Dr. Emer
This year was the 10th Annual Summer Meeting for Cosmetic Bootcamp, held at the St. Regis, Aspen, Colo., June 12-15. Even if you wanted to attend this year, you had to register early to get a guaranteed seat — the meeting hit capacity this year and had a registration waitlist! Since I was fortunate enough to be in attendance, the editor of Cosmetic Surgery Times invited me to share my takeaways.
1. Combine or be left behind
Combination treatments give more impressive results. Vic Narurkar, M.D., lectured about global facial rejuvenation and his combination of Fraxel or Clear and Brilliant for improvement in texture and tone; Thermage for skin tightening; fillers such as Voulma for volume and facial contour; and Botox (neuromodulation) for dynamic lines of the forehead, glabella and crow's feet. According to Dr. Narurkar, this combination of treatments provides optimum outcomes and high patient satisfaction.
2. The consultation is key
The cosmetic consultation is extremely important not only for suggesting treatments and offering long-term plans, but also for developing your patient relationships and demonstrating confidence and success. Here's the golden nugget: Listen to what your patients want, but give them what they need. Suggest the most appropriate treatments for the best results, not only what the patient believes he or she needs.
​3. Neglected areas of the past are no more
Don't forget the neck, chest, hands, temples, forehead and lashes. Patients may not seek out rejuvenation of these areas, but it is our responsibility as aesthetic physicians to start the conversation if treatments in these areas would give enhanced aesthetic results. The neck, chest and hands can be treated safely and effectively with lasers, light and peels for textural improvements, as well as fillers for "crepey," wrinkled skin. Treating the temples not only provides improvement in lost volume, but also rejuvenates the entire periorbital area by providing an indirect eyebrow lift.
Wrinkles of the forehead can be addressed with a combination of Botox (neuromodulation) and deep depot filler injection, which is specifically impressive in patients with deep midline horizontal lines, a "neanderthal" type forehead, or those with low eyebrows for which excessive toxin may improve wrinkling but cause eyebrow ptosis.
4. Beauty comes from within ... jars, tubes and bottles
Don't forget to offer skincare product options to your patients. Combining treatments with at-home skincare product use can improve patient satisfaction, enhance the results of treatments, and increase compliance and revenue. It was discussed that fractional laser delivery of skincare can enhance results. Research is focusing on the use of antioxidants, growth factors and skin-brightening products after fractional laser therapy to enhance the topical delivery of skincare. This may translate to alternate uses for lasers and topical medications to treat other dermatological conditions such as skin cancer or psoriasis.
5. Use blunt-tipped cannulas for a painless procedure
There is an increased trend to using blunt-tipped microacannulas for the placement of fillers, as they have less risk of bruising or swelling and and can be used in thin skin or high-risk areas. They also cause little to no pain during injection. The best locations for use include the midface, marionette lines, jawline, preauricular area and temples. From very few entry points, multiple locations of the face can be accessed and treated with less risk of bruising and swelling as compared to sharp needle.
- Mary Lupo, M.D., demonstrated the use of cannula for filler placement into the dorsal hands. The blunt-tipped instrument bounced off vessels and caused no pain, with significant improvement in the tendinous appearance of the hand.
- Jose Montes, M.D., showed his technique of using the cannula to fill lines of the upper and lower eyelids in patients with dark circles and fine wrinkling of the periorbital area.
6. Use the pico for pigment
Picosecond Q-switched laser technology goes beyond the tattoo. Roy Geronemus, M.D., discussed the most advanced laser technology for treating pigmented lesions and tattoos, the picosecond laser. The fast pulses of this laser give superior results with less epidermal injury compared with the older nanosecond Q-switched lasers. Focused (fractionated) handpieces may offer superior treatment for scars, striae and photodamage. Studies are already under way and many companies are said to be creating devices. Stay tuned...
7. Go green to get rid of red
The Cutera Excel V laser (KTP, long-pulsed Nd:YAG) is a modern platform for treating facial redness, acne, scars, veins and vascular malformations of all depths. Joely Kaufman, M.D., presented an excellent review of a vast array of clinical cases for which she chose to use this modern laser system that offers high energy in short pulses for exceptional clinical results. Contact cooling and versatility in parameters makes this a laser of choice in her practice.
8. Fat is the future
Grant Stevens, M.D., discussed his experience with all the noninvasive body contouring devices that are dominating the fat loss and skin tightening market. Although liposuction is still one of the highest sought out cosmetic surgical procedure, many more patients are seeking a quick and painless way to shed the pounds and tighten their bodies. This is a quickly growing market and aesthetic physicians are rushing to get involved.
9. Say hello to Halo
Halo, the first fractional hybrid laser combining both ablative (2,940 nm) and nonablative (1,470 nm) wavelengths for skin rejuvenation, was demonstrated at the conference. It offers the ability to fully tailor treatments for individual skin types with differing degrees of photodamage with very little pain and downtime.
10. ATX101 is on the horizon
Injectable medications for submental fat reduction are coming. Could ATX101 possibly replace liposuction as a gold standard treatment? Only time will tell!
