CARBOXY-PEN®

THE LATEST TECHNOLOGY FOR CARBOXYTHERAPY

Carboxytherapy : History

1932 ROYAT

Administration of CO2

1983 ROYAT

400,000 patients treated

2001, 2004 University of SIENNE

Dr Brandi

1953

Dr Jean Baptiste Romuef

Publication about 20 years of treatment

1992

Dr Jérome Berthier Cellulite treatment

Currently

20,000 patients / year

[1] Brandi C, D’Aniello C, Grimaldi L, Bosi B, Dei I, Lattarulo P, Alessandrini C. Carbon dioxide therapy in the treatment of localized adiposities: clinical study and histopathological correlations. Aesthetic Plast Surg. 2001 May-Jun;25(3):170-4.
[2] Brandi C, D’Aniello C, Grimaldi L, Caiazzo E, Stanghellini E. Carbon dioxide therapy: effects on skin irregularity and its use as a complement to liposuction. Aesthetic Plast Surg. 2004 Jul-Aug;28(4):222-5

CARBOXY-PEN: A world reference for Carboxytherapy

20 years of development in compliance with medical demands

UNIVERSAL: ANY TYPE OF CO2 SOURCE

A silver cylinder and some green bullets
A silver gun with the words carboxy pen on it.
A drawing of the side view of a gun.

Whole control

Total control

Painless effect

Simultaneous massage

Main Carboxytherapy indications

And many more…

A woman sitting on the ground in her underwear.

Carboxytherapy : Processus generated

Decrease of veins disorders
Improvement of the skin elasticity

PHYSIOLOGICAL PRINCIPLES:

A close up of some food on the side

Carboxytherapy : Technical informations

Oxyhemoglobin dissociation curve
Bohr effect (1904): Improvement of the oxygen level in the skin by injection of CO2
A graph showing the ph of an individual 's body.

CO2 + H2O -> H2CO3 -> H+ + HCO3-

Excess of CO2 reacts with water to form carbonic acid Carbonic acid is dissociated in bicarbonate ion & H+ ion
CO2 induces a decrease of pH by a release of H+ ions and hypercapnia
Right shift of the oxyhemoglobin dissociation curve induces O2 release in the tissue.

Carboxytherapy : All areas

Poor blood and lymphatic microcirculation
Better blood and lymphatic circulation
A close up of an eye with blue eyes
A drawing of a person standing in front of the camera.
A large area of land with various topography and lines.

CO2 induces O2 release in the tissue

A picture of an image with the caption, " laser surgery."

Wrinkles protocol

Several injections in wrinkles
6 – 8 sessions for a complete treatment

P R O T O C O L
c o m b i n a t i o n

Needle

Injection

Use 30 G – 32 G

2 cc / point

Depth

Frequency

From 1 to 3 mm

2 sessions / week

Skin laxity improvement

Reoxygenate the treatment area
Increase blook’s circulation
Generate the firming up of muscles
Injection all over the treatment area 4 – 6 sessions for a complete treatment

P R O T O C O L
c o m b i n a t i o n

Needle

Injection

Use 30 G – 32 G

2 - 4 cc / point

Depth

Frequency

From 1 to 2 mm

1 or 2 session (s) / week

Dark circles protocol

Several injections in dark circles

P R O T O C O L
c o m b i n a t i o n

Needle

Injection

Use 30 G – 32 G

2 - 4 cc / point

Depth

Frequency

6 – 8 sessions for a complete treatment
A woman with blue eyes and blonde hair.

Periorbital rejuvenation: Results

A woman with blue eyes and no makeup on.
Dark circles around the eyes
*not actual patients of Dr. Izadi
A woman with blue eyes and no makeup.
Wrinkles of the lower eyelid
*not actual patients of Dr. Izadi
A woman 's eyes are shown with brown and black eye makeup.
(Before) Skin elasticity improvement
*not actual patients of Dr. Izadi
A close up of the eyes of a woman
(After) Skin elasticity improvement
*not actual patients of Dr. Izadi

Stretch marks improvement

4 – 6 sessions for a complete treatment Time of treatment cure : 3 to 4 months
A before and after picture of the skin on someone 's arm.
*not actual patients of Dr. Izadi

P R O T O C O L
c o m b i n a t i o n

Needle

Injection

Use 30 G

2 cc / point (superficial S.M) 5 cc / point (deep S.M)

Depth

Frequency

1 mm (superficial S.M)
4 – 6 mm (deep S.M)

2 sessions / week

Scars improvement (Nach et al 2010)

A before and after picture of the skin on a woman 's face.

Before

After

A woman 's face with wrinkles and redness.

*not actual patients of Dr. Izadi

Scars 5 years after rhytidectomy procedure
4 – 6 sessions for a complete treatment

P R O T O C O L
c o m b i n a t i o n

Needle

Injection

Use 30 G

2 cc / point (superficial Scars) 5 cc / point (deep Scars)

Depth

Frequency

1 mm (superficial Scars) 4 – 6 mm (deep Scars)

1 session / 2 weeks

Increase of the microcirculation and reorganization of the collagenous fibers improve scars

Cellulite improvement

Injections in square areas
12 sessions for a complete treatment
*not actual patients of Dr. Izadi
A woman 's legs with very large, wrinkled skin.

Before

A woman 's legs with no visible underwear on.

After

P R O T O C O L
c o m b i n a t i o n

Needle

Injection

Use 27 G - 30 G

2 cc / point (cutaneous relaxing) 5 cc/point (lipolysis)

Depth

Frequency

1 - 2 mm (cutaneous relaxing) 5 - 8 mm (lipolysis)

2 session / 1 weeks

Treatment of thighs localized adiposities (Brandi et al 2001)

50 cc/min, total 300 cc, 30G needle, 2 subcutaneous treatment per week during 3 weeks. Injections made anteriorly and posteriorly at the medium, medial, and lateral third of the thigh.
Average of 48 women Before After
Thighs circumference (cm) 56.1 54.2* (after the last session)
Knees circumference (cm) 37.8 36.7* (after the last session)
Abdomen circumference (cm) 78.4 75.7* (after the last session)
Laser Doppler values (PU) 12.29 20.65* (after 30 min)
PO2 (mmHg) 61.17 80.30* (after 30 min)
* Statistically significant
Adipose tissue reduction and increase of microcirculation and O2

Subcutaneous tissue histology of the thighs before and after CO2 treatment
(Brandi et al 2001)

A white wall with red paint on it.
A close up of the surface of a marble slab
A white marble surface with some brown spots
Subcutaneous layers before treatment
Subcutaneous layers after treatment (3 weeks)
Detailed photography showing lysis of the adipocytes after treatment (3 weeks)
Carboxytherapy induces lipolysis of the adipocytes without involving the vascular structures.

Skin remodeling (Brandi et al 2001)

A close up of the inside of a person 's skin
Before CO2 treatment
After CO2 treatment (3 weeks)
After treatment, the dermis presents a thicker appearance with the collagenous fibers distributed more diffusely (rearrangement)

Adipocytes cytometry of the abdominal wall (Costa et al 2011)

15 patients, 250 mL of CO2, 80 mL/min, 30G needle, 2 treatments per week during 6 weeks.
* Statistically significant
Parameters Before After
Area (µm²) 5349 56*
Perimeter (µm) 268.82 188.5*
Length (µm) 96.81 68.48*
Width (µm) 71.5 46.3*
Number (in the sample)) 449 300.13*
Ellipsity index (length/width) 1.35 1.48
Adipose tissue reduction and increase of microcirculation and O2

Carboxytherapy effects on skin irregularity and its use as a complement to liposuction (Brandi et al 2004)

Group A (12 patients) : liposuction
Group B (12 patients) : 3 weeks after liposuction, 2 CO2 treatment per week during 10 weeks, 100 cc/min total 300 cc, 30G needle
Group C (18 patients) : CO2 therapy alone, 2 CO2 treatment per week during 10 weeks, 100 cc/min total 300 cc, 30G needle
Time Thigh circumference (avg in cm) Knee circumference (avg in cm)
Liposuction Liposuction + Carboxytherapy Liposuction Liposuction + Carboxytherapy
Before surgery 58.9 58.1 42.1 40.3
After 3 weeks 55 53 38 38
After 2 months 53.7 51.4 37.7 36.9
Carboxytherapy improves skin irregularity caused by the persistence of localized adiposities after liposuction.

Skin elasticity improvement (Brandi et al 2004)

Time Skin elasticity with a cutometer (average)
Before (Liposuction group) 2.98
After 2 months (Liposuction group) 4.39*
Before (Liposuction + CO2 group) 3.2
After (Liposuction + CO2 group) 4.92*
Before (CO2 group) 2.88
After 2 months (CO2 group) 4.48*
Carboxytherapy improves skin elasticity and is a good complement to liposuction

Carboxytherapy in the treatment of cellulite (Lee et al 2010)

57 women, 800 to 1000 cc for each thigh, 30G needle, 5 treatment sessions.
27 women (20-29 years old) 18 women (30-39 years old) 12 women (40-50 years old)
Before After last session Before After last session Before After last session
Right thigh circumference (cm) 55.1 53.6* 54.3 53.2* 58.2 56.6*
Left thigh circumference (cm) 55.0 53.6* 53.9 52.8* 57.5 56.0*
Weight (kg) 53.7 53.2 51.9 51.0* 58.2 56.6*
*statistically significant
Carboxytherapy decreases thigh circumference in the treatment of cellulite which leads to weight decrease.

Side effects and contraindications

Resolved within less than 1 hour:
Occasional side effects:
Contraindications: Phlebitis, cardiac/respiratory insufficiency, renal/hepatic insufficiency, severe arterial hypertension, pregnancy.
*not actual patients of Dr. Izadi

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