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The machine age: What's next in technology?

Article-The machine age: What's next in technology?

Dr. NiamtuInto 2016 and beyond, this past decade will likely be known as cosmetic surgery’s technology-driven “machine age,” according to Joe Niamtu, III, D.M.D., an oral and maxillofacial surgeon with a practice limited to cosmetic facial surgery in Richmond, Va.

“We have seen assisted liposuction, hair removal devices, IPL, fractional lasers, tattoo removal lasers, Thermage, Ulthera, Pelleve, CoolSculpting, VelaShape, ThermiDry, ThermiTight, MiraDri, Exilis, Venus Freeze, and on and on,” Dr. Niamtu says. “The number of aesthetic devices released in the last decade is beyond the scope of this article, but no one can dispute their effect on cosmetic surgery.”

But devices come and go. That’s the challenge for doctors and their patients, according to Dr. Niamtu.

“Many doctors have been sold a machine that was supposed to produce maximum results with minimum recovery, only to disappoint the doctor and patients. I have seen many doctors spend $100,000 for a device that now serves as a door stop,” he says. “[By the same token,] staying on the cutting edge is great for the profession, the doctor, office, staff and patients. This is particularly true for devices that actually produce a noticeable result, and some do.”

NEXT: What to Expect in 2016


What to Expect in 2016

Dr. HirschCambridge, Mass.-based dermatologist Ranella Hirsch, M.D., says technology is becoming more refined in meaningful ways.

Dr. Hirsch, a past president of the American Society of Cosmetic Dermatology and Aesthetic Surgery, says the refinements have meant, for example, that aesthetic physicians are able to safely treat a broader range of skin types. In addition to light, newer technologies use other modalities, including radiofrequency and ultrasound energy.

“We’re seeing some level of skin thickness, skin tightening,” she says.

Among the trend-setting skin rejuvenating devices are fractional radiofrequency devices, which not only help to lift and revive crepey skin, but also provide improvement in complexion and wrinkles without complication risks for darker skin types, according to Beverly Hills, Calif., dermatologic surgeon Jason Emer, M.D.

Dr. Emer“In the past, Hispanics, blacks, mixed ethnicities and those with sensitive skin types couldn’t have a laser procedure because they would risk complications…. Now, with fractional devices — radiofrequency, laser, microneedling — you can treat them with less worry,” Dr. Emer says. “The radiofrequency device that I’ve been using is the Venus Viva [Venus Concept].  I’ve also had experience using the Eclipse Skinfinity [Eclipse Aesthetics], which is another type of fractional radiofrequency that uses a rolling technique as opposed to stamping. These devices were created to deliver energy to the skin in a much safer way — even more so than lasers, which are a staple in my practice.”

Fractional radiofrequency devices can treat acne scars, abnormal pigmentation, fine lines, rosacea, complexion issues and large pores, according to Dr. Emer. But the trend is to build on the technology to go beyond and use combinations to treat superficial and deep skin layers. An example, according to Dr. Emer, is taking the radiofrequency energy and putting it on a needle.

“There are a couple of devices. One is called Profound [Syneron Candela]. Another is called Infini [Lutronic]. Those are using needles, like microneedling, to improve the skin, by adding trauma and energy to the skin. By doing that with radiofrequency, you can get a more aggressive, yet safer treatment even in darker skin types,” Dr. Emer says.

Boca Raton plastic surgeon Jason Pozner, M.D., predicts technology winners in 2016 will include Sculpsure (Cynosure).

“Look for more direct-to-consumer [advertising] and discussion about non-surgical fat removal,” Dr. Pozner says.

Physicians and consumers will also hear a lot about the Sciton Halo in 2016, and nonsurgical skin tightening with microneedles and energy will be hot this year, he says.

“Vaginal rejuvenation [is going to be a] hot topic, with new devices from a range of companies, including Thermi and Sciton,” Dr. Pozner says.

NEXT: Claims and Promises


Claims and Promises

Dr. FagienBoca Raton, Fla., oculoplastic surgeon Steven Fagien, M.D., says lasers, in general, continue to be a disappointment.

“They make a lot of claims and promises, only to find that patient satisfaction is not that high. That’s not across the board with all lasers. There are some that are very good. We use a Sciton/Halo. It’s a great device, with high patient satisfaction, and a wide range of versatility to address many patient concerns,” Dr. Fagien says. “Whereas, some of the others [technologies], particularly those touted to be ‘skin tightening’ lasers are generally very weak on results. They cost a lot of money for the doc and patient. I see several patients a day who say they had something done and they don’t see much of a difference. It’s obviously worse to have a bad result, but it’s also disconcerting to have no result.”

It doesn’t always pay to be the first in your community to offer a device, according to Dr. Niamtu. Doctors who purchase and heavily market devices that have yet to be vetted for safety and results, might see consumers respond in a flurry, only to come back in three months disappointed and unhappy.

“Some want refunds; others will just badmouth and leave negative reviews. Now, the doctor with the suddenly thriving practice is seeing negative effects of a big machine with small results,” Dr. Niamtu says. “How well a specific device will integrate into a practice largely depends upon the ‘flavor’ of the practice. While my dermatologist friend next door may have very happy patients with small improvements, my practice is surgical and my patients expect a big result.”

The key to success with aesthetic technology in 2016? Research devices that are proven to have high patient satisfaction and don’t over-promise results, says Dr. Fagien. 

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