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The article was translated into English using automatic translation. The editors are working on its improvement.

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<hr />Editor&#39;s note: Danne Montague-King is one of the pioneers of modern cosmetology. A legendary man who has crossed the 70-year mark, but has not stopped developing and looking for new ways of professional self-realization. This article describes the experience of this outstanding specialist in the field of combining injection and traditional cosmetic procedures. <hr /> <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/files/DANNE-Montague-King-e14497374059271.jpg" style="width: 250px; height: 314px;" /> Danna Montague-King Doctor of Biochemistry and Pharmacology, founder of DMK (USA)<hr /> Over the past few decades, I have experimented a lot with various injectable treatments, in particular with the injection of fillers. So, I can say that I was the first male model to undergo a demonstration procedure for injecting Restylane drugs at Q-Med in Sweden, many of these experiments were carried out with the assistance of my dermatologist colleagues in Ukraine and Russia. And there is probably no need to say that all these “first” times were quite traumatic, so each time I set myself the goal of finding and determining the most effective skin treatment protocol before and after minimally invasive procedures (contour plastic surgery and other injection technologies) and surgical interventions . Thus, over the past years, my team and I have developed many ways to prepare skin tissue for the introduction of fillers and increase the duration of the latter. FILLERS Fillers of different viscosities, mainly based on hyaluronic acid, can successfully fill tissue on the face and neck, smooth out nasolabial folds and even add volume to skin suffering from lipodystrophy. But fillers cannot tighten skin damaged by sun exposure, stop the sagging of fat deposits, or restore elasticity to sagging neck skin. Yes, a combination of correctly performed contouring and plastic surgery allows you to achieve excellent results, but only in the case of healthy skin! Activities aimed at improving skin health before any intervention will guarantee long-term results, as a result of which patients will return to your clinic again and again for many years, just as they return to a good dentist or family doctor. Ways to prolong the action of fillers With age, the level of skin hydration decreases. The first to be involved in the process is the stratum corneum - its moisture-holding capacity decreases, then changes affect the intercellular matrix of the dermis, and subsequently the vascular component can join. The skin atrophies, becomes flabby, and begins to “sag.” At the same time, skin cells suffer from a lack of necessary amino acids and coenzymes, renewal processes are disrupted, the skin becomes covered with dead cells, like a shell, which is why it looks dry and wrinkled. If you inject filler into this skin condition, it will perceive hyaluronic acid as a nutrient and matrix restorer. Thus, instead of adding volume or evening out the skin in certain areas (as was originally intended), the filler becomes “food” for the surrounding skin, and what it does not have time to “eat” is absorbed into the thinned matrix. The patient sees that the result is very short-lived and does not return to your clinic. Whereas healthy skin prepared for the procedure is able to retain correctly selected and placed filler in the desired area for several months. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/files/%D0%91%D0%B5%D0%B7%20%D0%BD%D0%B0%D0%B7%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F%20%281%29.png" style="width: 400px; height: 200px;" /> Prevention of granulomatosis It is also very important to maintain the health of Langerhans cells in the epidermis through regular cosmetic procedures before and after injections. As is known, the dendrites of Langerhans cells penetrate all layers of the epidermis, reaching the level of the stratum corneum, and help maintain epidermal integrity at a high level, thus preventing the development of possible complications and, in particular, granulomas - tiny nodules that appear on the surface of the skin and are a skin reaction to the introduction of fillers of any type, an attempt by the body to get rid of a foreign substance. Granulomas form primarily in response to chemical, biological or physical injury, including trauma. A dysfunction of the immune system makes the patient susceptible to the formation of granulomas. Treatment options for these complications may include cosmetic procedures that generate “pseudo-heat” (chemical heat rather than thermal heat). Pseudo-heat and enzyme therapy procedures are the best choice instead of surgery when granulomas grow into surrounding tissues. BOTULIN THERAPY Although botulinum toxins are not classified as fillers, they are often injected concurrently with fillers, especially in “quick beauty” clinics in the US and Canada, as well as around the world. Patients who have not previously undergone any cosmetic procedures and signed up for botulinum therapy often expect a miracle, but in the end leave the doctor disappointed, since their face has not “rejuvenated” at all, because the toxin takes up to 14 days to actually work and “put them to sleep” muscles that create wrinkles. And you just need to first carry out a skin revision procedure - for example, enzyme therapy. Proper enzyme therapy removes dead cells, then fills the skin cells with oxygen, and reverse osmosis “washes out” all toxins and then triggers fibroblasts to produce new, strong collagen. Clogged pores are cleared, hyperpigmentation fades, and the skin looks tightened and radiant even before any type of injection, be it botulinum toxin, fillers, or a combination of both. A new type of non-injection mesotherapy also helps prepare the skin for injection procedures, which delivers powerful antioxidants and coenzymes, such as vitamins and E-ascorbate, deep into the tissues using silicon microcapsules that dissolve when exposed to body heat, instantly penetrating the tissue and creating temporary occlusion until until the skin has absorbed all the material. And home care medications that the patient uses daily are designed to support the results of injection therapy and even improve them.<hr /> Doing business in your clinic this way and realizing that injections are only good if the skin they are injected into is healthy can increase the number of clients and their confidence in you by one hundred percent. The patient will return to your clinic again and again - as a “one-stop” treatment center and pharmacy. First published in Les Nouvelles Esthetiques 2015/№1

Injection techniques in cosmetology