Saturday, July 28, 2012

Aesthetic Plastic Surgry/Anti-Aging Medicine: The Next Generation Highlights

July 20, 2012
Conrad Hotel, NYC

For a few hours, we listened to an expert group of practicing physicians weigh in on various topics related to aesthetic medicine, anti-aging, lipo-facial rejuvenation (fat transfers) and the changing perception of what an aging face, revitalized, should (and should not)- look like...during a morning session of the Aesthetic Plastic Surgry/Anti-Aging Medicine Conference.

First for us- was listening to James Carraway, MD - Director, Aesthetic Skin Care Center in Virginia Beach,  VA. His remarks concerned the importance-i.e. dangers and benefits ---of hormone replacement therapies, good nutrition, a healthy lifestyle that includes exercise- and vitamin regimens -in keeping his middle aged patients (51-71) looking years younger-in addition to surgical and non-invasive procedures.

Next up was NY based Neil Sadick, MD of Sadick Dermatology...who gave an informative (and fast talking-there were time limits, after all)---talk on the next generation of cosmeceuticals ...starting off with what we as consumers know-that there are hundreds of skin care products out on the market with so called "science behind it" ---that is often more about the science of marketing, so we think.

Sadick did point out a rather impressive list of effective ingredients with potent anti-aging components- often backed up with slides of before and after pics---

Many of the tested ingredients are derived from botanicals (soap nut tree, pine extract, perennial vine)...

Plus we have noticed- a trend in the relabeled in the USA- broad spectrum sunscreens-now loaded with collagen repairing/free radical scavenging ingredients that actually work---Sadick mentioned catechins- from tea leaves, chocolate, wine, resveratrol-grape extract, green tea and coffeeberry extracts, pomegranate, soy, vitamins c and e-to name just a few--- with goals of improving fine lines and to generate collagen synthesis.

Other effective entities cited that have been proven to stimulate collagen- include retinoids- a vitamin A derivative, peptides-protein derivatives, DMAE... and hydrating ingredients for 24 hour effectiveness- that provides a barrier to keep moisture in the skin---like dimethicone, ceramides and hyaluronic acids.

For uneven skin pigmentations-besides the prescription only in the USA- hydroquinone--- licorice extract, lignin peroxidase cream from a tree fungus, kojic acid derived from mushrooms, and tetrapeptide PKEK- were noted...and for redness- feverfew, thistle, tumeric, aloe vera, aframomum angustifolium seed, and malva sylvestris extract got the nod...

Needless to say, formulations and the ability to penetrate the skin to actually kickstart the turnover/generate new skincells- are key...and we wonder about formulations working synergistically-or just canceling each other out in those all-in-one products.

In the future, custom tailored cosmeceuticals---featuring the next genration of peptides that stimulate growth factors---with better penetration of the dermis, results driven formulations-  with self-regulating properties (smart)...and genetic cosmetics that target aging processes...IMPRESSIVE...are all 'something' to look forward to.

Hailing from Munich --- dermatologist Sabine Zenker, MD talked about her experience with Platelet-Rich Fibrin Matrix-using a patient's own blood...similar to PRPS-a therapy athletes treated with, swear by---and a topic we wrote about from last year's conference.

Her observations with her patients -who age differently---are that they responded positively to platelet rich fibrins, injected into the skin.

Zenker noted that platelets---are processed differently---and that there is no standard protocol for this...concluding that more clinical research- showing dermal thickening ---is needed---though it is "very exciting."

She also mentioned fat injections as another effective collagen stimulating technique- that also needs more research.

Lastly, Zenger concluded with how effective both magnetic pulse therapy (radio frequency delivery procedures-"for even heating")- combined with electro magnetic therapy typically used in wound healing -are effective in tightening lax skin, body contouring, and stimulating collagen growth.

Consumer friendly Heidi Waldorf, MD of Waldorf Dermatology&Laser Associates P.C. in Nanuet, NY...started off with how the $10 billion (at least) cosmeceutical industry lacks FDA approval process worthy science (randomized, double blind,  placebo-controlled studies)--- to backs claims of fabulousness.

What we appreciated about her talk was the common sense tips offered up- based on her experiences with patients...including...physical block sunscreens (not chemical) work the best...5% hydroquinone used -for uneven pigmentation-in the "Kligman" formula=a prescription only cream that includes retinoic acid and dexamethasone (and we assume the popular Tri-Luma)....should be used on a limited basis...for skin lightening. procedure---a protocol of no scrubs or vibrating cleaning devices should be used...and only "bland" moisturizers-not vitamin c laden for example (that can be irritating)-should be applied post laser swim googles for two weeks after injectible fillers to the eye area (can lead to weird ridges). 

Waldorf advises her patients to take a two fold approach to skin care-during the day- faces are protected with sunscreens/anti-oxidants, pigment protection---and at night, a protocol of the skin renewing itself rules-with collagen stimulators, pigment lightening and lipid barrier (moisturizing) ingredients. 

Ingredients found in formulations that get the two thumbs up (though in meaningful amounts that effectively sink into skin)--- include the Vitamins A, B, C, and E, CoQ Enzyme 10, soy, niacinamide, and the supplement Heliocare for added sun protection...and arnica and bromelain-a pineapple enzyme-for their anti-inflamatory properties.

Ivona Percec MD. Phd and J. Peter Rubin MD both touched on the abundance of adult stem cells found in adipose (fat ) tissues---with the former giving a very scientific slide presentation on her ongoing lab experiments/ findings...

J. Peter Rubin MD of Pittsburgh, PA. highlighted how stem cells from adipose tissues can be used in aesthetic surgery-as it can be molded and shaped...and how it is believed 'they' secrete growth factors to induce healing.

With Syd Coleman MD...the next speaker---Rubin cited their work funded by the Department of Defense in reconstructive surgeries for disfigured veterans...(our clip about this)...and also how stem cells from fat are showing great results in stimulating new collagen/improve skin texture in radiation and burn injury sufferers.

The concluding part of that morning session was led by Brian Kinney, MD who showed some pics of patients ---with something "done" and the panelists aforementioned -and including  Z. Paul Lorenc, MD had to weigh in on what procedure(s) were performed---and interesting ---what looked like some major mistakes, meaning bad work/bad results---with the assembled weighing in on what could be done to correct the errors, realistically.

Afterwards, we had some time to chat with some of the exhibitors...

The two new to us methodologies that really grabbed our attention ---was Cryoshape™ -an innovative cryosurgery treatment designed to reduce or eliminate keloid and hypertrophic scars in a single office treatment that freezes and thaws scars from the inside out, providing deep penetration of tissues (kinda like how warts are treated, we thought)...

...And Laviv™-what we figure to be an updated, FDA approved version of Isologen-owned by Fibrocell Science, Inc  (read a prior clip for more info) ...whereby a patient's own autologous dermal fibroblast cells ---taken from a skin-punch sample from behind the ear---are purified, cultivated, frozen (and then defrosted for treatments-usually three total)---that's injected into smile lines (severe to moderate-where the FDA approved it) ---and --- wrinkles, acne scars fill in via one's own cells replicating.