From dissolving double chins to body sculpting, aesthetic medicine is booming.
From dissolving double chins to non-surgical body sculpting, aesthetic medicine – also known as appearance medicine and cosmetic medicine – includes a widening gamut of medical procedures focused on ‘the body beautiful’.
Aesthetic medicine includes both surgical procedures such as liposuction, and non-surgical procedures like laser treatment, peels and injectables. A research report by Lexis Business Insights, ‘Aesthetic Medicine and Cosmetic Surgery Market’, reveals that the global aesthetic medicine market was valued at US$86.2 billion in 2020 and is expected to expand at an annual rate of 9.8 per cent from 2021 to 2028, indicating the already huge industry will just continue to grow. Facial injectables such as Botox continue to be the most popular treatment, a trend that has been also aided by the so-called ‘Zoom boom’ where communicating via computer screen isn’t the most flattering of mirrors.
Having worked in the field of aesthetic cosmetic medicine for many years, with special interests in cosmetic facial artistry and body rejuvenation using both non-surgical and surgical treatment modalities, cosmetic surgeon Dr Robin Chok has seen many trends and treatments come and go. Looking forward, Chok says, “Optimising the eye area will continue being a growing trend this year, given all the Zoom meetings and the wearing of masks. Nonsurgical enhancements such as the brow lift, to give a fresh new look, together with under-eye filler, to lighten and brighten making us look less stressed and better rested, will also be popular.
“Also, there’s a growing interest in treatment of the temporomandibular joint and improving the pain felt from teeth grinding and jaw clenching, with the bonus of slimming and softening the jawline from relaxing the masseter muscle.”
The new treatment Chok is seeing great results with is the HyaPenPro. “It enables safe, uniform and precise penetration of hyaluronic acid filler and pharmaceutical-grade sculpting and enhancement products into the skin, without a needle,” says Chok.
Aesthetic medicine is segmented into numerous markets. Facialrejuvenation aesthetic products include treatments such as dermal fillers, botulinum toxin, microdermabrasion, and chemical peels. Body contouring, another increasingly popular segment, includes treatment such as nonsurgical fat reduction devices, cellulite reduction devices, as well as surgical procedures like liposuction. Cosmetic implants and cosmetic surgery remain popular, particularly now that more people are working from home and can do the two to four-week recovery in private. Other categories include hair removal (such as laser hair removal and IPL); skin aesthetics (including laser resurfacing, non-surgical skin tightening, micro-needling and light therapy); tattoo removal devices; nail treatment laser; cosmetic dentistry; vaginal rejuvenation; and physiciandispensed cosmeceuticals.
Overall, the growing trend in aesthetic medicine treatments are those that rejuvenate the appearance, with minimal down-time.
“When selecting treatments, patients want honesty, options and an experienced medical practitioner to perform their preventative injectable procedures,” says Dr Chok. “It’s important for them to know you understand symmetry, structure and can provide natural-looking results by combining neuromodulators, PDO threads and fillers, giving them a look they are comfortable with.”
If you are considering aesthetic medicine, you do need to do your research when selecting practitioners and treatments. “In Australia, there is a wide range of practitioners performing cosmetic medicine procedures, with different degrees of training and experience, education and understanding. Unfortunately, this means there is a wide discrepancy in skill levels and the undertaking of responsibility,” says Cosmetic Physicians College of Australasia (CPCA) president, Dr Michael Molton. The CPCA has long been an advocate for patient safety, especially with regard to unregulated laser use in Australia.
BIOCOMPATIBLE INJECTABLE
First launched in 2015 by IBSA Pharma, one of the largest privately owned pharmaceutical companies in Switzerland, Profhilo has been causing quite a stir in the rejuvenation world. Said to restore firmness to the skin and improve texture, plumpness and elasticity, Profhilo is 100 per cent synthetic hyaluronic acid (HA), which is
injected into the face, usually over two sessions, with a four-week gap in between. According to IBSA, Profhilo is biocompatible as it is composed of a pure HA produced by biofermentation. Unlike other anti-ageing injectables that use fillers to add volume and stretch out the skin, being biocompatible and absent of additives it is said to reduce the risk of side effects.
FULLER LIPS FOR LONGER
In May 2020, Galderma announced FDA approval of Restylane Kysse, the first hyaluronic acid filler specifically indicated for the lips using XpresHAn technology, globally referred to as optimal balance technology (OBT). The new technology allows Restylane Kysse to plump up lips for up to one year.
The filler also contains lidocaine, a medication used to numb the area to decrease pain and reduce discomfort associated with injections in the lip area. “Restylane Kysse is a game changer with a formulation specifically designed to provide excellent outcomes in the lips,” says Dr Melanie Palm, dermatologist and cosmetic surgeon and a clinical investigator in the Restylane Kysse phase 3 trial.
FINE PRECISION SURGERY
Piezosurgery is a technique of bone surgery that is gaining popularity with cosmetic surgeons’ approaches to procedures such as rhinoplasties (nose jobs) as it allows very fine precision, often with less bruising and recovery and a more accurate result.
The piezosurgery device produces specific ultrasound frequency modulation that allows for the extreme precision and safety as well as micro-metric cutting, thus allowing the surgeon to selectively section the mineralised bone structures and reshape them with minimal bleeding and swelling. Prior to piezosurgery, reshaping the nasal bone was done almost exclusively with rasps and chisels, which can be traumatic to the surrounding tissues and result in a longer recovery time.
BODY CONTOURING
Liposuction has been the popular procedure for people wanting to reduce excessive localised subcutaneous fat tissues. However, there are many risks attached to liposuction – from baggy skin to blood clots – and, as a result, minimally invasive surgery such as liposculpture as well as non-surgical fat reduction options such as lipolysis are growing in popularity. Nonsurgical and minimally invasive options for fat reduction include technology that uses heat or cooling or an injected medication to reduce fat cells.
Liposculpture is a minimally invasive cosmetic procedure that removes pockets of fat, unlike liposuction that covers large areas. Instead of just removing fat, liposculpture also moves it around for a desired shape. There are different procedures for liposculpture including power-assisted liposculpture, which uses a vibrating tool to help break down fat; ultrasound-assisted liposculpture, which melts fat with ultrasonic energy through a handpiece; and laser-assisted liposculpture, which melts fat through low-energy waves.
Lipolysis is a non-surgical treatment that uses lasers (such as SculpSure), medication (such as Kybella, the only FDA-approved injectable treatment that destroys fat cells under the chin), cooling (also known as cryolipolysis such as CoolSculpting) or radio frequency (such as Vanquish) to break fat cells apart, reducing the volume of fatty tissue. It typically has less pain following the procedure, than liposuction and liposcultpure.
Launched late in 2020, and approved by the FDA, the body contouring treatment, EmSculpt Neo, is the first to combine radiofrequency heating to melt fat and electromagnetic waves to build muscle. According to the manufacturer, BTL Aesthetics, the results of seven new clinical studies with a combined cohort of 167 patients indicate that the device has an average of 30 per cent fat
ADVANCES IN THREAD LIFT TREATMENTS
Until fairly recently, the only way to address problems caused by facial skin laxity – such as jowls and drooping cheeks – was facelift surgery. Now, sitting in-between non-invasive facial rejuvenation and facelift surgery is a thread lift. It’s a type of procedure in which temporary sutures are used to produce a subtle but visible ‘lift’ in the skin. While the results of a thread lift are more subtle than a facelift, the biggest advantage is the greatly reduced recovery time. There are different types of thread lifts including PDO and anchoring thread lifts. reduction and 25 per cent increase in muscle mass. Another new development in body sculpting is out of the Massachusetts General Hospital (MGH) laboratory, which also invented cryolipolisis or ‘CoolSculpting’. The researchers are developing a new form of the technology that can selectively reduce fat almost anywhere in the body using a safe, injectable ice solution or ‘slurry’. Unlike CoolSculpting, which can take up to an hour, the new technique is a simple injection that takes less than a minute.
Not yet approved for use on humans, the technique trials by MGH and the Department of Dermatology at Harvard Medical School showed injection of the ice solution into pigs resulted in a 55 per cent reduction in fat thickness compared to that of pigs injected with the same but melted ice solution, according to the research paper published in Plastic and Reconstructive Surgery, journal of the American Society of Plastic Surgeons.
HAIR RESTORATION
Research recently published in the Journal of Cosmetic Dermatology shows that there has been regular growth in the number of non-surgical and surgical hair transplants for men and women in the past decade.
Follicular unit extraction (FUE) is currently the most popular treatment for hair transplant, a process that involves removal of donor hair one graft at a time (as opposed to the ‘strip method’), which is then transplanted one graft at a time. The technique is a way to get the most hairs into the smallest possible site creating the smallest wound and a more natural look.
The limitation of FUE is that it requires special skill, it is labour intensive and time consuming, making it too expensive for some people. New treatments, such as NeoGraft, are becoming semi-automated, therefore reducing the manual work and time required. Non-surgical treatments such as platelet-rich plasma (PRP), where a person’s blood is drawn, processed, and then injected into the scalp, which is said to trigger natural hair growth, are also growing in popularity.
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“OPTIMISING THE EYE AREA WILL CONTINUE BEING A GROWING TREND THIS YEAR.”
DR ROBIN CHOK