Pursuit of Anatomy-Based Injectable Treatment and Knowledge Transfer to the Next Generation

―Bringing the Essence of Medicine to Aesthetic Medicine―

Clinic Philosophy

Aesthetic Medicine is Also Medicine

At La Belle mira clinic, our mission is to promptly return the knowledge gained from research and education in aesthetic medicine to society. Aesthetic medicine is medicine, and it is a science. Even as elective medical care, it remains medicine and science, and as such, we believe that logical, evidence-based treatment with solid foundations should be pursued.
Fortunately, modern aesthetic medicine has various research data available, and evidence is becoming increasingly comprehensive. We provide knowledge and techniques of anatomy-based injectable treatment through practical programs, and we focus on educational activities to deepen understanding of aesthetic medicine.
As a clinic that pursues technology and explores and disseminates the possibilities of injectable treatment, we aim to contribute to the development of aesthetic medicine.

Director Introduction

Dr. Konyou Arai – Allergan Certified Trainer & Faculty

Dr. Konyou Arai is certified as an Allergan Certified Trainer & Faculty, one of the few in Japan, and the only one in the Tokai region. Particularly in the field of hyaluronic acid injection, he shares theoretical and practical knowledge through lecture activities both domestically and internationally, and has provided educational guidance to hundreds of doctors to date.
He has earned the trust of many medical professionals through his delicate techniques based on an anatomical approach and evidence-based treatment planning. He has also learned directly from Dr. Mauricio de Maio, the developer of MD-codes, and applies this knowledge to clinical practice and education.

Treatment Philosophy – Total Facial Treatment (TFT)

From Isolated Part Treatment to Holistic Balance Treatment

The core of our treatment philosophy is “Total Facial Treatment (TFT).” Rather than treating each part separately, we achieve truly natural rejuvenation through a comprehensive approach that considers the balance of the entire face.

TFT Principles:

• Comprehensive evaluation of facial anatomical structure
• Understanding the interrelationships of skeletal structure, muscles, adipose tissue, and ligaments
• Treatment planning based on the mechanisms of aging changes
• Customized treatment respecting patient individuality

Treating only a single area without overall balance often results in low patient satisfaction. At our clinic, through counseling sessions that sometimes exceed one hour, we thoroughly discuss with patients the points to be treated and the expected changes.

Hyaluronic Acid Injection Treatment – Anatomical Approach

Building from the Skeletal Structure – Essential Understanding of Rejuvenation

Our hyaluronic acid injection treatment addresses the essence of tissue changes associated with aging, rather than superficial wrinkle removal.

Understanding Aging Theory:
Many people think “I look old because I have wrinkles,” but actually “wrinkles form because of aging.” In other words, wrinkles are the result, not the cause. The true causes lie in the following tissue changes:

1. Skeletal Resorption – Loss of three-dimensional structure due to facial bone resorption
2. Ligament Laxity – Tissue ptosis due to weakening of support structures
3. Fat Redistribution – Atrophy of adipose tissue and ectopic accumulation
4. Muscle Changes – Coexistence of muscle weakness and hypertension
5. Loss of Skin Elasticity – Superficial changes due to collagen reduction

Treatment Strategy:
To reverse these changes, we use hyaluronic acid to:

• Supplement skeletal structure and restore facial three-dimensionality
• Strengthen ligament structures and achieve tissue lift
• Recreate ideal fat distribution
• Optimize muscle balance
• Support the skin from its foundation to improve the surface layer

Injection Techniques:

• Deep injection (supraperiosteal/subperiosteal) for structural support
• Mid-layer injection for volume correction
• Superficial injection for delicate adjustment
• Strategic use of cannulas and needles
• Precise control of injection depth, volume, and location

Products Used:
We primarily use Allergan’s hyaluronic acid products. Leveraging the VYCROSS technology that achieves appropriate elasticity and long-term persistence, we select the optimal product according to the treatment area and purpose:

• Volux XC (Highest elasticity/Shape retention) – Chin, jawline, nose, and areas requiring sharp contour definition
• Voluma XC (High elasticity/Smoothness) – Versatile use from periosteal to subcutaneous fat layers, applicable to most facial areas
• Volift XC (Moderate elasticity/Flexibility) – Subcutaneous fat layer injection, creating soft, rounded contours for forehead and cheeks
• Volbella XC (Highest flexibility) – Mid to superficial subcutaneous fat layers, lips, tear troughs, periorbital areas, and other dynamic or delicate regions

Botulinum Toxin Treatment – Science of Neuromuscular Modulation

Aesthetic Optimization Through Facial Muscle Control

Botulinum toxin treatment is a therapeutic method that controls muscle activity by modulating acetylcholine release at neuromuscular junctions.

Treatment Principles and Clinical Applications:
1. Improvement of Expression Lines　We appropriately suppress muscle activity for dynamic wrinkles formed by excessive muscle contraction. However, simply weakening muscles is insufficient.
Important Clinical Consideration:　Consider botulinum toxin treatment for forehead wrinkles, for example. Many physicians think “inject botulinum toxin because there are wrinkles on the forehead,” but what’s medically important is being able to theoretically answer the question “why inject botulinum toxin for forehead wrinkles.”
Most forehead wrinkles result from compensatory frontalis muscle hyperactivity due to brow ptosis. Simply weakening the frontalis muscle may worsen eyelid ptosis. Therefore, combining with treatments that lift the eyebrows (structural support with hyaluronic acid or botulinum toxin to depressor muscles) enables safe and effective treatment.
2. Facial Contour Adjustment For prominent mandibular angles due to masseter hypertrophy, we reduce muscle mass to achieve a more refined contour.
3. Expression Optimization By adjusting the balance of antagonistic muscles:

• Optimization of eyebrow position and shape
• Elevation of oral commissures
• Improvement of eye opening
• Formation of softer and more approachable expressions

4. Hyperhidrosis Treatment We temporarily block neural innervation of eccrine sweat glands to suppress excessive sweating.
Administration Techniques: Based on a deep understanding of facial muscular anatomy and the interactions of facial muscles, we achieve maximum effect with the minimum necessary dosage. We emphasize obtaining treatment effects while maintaining natural expressions, considering the balance of antagonistic muscles.

Educational Program – Aiming for “The Student Surpasses the Master”

Developing the Next Generation of Injectable Treatment Specialists

Our educational philosophy is “the student surpasses the master.” When teaching, we always give our full effort without holding back, so that our students can surpass us.

Important Insights in Education:
1. The Courage to Learn from Scratch To efficiently master injectable treatment, it is necessary to temporarily discard all previous injectable treatment experience and concepts and learn from the basics. This is not as easy as it sounds.
Metaphorical Explanation: When you have some experience with conventional injectable treatment, you tend to try to update by adding new knowledge to that experience. However, this often doesn’t work well because the underlying theory is fundamentally different.
No matter how hard you cultivate an orange tree, it will only produce oranges, never apples. If you want to grow apples, you must pull out the tree from the roots and plant apple seeds to cultivate. For quick growth, you need to realize you’re growing an orange tree and replant as soon as possible.
2. Medically Based Treatment There was a time when appropriate textbooks and education were scarce in aesthetic medicine, and many physicians had no choice but to follow what their seniors told them. However, aesthetic medicine is also medicine and science.
Physicians who practiced medically informed and diagnosis-based treatment in insurance medicine sometimes skip the medical process when it comes to aesthetic medicine. This should be avoided.
3. Necessity of Theory, Research Data, Evidence, and Anatomy Injectable treatment is not something to be performed “just because” or “casually.” It’s not a cosmetic procedure that beginner doctors should learn as a starting point. It is a logical, evidence-based medical treatment, requiring:

• Deep understanding of facial anatomy
• Research data on aging change mechanisms
• Clinical evidence for each treatment method
• Practical knowledge through anatomical dissection

4. Understanding and Utilizing MD-codes MD-codes is not something to believe in or agree with, but something to utilize. As a knowledge system in which vast amounts of data, anatomical knowledge, and safety techniques have been carefully examined and incorporated, properly understanding and utilizing it provides a foundation for safe and effective treatment.
However, MD-codes alone cannot cover everything. A flexible attitude of understanding the meaning and purpose contained in MD-codes and utilizing applicable parts is important.

Educational Program Features:
Beginner Seminars:

• Fundamentals of facial anatomy
• Mastering safe injection techniques
• Understanding complication prevention and management
• Basic treatment planning

Advanced Training:

• Practice of TFT (Total Facial Treatment)
• Handling complex cases
• Approach to revision treatment
• ase studies and case discussions

ハHands-on Training:

• Practical training with model patients
• Real-time feedback
• Confirmation of anatomical landmarks
• Detailed adjustment guidance for injection techniques

Educational Results – DNA Inheritance Doctors who acquire injectable treatment at La Belle are both copies and not copies of us, being completely original yet having the same core information. Just like DNA being inherited, the essential understanding of treatment is passed on.

Complication Management and Safety

Treatment Practice with Safety as the Highest Priority

In injectable treatment, understanding complications and appropriate response are essential.

Major Complications:
1. Vascular Occlusion The most serious complication, vascular occlusion, is a condition where hyaluronic acid is injected into a vessel and becomes blocked. Blood flow doesn’t reach beyond the blockage, causing oxygen deprivation and tissue damage such as skin impairment.
Observation Points for Early Detection:

• Nature of pain: Strong pain such as “throbbing pain that increases” or “pain preventing sleep”
• Skin color changes: Blanching or purple discoloration
• Abnormal symptoms immediately after injection

Response: Prompt administration of hyaluronidase to dissolve hyaluronic acid is essential. As time passes, tissue damage worsens, so early detection, diagnosis, and treatment intervention are critical.
2. Delayed Allergic Reactions May develop several months after treatment. Recent products have reduced protein content and reports are less common, but the possibility should be recognized.
3. Infection Injection site infection is rare, but thorough aseptic technique and appropriate patient instruction are key to prevention.
Prevention Strategies:

• Complete understanding of anatomical danger zones
• Selection of appropriate injection depth
• Performing aspiration
• Reducing vascular injury risk through cannula use
• Always having hyaluronidase available

Research and Clinical Circulation

Integration of Evidence Creation and Clinical Practice

At our clinic, we emphasize the cycle of publishing insights gained from clinical experience as research and returning the evidence obtained back to clinical practice.

Activities:

• Presentations at domestic and international conferences
• Hosting physician seminars (multiple times annually)
• Faculty activities at Allergan-sponsored seminars
• Technical exchange with international instructors
• Continuous learning of latest techniques and clinical application

This circulation enables us to continuously provide the latest and best treatment.

Clinic Information

La Belle mira clinic

• • Location: Hilton Nagoya, 1-3-3 Sakae, Naka-ku, Nagoya, Aichi, Japan
  • Access: 3 minutes walk from Exit 7 of Fushimi Station, Nagoya Municipal Subway
  • Hours: 10:00-17:00
  • Closed: Mondays
  • Specialization: Injectable treatment specialist clinic focusing on hyaluronic acid injection and botulinum toxin injection

Contact: TEL: +81-52-253-8155 Website: https://labelle-miraclinic.jp/

To Medical Professionals

For Physicians Who Want to Learn Injectable Treatment from Its Essence

We offer programs for physicians who want to systematically learn injectable treatment from the fundamentals. Regardless of previous treatment experience, we welcome those who want to master true injectable treatment based on anatomical foundations and evidence.
Injectable treatment is medicine and science. Together, let’s contribute to the development of aesthetic medicine.
For seminar information and observation inquiries, please contact the clinic directly.

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