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Physicians weigh in on hot techniques, trends for cosmetic surgery in 2011

Article-Physicians weigh in on hot techniques, trends for cosmetic surgery in 2011

Key iconKey Points

  • Noninvasive fat reduction may develop into significant market this year
  • Platelets rich plasma has potential to fill deflated facial volume, trigger cell migration
  • Adoption of blunt-tip cannulas for treating face with fillers will make impact in cosmetic medicine

Editor's Note: Aesthetic Exchange is a new department in Cosmetic Surgery Times that offers cosmetic surgeons the opportunity to provide input on various industry-related issues/trends. Each month, we ask several physicians to comment on a question that is impacting the cosmetic surgery field. This month's question is:

What advancements in terms of technology do you foresee in the field of cosmetic surgery in 2011?


Dr. Fitzpatrick
"2011 is likely to be the year that noninvasive fat reduction becomes a reality and develops a significant market. Cryolipolysis, or 'CoolSculpting,' by Zeltiq uses a novel approach of selectively freezing fat cells just below the dermis to reduce localized fat bulges, such as love handles and mid-abdominal fat that doesn't respond to diet and exercise. The cold injury induces apoptosis, or programmed cellular death, which results in gradual fat loss over a period of about three months. The device was approved by the FDA (Food and Drug Administration) in September 2010. There are currently about 150 devices in use.

"LipoSonix (Medicis) and UltraShape both use focused, intense ultrasound to damage fat cells in a noninvasive approach. The damaged adipocytes are gradually eliminated over a 90-day period. Both devices have been through extensive FDA evaluation and are expected to reach the U.S. market this year.

"The fractional treatment paradigm continues to dominate facial procedures. Solta's thulium laser (1,927 nm), the Fraxel Dual, delivers precise depth control (200 m) that is ideal for safe, rapid healing when treating facial pigment, such as melasma and lentigines, actinic keratoses and mild textural irregularity. Another ultrasound technology, Ulthera, delivers deep intense pixilated spots of heating at selected levels (deep dermis, possibly SMAS), to achieve tightening of facial skin. One other interesting new technology is Syneron's ePrime, which uses a minimally invasive, micro-needle electrode array to precisely heat the dermis to a specific temperature to induce tightening of collagen fibrils and neocollagenesis."


Dr. Tom
"Patient demand is primarily centered on no downtime, cost effectiveness and significant cosmetic improvement. Although a difficult task, it is rewarding for both patient and surgeon if accomplished with advanced minimally invasive technology and appropriate expectation management.

"The new paradigm of 'natural' facial rejuvenation is based on revolumizing the aging deflation of the face. I am a big proponent of facial fat grafting, yet there is still a minimum of several days of cosmetic downtime.

"An answer may be our own plasma with a concentration fraction of platelets. Platelets rich plasma (PRP) theoretically has the potential to not only fill deflated facial volume, but may indeed trigger cell migration and differentiation. If this is borne out, then we have relatively inexpensive filler that is autologous with long-term benefit and a minimum of side effects. There is now a commercially available FDA-approved kit (Selphyl, UBS Aesthetics) that simplifies the whole technique for blood draw, centrifugation and activation of the PRP.

"This is extremely important for the everyday practitioner who wants to offer PRP for their patients. The treatment consists of injecting PRP into the dermis as well as deep along the periosteum for volume restoration.

"Anecdotal testimony is that patients who have had PRP facial injections noticed not only more volume, but improved skin texture and thickness. It seems to mirror the skin results noted with facial fat grafting, but with less cosmetic downtime. Of course, PRP stand-alone treatments will not last as long as facial fat grafting. Clinical studies suggest about a year's duration.

"The most exciting news at the 27th Annual American Academy of Cosmetic Surgeons meeting is that of stem cells and tissue regeneration. PRP and its ultimate role will be more clearly delineated through clinical use and trials."

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