Holistic Aesthetics: A Practical Guide to Incorporating an Integrative ApproachHolistic Aesthetics: A Practical Guide to Incorporating an Integrative Approach

Aesthetic practices are the ideal place to incorporate integrative medicine. Integrative medicine takes a holistic approach to health and wellness and the majority of people in aesthetics are focused on precisely that, according to Raheleh Sarbaziha, MD (Dr. Rahi), who directs an anti-aging and integrative medicine practice in Beverly Hills, Calif.

“Aesthetic practitioners [understand] that in order to look good you have to be healthy,” stated Dr. Rahi. And like many others, Dr. Rahi thinks integrative and holistic approaches are becoming more mainstream in traditional aesthetic practice. “When I started my residency around 2011 at the University of Southern California (USC), I wanted to do a rotation in integrative medicine and my program was completely against it. They had no idea what it was,” she commented. “Now, USC has programs in integrative medicine.”

The scope and opportunity for aesthetic providers is massive, according to J.D. McCoy, NMD, naturopathic physician and medical director of Contour Medical in Gilbert, Ariz. “The reason for this may simply come down to time. Most patients spend more time with their aesthetic providers annually than they do with their primary care physician,” he declared. “This creates an opportunity to discuss many of the wellness issues that get missed: nutrition, metabolic enhancement, hormonal assessment, mind-body medicine, sleep difficulties and prescription reviews, as examples.” Another factor is patients’ growing dissatisfaction with medicine’s focus on treating sickness. Many want more resources for health optimization and wellness, Dr. McCoy remarked.

Integrative Medicine Defined

Integrative medicine focuses on the human being as a whole – on the body, mind and spirit – to achieve optimal health and healing. It is a synthesis of conventional and complementary treatment options, according to authors of a paper in Medicina entitled “Integrative Medicine and Plastic Surgery: A Synergy – Not an Antonym.”¹

The German authors, including plastic surgeons and integrative medicine specialists, write that while little is known about integrative medicine’s role in plastic surgery, there is evidence to support the use of many aspects of complementary medicine, such as Arnica montana, onion extract, vitamin E products and Melitolus (sweet clover). “Mind and body practices, such as hypnosis and meditation, are also known to have a positive effect on the postoperative course of plastic surgery patients. It should also be mentioned that therapeutic concepts of integrative medicine can be applied in all four pillars of plastic surgery (aesthetic surgery, reconstructive surgery, burns and hand surgery),” they wrote.

The goals of incorporating integrative medicine in the aesthetic practice are to improve patient outcomes, safety and comfort. All of these components are optimized when a patient’s health is optimized, according to Dr. McCoy. Ideally, integrative medicine views each patient as a dynamic system: mind, body and environment, he added.

Integrative medicine in aesthetics includes not only alternative options to traditional Western medicine, but also wellness and prevention for the best outcomes in the least invasive way possible, according to Dr. Rahi. Common integrative medicine approaches in today’s aesthetic practice include targeted supplementation, optimized hormone levels, weight loss and improved immunity and wellness.

Value in Holistic Aesthetics

Integrative medicine combines different techniques and technologies and treats multiple anatomical layers, requiring clinicians to choose a medical plan based on all medical information, according to Jennifer Levine, MD, a facial plastic surgeon in New York, N.Y. She believes this is particularly important in aesthetics, because, anatomically, the face and body are composed of many different layers and interconnected. “So, we must treat all aspects for ideal aesthetic results,” she explained.

Furthermore, incorporating integrative medicine into the aesthetic practice allows clinicians to create better relationships with patients and can lead to longer lasting and better results (because you are looking at someone holistically), observed Dr. Rahi.

Taking the First Step: Education

Traditional aesthetic practices can incorporate integrative services with a little planning and a slightly different approach to patient consults. Education is required and can be formal or informal, including research, courses, lectures, podcasts and more, according to Dr. Levine. Many universities offer individual courses in integrative medicine, noted Dr. Rahi, and some of those academic courses are free. “Or you can do a fellowship, like I did,” she mentioned. “I went to the University of Arizona. They have the oldest integrative medicine program in the country.”

Dr. Rahi highly recommends aesthetic clinicians read the textbook Integrative Medicine² by David Rakel, MD. It is an easy read and is so comprehensive that many who read it will be prepared to pass the integrative medicine boards, she asserted. Webinars are another good option.

However, finding the best training program for an individual practitioner can be tricky, as there are many different perspectives in integrative medicine, according to Dr. McCoy, who trained at the Institute for Functional Medicine from 1999 to 2000 and then throughout the years with the American Academy of Anti-aging Medicine (A4M). “My observation is that the majority of providers are following what is trendy and ‘hot’ versus what may be more grounded in good science. Many of the modern common practices are based on industry-driven research that can be highly biased (funded by a form of testing, drug or device),” he asserted.

Some of the best literature relating to many non-traditional assessments or therapies were written long ago, Dr. McCoy observed. “Seek out this literature. Seek out mentors and colleagues that can teach, inspire and challenge you,” he recommended. “When you learn about a method that is very different from current belief, explore, investigate and assess. My greatest leaps forward in my art and practice have come from confronting opposing views.”

As for costs related to integrating complementary and alternative approaches, they tend to be much lower than buying a new laser or even a syringe of filler, according to Dr. Rahi. Although the scope of integrative services will range from practice to practice, practitioners who delve into integrative medicine might find themselves spending more time (than money) asking medical history questions – going beyond what they see with their eyes, suggested Dr. Levine.

Consider These Integrative Services

Choosing which integrative services to incorporate depends on the practice’s goals. Dr. Levine, for example, emphasizes weight loss services tied in with the rising popularity of GLP-1 medications. “It seemed that many of my patients were not able to be satisfied with aesthetic treatments until they were happy with their weight,” she explained.

But weight loss is not the only service that complements common aesthetic treatments. Patients receiving a treatment like Ultherapy® from Merz Aesthetics (Raleigh, N.C.) need to be made aware that protein intake and vitamin C affect collagen synthesis, “which is what we are trying to induce from the treatment,” Dr. Levine remarked. “Smoking cessation advice and stress reduction are key for surgical patients.”

Dr. Rahi believes hormonal therapy services are a natural extention of the aesthetic practice. She also focuses on weight loss in her practice and shared her approach in a recent TAG article.³ Dr. Rahi also offers nicotinamide adenine dinucleotide (NAD+) drips, as part of her practice’s healthy immunity and wellness strategies. “NAD+ regulates energy metabolism, DNA damage repair, gene expression and stress response. NAD+ deterioration contributes to the progression of multiple metabolic disorders, cancers and neurodegenerative diseases,” according to a paper in Molecular Medicine.⁴ “Human clinical trials to determine the benefits of restoration of NAD+ by using NAD precursors are in progress.”

According to Dr. Rahi, the IV drip provides patients with increased energy and supports cellular production (helping with anti-aging). It also helps with addictions and cravings.

Three Tips for Getting Started with Holistic Aesthetics

1. Start simply with questions and observations. Dr. McCoy suggested beginning by reviewing patients’ medications. “You will find that many have not been evaluated in a significant time,” he remarked. “Ask about sleep quality and digestion. Talk about breathing and focus of attention. Suggest simple strategies to bring more joy to daily life (getting barefoot and walking in the grass). It is amazing how some of these simple places to start can elevate the way a patient feels. Every patient wants to feel good and look good.”

2. Focus on a few things and do them well. Clinicians should consider focusing on a select few complementary and holistic services early on because there are so many options, advised Dr. Rahi. “I think if you overwhelm yourself with too many services it can be stressful for the provider and clinic,” she commented.

3. Be your own billboard. According to Dr. Rahi, incorporating integrative therapeutics in practice has made her a healthier woman, overall. “As an integrative doctor, I use these services myself and feel they work,” she affirmed.

The Future is Integrative

Integrative medicine, with its holistic view of patient health and wellness, is the future of medicine, asserted Dr. Rahi. “You do not necessarily need to make your aesthetic practice integrative, but you should have an understanding of what it is and could start offering maybe a few things, such as post-care supplements to help with bruising, swelling and pain (which helps eliminate the use of steroids),” Dr. Rahi suggested.

Dr. McCoy noted that the purpose of his practice is to change patients’ lives, inside and out, every day. Infusing integrative medicine into his aesthetic practice allows him to achieve that goal. “It is a lifelong journey, since you are never done (physically, mentally, spiritually),” he concluded.

References:

1. Megas I-F, Tolzmann DS, Bastiaanse J, Fuchs PC, Kim B-S, Kröz M, Schad F, Matthes H, Grieb G. Integrative Medicine and Plastic Surgery: A Synergy—Not an Antonym. Medicina. 2021; 57(4):326. https://doi.org/10.3390/medicina57040326

2. Rakel DP, Minichiello V (Eds.). Integrative Medicine. 5th ed. Elsevier. 2023.

3. Sarbaziha R. A Holistic, Integrative Approach to the Aesthetic Weight Loss Program. The Aesthetic Guide. Published October 28, 2024. Available at: https://www.theaestheticguide.com/ health-wellness/a-holistic-integrative-approach-to-theaesthetic- weight-loss-program. Accessed November 12, 2024.

4. Amjad S, Nisar S, Bhat AA, et al. Role of NAD+ in regulating cellular and metabolic signaling pathways. Mol Metab. 2021;49:101195. doi:10.1016/j.molmet.2021.101195.