Sponsored By MRP/Perigee;

Non-invasive body contouring is a prime example of a therapy which understandably crosses over the line between dermatologists and plastic surgeons – the ‘core’ specialties of aesthetic medicine. Like many in the field, Jeanine Downie, MD, dermatologist and medical director of Image Dermatology (Montclair, N.J.), has embraced the capabilities of energybased body contouring technology to provide better overall healthcare to patients and add another dimension to her practices.

LipoCel from MRP/Perigee (Park City, Utah) harnesses high-intensity focused ultrasound (HIFU) to heat fat cells non-invasively, causing fat cell destruction. The resultant debris and free fatty acids are dealt with by the body naturally. “The device’s mechanism of action involves high-frequency ultrasound, which helps to reduce fat in patients of all skin types,” Dr. Downie noted. “Unlike the previous HIFU technology, LipoCel is not painful. It is effective for reducing belly fat, back fat and thigh fat so we usually use it on the belly, flanks and inner thigh. Physicians like it a lot, and it can be used on patients of all races, ethnicities and genders. LipoCel causes true apoptosis, which is the genuine destruction of fat cells, thanks to the HIFU. It is safe, effective and works well.”

In Dr. Downie’s opinion, the device is best used as part of a more comprehensive program, which optimizes not only the outcomes themselves, but their longevity. “We also encourage patients to follow a Mediterranean diet, to exercise and to limit their alcohol intake, particularly beer because LipoCel is not a ‘get out of jail free’ card,” she explained. “We weigh and measure patients at every visit, and we note any changes, such as bloating due to menstrual cycles in women.”

Treatment itself is rapid and pain-free, thanks to onboard contact cooling which also assures maximum delivery of therapeutic levels of energy, thereby optimizing outcomes. By cooling the skin’s surface to 5° C, the highest amount of HIFU energy can be delivered safely and without damaging skin, allowing more energy to be delivered to its intended target – fat. “The key advantages of LipoCel are the ability to treat multiple areas, and that it can be used on patients of all ages, genders and races,” Dr. Downie expressed. “The patient’s experience is comfortable and pain-free, with a pleasant sensation of pressure. If it becomes too hot or painful, we can easily adjust the settings.

“Patients tend to recommend LipoCel to their friends and family, and it can jump-start their weight-loss journey, which is why I never hesitate to recommend it to physicians on a personal basis,” Dr. Downie added. Also, the transducer handpiece is small enough to facilitate treatment of hard-to-reach areas.

Regarding the recommended number of treatments: “Our assessment includes weighing and measuring each patient as we determine their goals, and from there we build a budget,” Dr. Downie shared. “We typically want to treat once a month for the first three months, then take a month off, depending on their goals. With LipoCel we typically see reductions of at least two inches off the waistline within three to five sessions, provided patients follow our instructions.”

Sponsored By Advalight;
According to a 2020 study published in the microbiology journal mSphere¹ porphyrins are intermediate molecules in biosynthesis of key compounds in nature; in bacteria these tend to be proinflammatory. Thus, the management of porphyrins would be a key component to many skin therapies as one aspect of managing inflammation.

Farhan Taghizadeh, MD, medical director of Arizona Facial Plastics (Scottsdale, Ariz.), completed a trial^* looking at the impact that treatment with the ADVATx laser system from Advalight (Copenhagen, Denmark) had on erythema, texture, tone and porphyrin levels in skin over the course of three treatment sessions. Dr. Taghizadeh measured the levels of these facial skin characteristics both before and after ADVATx treatment using the VISIA skin visualization device from Canfield Scientific (Parsippany, N.J.). Visible improvement was yielded on all four.

Requiring no consumables, the ADVATx platform can emit both 589 nm and 1319 nm wavelengths, individually, or in tandem via proprietary PulSync Technology. It starts with a 1319 nm beam which, when passed through a YAG crystal and combined with a second beam (which is then passed through a Q-switch, then a non-linear LBO crystal), forms the 589 nm beam. Users rely on the 1319 nm wavelength to promote neocollagenesis as water is its chromophore; however according to Dr. Taghizadeh, it is the 589 which has the most effect on porphyrins, as shown by his research. “The wavelength is especially disruptive to the P. acnes bacterium,” he explained. “What you are essentially targeting with the 589 nm wavelength is the porphyrins themselves, and by reducing the porphyrins you are creating space to reduce inflammation of the skin, and that is very significant in terms of a host of inflammatory conditions of the skin.

“Reduction of inflammation is foundational to clinical improvement for so many skin conditions and a major focus among many fields of medicine,” Dr. Taghizadeh continued. “It is a goal for just about every patient we see. The effect of the 589 nm is harmonious with that of the 1319 nm for improving skin, but to me, it is the 589’s capacity to reduce inflammation that is so essential to what we are doing in our practices. It also provides a basis for additional work in combination protocols for a better overall outcome.

“And while most lasers will just target a chromophore in skin, certain wavelengths such as the 589 nm in ADVATx tend to be very effective for reducing inflammation,” he added. “In our patients we have generally seen that improvement in tone and texture in very short order, plus reduction in the porphyrins and other inflammatory markers promotes their consistently high willingness to fulfill a complete course of therapy and get the maximum improvement we can deliver for them.”

ADVATx is also easy to integrate into one’s practice; it weighs less than 200 pounds and runs on standard 120 V power. The intuitive graphical user interface (GUI) is easy to learn and use, and the handpiece allows on-the-fly settings modulation.

Reference:

1. Barnard E, Johnson T, Ngo T, et al. Porphyrin production and regulation in cutaneous propionibacteria. mSphere 2020 Jan 15;5(1):e00793-19.
*Data on file, Advalight (Copenhagen, Denmark)

Sponsored By SHEnB;

Featuring three unique handpieces – SmartRF, DeepRF and ExactRF – along with highly adjustable pulse configurations, needle depths and energy levels, the VirtualRF radiofrequency microneedling (RFMN) device from SHEnB (Seoul, South Korea) is now available in the U.S. through an exclusive distribution partnership with Cartessa Aesthetics. Users appreciate how this single-platform solution safely addresses patient concerns from head to toe – including skin laxity, lines, wrinkles, scarring and textural concerns.

Nazanin Saedi, MD, a board-certified dermatologist at Dermatology Associates of Plymouth Meeting (Plymouth Meeting, Penn.) has been using this second-generation device for three years. “I like that it has so many different ways to tailor the treatment, and the fact that treatments are not painful. It provides effective tightening, especially along the jawline, and I have found that it is safe for acne scars in all skin types,” she expressed.

Acne scars on the cheeks reflect deep damage, Dr. Saedi continued. “And with VirtueRF, you are able to deliver RF energy 3.5 mm into the skin to stimulate collagen.”

Dr. Saedi also likes layering treatments, performing three passes over the same area with decreasing depth and energy levels. “This creates multiple layers of dermal injury, stimulating a cascade of neocollagenesis.”

Delivering the total amount of energy evenly is the key to exceptional results, said Sung Bin Cho, MD, PhD, owner of Yonsei Seran Dermatology and Laser Clinic (Seoul, South Korea). “Since I started using VirtueRF I have achieved a higher level of perfection in treatment and patient satisfaction, which has resulted in an increase of profits by more than 20%.

“Patients like it very much because they feel comfortable during treatment,” he continued. “In some cases, no numbing cream is needed. I can adjust treatment parameters according to specific skin concerns and pain sensitivity.” For patients with low pain sensitivity, he uses a single 0.5 MHz pulse – available on the DeepRF handpiece – to treat wrinkles, scars, skin quality, and laxity, instead of dividing the RF energy into seven or eight sub-pulses for more sensitive patients. This sub-pulse technology is unique to the VirtueRF system and makes it possible to maintain therapeutic energy levels while decreasing discomfort. This feature makes VirtueRF more customizable in terms of treatments and experience.

For pigmentation on the face, he chooses the precise yet gentle SmartRF handpiece. Robotic Precision delivery minimizes trauma to the skin, thus, adding other modalities after a VirtueRF RFMN treatment to further target pigment is common and effective. “This can include CO2 resurfacing, picosecond Nd:YAG treatment, and SHEnB’s PlaDuo nitrogen-derived plasma device,” Dr. Cho added.

Another efficacious application is combining RFMN with topical agents, enabling more effective penetration of products In Dr. Cho’s experience, applying SMPF Biocellulose Rejuvenating Mask from BNV Biolab (Seoul, South Korea) before or after RFMN can boost results.

Sponsored By Zimmer MedizinSystem;

Cryolipolysis is a top revolutionary aesthetic body shaping treatment and a very popular offering in today’s spas and aesthetic practices. But, a practice can stand out by adding Z Wave^® from Zimmer MedizinSystems (Irvine, Calif.) after cryolipolysis treatments for improved results, consistent outcomes and quicker patient recovery.

David Goldberg, MD, JD, medical director at Skin Laser & Surgery Specialists (Hillsborough, N.J.) was involved with the original FDA studies for cryolipolysis. “Cryolipolysis has become a very common procedure, so we stopped doing a lot of it because everybody else was doing it,” he stated. “However, when we added Z Wave to the treatment, we saw improved results and a better experience. Word eventually got out, especially through social media, giving our practice a competitive advantage. Whereas we were doing almost no cryolipolysis five years ago, it is once again one of our top treatments.”

According to Dr. Goldberg, Z Wave improves the results for cryolipolysis and virtually any method that involves non-invasive body contouring. “Cryolipolysis freezes the fat, which can look lumpy until the body removes it. Z Wave technology is low-intensity shockwave therapy that breaks up the fat by increasing metabolic activity and stimulating blood circulation, leading to quicker and more comfortable dissipation of the swelling caused by cryolipolysis and of the fat itself.”

Triple board-certified plastic surgeon Gordon Sasaki, MD, of Sasaki Advanced Aesthetic Medical Center (Pasadena, Calif.) has offered Z Wave therapy since 2014. “I felt it was incumbent to provide patients with an acceptable treatment to solve issues of irregularities after liposuction, cryolipolysis or surgical procedures such as abdominoplasty, brachioplasty or thighplasty,” he explained. “Z Wave helps reduce the appearance and symptoms of acquired soft tissue distortion and successfully treats the side effects of cryolipolysis or liposuction.”

Dr. Sasaki shared his treatment protocol. “We apply Z Wave immediately after cryolipolysis is complete, while there is still anesthesia to the region,” he reported. “We wait about three to ix weeks when the normal sensitivity to the area has subsided, and then do one treatment every week for about six weeks, which seems to help increase volume change by about 20% to 25% in addition to that which has been obtained by the cryolipolysis itself.”

Hand massage is a common protocol following cryolipolysis, but according to dermatologist Mitchel Goldman, MD, of Cosmetic Laser Dermatology (San Diego, Calif.), this can be painful and tedious for both the patient and practitioner. “After the fat is frozen, massaging with Z Wave helps break down the fat by destroying the fat cell membrane,” he reported. His practitioners find that Z Wave enhances the results of cryolipolysis, with less discomfort and a more consistent outcome than hand kneading the treatment area.

Z Wave is not limited to improving body shaping outcomes. Dr. Goldberg takes advantage of the benefits to improve results with other treatments too. “Z Wave improves circulation and the body’s response to treatment is to create new blood vessels, and there is very solid evidence in the urology literature that shockwave treatment can help treat erectile dysfunction (ED). Because of this, we use Z Wave in our practice for post cryolipolysis, post laser tattoo removal treatment and as a novel and innovative treatment for ED.”

It is clear Z Wave is an effective, FDA-cleared treatment to combat cellulite. It can also greatly complement and improve patient outcomes with cryolipolysis, while helping aesthetic businesses stand apart from the rest.

Sponsored By Sciton;

Delivering a blend of 810 nm, 940 nm and 1060 nm wavelengths, one handheld laser is enabling safe and effective hair reduction with speed, precision and comfort. Furthermore, the laser’s ability to address large body areas faster than was previously possible ramps up patient turnover and return on investment.

Angela Negron, MSN, FNP-C, the nonsurgical clinical supervisor at Steven Camp MD Plastic Surgery & Aesthetics in Fort Worth, Texas, explained that their practice previously owned a multifunction device that could remove hair; however, the device was never used for this purpose, because treatments would have taken too long, cost too much, and caused patients’ pain. “When BARE HR from Sciton (Palo Alto, Calif.) was introduced to our practice in 2022, it became a no-brainer because the treatments were so fast,” she stated.

A demonstration of the device showed that a male back could be treated in three minutes – versus 30 minutes with the practice’s previous device, Ms. Negron noted. “And it is like that for all treatment areas – very quick.”

The laser’s efficiency means that patients typically choose to get more areas treated. “We can now treat in minutes, what used to take an hour. It is a better return on investment when we see a single patient for multiple treatment areas rather than trying to fit more people on the schedule,” Mrs. Negron explained. “Patients often cannot believe how quick and easy the treatment is,” she reported. “Everyone gets a complete series of six sessions, but patients consistently see results after one to two sessions.”

Providers can adjust settings such as energy level and pulse duration and can choose between two operating modes based on each patients’ comfort level. The device allows users to treat every skin type because the wavelengths target melanocytes deep in the hair bulb, bypassing epidermal melanin.

BARE HR’s Blend handpiece combines 810 nm with 940 nm and 1060 nm wavelengths. The latter two wavelengths penetrate more deeply to treat darker or tanned skin, and coarser hairs. “With it we can treat almost anybody who walks through our door,” Ms. Negron shared. “It does not matter what time of year.”

Moreover, the laser offers comfort and speed modes. “As long as your patient is not getting too warm, or they do not have really dark skin, you can keep them on speed mode, which allows you to treat very quickly.” Flatter surfaces such as the legs and back allow for the swiftest treatment, she said. BARE HR generates its powerful cooling at the system level with the sapphire crystal delivering 5° C to the treatment area. Applying light pressure on the handpiece during treatment allows the crystal to keep surface skin at approximately 40° C while targeted layers below reach up to 70° C.

The combination of speed, power and the right blend of wavelengths makes BARE HR the perfect complement to any aesthetic practice. Specifically with the Blend handpiece, users have the opportunity to generate revenue year-round while treating patients safely and effectively.