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Cosmetic Dermatology Today and Tomorrow

Aesthetic and anti-aging medicine, cosmetic dermatology, minimally invasive skin rejuvenation are among the most recent and dynamically growing fields of medicine. Dermal fillers, laser hair treatments, laser skin resurfacing, body contouring and laser assisted liposuctionare quickly becoming a standard offering at many forward-looking medical practices. These treatments are no longer part of the close captioned realm of plastic and cosmetic surgeons. OB/GYNs, family practitioners, internists and dentists are moving in the field expanding the availability of aesthetic services and increasing customers’ awareness.

Here is a good panel of doctors talking about cosmetic dermatology.

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  • Filed under: Market | businesses
  • Fraxel Re:pair versus Face Lift

    Last week, Solta Medical presented a study by Steve Weiner, MD at the annual American Academy for Dermatology meeting. The presentation sparked a few discussions among doctors who have had some experience with the “new Fraxel”.

    Fraxel Re:pair is a “non-invasive” laser treatment used for the reduction of fine to moderate wrinkles on the face, neck and chest. “As a plastic surgeon I’ve found this to be the best treatment on the market to date and I don’t anticipate anything will replace it for many years,” said Weiner. Some may argue that Dr. Weiner’s opinion is biased since he did the study on the Solta’s buck and featured his patients at several nationwide webinars promoting Solta’s lasers. However, Weiner’s research clearly shows the advantages of his technique, which are very valuable for many physicians.

    How does Fraxel Re:pair compare to a traditional face lift?

    A face-lift is a surgical procedure under general anaesthesia performed by a plastic surgeon, often in a specialized outpatient center or a hospital. The Fraxel Re:pair is considered to be a non-invasive treatment with the use of CO2 laser technology, which can be done by physicians of different specialties and in a doctor’s office. Results are expected to last up to 10 years. For most patients only one treatment is required, for deeper wrinkles two may be necessary, according to Weiner.

    The laser effectively removes portions the epidermis and heats the dermis to tighten the skin and help with collagen elasticity, referred to as resurfacing. As with other laser treatment the new skin is exposed and wound care is necessary. This is the part where one may question the definition of a non-invasive treatment. After the Fraxel treatment the patient goes home with dressings on the face. The dressings need to be changed every 3-4 hours and you have to stay indoors for 5-7 days. Most patients would arguably call this pretty invasive.

    The Fraxel Re:pair seems to work very well on mildly deep wrinkles, acne scars and brown spots, caused by the sun exposure. With some extra skill and experiens a doctor can work with Asians and Hispanics. Smokers and individuals with heavily tanned, pigmented or very dark skin types are not good candidates for this treatment.

    The cost for Fraxel Re:pair ranges from $1,300 to $6,300, approximately 1/3 the cost for a surgical face lift which can cost more than $10,000.

    LaserOffers comment

    Our medical panel agrees that leaving the issue of cost differential aside, for the vast majority of patients the CO2 fractional treatment with Fraxel will work just as well, if not better than the surgical face-lift. The additional benefit is that the laser actually improves the skin texture, whereas the lift merely stretches the skin.

    Actifirm Post Laser Gel combines skin-soothers like Aloe and Chamomile with a Mushroom-derived, exfoliating enzyme, Mucor Miehi Extract, to inhibit pain and inflammation, while helping renew your skin to its freshest form. You’ll be looking your best in no time.


    More skin care recommendations by LaserOffers.com

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  • Filed under: Laser Clinics, LT | fractional, New Lasers, Research
  • There is a good article at empowerher.com, which deals with the subject LaserOffers.com staff has been covering in the last couple of months – the trend towards less expensive surgery and more affordable non-invasive treatments. ”Women who would really benefit most from a facelift would do well to consider the long-term cost of a series of non-invasive treatments versus surgery. One surgeon noted that while facelifts aren’t cheap, the beneficial effects typically last up to 10 years. You can pay as much or more for 10 years of injections with less dramatic results”.

    Facial plastic surgeons are experiencing a slowdown in demand for high-ticket plastic surgery. Some of them are trying to adapt and offer new services with the use of non-invasive tools like injectables, chemical peels, lasers and other treatments.

    We believe that given the current economic situation, rapid development of the anti-aging medicine and the downtime associated with major plastic surgeries, we will see many more traditional plastic surgeons expand their practices by offering non-invasive and routine maintenance services such as photorejuvenation and dermal injectables.

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  • Filed under: CURRENT NEWS
  • Medical Spas and a lot of aesthetic physicians have adopted IPL devices to treat a variety of skin conditions, from hair removal to age spots.

    Intense Pulsed Light (IPL) is a non-laser flash lamp light source that emits broad spectrum, high-intensity visible and infrared (IR) light and is used for permanent hair reduction, acne (including photo dynamic therapy, aka PDT), Rosacea, dyschromias and telangiectasias, and age related treatment of facial lines and creases.

    Wavelengths are chosen by selecting a particular wavelength filter or attaching a specific treatment head or hand piece that is configured with the filter already attached. Since IPL medical devices use a ‘pulse’ of light they deliver their energy into the dermis over a longer time than a laser, providing different treatments and usually resulting in significantly more pain for the patient.

    Shorter wavelengths in the visible spectrum are used to target hemoglobin (red skin conditions like acne and Rosacea) and melanin (brown spots). Longer infrared (IR) wavelengths target water in the skin and can treat other conditions. Since IPL devices use a ‘pulsed’ light instead of a high-intensity focused beam like lasers do, IPLs emit more scattered light (feathering) and are less selective than a laser in heating the skin. With IPL devices there are often additional treatments needed to achieve optimal results than with lasers.

    Practitioners more or less agree on the applications of different wavelength available in IPL devices:  

    Wavelength (nm) Used to treat:
    420 acne
    500 pigment
    510 pigment
    515 pigment
    520 pigment and some vascular lesions
    525 pigment and some hair removal
    560 pigment and some vascular lesions
    590 pigment in skin types
    615 larger facial spider veins
    640 superficial leg veins
    650 hair removal
    695 thicker vascular lesions (angiomas, hemangiomas), superficial leg veins, hair removal
    755 thicker vascular lesions (angiomas, hemangiomas), superficial leg veins, hair removal

    Major manufacturers of IPL Intense Pulsed Light devices: Candela, Palomar, Cutera, Lumenis and Sciton. 

    IPL Pros

    • Cheaper than lasers
    • More compact than most lasers
    • Results are comparable to the 810 nm Diode or the 770 nm Alexandrite lasers for hair and to the 532 nm KTP Laser, the 595 Pulsed Dye Laser for the treatment of Rosacea and vascular lesions

    IPL Cons

    • Cannot be used safely on darker skin types (IV-VI) or tanned skin
    • Filters (heads) have a short life span (50,000-75,000 pulses)
    • Filter/head replacement is expensive
    • Many different wavelengths, settings, cooling requiremnts may be confusing for the operator
    • Maintenance and service required

    LaserOffers.com Comment:

    More and more experts agree that from the practical standpoint Nd:YAG 1064 nm may have established itself as the single most versatile wavelength for all of the treatments mentioned above. For all skin types and tanned skin.

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  • Filed under: Laser Clinics, RS | IPL and Lasers
  • Just a few quotes from Men facing up to nips and needles published on FT.com yesterday.

    “Anyone who says looks are not important is a liar,” says the 33-year-old account manager, who works for a British marketing agency. “You need to look good – fresh and bright rather than tired and stressed out.”

    “I perform better if I feel confident so it may have increased the num­ber of contracts we have won”

    “There are definitely more business guys coming in and they have very focused demands,” says Cap Lesesne, pictured, one of Manhattan’s leading cosmetic surgeons. “They are worried about their job futures and their professional longevity.” Typical male patients might be in their mid-forties, he adds. “They’re fairly successful and they’re looking to work into their sixties.”

    “I was beginning to look kind of tired and wanted to have something that made me feel refreshed but not surgically altered,” says a 56-year-old maths and science academic. Prolonging his career was a big motivation: “I would like to work for another 10 years.”

    In the UK, Steven Clarke, a 25-year-old engineer at Rolls-Royce, has had laser treatment at plastic surgery specialists Harley Medical Group to remove sun scars under his eyes. It seems that younger men, like such as Mr Clarke and Mr Burling are part of a generation that may be more comfortable with the idea of at least the non- invasive treatments.

    Mr Clarke says: “If you don’t look after yourself it shows that you’ve got no discipline and that doesn’t reflect well on your work life. I’ve thought that if after lots of late nights working for Rolls- Royce I start to look tired, then I’d probably have an eye lift.”

    “People are scared about losing their jobs and they want to look their best.”

    “People might say: ‘You look tired.’ What that implies is you’re not as vigorous or energetic, or not as competitive as you might be.”

    However, many in the sector are confident that they can weather the storm. “I know we will see a fall-out here even though this is a pretty affluent community,” .

    She recentlystimulated demand by offering a 10 per cent holiday discount for facial “injectables”, such as Botox. “In my practice e surgical volume was down so we had to be creative. When the world gives you lemons you make lemonade.

    “We’re not recession-proof but we’re recession-resistant,” says Dr Boxrud, who specialises in facial and ophthalmic aesthetic and reconstructive surgery in Hollywood. “There are some surgeons who only do cosmetic surgery and if they are only doing big, cosmetic procedures, they are going to have to rethink their practice.”

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  • Filed under: Market | businesses, Market | consumers
  • Any physician can’t but notice a significant increase in non-invasive and non-surgical procedures.

    The job market is very competitive, and people are scared. With the combination of financing, decreased pricing and a wider range of services available, it becomes very realistic to give yourself a boost, go into that interview with an edge and just feel good all around. Procedures such as a photorejuvenation, injectable fillers takes a few minutes, zero down-time, produce quick or almost immediate results and cost a fraction of what a surgical face lift would be. Lasers, Botox and fillers can accomplish a very broad range of results from simply filling in the little lines around your mouth, to a completely different look.

    More and more aesthetic practices offer financing with programs that range from interest free to 48 month extended plans.

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  • Filed under: Market | businesses, Market | consumers
  • You get what you pay for – an old saying with 100% accuracy – applies as usual.

    There have been many incidences in the media of late with reference to botched cosmetic surgery procedures and 9 times out of ten this seems to stem from paying too little and using unscrupulous practitioners who prey on the uniformed and the gullible.

    Nothing against cosmetic dentists offering dermal fillers and simple laser treatments, but you should be very thorough in checking his background if he offers to perform breast augmentation surgery.

    It really is crucial that you research any prospective cosmetic surgeon to ensure you will receive the best quality surgery and aftercare. You cannot guarantee this with a surgeon who is not accredited as they don’t have the strict regulation of association members.

    These days, there are so many excellent non-invasive treatments, such as dermal fillers and/or laser treatments, and consumers should consider those first and well before taking the risks of any cosmetic surgery. Non-invasive procedures are effective, require minimum downtime if any, and can be safely done by a wide range of medical professionals.

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  • Filed under: Risk & Safety, RS | cosmetic surgery
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