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Big Ideas 2016 – 5 Medical Aesthetic Predictions

Jan 13 2016

Big Ideas 2016 - 5 Medical Aesthetic Predictions

Dean M. Tomasello, MD

With less than two weeks to 2016, it’s time to give you a heads up on some big changes coming to the world of medical aesthetics and skin care. Some of these are brand new and others you may have seen coming. 2016 is certain to bring much excitement when it comes to what is available to help you look and feel more beautiful than ever. #1 – Microneedling Challenges Laser Resurfacing (and Treats Hair Loss?) Microneedling is a procedure whereby thousands of tiny holes are punctured in the skin. It is ‘control

#1 – Microneedling Challenges Laser Resurfacing (and Treats Hair Loss?)

Microneedling is a procedure whereby thousands of tiny holes are punctured in the skin. It is ‘controlled skin injury.’ These holes or ‘micro-wounds’ trigger the body to fill in these holes by producing new collagen and elastin in the dermis along with new capillaries. The new blood flow and collagen production results in improvement of scars and rejuvenation of the skin. The texture, firmness and hydration of the skin are improved. Microneedling is also referred to as collagen induction therapy (CIT) which is a very accurate description of what is happening. The depth of the needle penetration dictates the level of injury to the skin and the potential results to be achieved.

Plastic surgeon Des Fernandez, MD introduced a microneedling roller back in 1996. 20 years later, improvements in his original concept will make this a huge cosmetic procedure in 2016. Simply put, the newer microneedling devices work better. Beverly Hills plastic surgeon Dr. Sheila Nazarian agrees stating the roller devices are, “sending needles in and out of your skin at an angle, actually nicking the skin as they come out, so it’s causing more damage that you want.”

AAEAAQAAAAAAAAcSAAAAJDJmZTQwNmY0LTY2ZWItNDc5OC1hYzI3LTc4YmJhNTdlMDEwZQThe newer battery powered or electrical devices are able to penetrate more deeply (and vertically) into the dermis giving you a huge boost in collagen and elastin formation. MicroPen , SkinPen II™ , Collagen P.I.N.™ , and Rejuvapen® are some of the well known devices used in medi-spas and dermatology/cosmetic surgery practices. They have between 9 and 12 needles, smooth or beveled tips and the ability to change the needle depth from 0.25-3.0 mm.

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Microneedling can treat many MANY skin conditions and has become a hot topic on sites such as RealSelf. The list of benefits of microneedling keeps growing making this an even more widespread procedure in 2016.

  1. It is an effective means to treat fine lines, wrinkles, loose skin, acne or other scarring, stretch marks, melasma or hyperpigmentation.
  2. It is less expensive than laser skin resurfacing procedures like Fraxel and arguably equally as effective. In an office questionnaire I found that people opted for microneedling over laser procedures due to, “excellent results for less money.”
  3. There is far less downtime with microneedling vs. laser skin resurfacing.
  4. Unlike chemical peels, microneedling can be used on any skin type.

What to watch for in 2016:

  1. Treatment of Cellulite and stretch marks.  Endymed Intensif RF beautifully combines microneeling and radiofrequency to give maximal results. Expect to see more of these treatments in 2016, with newer devices incorporating more than one technology for skin rejuvenation.
  2. Treatment for Hair loss. The International Journal of Trichology showed 2 years ago that the use of, “Dermaroller along with Minoxidil was statistically superior to Minoxidil [alone] in promoting hair growth.” In the past six months there have more studies and more patients being treated for hair loss using microneedling technology. Essentially the list of known and new benefits for microneedling keeps growing.

Microneedling is typically combined with the use of a wide array of skin care ingredients to increase the effectiveness and absorption of these products. For instance: Vitamin C (collagen), hydroquinones (pigment), Vitamin A (skin rejuvenation and acne) and peptides (collagen).

Which brings us to prediction #2.

#2 – Neuropeptides will challenge Botox

 When we discuss peptides we are talking about Signal Peptides, Copper peptides and Neuropeptides.

When protein is broken down, peptides are formed. These peptides can combine with amino acids to form more protein. The fact that peptides are present, however, serves as a signal that collagen has been broken down and needs to be replaced. Therefore, more peptides mean a stronger signal for your body (skin) to make more protein (collagen). Applying peptides directly to your skin thereby tricks your skin into making more collagen. The most popular ‘signal’ peptide seen in skin care is Palmitoyl Pentapeptide.

Copper peptides do amazing things.  When copper is attached to a peptide, the peptide can deliver copper to the living layers of the skin. Copper is an effective agent in skin healing which is why it has been used for years to treat chronic wounds. Copper peptides promote collagen while exerting antioxidant power. They are needed for natural healing and regeneration of your skin and to help remove damaged collagen.

Neuropeptides vs. Botox

Neuropeptides are peptides that play a role in nerve cell communication. Botox binds to facial nerves to ultimately prevent contraction of facial muscles. A neuropeptide known as argireline may block the release of neurotransmitters from nerves. In theory, if absorbed all the way to the level of the muscle, it may block contraction of the muscle leading to smoother skin, much like Botox. While Dr. Perricone has products claiming to do so, there is no solid research to back it up. This issue appears to be the product is not penetrating deeply enough to fully effect the nerve. Expect to see more research and studies aiming to prove Neuropeptides can do what Botox does. If it does not happen in 2016, mark my words, the day that a skin cream or serum can be applied to the face to give results similar to Botox, is coming quickly.

Botox, by a huge margin is the #1 medical aesthetic treatment. It will be challenged. Nobody stays on top forever.

#3 – Medical Aesthetic Apps and telemedicine become mainstream

There seems to be an App for everything and the Medical Spa arena will see a growth in this technology as well. A few months ago Modiface partnered with Allergan Canada with the birth of a live facial rejuvenation app. Here the technology offers clients considering different facial treatments to view projected results. Do you want to know what you will look like following treatment with Juvederm? This app will allow this along with views from multiple angles. This is a game changer and will do nothing but increase the already staggering growth of the medical aesthetics industry. I foresee that offices will either incorporate apps like this or newer ones along with a real time telemedicine encounter.

Here is what is coming: You go to a medi-spa website or go through the medi-spa app. You use the app you see how your face will look before and after specific treatments (for instance – 1ml of Restylane to each nasolabial fold). Then, you will be able to have a telemedicine (‘real time’) face to face online consult with a skin care professional to discuss options, treatments, cost, and to book an appointment. The medi-spa and surgery centers at the forefront of this technology will stand out as leaders in the industry. This is coming. Guaranteed.

Before discussing number 4 and 5, it is worth noting that in terms of cosmetic surgery (surgical procedures performed), the 2014 data from the American Society of Plastic Surgeons showed:

Liposuction and facelifts remain huge markets for cosmetic surgeons and make up 33% of surgical procedures in 2014. This is important because these two areas will continue to show tremendous growth in the non-surgical arena.

#4 – The non-surgical fat reduction market shows a huge increase.

When it comes to non-surgical fat reduction, big players in this market include Coolsculpting, Quantashape, Liposonix, Vanquish RF and Alma Accent.

According to a survey performed by the American Society for Dermatologic Surgery (ASDA) in 2014, up to 65% of people said they  have a level of dissatisfaction with under-the-chin fullness.  Coolsculpting, for example, essentially freezes stubborn fat cells, which the body then disposes of through the lymphatic system. The treatment is performed by placing an applicator on the treatment area, which attaches via vacuum suction, and gradually freezes the targeted fat over, typically, a 60-minute session. Patients may need to undergo a course of treatments to achieve their desired results, but many report seeing results after a single session.

Says Dr. Vitenas, plastic surgeon from Houston, “Seven different CoolSculpting attachments are available; each made to treat a different area of the body.  The most commonly addressed areas with CoolSculpting include the abdomen, lower back, upper arms, and the thighs.”

Three months ago the FDA approved the Coolsculpting “CoolMini” for treatment of the area under the chin. The CoolMini while designed for submental fat (under the chin), can also be used on hard to treat areas. Says Dr. Vitenas, “The CoolMini successfully eliminates layers of fatty tissue below the chin, leaving the jawline smooth and taut.”

AAEAAQAAAAAAAAaBAAAAJDBiN2FmZThkLTRmMzMtNGU4OS1iZjhmLWRjZWZiYWVmM2FmMQKybella is a product that is injected, dissolving the fat cell’s membrane to effectively kill the cell, which is then cleared through the body’s lymphatic system. This procedure is much quicker than a coolsculpting treatment. However, with Kybella it is important to note that results are highly injector dependent. Expect to see more medical aesthetic doctors being trained to perform this procedure in 2016.

#5 – More Non-surgical “Face Lifts”.

Dermal filler use has nearly doubled in the past 5 years (94% increase). Expect this to continue and for increased use of deeper dermal injections especially cheek and mid-face augmentation.

Products like Juvederm Voluma, Radiesse and Restylane Lyft will show strong growth in 2016 due to the unique attributes of these products. Namely, large molecular size, more cross-linking and a higher “G-Prime.” which is a measure of the ‘hardness’ of the filler. These bulkier, ‘stickier’ fillers have the ability (when injected properly) to give a true LIFT particularly to the areas of the cheeks and mid face.

There is certain to be more than 5 amazing developments in the world of medical aesthetics. I have personally seen more focus on organic skin care, health, diet and wellness more so than I did perhaps 5 years ago. Regardless, visit me to learn all about medical aesthetics, skin care and wellness at ClearSkinMD

I wish you all a safe and happy holiday season and may all your dreams for 2016 come true.

Be well,

Dean M. Tomasello, MD

#BigIdeas2016

Source: Big Ideas 2016 – 5 Medical Aesthetic Predictions

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