Dr Paul Han and Dr Manos Dimonitsas
GOURI neck protocol to reverse aging
Everyone ages differently, yet the neck and hands are considered to be the very first parts of the body to age. Transverse neck wrinkles – known as the rings of Venus – appear at a very young age. Aging processes, sun exposure, and even sleeping positions contribute to neck sagging. GOURI, a PCL-based collagen inducer, improves skin laxity and fine lines on the neck, being a powerful tool in the physician’s quiver.
Dr. Paul Han’s Case: I had a 70 y.o. patient with noticeable sagging of the neckline, skin laxity, and both horizontal and vertical wrinkling. GOURI was offered to the patient due to the following reasons: 1) the spreading ability of the product allows it to cover the extensive wrinkle area; 2) neocollagenesis stimulation should effectively improve the skin laxity and give the desired lifting effect.
GOURI is a fully liquid injectable that, unlike filler, is not designed for a specific localised injection, thus instead of injecting directly into the wrinkle lines a three-line per-side injection protocol was chosen to cover the whole neck area. Before the product injection, a local anaesthetic was administered. The protocol included one entry point made with a 23G needle at each side of the anterior triangle area. From the entry point, a total of 3 vector injection lines (on each side) were drawn to cover the upper, middle, and lower third of the neck.
A total of 6ml of local anesthetic were prepared and applied injecting 0.5ml into each of the six designed lines in retrograde linear technique using 25G 50mm cannula. After that, GOURI was infused along the same lines and the same tissue plane where the anesthetic was injected. Approximately 0.33ml were injected into each vector. The injection lines were not visualised by the time the patient left the clinic. No adverse effects were noticed during or after the treatment. The visual evaluation of results 2 months later demonstrated significant improvement in vertical wrinkles with only one session. Additional sessions are recommended for further improvement.
Dr. Manos Dimonitsas’ Case: My experience of GOURI’s efficacy for neck wrinkles improvement can be demonstrated with this case study. The patient had 1 session with 2 syringes of GOURI. The protocol included 2 entry points on each side. The first entry point was 2-3 cm medially from the upper part of the sternocleido-mastoid muscle in the horizontal line of the midline between the submental border and hyoid bone. The second entry point was upon the middle part of sternocleidomastoid muscle, at the intersecting point with the horizontal line of the apex of the Adam’s apple. 0.1 ml of xylocaine solution was injected into entry points before introducing the entry needle. Then, 0.25ml xylocaine was infused deep in the dermis for every route using 25G 50mm cannula. The route for the cannula after its insertion from the first entry point was up and down the horizontal midline between the submental border and the hyoid bone.
GOURI was infused at the same tissue level as xylocaine (0.25ml in each direction, a total of 1ml for both sides for 1st entry point). From the second entry point, the cannula followed 3 different routes. First, the cannula was directed toward the hyoid bone. Secondly, it was gently twisted and headed to the horizontal line of the apex of the Adam’s apple and finally, it was directed towards the midline between the base of the thyroid cartilage and the sternal notch. The infused amount for every route was about 0.15ml, a total of 1ml for both sides for the second entry point.
Thirty minutes before the start of the treatment, a cetirizine pill was given to the patient, and after the treatment, a 3-day prescription of 4mg methylprednisolone was provided. The patient was instructed to avoid any anti-inflammatory drugs and any other treatments that act at the same level (skin boosters, threads, or heating devices) for the next 15 days. The first signs of the skin texture improvement were noticed 15 days after the treatment and the final result was visible after the fourth week. The patient was satisfied with the result as they noticed the difference in skin firmness, improvement of the skin texture, as well as the lifting effect. The primary goal of aesthetic medicine is to improve and strengthen the deep layers of the skin and promote our natural body resources. The key to success lies in improving skin imperfections from the inside and this is exactly how GOURI works.
The rings of Venus are called so because of the famous Greek images of Venus de Milo. Ancient Greek mythology glorified beauty and Venus was an embodiment of it. Despite her divinity, she had an imperfection – the rings on her neck. So, maybe GOURI came to the market to correct the mistakes of the ancient gods?
Dr Paul Han and Dr Manos Dimonitsas
Dr. Paul Han, Australia International KOL and trainer.
MBBS degree at UNSW Sydney. More than 20 years of experience in aesthetic medicine. Founder of two aesthetics clinics in Sydney. Conducted more than a thousand GOURI treatments within the last year.
Dr. Manos Dimonitsas, Greece International KOL and trainer.
Has finished his education in plastic surgery in Athens and actively uses injectables in his practice. Holds a Master’s degree in Dermatology-Allergy and a Ph.D. in Dermatoncology. Owns a medical blog myeyzin.com where he shares his experience with beauty treatments and cosmetics.
