption of vit.B12 by atrophic gastritis and/or pernicious anaemia associated with autoimmune thyroid disease. Atrophic gastritis is an inherited autoimmune disease that attacks parietal cells, resulting in hypochlorhydria and decreased production of intrinsic factor. Consequences include atrophic gastritis, B12 malabsorption, and this condition is also seen in 35 to 40% of autoimmune thyroid diseases. There are several studies suggesting that the prevalence

of vit.D deficiency is high in patients with HT and that there is a relationship between hypothyroidism and vit.D in these patients.

In his 2019 study, Dr Hanife Serife Aktas, found a negative correlation between vit.D levels and anti-TPO levels in these patients, bringing him to the conclusion that vit.D deficiency may cause autoimmune hypothyroidism.

The relationship between vit.D deficiency and thyroid autoimmunity remains unclear. However, it is suggested that vit.D may be associated with anti-inflammatory and immunomodulatory effects. Vit.D plays a significant role in modulation of the immune system.

In his study, Dr Aktas found that the incidence of vit.B12 deficiency in autoimmune hypothyroid patients was 46%. They also found that there was a negative correlation between the presence of anti-TPO antibodies and vit.B12 levels. It is possible that this may be due to pernicious anaemia or atrophic gastritis accompanying autoimmune hypothyroidism, which is often accompanied by other autoimmune diseases.

Patients with both hypothyroidism and vit.B12 deficiency also have similar symptoms. Symptoms such as fatigue, weakness, dementia, depression, memory impairment, lethargy, and tingling are frequently seen in patients with hypothyroidism and vit.B12

deficiency. Thus, vit.B12 deficiency may be ignored in hypothyroidism.

Vit.B12 deficiency increases homocysteine levels and a relationship is known to exist between hyperhomocysteinemia and the development of atherosclerosis. Several studies have shown a relationship between hypothyroidism and homocysteine levels. Thus, if vit.B12 deficiency is overlooked in hypothyroid patients it may increase cardiovascular risk through hyperhomocysteinemia.

In this study, vit.B12 and vit.D deficiency was found to be prevalent in patients with HT. In patients with autoimmune hypothyroidism at the time of diagnosis and during periodic follow-ups, genetic snps should be investigated (such as MTHFR) together with Vit.D, vit.B9 and vit.B12 deficiency. Also antibody levels (Anti-TPO and Anti-thyrogobulin antibodies) and homocystine levels should be verified and supplementation should be performed in those who need it.

Source: Hanife Şerife Aktaş https://www.ncbi.nlm.nih.gov/pmc articles/PMC7445676/

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How to reduce

Parkinson’s disease

by Raffaella Quieti Cartledge

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symptoms with the help of nutrition Author, award-winning nutritional therapist, lecturer and the Nutrition Director of the Parkinson’s Disease Integrated Nutrition Clinic in London, Lucille Leader has served as the Nutrition Director of the London Pain Relief and Nutritional Support Clinic at The Highgate Hospital in London which has now been replaced by the Parkinson’s Disease Integrated Nutrition Clinic in central London. The clinic’s medical director Dr Geoffrey Leader, was an early pioneer of the integrated, team approach to the management of chronic illness, with a special interest in the management of Parkinson’s Disease.

Mrs Leader, how does nutrition influence functional health and Parkinson’s in particular?

The influence of nutrition on functional health in Parkinson Disease (PD) is widespread. Cellular functions are dependent on the adequate nutritional status of cells.

Vitamin C deficiency may cause scurvy, iron with anaemia, essential fatty acids with inflammatory disease. Similarly, dopamine deficiency is cardinal in PD. Dopamine is metabolised from dietary protein. Specific enzymes are necessary for dopamine metabolism. In order to be activated, those enzymes need coenzymes which are the nutrients zinc, folate, iron and vitamin

B6. Their deficiency may therefore compromise this metabolic pathway and the adequate production of dopamine.However, supplementing these nutrients is very specialised because in Parkinson’s there can be problems with the way the cells handle these.Therefore all nutritional support must always be with the guidanc and prescription of the healthcare team of each patient. There are medical laboratory tests available to assess the need for any supplementation.

What is the role of stress in PD ?

Stressors – mental, emotional and physical stress are not comfortable for the body. When we need to control any form of stress, our bodies need to produce adrenaline…but adrenaline is produced from dopamine! People with PD have trouble with production of dopamine and consequently of adrenaline.

It is then therefore understandable that this metabolic pathway is compromised. Even though a person is taking the correct dopaminergic drugs to help regulate movement, when there is stress of any kind, control of movement becomes problematic.

I therefore recommend acquiring stress management techniques as essential in support and management. There is an excellent technique specific for Parkinson’s Disease by David Uri, available as a CD. It is called Parkinson’s Disease Relaxation. (www.denorpress.com) I also recommend learning Autogenic Training Techniques which can be used at times of stress. These techniques, as well as the CD by David Uri, are very helpful in PD for both patient and carer or family.

Is there a nutrition protocol to support the efficacy of PD medications ?

Specific amino-acids in dense protein-containing food compete with L-dopa for the carrier at the absorption site of the L-dopa medication through the intestinal absorption site and through the Blood Brain Barrier (BBB) into the brain where it metabolises to dopamine.

Separating the timing of any meals containing dense protein

foods from the time of taking L-dopa, may optimise absorption of the drug, which could optimise its effectiveness.

The foods containing a high amount of protein containing the competitive amino acids are : meat, poultry, fish, dairy (except for butter) eggs, soy, pulses, semolina, avocado, asparagus, coconut, nuts and seeds, gluten-containing products such as wheat, rye, oats, barely, spelt, bulgar wheat and couscous.

If you have eaten from the dense protein list above, I recommend that you wait 2 hours before taking L-dopa. Wait until the drug has ‘kicked-in’ before eating. A snack or meal can be taken immediately after the drug has had its effect.

Protein foods can at this point be included as the drug has already entered the brain and therefore there will be no competition at the absorption sites.

If you have eaten any other food that is not on the above list– fruit , vegetables, oils, I recommend that

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Health and medicine

How to reduce Parkinson’s disease symptoms with the help of nutrition you wait only 1 hour before taking L-dopa.

Other protocols for dopaminergic drugs are listed in PARKINSON’S DISEASE – Reducing Symptoms with Nutrition and Drugs (www. denorpress.com).

What are your basic nutrition recommendations ?

Do not cook in ALUMINIUM. Use stainless steel or glassware. Eat RAINBOW – COLOURED (dark green, orange, other colours) fruit and vegetables (but no citrus if you are taking L-dopa).

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If changing anything in the diet, only make one change every 3 weeks – otherwise there can be difficulties with processing.

Gradually reduce GLUTEN-CONTAINING GRAINS (wheat, rye, barley, spelt, oats ( unless gluten free) and substitute with other grains, for example buckwheat, rice (Basmati), millet.

Gradually reduce and then avoid ANIMAL MILK products as they contain casein, except for butter. Vegetable-based milk (almond and coconut) are excellent substitutes. Avoid carrageenan in some processed nut milk as it can be pro-inflammatory.

Gradually reduce RED MEAT which may produce inflammatory leukotrienes in the gut and is not ideal with constipation. Substitute with wild sea fish or free-range poultry, organic eggs, nuts and seeds in powdered form, except for peanuts and cashews which contain mycotoxins. All nuts need to be refrigerated.

Gradually reduce ALCOOL very gradually and slowly of eliminating it. Herb and fruitbased drinks can be enjoyed instead and served in wine glasses. Fruit juices should ideally be natural and diluted with still mineral or filtered water.

Water: tap water may contain heavy metals and other contaminants. It is best to drink filtered or good still mineral water.

Eat good helpings daily of dark green, leafy vegetables. They contain minerals which are essential for immune function, bone integrity and cell energy production. Do not cook in aluminium pots. Use stainless steel or glassware. Include oily fish in the diet (sardines, mackerel, salmon, herring) nuts and seeds (exclude peanuts and cashews as they contain mycotoxins). Nuts and seeds must be ground and powder-like in consistency as there can be difficulty for some with swallowing. Keep nuts and seeds refrigerated.

Focus on food containing essential fatty acids (GLA, EPA and DHA). These oils are used by cell membranes in immune function and the production of anti-inflammatory prostaglandins.

GLA is found in nuts and seeds (exclude peanuts and cashews as they contain mycotoxins). Keep nuts and seeds refrigerated.

Nuts and seeds should be powdered if there are swallowing difficulties. EPA and DHA are contained in oily fish such as sardines, mackerel, salmon and herring.

Margarine, cooking oils and fats that contain hydrogenated fats should never be used. Only the unrefined, unheated forms of oils can be used (cold and cold-pressed) on salads.

Cooking should be with either cold-pressed extra virgin olive oil, avocado oil or cold-pressed organic coconut oil and occasionally butter if not contraindicated. These oils are the most stable when heated. Keep cooking temperature under 180C and grill and oven temperature not higher than 160C. Water: tap water may contain heavy metals and other contaminants. Better to drink filtered or good still mineral water.

Reduce red meat which may produce inflammatory leukotrienes in the gut and is not ideal with constipation. Substitute with wild sea fish or free-range poultry, organic eggs, nuts and seeds in powdered form, except for peanuts and cashews which contain mycotoxins. All nuts need to be refrigerated.

Avoid animal milk products as they contain casein except for organic butter. Vegetable-based milk (almond and coconut) are excellent substitutes. Avoid carrageenan in some processed nut milk as it can be pro-inflammatory.

Alcohol: very gradually and slowly reduce consumption with the aim of eliminating it. Herb and fruit-based drinks can be enjoyed instead and served in wine glasses. Fruit juices should be sugar and artificial sweetener-free and diluted with still mineral or filtered water. Have caffeine in moderation if you do not have any other health condition which contraindicates caffeine- High blood pressure, for example.

And what are your supplements recommendations?

Following medical laboratory testing, patients who have

Permeability of the intestinal mucosa was often found to be increased and the microbiome needing support of pro and pre biotics.

Each patient had different results so that nutritional supplement and dietary needs always needed to be personalised by a health professional for the individual.

Following is a list of commonly used nutritional supplements, but each person’s needs and doses are different and not always needed long term. Professional supervision is essential and nobody should self – administer any supplement.

Vitamins: C, B vitamins – 1, 2, 3, 5, 6, 12 (including methyl B12 and methyl folate), D3, K2 General: Co-enzyme Q10, essential fatty acids (Omega 3 and Omega 6), phosphatidyl choline, and curcumin MINERALS: Magnesium - Zinc - Intestinal: Probiotics, Prebiotics, Butyric Acid Vitamin A (needs to be taken under medical supervision as there might be serious health contraindications) implicated in the integrity of the gut mucosa and it is an important antioxidant.

Vitamin B (methyl complex to assist methylation). B vitamins are best taken as a complex. B vitamin plays a role in mi-

tochondrial energy production. Vitamin B6 can be part of nutritional support for patients taking ‘Sinemet/Stalevo/Madopar’. It is an essential co-enzyme in the metabolic step between L-dopa and dopamine. – are there cautions? My understanding is that B6 should be taken away from the meds and at a very moderate dose?

NADH (Vitamin B3 derivatives) may stimulate L-dopa biosynthesis. Vitamin B12 is implicated in neuromuscular function and methylation. A deficiency of B12 is associated with movement disorders, including tremors and Parkinsonism.

Vit C and Vit D3 deficiencies have been detected in Parkinson’s Disease. Vitamin D acts as a neuro-immunomodulator. Findings from one study showed that low serum 25-hydroxyvitamin D levels are associated with an increased risk of developing PD. Zinc is implicated in many enzyme functions and protein metabolism. Magnesium deficiency can exacerbate muscle spasm. A glass of coconut water, which is rich in potassium, with magnesium twice a day will provide the two minerals and support a healthy bowel movement, if the patient makes sure he intakes 8 or 9 glasses of fluid a day.

Butyric acid is an agent for repair of intestinal mucosa. Glutamine, often prescribed for the repair of the intestinal mucosa, is contra-indicated in therapeutic doses for PD as it may manifest as excitotoxins, a class of chemicals that overstimulate neuron receptors. As a consequence, neurons are damaged and killed by this receptors overactivation. Butyric acid can be used as substitute. Es-

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visited our clinic have demonstrated deficiencies of various nutrients – including vitamins, minerals, essential fatty acids and digestive enzymes. Some patients also demonstrate the presence of parasites, viruses and bacterial infections.

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How to reduce Parkinson’s disease symptoms with the help of nutrition sential fatty acids enhance cellular integrity.

Inflammatory and anti-inflammatory cellular responses are controlled by hormones which are also dependent on zinc and vit B6 .

A recent study published in November 2020 by Christine E. Cherpak-Castagna,of Maryland University of Integrative Health has found that the antioxidant properties of curcumin may be particularly beneficial for individuals with PD as a component of an anti-inflammatory diet.

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Recommended probiotics are lactobacillusGG/longum/plantarum/rhamnosus/salivarius/acidophilus/bulgaricus.

Ayurvedic medicine uses the seeds from the legume M. pruriens, a naturally occurring botanical source of levodopa, as a PD treatment. Studies suggest that the M. Pruriens seeds and the traditional lab-created levodopa differ pharmacokinetically and that, unlike levodopa, the seeds from M. Pruriens confer neuroprotective effects.

Of note, a finding that a HP-200 M. pruriens endocarp preparation improved Parkinsonism symptomatology but did not influence dopamine metabolism to an appreciable extent, implies that other constituents in the botanical (i.e. not levodopa) may be responsible for the benefits of M. Pruriensin individuals with PD. To conclude, are there nutrients/compounds to be avoided in PD ?

Red meat takes a long time to be digested and during digestion, it activates inflammatory compounds, so I would limit or ideally eliminate its intake. I recommend my patients avoid supplemental calcium + manganese. Iron is a very important co-factor but there are possible contraindication with PD because it causes oxidative stress. It should only be taken if deficient and strictly medically monitored.

Gluten sticks on the walls of the gut. Gluten-free grains help bowel function. All genetically modified wheat should be avoided

as much as dairy products as casein acts similarly as gluten.

Alcohol affects the central nervous system. Balance very often is a problem in PD and alcohol can influence balance.

Alcohol requires dynamic detoxification. In Parkinsons’s the liver does not function so well therefore it is not wise to overload such an important detoxification organ.

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SUCCESS STORIES AND RESEARCH

Davide Di Maggio General Manager Andrea Ortolani Sales Manager

“

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OEO

The most valuable and complete digital library dedicated to Aesthetic Medicine

How did the idea of making books dedicated to medical-scientific area come about?

Davide Di Maggio:

The publishing market is such a vast sea that the choice of direction to follow for a publishing house at the beginning of its path can mark its destiny for better or for worse.

On a personal level, I can certainly say that my choice was dictated by various editorial experiences I had in the years preceding the birth of OEO, when I was collaborating with other Florentine publishing houses such as SEE and Giunti and by meeting with Progetti Distribuzione where my two partners were working. The technical / editorial know-out, the contacts with the scientific and cultural world of international appeal, combined with the desire to do, to move and to communicate, have done the rest and given life to the OEO Firenze.

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DIGITAL LIBRARY

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https://digital.oeofirenze.com/

OEO Digital Library works with all devices, smarthphone, tablets and computers. Includes more than 20 practical manuals and more than 100 video.

www.oeofirenze.com

How many books do you have in your catalogue?

Davide Di Maggio:

Although our production is focused more on the quality of the titles than on the quantity, to date we have more than 100 editions in foreign languages (English, French, Spanish, Russian) and in Italian; with digital editions the number of titles doubles.

You have presented the “OEO DIGITAL LIBRARY” internationally. What is it and how can the aesthetic physician interact?

Davide Di Maggio:

The project was conceived to keep up with the ongoing digital revolution and with the new trends in the medical-scientific sector.

In January 2020, two months before the outbreak of the pandemic, we presented our digital library, “OEO DIGITAL LIBRARY”, at the IMCAS Congress in Paris. Through a simple online subscription, we allow subscribers to access the entire collection of publications, videos and extra content created by the OEO since its birth, which can be easily consulted

on any device and in every corner of the world.

From paper to digital, a necessary step. Do you strongly believe that digital will be the future or will paper always have its strength within medical-scientific education?

Andrea Ortolani: We believe more in integration than in the transition from paper to digital and, anyway, this phase is evolving faster and faster.

To keep up with the times, we have developed a so-called integrated publishing.

It is necessary to combine the benefits of digital, such as ease of access, speed of consultation, modernity, with the charm of paper.

Technology and beauty, this will be the key to the success of our future publishing projects.

Which are the characteristics of the latest generation hyperrealistic models for injection practice? How are they different from those that have been on the market for the longest time?

Andrea Ortolani: The characteristics are numerous. Our facial and vulva manikins, both visually and to the touch, are so hyper-realistic that they truly cause amazement in medical professionals. We have eight

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THE NEW RELEASES FOR IMCAS BY OEO:

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facial models on the market that differ in age and gender. In each manikin, all those imperfections of the skin aging process are visible, and that is undoubtedly useful to the aesthetic doctor who wants to simulate an injection. They are sold with a QR code that allows the doctor to view videos of injection techniques. A continuous search for improvement mechanisms with a constant and continuous study of the silicones used, allows us to create very innovative models such as the one we have prepared for the 2022 edition of the IMCAS Congress in Paris. The prices are absolutely competitive and the distinctive element is the continuous and professional assistance provided to the customer after the purchase. OEO considers the loyalty of its customers to be fundamental in its business strategy through purchasing assistance and communication.

After the digital library and the hyper-realistic models for injection practice, which will your next steps be?

Davide Di Maggio:

From a technological point of view we are developing editorial projects that offer the reader the possibility, through a simple smartphone, to combine paper content with augmented reality.

We are trying to improve our content by keeping in mind that Aesthetic Medicine always deal with that scientific evolution as well with the change of customs and traditions.

Debbie model: hyper-realistic vascular and anatomical manikin for injection practice.

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Thread Lift by I. Ashary.

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Medical Rhinoplasty by F. Braccini and A. Redaelli

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Fiuggi Palace

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Spa

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The water of well-being

Fiuggi Wellness Medical Retreat opened its doors in May 2021, following a complete transformation of one of Italy’s most iconic and historical hotels. This can be seen through the splendor of its immaculate new spa facilities, to include the 700 m2 Roman Baths, the 1936 luxurious outdoor & indoor pools and the surrounding 8 hectares of park its situated in.

Following years of scientific and medical research, a team of experts, headed by Dr. David Della Morte Canosci, has developed pioneering ways to strengthen the immune system and cellular regeneration of the body and mind, to maximise guests’ health, wellbeing, prevention, longevity and “remise en forme”, in the form of Western Science and the Eastern Practices.

It’s home, spread over 6,000 m2, features some of the world’s leading technologies, including the highest range of MRI & infrared technology for brain health & sleep, retinal scanning & diagnostic testing.

In Fiuggi everything is born from “the water of well-being”, which has been known since the Middle Ages for its depurative properties and

By Raffaella Dallarda

ability to “break kidney stones”, which cured the ailments of Pope Boniface VIII and Michelangelo.

The Five Pillars and the main concept of the Wellness Medical Spa consists of: Energization, Harmonization, Longevity, Purification & Ayurveda, all running alongside bespoke Nutrition Lines developed by 3 star Michelin Chef Heinz Beck.

The Beauty Spa includes: multifunctional rooms, 8 beauty cabins, Hydrotherapy rooms (mud room; wraps, hydro massage), a traditional Hammam, 1 Spa Suite, 6 medical cabins for CT and MRI scans, Pilates and yoga studios and a Hydrotherapy circuit founded by the thalassotherapy protocol patented by Dr. Angelo Cerina of Forte Village Spa in Sardinia.

The Holistic Area hosts: Psammo therapy rooms, Quartz Vibrahealing® Sound treatment that uses bell vibrations and therapeutic sounds such as binaural and monoaural frequencies.

From 10th January 2022, Dr Vikas Gupta has joined as a full-time member of Dr David Della Morte Canosci’s medical wellness team, bringing a wealth of experience with him. His expertise and training come from the Himalayas, Integrated Health & Personal Transformation, a Masters in Yoga and Alternative Principles of Medicine and bringing over two decades of diverse experience in Mind- Body Medicine from the luxury hospitality sector.

Dr Gupta specialized in global Ayurveda, Nutrition & Lifestyle

45 https://www.palazzofiuggi.com and his techniques include yoga practice, advising on food, movement and mindfulness, as well as calling upon spiritual practices from the east and west. He uses the Gurus / Vaidya traditions and the miraculous healing power of traditional Indian medicine that combines three main components: healthy food, yogic breathing and potent herbs, supported by the natural healing properties of the Fiuggi waters.

Ayurvedic treatments include, Abhyanga, a rhythmic massage, to stimulate the blood circulation, lymph and prana and Shirohara, to improve clarity of mind and stimulate the third eye chakra.

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They offer an extensive aesthetic menu using new technologies and methods to include: - Biostimulation, that counteracts and prevents the skins aging process and the signs of aging, stimulating the normal metabolism of fibroblasts and skin returning turgor, elasticity, firmness and hydration that will make it look fresh - Biorevitalization, that has the same purpose as biostimulation with the difference that hyaluronic acid is administered fluid “hydroreserve” for a deeper hydration & to increase skin tone, restructuring substances such as amino acids, antioxidants to counteract the aging action of free radicals, in some regions such as the neck, the décollete and the hands - Superficial, medium, deep peeling, with glycolic, mandelic, salicylic or pyruvic acid to correct specific imperfections such as texture, spots or excessive seborrhea of the skin and manifestations of juvenile and late acne - Fillers for wrinkle relaxation, facial contour remodeling and lip enhancement to recompact a natural lifting effect without surgery - Totally absorbable support, traction & remodeling threads for face & body, arms, thighs, buttocks, abdomen. Stimulating the dermis components, creating an intense biostimulation of the tissues and providing an effective recompacting with biorevitalizing & lifting action - Sagging skin folds with botulinum, also for excessive sweating, hands & feet hyperhidrosis - FELC – Conveyed electron flow to eliminate excess dermal formations on the face and body such as dermo-epidermal fibroids, thickening of the skin, hyperkeratosis & hyperpigmentation of circumscribed areas The Wellness Medical Retreat of Palazzo Fiuggi holds all the premises for having brought an iconic Wellbeing Destination back to the timeless splendor of the past.

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Every day, Dr. Lorenzo De Stefano, a certified plastic surgeon and doctor specialising in aesthetic medicine, actively collaborates with Dr. Regina Fortunato, to create interesting treatments, noninvasive but very effective, for correcting aesthetic imperfections.

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Spa

AQUA tDOME ories

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Tirol Therme Längenfeld in the heart of the Ötztal Valley

Who hasn’t dreamt of floating across the surface of a heated pool as they gaze up at the alpine peaks above?

Covering more than 65,000 square metres, the AQUA DOME – Tirol Therme Längenfeld in the heart of the Ötztal Valley is the ideal place to make this dream come true. The most modern and eyecatching SPAresort in the Alps boasts futuristiclooking SPAand fitness facilities with a range of pools, saunas and a small play area for children. Guests staying at the 4* superior AQUA DOME Hotel also have exclusive access to the award-winning SPA3000.

“The AQUA DOME has been one of the most important attractions in Tyrol since it first opened in 2004,” comments CEO Bärbel Frey.

In 2013 work was completed on a new premium SPA as well as 54 new rooms, 6 new family suites and a larger seminar area. Today, a combination of state-ofthe-art SPA facilities and beautiful alpine landscape makes the AQUA DOME the ideal place for a romantic break or a family holiday.

Reserved exclusively for guests staying at the AQUA DOME Hotel, the recently opened premium SPA“SPA3000”is spread across two floors and offers magnificent views of thesurrounding mountains. Its modern design combining pinewood, granite and large glassfacades with panoramic views brings the raw beauty of the Ötztal Valley into the AQUADOME. This focus on nature is also to be found in the SPA and sauna area, with its use of local mountain herbs, woods and minerals, while a spectacular combination of fire and water complete the modern yet traditional alpine atmosphere.

The local theme continues in the Treatment & SPAwith a selection of AQUA DOME signature treatments such as the Ötztal Valley Stone Massage and the Mountain Herb Massage. Regular infusions using scented oils, herbs from the region and glacier ice to cool off, make a visit to the 22,000m.

Sauna area an experience to savour. Those wishing towork up a sweat in a different way will find exactly what they are looking for in the gym equipped with the latest training machines from leading fitness company Cybex. And, last but by no means least, the crystalshaped thermal dome and its three “levitating” bowls filled with spring water are today the unmistakable symbol of the AQUA DOME. Warm welcome and modern design in the heart of the Alps With its traditional yet modern design, the 4* superior AQUA DOME Hotel and its 200 spacious rooms and suites are inspired by the contrasts of the Ötztal Valley.

A heated walkway connects the hotel to the main SPA

and sauna area. Each room is decorated using warm colours and wood from the local region.

“The furniture is spread out across the room, just like in theparlours of traditional Tyrolean farmhouses,” says Bärbel Frey, explaining the design concept behind the 54 rooms recently added to the hotel complex.

“We want our guests to feel at home.” This contrast of cultures continues in the hotelrestaurant, where traditional alpine decor and a new south-facing pergola provide theperfect backdrop for a sumptuous breakfast buffet including hot and cold dishes, freshly baked bread and homemade jams and marmalades. In the evening, diners can choose from a selection of dishes and themed buffets, before retiring to the lobby bar for a relaxing drink. For business travellers and companies the AQUA DOME also offers a 900m.meeting area capable of hosting events for up to 800 guests and even spaciousenough for car presentations.

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https://www.aqua-dome.at/it/

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Teology Rose Quartz

€ 279,95

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www.beko.it Vibrating Face Roller

They are designed for everyday use, with a unique style and design and superior acoustics. They are perfect for listening to streaming songs while pedaling or for answering calls when walking with your dog, all while remaining aware of what is happening in the surrounding environment.

An Ancient Chinese tool made up of natural rose quartz crystals that have been incorporated in skincare rituals as far back as the 7th century. It is designed to massage the face for relieving stress and tension while promoting lymphatic drainage. Today this tool has become the new beauty addiction around the world and Teaology gives it and additional booster:

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Made for music lovers or podcast fans

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€18,88

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HAB5-Hydra Serum is a serum enriched with pro-vitamin B5 (or panthenol), which is considered as the leading skin moisturiser. It enhances hydric balance and replenishes the skin’s moisture barrier.

Thanks to hyaluronic acid, known in aesthetic medicine for its moisturising and filling properties, it efficiently smoothes the appearance of dehydrated wrinkles.

Apply one pump onto cleansed skin in a patting motion. Use morning and night for best results.

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Clairial Day Repair Cream Emocean Absolute lifting € 40,00 www.emocean.it Lift-up effect with this cream with the latest innovations in functional substances, such as Seadermium combined with Sirtalice, for the ultimate lifting action while stimulating Collagen production. Black Tahiti Pearls are rich packed in minerals and amino acids, while Perlite is an organic powder increasing reflflectance and minimizing imperfections, for Powerful incredibly velvety skin.

Narciso Rodriguez Parfum

€ 30,00 www.emocean.it The Brilliant Day Cream - white specialist Face cream packed with natural enzymes extracted from Papaya, Mango and polyhydroxy acids such as Lactobionic and Lactic Acid, supporting the cell renewal process in case of hyperpigmentation and skin thickening. The photoluminiscencebased phyto-complex extracted from Mullein prevents the synthesis of tyrosinase and melanin, protecting skin from the oxydative stress caused

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Hawaiian Tropic Self-tanning foam

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www. narcisorodriguez.com/fragrance Narciso Rodriguez probes the mystery of modern masculinity with Bleu Noir Parfum, The new bold fragrance from the for him collection. The inspiration comes from the fascination that for Narciso Rodriguez derives from the deep shades of the night sky, from its shades of blue and black at the beginning almost imperceptible, but more and more evident the more you scrutinize, which instill a characteristic duality.

https://www.hawaiiantropic.com/ Sunless Tan Foam Ultra-light, quick-drying formula hydrates and moisturizes, leaving behind a flawless streak-free glow.

Hawaiian Tropic® Sunless Tan SelfTanning Foam is crafted with your inner and outer beauty in mind. This self-tanning foam pampers your skin, with an ultra-light formula, containing aloe and Vitamin E, that hydrates your skin. Infused with a tropical scent that transports you to the islands, Hawaiian Tropic® Sunless Tan is dermatologist tested and offers a flawless streak-free glow. Size: 6.7 oz.

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