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On arrival into Monaco on the 2nd April 2019, delegates were met with thunderstorms, lightning and torrential rain, providing a tempestuous start to the Aesthetic and Anti-Aging Medicine World Congress (AMWC) 2019. Thankfully, this cleared the air for the next few days, and the sun was shining on delegates for the majority of the conference.
As always, Monte Carlo served as the perfect setting for a medical aesthetics conference. This year's AMWC took place on 3–6 April 2019 at the Grimaldi Forum, beautifully located on the seafront of the French Riviera. Under the scientific supervision of the World Society of Interdisciplinary Anti-Aging Medicine (WOSIAM), the Scientific Committee delivered a 3-day scientific programme that featured international thought leaders and provided high-quality presentations on the most relevant techniques in aesthetic and anti-ageing practice.
In addition to the scientific programme, the conference also featured three pre-congress practical courses: the AMWC threads academy, the advanced course on genital rejuvenation and cosmetic gynaecology, and the advanced facial aesthetic masterclass.
On top of this, the five floors of the Grimaldi Forum bustled with over 300 leading international companies showcasing their latest products and technologies. The Journal of Aesthetic Nursing's editor attended the event to report the key themes and learning points back to readers.
Forehead and eyebrow management
The conference kicked off with a session on forehead and eyebrow management, with Andre Braz giving a live demonstration of how to treat the forehead in conjunction with the eyebrows. Simon Ravichandran gave a review of the anatomy of the ageing forehead and how this relates to safe and effective volumetric rejuvenation. This session also included presentations on choice of filler and avoiding vascular complications, and eyebrow positioning.
Holistic facial rejuvenation
This was a recurring theme throughout this year's conference, with many speakers advocating a full-face treatment plan, rather than isolated treatments. Chytra Anand gave a presentation on facial glamourisation and the various procedures involved in this comprehensive treatment option, and Henry Delmar discussed how to balance a full-face treatment. Tatjana Pavicic gave a live demonstration on her approach to full face treatment, which was well received by the audience.
Natural results
The final session of the first day focused on achieving natural results when using dermal fillers and the idea of ‘attractiveness’. Jani Van Loghem gave an excellent talk on the elements of the face and how to balance these features to enhance the patient's natural attractiveness. Raj Kanodia stressed the importance of dermal support of the perioral region, which is critical to maintaining the ageing face. The live demonstration of this session focused on attractiveness in male and female patients, providing a useful comparison between the genders.
Reducing and managing dermal filler volumes
Tying in with the emphasis on natural results at this year's meeting, there was also a heavy focus on managing the amount of dermal fillers used during procedures. Many of the talks focusing on dermal fillers included a section on determining the correct volume of fillers to be used for a particular procedure, with some speakers providing helpful equations to help determine this.
In addition to this, Saturday included a 2-hour session on managing the amount of dermal fillers, chaired by Kate Goldie. This session included several talks on how to evaluate the amount of filler needed in each zone of the face, establishing a treatment plan and using the minimum amount of product for maximum effect. One talk by Kay Durairaj focused on how to minimise the effect of an overfilled face with strategic bony contouring using calcium hydroxyapatite.
Threading
This year, the programme featured a day-long threads academy, which aimed to provide an in-depth perspective on the anatomy of the face, scientific evidence for threading, facial dynamics, rheology of threads, specific thread techniques, live demonstrations and efficacy and long-term safety of threading.
This focus enabled delegates to understand the concept of cosmetic threading, know how to properly evaluate patients, understand how to avoid and manage possible complications and assess controversial topics in thread treatments.
Complications and their management
Many presentations rightly focused on the complications that can arise as a result of injectable procedures. There was an extensive focus on the use of hyaluronidase to manage complications with hyaluronic acid fillers. Hyaluronidase protocol was covered at length, and talks on the uses of hyaluronidase in aesthetic practice were interesting and relevant, especially Cameron Chesnut's talk on restoring visual loss with retrobular hyaluronidase after hyaluronic acid filler injection.
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