Sunday, July 24, 2011

CUTTING EDGE DERMAL FILLERS AND REJUVENATING ENERGY BASED DEVICES

CUTTING EDGE DERMAL FILLERS AND REJUVENATING ENERGY BASED DEVICES

A Brief Overview-

Waldorf Astoria, NYC

An annual event, the enormous confab on aesthetic surgical and non-surgical, trendsetting techniques and research--- and anti-aging medicine---

...brought together leading aesthetic physicians/surgeons, research types and media---to discuss, and debate---and review clinical studies.

It started for us- with a fact-packed, AM media meet on three major topics---

The Next Generation of Wrinkle Relaxing Agents and Dermal Fillers-presented by Z. Paul Lorenc, M.D., F.A.C.S.

What’s Hot (literally) in Skin Tightening and Fractional Resurfacing-presented by David J. Goldberg, M.D., J.D.

Modern Advancements in Fat Grafting and the Science of Stem Cells-presented by Sidney R. Coleman, M.D., F.A.C.S.

‘Hosted’ by Wendy Lewis, President of Wendy Lewis & Co. Ltd…a well known expert on all things related to the topics at hand…Ms. Lewis began with a slide presentation on global trends in aesthetic medicine---with the focus on European developments.

There was a lot of information to digest, (from all presenters)…

Some Highlights

We zeroed in on what’s on the horizon for USA skin/body rejuvenation procedures---including some that are currently going through the FDA review/approval process.

Examples include the much buzzed/written about Platelet Rich Plasma (PRPS)-popular in certain orthopedic circles to aid healing (pro athletes like Tiger Woods swear by this) and part of what is known generally as autologous fibroblast therapy ---where for example- a patient’s own blood cells are spun in a centrifuge-with the separated out platelets injected as wrinkle fillers. Other examples of autologous fibroblast therapy (which have the benefit of being one's own)---as in using one’s very own fat cells as fillers--- were discussed in more detail later.

Ms. Lewis also touched on some of the latest devices that use photodynamic light waves and radio frequency to improve/tighten/stimulate the collagen in the skin by targeting different layers of the dermis-including some procedures that are (virtually) pain-free-and some at-home devices for hair and wrinkle reduction, and acne treatments, non-invasive devices for body contouring using ultrasound and fat freezing/melting techniques- plus promising new surgical and non-invasive techniques, and longer lasting fillers-important developments for those people who are pain avoidance/little if any downtime at all types.

MAJOR INTEREST for needle phobics--the topically delivered botulinum toxin variation (by privately held, Revance® Therapeutics Inc).---what we were told is ‘mildly’ similar in effect to the widely popular Botox® and Dysport®.

ALSO: a highly effective laser that eliminates toe fungus in one treatment (GenesisPlus- by Cutera® ---we predict will be huge), and new hylauronic acid gels like the non-permanent Belotero® for fine wrinkles –(FYI widely used popular fillers like Juvaderm®  and Restylane to treat wrinkles, restore/create volume etc.- belong to this group too).

What popped out most for us…is the need to do one’s research on aesthetic options…and on the practitioners obviously- if one decides to undergo any skin/body rejuvenation/anti-aging/contouring. With so much out there and so many people, qualified and NOT- offering services, including Beauty Spas without MDs on the premises, it is almost even more critical to seek expert advice, IMHO- beyond the internet- from Board Certified, experienced doctors and/or dermatologists---to sort through what’s best for what, given desired results (realistic ones at that)…the dollar costs and recovery times involved, and the effectiveness of what one decides to do/use---how long it’s been out on the market…safety knowns versus unknowns and potential problems. A lot to consider and we feel-this sort of endeavor is not a good time to go bargain hunting.

First up from the panelists was the highly regarded Z. Paul Lorenc, M.D., F.A.C.S.  who among many accolades- has a busy office on Park Avenue that does non-surgical and surgical procedures.

One part of this segment really stood out for us- that some “next generation” products are the result of “tweaking” of dermal filler products that have been on the market for years in some cases---to adhere to (new) FDA guidelines--- and/or that have had their concentration changed (sometimes based on how experienced the doctor is)--- or “used in a different way” like injecting deeper-with regards to the volume fillers Scupltra  and Radiesse ---for more consistent, possibly longer lasting results--- and that have also been observed to stimulate  collagen itself---a good thing.

Again we thought of how important it is to ‘employ’ a skilled medically trained person for any of these fillers –we strongly believe technique is key to a satisfactory outcome.

Also discussed was the use of ‘heavier” fillers to lift versus lighter fillers for fine lines---with Belotero®  mentioned again- as a “soft product”…great for around the eyes and fine wrinkles over the lips- as it’s extremely smooth…no lumps or beading…for even distribution under the skin.

PLUS:  The injection of botulinum toxins with typical durations of 4-6 months to temporarily smooth out crow’s feet, deep furrow/frown lines, soften neck bands etc –-using type As Botox®, Dysport®  for cosmetic purposes-and “the most widely non-surgical procedure in our practices), Xeomin®-also type A---  and then the new FDA cleared type B Myobloc®   for therapeutic applications.

What’s Hot in Skin Tightening and Fractional Resurfacing-presented by David J. Goldberg, M.D., J.D. started with what we had heard a lot about for sagging jaw line complainers ---the non-invasive ultrasound, facial tightening Ultherapy® --- and ePrime™ from Syneron® -a one time treatment that is a radio frequency device that precisely delivers heat deep into skin’s lower layers to stimulate collagen growth (and smooth wrinkles/acne scars)…somewhat similar to eMatrix™ by the same company---that usually requires 3 treatments about 4-6 weeks apart…and is okay for all ethnic skin types-A BIG PLUS.

Body tightening  ---using CoolSculpting that freezes fat cells---that then melts away (we tried to visualize this)----and various lasers that all use radiofrequency to (temporarily) improve the appearance of cellulite by delivering deep heat with different frequencies, often with a vacuum massage like therapies too---including the FDA approved Velshape ( available now), the Unipolar and Bipolarr radio frequencies’ Accent™, and “new players” the FDA cleared Viora’s Reaction™.

PLUS: Bella Contour   “combines things” meaning volume reduction and tightening…using ultrasound, electric current fields and vacuum therapy--- seemed “very promising’ according to Goldberg---with “consistent results- that last a year.” Which we gather is a decent length of time for cellulite treatments---and maybe worth it if we were swimsuit models (in our next life).

Though not part of the panel, we did pay a visit to Z. Paul Lorenc, M.D., F.A.C.S. office to see among other things, the new Sciton JOULE ---a multi-tasking ‘machine/platform’- that is capable of performing an “array of laser and light wavelengths through any of its three distinct delivery modes…”

What we took this to mean is that there are skin rejuvenating/resurfacing/texture improving  (MicroLaserPeel®), tightening/firming (the non-surgical, non-ablative/non-invasive Skin Tyte™) and light therapy for uneven skin tones/age spots/small facial veins and melasma (BBL™) treatment options--- to name a few- performed with this one, space saving instrument---often in combination with each other---and importantly if we were the patient-at the same office visit.

Very space age looking, we might add.

The last topic covered got a ton of interest and interesting questions---fat grafting presented by Sidney R. Coleman, M.D., F.A.C.S. –who immediately launched into the so-called buzzy stem cell facelift---which is really fat transfers---since fat cells themselves are full of “multipotent” cells. Also talked about was how centrifuge fat---is a new approach-hopefully being studied in a meaningful way---- to isolate the possible adult stem cell rich portion of the fat ---that in turn stimulate fibroblasts for permanent volume and improved skin texture. 

Dr. Coleman strongly felt that not only did fat restore shape/volume to one’s face---with cheeks sadly ‘sinking’ with age-loss of volume,  we feel…but also---with his observations over the years- that many of his patients saw improvement in the quality of their skin---that seems to be lasting.

 Before and after slides of Dr. Coleman’s patients showed examples of this ---including wrinkle and pore size reductions…and also including how fat filled/injected into a patient’s hands--- with a youthful plumpness achieved-all still holding up, years later- versus using temporary fillers like Radiesse. What we guess next up - are controlled scientific studies---though again with fat grafting, the finesse/experience of the practitioner is really important.

Also shown via slides--- and very controversial with many in the audience/panel concerned with the possible risk of breast cancer…was the reshaping/augmentation of female breasts via selective, controlled sculpting using the patients’ own fat…as fat cells are loaded with estrogen hormone receptors too. (Which of course makes us wonder why there are not more bio-identical estrogen loaded facial creams on the market).

ADDED PLUS: The Department of Defense is funding cell-assisted transfers of fat studies- for war wounded soldiers ---as fat grafts “feels like muscle and bone.” We say bravo to that.

Some conclusions---that “regenerative medicine is the future”…that “the FDA really scrutinizes what we do---(and) they are doing the right thing” (imagine a federal government agency getting two thumbs up by the regulated)….”fat-you don’t have to grow it”…and “ideally, fillers should last two-three years.”


INFO: http://www.lorenc.com

           http://www.skinandlasers.com

           http://www.lipostructure.com

           http://www.beautyinthebag.com

           http://www.apssny.org