
The 4th dimension in Aesthetic  Medicine 
With the Bio-Rivolumetria we’ll  not only recreate  the lost volume  in a natural way, but at the same  time we take care of the aging process of the skin and the face will look brighter and younger
Let’s not get  anxious about finding increasingly resistant and long lasting but often rigid fillers, that are visible in the facial  expressions   and  unnatural   in the results
For a long time I have taken a completely opposite  approach   prioritizing  not only   natural  result  but also the prevention and  care   of   the  facial  skin aging  process 'using natural substances   that reflect qualitative  standards, and are   chemically- treated  as little as possible.
From the confluence of these observations, the needs identified in the past from several years of professional experience and, the availability of new special and unique drug injectors, an evolutionary concept in aesthetic medicine has emerged, called "Bio-Revolumetry"
We can do two simultaneous actions
- An increase in the volume
- A dermo-hypodermal stimulation
The word Bio-Rivolumetry is comprised of 3 fundamental objectives: "Bio" refers to the use of absolutely biocompatible and bioabsorbable substances, "Ri" summarizes the effect of regeneration, renovation and "Volumetry" which clearly indicates the formation and restoration of new volume.
So the term "filler", as a functionally  inert  substance,  mainly  able to  occupy and fill in the blanks,  is replaced by the term  Bio-volumetric  that identifies substances  that not only create volume, but   also  interact with the functions of the host tissue. They exert a simultaneous vital   action  and   stimulate    a  restructuring  of tissue : So  we create the volume  and at the same time we take care of the  treated areas.
  
The skin will become more   firm , hydrated, supple and young,
  facial contours will improve in their entirety 

THE DIFFERENT TISSUTAL BEHAVIAR BETWEEN FILLER AND BIORIVOLUMETRIC.
It has been possible , by perfecting the the technique and the materials used in compliance with patients and the environment in which we all live. The patient is guaranted that hyaluronic acid used is pure and of the best quality and, thanks to a particular patented chemical process we can obtain a high therapeutic efficacy , with very a low amount of cross-linked such as BDDE,
Currently in order to fulfill this purpose we have at our disposal  two highly innovative materials that belong to  the BIORIVOLUMETRIC  category but which  have  different  applications.
  They are Bio-Expander by Regenyal Laboratory and IAL-System DUO  by Fidia  Farmaceutici. 
  They differ mainly  with  respect to their formula and interaction with  skin  and the different ipovolumetric  characteristics. 
The Bio-Expander is used   when   we have a scarce subcutaneous tissue  with high structural  skin   impairment  of the skin  ,   while   Ial-System DUO is used   in   cases   where     a more localized reduction of  volume   prevails 


Bio-expander  with  its peculiar network  formulation   of  HA  in differentiated  molecular weights  with   a  slow  cross-linkage   wich  traps   free   HA 
 Once   INJECTED     HAS A HIGH DIFFUSION CAPACITY (HENCE THE NAME)  managing to penetrate into the most impervious   interfibrillary and intercellular   spaces .The portion of free HA   allows to obtain in the initial phase an intensive hydration to both the  implant  and the tissue 
The Bio-Expander   is therefore adviced  when  the reduction of the hypodermic bearing  is  more  widespread and is associated with  advanced impairment  of the dermis’ structure  and to  a reduced concentration  of fluid in the extracellular  compartment with loss of  osmolarity: in a few words in the   ipovolumetric  destructuring.  Its filling  capacity is  associated with a constant  and prolonged receptor stimulation  that as time passes  becomes visible with a marked improvement of the skin structure which will be more elastic, bright and firm.

  Bio-expander  in  povolumetric  destructuring 
In order to have the best result the product is injected into the superficial layers of the hypodermis, forming a support and can interact bilaterally (dermis-hypodermis). The Bio-expander has been planned from the beginning to be used with micro cannulas but can and should also be used with small needles for a implant of total renovation.
IAL-System DUO is adviced when the problem is mainly an HYPOVOLUMETRY, accompanied by a structural impairment. Typically we find areas more or less localized as the temporal area, the malar area in its front portion, the cheek, the chin, in this cases we use the IAL-System DUO. But what makes it unique? We find in front of a particular chemical process that combines chemical HA cross-linked, with BDDE, to HA autocross-linked by a patented esterification process that occurs between the carboxyl and hydroxylic groups of HA.

Ial-System Duo   is  a  product   that   combines its high plasticity, elasticity,  at  a   correct firmness and resistance and finds its main   application in the correction of the hypovolumetry  where the hypodermic  reductive  appearance  is more prevalent  respect to the   deconstruction which is  more   or less   in an embryonic  phase . 
  The product is positioned in the deep hypodermic  areas  also in this case with the aid of  needles or cannulas .
  What happens when you inject it into the  skin? Alongside an immediate   volumetric   restoretion  the  share of   HA   auto-cross-linked  , goes   towards  an  hydrolysis process, put in place from  the interstitial fluid, releasing in  subsequent months interactive HA fractions    in  various molecular weights: 
is accomplished the restructuring process which gives  the  face  a unique and natural appearance.
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Ial-System DUO nelle Ipovolumetrie Localizzate
we  often   find  cases where   different  problems coexist  :   hence we  find in  the same  face areas  that   require a  volumetric  localized  action   close  deconstructed  areas .. In these  cases you can use the combination  of the two bio-volumetric, treatments   diversifying the implant in the depth and in the  localization ..
With the Bio-Revolumetry we restore the volume   but we also fight  the time: this is the    revolution   of the Bio-Revolumetry- the fourth dimension 
The treatment  is  in  outpatient clinic  , does not require  any type of anesthesia, (in some cases an anesthetic cream can be used). Are used for  small cannulas that unlike the  needles do not have the sharp tip and therefore are not painful and hardly affecting  blood vessels.
The session lasts about 30 minutes and  the patient can immediately  return to work 
The trauma is minimal and the  side effects are rather scarce:
- Swelling  is always more or less accentuated due to the  actraction  of water. But  Generally disappears within 24 hours  except  in about    5% of cases.
- Small hematomas due to the rupture  of capillaries and venules,  don’t  last  long ,are  reabsorbed   in   4  or  5  days 
- A  rash may occur immediately after implantation,  to a particularly sensitive  skin. They last a few hours 
Normally    the  application of  light  make-up  the normal activities can be immediately    resumed 
Since  HA is a natural  and biocompatible  substance after a certain period  it   can   degrade and is therefore  totally absorbed by the skin.
We can say that the average duration of the effect of the volume  varies  from 8 to 10 months. As already mentioned, the  interesting thing is that in addition to the volume we have a clear improvement  of the skin: texture, tone, elasticity and this is indicative of a  restructuring occurred that endures over time. 
- Forehead  : To restore the convexity and to  correct wrinkles
      
      - Cheeks: for  lifting effect giving tone and firmness
      
      - Cheekbones :  to   increase   volume in a   natural   way
      
      - Corners   of   the  mouth : To remove  the folds 
      
      -  BAR Code : to eliminate wrinkles and give back  firmness
      
      -  Jaw  area and chin: to redefine  the face countours 
It’s  difficult  to  estimate  the cost    of  the  Bio-Rivolumetria,   since   it   concerns  large areas of the face, but  the session  can cost   average   600 Euro.
  It 'true that the cost is significant  but the safety is even more important  therefore  we  use  widely tested   and safe materials .
Beware of  low cost medicine,  it is not possible to maintain a quality  standard  below certain  costs!  
-     Skin   allergy   in   the  area of treatment 
 
- Pregnancy 
 
- Herpes in active phase
 
- Autoimmune dermatologic deseases
I firmly believe that this process, already started some time ago , is the right one addressed at the safety , the naturalness and at the prevention and not at the exasperation of the results, as we unfortunately and frequently see

