Non-Ablative Surgery
The term Non Ablative Surgery is an oxymoron since it describes a surgical technique that contrasts with the classical Ablative Surgery.
The term Surgery literally means "operate with hands" apparently through appropriate organs and is always bloody.
Instead, Non Ablative Surgery seeks to simplify the procedures of traditional surgery both in the field of dermatology and in the field of aesthetic, by means of non bloody intervention, without affecting the tissues and without resorting to anesthetic injections or sutures.

Certainly, the non-Ablative Surgery and the suitable equipment to practice it are the result of a long study in continuous evolution since it was conceived for the first time (Giorgio Fippi 1974).

The method was optimized thanks to technological developments in order to avoid the risks and complications associated with surgical interventions performed using traditional techniques. However, sometimes, it is performed with obsolete or, even worse, passed off equipment to be suitable for Non Ablative Surgery as laser, folgoratori (electric puncture devices) radio scalpels and felc.
Interventions to date unthinkable without resorting to operating theatre and traditional surgery are now possible thanks to non-Ablative Surgery.

Non Ablative Epidermal Surgery does not involve the papillary layer of derma and Non Ablative Dermal Surgery changes derma without causing fibrosis and without cutting or sutures.
By means of tiny sublimation dots arranged in the form of a triangle we are able to shorten the excess skin without resorting to surgery or the tissues being defatted using a painless technique that never causes bleeding.
If these tiny sublimation dots are arranged side by side or in a square form, we will obtain both surface sublimation without shortening and tissue stretching.
Non Ablative orbitopalpebral Surgery is used in 3-dimensional aesthetic ophtalmoplasty.
"Non Ablative Dynamic Blepharoplasty 3D" is a technique used for years to correct alterations of convexity and concavity in plus or in minus of orbitopalpebral tissues..
Various clinical cases, documented for over 20 years, have confirmed the validity of the methodology and the durability of the results obtained.
This technique of blepharoplasty is called "dynamic" because it allows the operator to instruct the patient to open and close his eyes during treatment, showing the skin folds still to be treated.
What is Plexr?
Plexr is a revolutionary device that offers an alternative approach to aesthetic surgical treatments that could be highly invasive due to pre and post-operative procedures such as injection anaesthesia, surgical resection, sutures and inpatient recovery.
Plexr uses the fourth state of matter: plasma; the other three being solid, liquid and gas.
Skin treated with Plexr sublimates with minimal transfer of heat to the underlying tissue. The device ionises air gases forming a tiny electrical arc, similar to a lightning bolt, which can be used to treat a broad range of skin and mucosal conditions.
Plexr is the last brainchild of Prof. Giorgio Fippi, ideator of Non-Ablative Surgery more than 20 years ago, a compendium of techniques implemented to treat skin and mucosal condition avoiding invasive procedures related to traditional surgery.
Plexr device treatments and in particular Non-Surgical Blepharoplasty have been endorsed as an approved procedure by the Governance Team of the KIMS hospital in Maidstone.
Main treatments: Non-Surgical Blepharoplasty, Asian eyelid surgery, Umbilicoplasty (belly button lift), Acne (active and scars), Improvement of deep wrinkles and scars, Xanthelasma removal, Sebaceous cyst removal, Removal of benign lesions (fibromas, angiomas, warts, skin tags, age spots etc), Halo naevus (Sutton's naevus), Tatoo removal (any colour)
 
How does the Plexr work?  The Plexr treatment works creating a series of minute dots on the skin, which triggers an instant contraction and tightening of skin fibres to create a lifting, remodeling and rejuvenating effect.  Does it hurt?  The treatment is performed using topical anaesthetic and the treatment is pain-free.Soft Surgery with Plexr® is definitely one of our most interesting non-invasive procedures, a real innovation that offers an alternative approach to cosmetic surgery.
The Plexr® device uses the principle of ionisation of gases contained in the air to get a small electrical arc similar to a tiny lightning, with which it is possible to treat dermal and epidermal areas affected by aesthetic problems, without communicating an unwanted heat to the surrounding areas.

Excellent results without risks Many people affected by that excess skin on the eyelids, giving them a tired and “dated” expression, avoid facing a blepharoplastic procedure for fear of the anaesthetic or of encountering the possible complications that can follow the traditional procedure.
Non-ablative blepharoplasty, as the name itself implies, does not use scalpel or laser to remove the excess skin, thus avoiding the risks inherent in the traditional procedure.
This blepharoplasty technique is defined as “dynamic” as it allows the operator to invite the patient to open and close his eyes during treatment, thus highlighting the folds of skin still to be treated.
This technique is also defined as “non-ablative” as it is performed without incision, without removing excess skin, without removing fat and without modifying the orbicularis muscle in the eyelids.
Non-Surgical Blepharoplasty for hooded and droopy eyelids
For non-surgical blepharoplasty, we use soft surgery with Plexr® which is a revolutionary and patented innovation, opening a new and exciting frontier in the fields of Medical Aesthetics.
Non-surgical blepharoplasty is performed without cutting, without removing excess skin or fat and without modifying the orbicular muscle of the eyelids.
This helps avoid all risks inherent to the traditional surgical intervention.
Plexr®, is a device that forms plasma to sublimate the excess skin.
It delivers its energy only on the superficial skin cells, without affecting deeper tissues, thus enables the perfect plasticity of the eyelid movement immediately after the treatment.
The result is immediate reduction of the excess skin on the upper or lower eyelid, as well as the shrinking of the excess skin in the external region around the eye.
The benefits are also the improvement of the expression lines at the corner of the eye and the cheekbone (“crow’s feet”).
This blepharoplasty technique is defined as “dynamic” as it enables the practitioner to ask clients to open and close their eyes during the treatment. A typical session will last no more than 30 minutes and the tiny point-like crusts will fall off after 3 to 7 days.
Depending on the nature and extend of the excess skin and area treated you may need between 1 and 3 treatments, 4 to 6 weeks apart.
Patients may experience some swelling and soreness in the treated area following the treatment. Any residual crusts do disappear within 7 days, but can be covered with liquid foundation.
During your free consultation, our doctor will discuss your suitability for the treatment and what you can expect.
Soft surgery with PlexR®, Vibrance® and Off® is an innovative system developed by Giorgio Fippi.
It is a revolutionary technology that achieves stunning results with non-invasive procedures. It is suitable for men and women, for all skin types and ages, and can be used for lifting, rejuvenation, bio-stimulation, and remodelling of face and body.
Non-surgical blepharoplasty
Non-ablative blepharoplasty does not use scalpel or laser to remove the excess skin, avoiding all risks inherent to the traditional intervention.

This blepharoplasty technique is defined as "dynamic" as it enables the practitioner to ask clients to open and close their eyes during the treatment.
The treatment is performed without cutting, without removing excess skin or fat and without modifying the orbicular muscle of the eyelids.

The treatment is performed through little 500 micron spots made with the Plexr at certain distance one from the other to enable the perfect plasticity of the eyelid movement immediately after treatment. Each of these spots sublimates the superficial corneocytes without affecting the basal laminae and without causing bleeding and more importantly without causing any damage to the surrounding tissue and the ones beneath.

With non-ablative blepharoplasty as well as reducing the excess skin on the upper eyelid, also shrinks the excess skin at the external periocular level with consequent disappearance of periorbital zygomatic expression lines.

A typical session will last no more than 5 minutes and the tiny point like scabs will fall off after 3 to 7 days.
We recommend 2 - 4 treatments.

You may experience some swelling and soreness in the treated area following your treatment. Any residual scabs will disappear within 7 days, but can be covered with liquid foundation. We will discuss your treatment and what you can expect during your consultation.
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Plexr uses the ionisation of gases in the air, forming plasma. This creates a small electrical ionization that can treat various problem areas without spreading unwanted heat to the surrounding skin. Suitable for all skin types.
 
 Clinical Study on Non-Ablative Blepharoplastybr>
Introduction

Non-Ablative Surgery is an oxymoron, which describes a surgical technique able to provide an alternative to mainstream Ablative Surgery.

The term Surgery literally means "operate with hands", obviously with the help of adequate instruments; it is always been invasive.

Instead Non-Ablative Surgery is meant to simplify the traditional surgical procedures, both in the dermatological and aesthetic field, with non-invasive procedures that do not involve making an incision, injective anaesthesia and sutures.

Non-Ablative Surgery and the devices to perform it have been developed since 1974 via many years of studies in continuous evolution.

This procedure, with tiny points of tissue sublimation, is able to shrink any excess skin without the need of a scalpel or making the skin thinner, using a painless and no-bleeding technique.
Also Non-Ablative Blepharoplasty, as name implies, does not need traditional, radiofrequency or laser scalpel to remove excess of skin, thus avoiding risks and complications related to traditional surgery.

This Blepharoplasty technique is defined as "Dynamic" because the physician can ask the patient to open or close his\her eyes during the procedure, thus revealing excess skin that needs treating.

InviaTo correctly understand Non-Ablative Blepharoplasty it is important to mention the anatomy and physiology of the eyelids.

The eyelids are cutaneous-membranous structures that cover the eyes, providing protection from excessive light and atmospheric conditions, and performing at the same time many essential functions; there are two sides, an internal one covered by mucosa that contributes to form the conjunctival sac, and an external one covered by skin.

Under the palpebral skin there is the Muller muscle (superior tarsal) that allows movements of the eyelids. 

The eyelids have lacrimal glands and eyelashes; the movement of the latter distributes the lacrimal fluid, thus avoiding corneal dehydration.

The eyelid is externally covered by very thin skin; beneath we find the subcutaneous connective tissue, more deeply we find the muscular layer with his submuscular connective tissue, internally covered by the conjunctival layer.
The levator palpebrae superioris is antagonised by the orbicularis oculi, both contribute to the physiological blink reflex, which is essential to maintain proper hydration in the surfaces exposed to the air.

The tarsal plates are formed by very dense fibrous tissue that supports the eyelids. The superior tarsus connects with the superior tarsal muscle, on its surface there the insertion of the aponeurosis of the levator palpebrae superioris.

InviaWhen some of these structures change for mechanical stress, for the skin aging process and postural habits, a surgical intervention may be needed to restore the physiological anatomy.

Blepharosplasty is one of the most sough after procedure for both aesthetic and functional reasons.
InviaTo correct the eyelid imperfections with traditional surgery we need local, at times general, anaesthesia, incision and removal of excess skin, surgical suture, removal of sutures, wound care dressings and follow-ups.

The number of people looking to have traditional surgical blepharoplasty is constantly reducing because of potential intraoperative risks and long postoperative recovery time.

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Aim of clinical study

1) To evaluate the possibility to treat conditions of the periorbital area without invasive procedures. 

2) To verify in the long term the results obtained with a non-invasive procedure performed avoiding the traditional technique and using a device manufactured for this purpose.

The device is made from three plasma-generating handpieces, each one with unique characteristics specific for the type of palpebral skin to treat.

This device allows performing Non-Ablative Surgery without the need of injective anaesthesia, skin removal, stitching and removing sutures and risk of complications.

One of the objectives of the study is to devise a standardised protocol able to obtain results both safe and repeatable.

The standardised protocol proposes:

1. Appropriate anamnesis
2. Evaluation of patient expectations and concerns
3. Plan of treatment
4. Adequate knowledge and training in Non-Ablative Surgery
5. Adherence to detailed after treatment instructions
Non-Ablative Surgery, performed for over 20 years by its inventor, Prof. Giorgio Fippi, holds a huge number of clinical case reports, national and international articles, press articles; it is subject of postgraduate study with national and international Masters.

The absence of complications and the high level of safety of the technique when performed by experts, have contributed to the huge success of Non-Ablative Blepharoplasty, which in the last few years, has become the first choice procedure compared to the traditional surgical blepharoplasty.

InviaThis Non-Ablative technique does not cause bruising, "dog ear" (excess of skin laterally to the suture), asymmetry, unnatural look or the dreaded lagophthalmos (inability to close the eyelids completely).

With the Non-Ablative Blepharoplasty, performed following precise guidelines, the skin in excess is not incised and removed, as it happens in with the traditional operation, but it is reduced in size bringing it back to the original thickness by simply sublimating the dead cells of the keratinised stratified squamous epithelium.

Sublimation is the direct transition from solid to gas state.

This device is able to achieve results impossible to obtain with other techniques by means of sublimation of the keratinised stratified squamous epithelium with concentrated microplasma.

The device is made from three plasma-generating handpieces, each one able, without touching the skin, to direct an adequate flow of microplasma to different structures of the skin, at the same anatomical site.

InviaEach microplasma spot sublimates the superficial corneocytes without involving the basal lamina and causing bleeding, furthermore without causing any necrotic damage to the surrounding and underlying tissue. 

Thanks to microplasma generated by the handpiece specific to the tissue to treat, we are able to obtain tiny spots, each one500 micron in size; the spots will be kept apart differently according to the type of procedure.

These tiny spots, placed in a specific pattern, will make the skin recovering the correct thickness as a result of reducing the excess.

Results are immediate, the session lasts a maximum of three minutes, there is no bleeding because we remain superficial to the basal lamina and never involve the dermis where the blood capillaries are.

Results are immediately visible and will last for years.

As soon as the procedure is completed it is possible to evaluate the perfect flexibility of the palpebral movement.

Non-Ablative Blepharoplasty technique does not cause scars or asymmetry; the pinkish colour of the treated area, which is visible at the 28-day follow-up, will resolve within few days; there is never a droopy eyelid with sad look, which is a complication at times caused by incorrect traditional blepharoplasty.

Invia

If the treated area is particularly extended it is possible to cause oedema that starts the day after the procedure and usually lasts about two days.

It is possible to prevent this secondary effect, usually mild and transitory, by dividing the procedure in two or more sessions and applying after the procedure an osmotic active glucidic paste.

The glucidic paste is prepared mixing a tablespoon of icing sugar with a teaspoon of water, and if needed adding 3-4 drops of naphazoline/benzalkonium chloride eye drops.

For any Non-Ablative procedure performed on the eyelids or near the eyes, the following precautions should be followed:

1) Do not anaesthetise the area if avoidable.
2) Do not apply any type of dressing, apart from applying benzalkonium chloride eye drops to disinfect the treated area.

3) Patients should wash the treated area as usual; they should avoid rubbing the area to dry it, only dabbing with a cotton tissue is allowed.

4) Apply few benzalkonium chloride drops on the treated area, not in the eye.

To perform correctly Non-Ablative Blepharoplasty it is paramount to evaluate the type of tissue on which we are going to operate, thus choosing the appropriate handpiece, the correct tip, establishing the vectors of skin shrinking and the tissue thickness we would like to achieve.

Obviously the energies involved change according with the handpiece and the tip used.