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ASAPS Reports 12 Percent Overall Increase in Cosmetic Procedures Performed in the US in 2013

The American Society for Aesthetic Plastic Surgery (ASAPS) released its complete 17th annual multi-specialty statistical data indicating a 12 percent overall increase in cosmetic procedures performed in the United States in 2013. More than 11 million cosmetic surgical and nonsurgical procedures were performed by US board-certified plastic surgeons, dermatologists, and otolaryngologists, totaling more than 12 billion dollars for the first time since the recession began in 2008. Of that total, more than seven billion was spent on surgical procedures and more than 5 billion was spent on nonsurgical procedures.

This year, liposuction replaced breast augmentation as the most frequently performed surgical procedure with a 16 percent increase and more than one billion was spent on the procedure nationwide.

The top five surgical procedures were:

  • Liposuction (363,912 procedures, up 16.3%)
  • Breast augmentation (313,327 procedures, down 5.2%)
  • Eyelid surgery (161,389 procedures, up 5.4%)
  • Tummy tuck (160,077 procedures, up 2.3%)
  • Nose surgery (147,966 procedures, up 2.9%)

“The numbers do not come as a surprise,” states Jack Fisher, MD, President of ASAPS. “Technological advances, less-invasive procedures, greater accessibility are making aesthetic procedures, surgical and nonsurgical, far more attractive to the public at-large. Further, the rebounding economy is encouraging people to start investing in themselves once again.”

Buttock augmentation and labiaplasty, which have not previously been considered ‘popular’, took the top spots for the most significant increases in number of procedures performed over the course of a one-year period—with a 58 percent increase in buttock augmentation and a 44 percent increase in labiaplasty procedures compared to 2012.

Women had more than 10.3 million cosmetic procedures, 90.6 percent of the total. The number of cosmetic procedures for women increased over 471 percent from 1997. The top five surgical procedures for women were breast augmentation, liposuction, tummy tuck, breast lift, and eyelid surgery.

Men had more than 1 million cosmetic procedures, 9.4 percent of the total. The number of cosmetic procedures for men increased over 273 percent from 1997. The top five surgical procedures for men were: liposuction, eyelid surgery, nose surgery, male breast reduction, and ear surgery.

Botulinum Toxin (including Botox, Dysport, and Xeomin) remained the most frequently performed noninvasive procedure with a 15.6 percent increase. Nonsurgical procedures increased in 2013 by 13.1 percent with 9.5 million procedures.

The top five nonsurgical procedures were:

  • Botulinum Toxin (3,766,148 procedures, up 15.6%)
  • Hyaluronic Acid (1,872,172 procedures, up 31.5%)
  • Hair Removal (901,571 procedures, up 2%)
  • Microdermabrasion (479,865 procedures, down 3.8%)
  • Photo Rejuvenation (456,613 procedures, up 35.3%)

In 2013, more than 2.5 billion dollars was spent on injectables alone. In addition, nearly 1.9 billion was spent on skin rejuvenation, a fast-growing sector of the aesthetic nonsurgical industry.

“A significant increase in the number of both cosmetic surgical and non-surgical procedures suggests that people are once again investing in their appearance and perhaps have more disposable income to do so. Given the state of the economy and the competitiveness of the job market, we expect to see the numbers for anti-aging procedures continue to increase,” notes Michael Edwards, MD, President-Elect of ASAPS.

Merz Aesthetics Launches New Physician Loyalty Program

Merz Aesthetics, a division of Merz North America, launched a new physician loyalty program, My Merz Select. Using My Merz Select, physicians are able to select the benefits, determine the details, and craft customized solutions for their practices. Combining straightforward discounting levels and a customer experience that goes beyond pricing, Merz explains that My Merz Select satisfies the diverse needs of today‘s aesthetic practices.

“Merz Aesthetics is committed to becoming the preferred partner of aesthetic physicians in North America, and we believe that flexible, intelligently-designed practice support programs like My Merz Select are an essential component of that partnership,“ said Jim Hartman, Vice President and Head of US Aesthetics/OTC for Merz North America. “The entire premise of My Merz Select is based on feedback from our physician customers, and we are pleased to provide them with a program that is truly responsive to individual practice needs.“

Benefits earned through My Merz Select are based solely on volume, not on portfolio pricing or “bundling,“ which allows physicians to purchase the Merz Aesthetics products that meet the specific needs of their practices. In addition, My Merz Select offers a range of ways for aesthetic practices to receive discounts and rebates, from up-front off-invoice discounts to account credit and free product. “Merz Aesthetics has a strong reputation for listening to their physician customers, and I’m impressed by their ability to translate that feedback into a simple, hassle-free program with benefits that will help me to both serve my patients and grow my practice,“ said Dr. Heidi A. Waldorf, Director of Laser and Cosmetic Dermatology at The Mount Sinai Medical Center in New York, NY and Associate Clinical Professor of Dermatology at The Icahn School of Medicine at Mount Sinai. Dr. Waldorf is also Co-Chief Medical Editor of Modern Aesthetics® magazine.

“The design of My Merz Select gives me the ability to choose the products and the benefit structure that make the most sense for my own practice,“ said Dr. Michael Fiorillo, a double board-certified cosmetic surgeon who practices in the New York City and New Jersey area. “Within my practice, I would never take a one-size-fits-all approach to aesthetic medicine – and with My Merz Select, I no longer have to accept a one-size-fits-all approach to practice benefits. My Merz Select combines the best parts of other loyalty programs with a real understanding of the unique needs of my practice and my patients.“ My Merz Select is one of several programs that Merz Aesthetics says it expects to launch in 2014 in order to demonstrate their commitment to providing high-quality aesthetic products supported by a superior customer experience.

Valeant Pharmaceuticals Donates $250,000 to The National Coalition Against Domestic Violence

Valeant Pharmaceuticals North America, LLC donated $250,000 to the National Coalition Against Domestic Violence (NCADV). The donation is a reflection of Valeant's ongoing support and commitment to the wellbeing of women, and is the first of four checks the company will present to NCADV in a one-year period for a combined donation goal of $1 million.

"NCADV is thrilled to be working with Valeant as a partner in our efforts to end violence in the home," said Rita Smith, Executive Director of NCADV. "Corporations have the ability to increase the awareness of resources and information about domestic violence to a much larger audience than we can alone, and as a result, together we can make a difference in so many more lives of people who are struggling to get free from the violence."

According to the Bureau of Justice Statistics, 85 percent of domestic violence victims are women, and 1 in 4 women report experiencing domestic violence in their lifetimes. Because Valeant's most important objective is to serve its stakeholders, the majority of which are women, the decision to support a cause like NCADV's came easily.

"Valeant's partnership with the NCADV provides us a tremendous opportunity to make a difference in the lives of those impacted by domestic violence," said Ryan Weldon, Executive Vice President for Valeant Pharmaceuticals. "We make these efforts on behalf of our employees and the consumers and healthcare professionals that support this cause by using our products. We hope this collaboration will continue to grow and enable the NCADV in its mission to end domestic violence."

Valeant partnered with NCADV in October 2013. To date, the partnership has helped 19,000 women by supporting NCADV in:

  • Expanding relationships with associations that provide services to victims of violence
  • Developing partnerships in the creation of information and materials addressing specific health issues and intimate partner violence
  • Expanding topics of health and wellness materials for victims and survivors of domestic violence
  • Creating training materials for service providers on how to best serve survivors struggling with health and wellness issues

To learn more about how Valeant is taking a stand against domestic violence and to contribute to the cause, visit

Selfies and Social Media are Influencing Facial Plastic Surgery Trends

The rise of ‘selfies’ is having a significant impact on the facial plastic surgery industry according to a new study by the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). The annual poll of a select group of the organization’s 2,700 members revealed that one in three facial plastic surgeons surveyed saw an increase in requests for procedures due to patients being more self aware of looks in social media. In fact, 13 percent of AAFPRS members surveyed identified increased photo sharing and patients’ dissatisfaction with their own image on social media sites as a rising trend in practice. As a result, AAFPRS members surveyed noted a 10 percent increase in rhinoplasty in 2013 over 2012, as well as a 7 percent increase in hair transplants and a 6 percent increase in eyelid surgery.

“Social platforms like Instagram, Snapchat, and the iPhone app, which are solely image based, force patients to hold a microscope up to their own image and often look at it with a more self-critical eye than ever before,” says Edward Farrior, MD, President of the American Academy of Facial Plastic and Reconstructive Surgery. “These images are often the first impressions young people put out there to prospective friends, romantic interests and employers and our patients want to put their best face forward.”

Social media is also a driving force behind an increasingly youthful face of plastic surgery. In 2013, more than half of surveyed facial plastic surgeons (58 percent) saw an increase in cosmetic surgery or injectables in those under age 30.

The AAFPRS survey found that 39 percent of members surveyed stated there is a rise in the demand for non-surgical cosmetic procedures to delay facial surgery. Thirty-four percent of facial surgeons surveyed stated that women under 35 are looking after their skin to prevent visible signs of aging for longer, while 23 percent of facial surgeons surveyed stated that men under 35 are seeking rhinoplasty, neck liposuction, chin implants, and acne scar reduction procedures.

“The top five things most patients are most concerned with are results, cost, recovery, pain and scars,” says Dr. Farrior. “Whether driven by a desire to stay competitive in the workforce, remain attractive to their mate or simply to look as good as they feel, advances in non-invasive anti-aging technologies are making it possible to delay the hands of time while retaining a natural outcome. As recovery times are reduced and results are more subtle, aesthetic procedures become a more viable maintenance option for young men and women.”

Almost three quarters of all procedures performed in 2013 were minimally invasive. Of these, Botx Cosmetic, made up approximately half of all minimally invasive procedures performed, followed by hyaluronic acid and peels.

Ellman Enters Body Treatment Market With FDA Clearance for PelleFirm

Ellman International, Inc., received FDA clearance to market its new PelleFirm RF Body Treatment System. The PelleFirm System is CE Marked for body skin tightening and cellulite reduction. It also has received FDA 510(K) clearance for tissue heating and the temporary reduction in the appearance of cellulite.

The PelleFirm System provides a non-invasive, pain-free RF treatment for the body, resulting in firmer skin and the impermanent reduction in the appearance of cellulite, according to Ellman. The company leveraged its expertise in RF based skin tightening with Pelleve in the development of PelleFirm. The system is comprised of two new, large diameter handpieces sized for the body that elevate tissue temperature up to 45 degrees Celsius, coupled with mechanical massage heads for treatment of areas with cellulite. PelleFirm is ideal for problem zones including the abdomen, arms, buttocks, and thighs. The PelleFirm handpieces are powered by the Pelleve S5 RF Generator, which also powers the Pelleve Wrinkle Reduction handpieces for facial skin tightening. These new PelleFirm RF Body treatment devices are compatible with the recently released enhanced Pelleve S5 Generator, as well as the large worldwide installed base of the original Pelleve S5 Generators from Ellman.

Josephine Hernandez, MD, a dermatologist and a primary PelleFirm clinical investigator, said, "Many of my patients request treatment for sagging skin in their arms, hands, abdomen, thighs and gluteal area." She commented further, "The results (with the PelleFirm system) are outstanding and superior to any of the many body contouring or skin tightening devices we have used in our practice. I have seen PelleFirm results in as little as a few treatments. We are very satisfied users."

Pollogen Ltd. Launches FDA-Cleared Imogen

Pollogen Ltd., launched the Imogen System, which is FDA cleared for dermatological procedures requiring ablation and resurfacing of the skin using the VoluDerm applicator. It is also intended for use in dermatologic and general surgical procedures for the non-invasive treatment of mild to moderate facial wrinkles and rhytids, according to the company. The system sets a new standard for aesthetic treatments delivering unsurpassed immediate and long-term treatment results.

The newly approved VoluDerm technology targets the mid-dermis with micro-pins and radio frequency, increasing production of hyaluronic acid, collagen regeneration and elastin growth. As a result, the company says, VoluDerm technology achieves significant and long-lasting dermal volumizing, wrinkle reduction, and skin resurfacing. TriPollar technology is a non-invasive solution that delivers immediate skin tightening and long-term skin rejuvenation results. The safety and efficacy of the technology have been validated in more than a dozen peer review papers and extensive clinical experience. The Imogen treatment is effective on all skin types and colors and is carried out in a fast 'walk-in walk-out' procedure with minimal discomfort. There is no downtime and patients can resume their daily routine immediately after treatment.

Dr. Michael H. Gold, MD from Gold Skincare Center said: "With the Imogen system, I can finally achieve the results my patients and I desire. The facial dermal volumizing and wrinkle reduction results are exceptional. The skin becomes more supple and elastic and my patients look and feel years younger. Most importantly, the results are natural-looking which is what my patients want."

Alma Lasers Introduces FemiLift

Alma Lasers launched FemiLift for minimally invasive laser resurfacing of the vagina. Providers can now offer an innovative in-office vaginal procedure with no patient downtime or anesthesia. According to Alma, FemiLift can improve quality of life for women and their partners. The 30-minute outpatient treatment can also improve body image and self-confidence. Patients report a near-immediate return to activity, including sexual intercourse. FemiLift provides a minimally invasive, virtually painless procedure, gentle treatment for controlled safety and accuracy, no patient downtime, and an excellent patient satisfaction record.

“FemiLift delivers to patients a high level of satisfaction, with quick recovery and no downtime,” says Yaniris R. Avellanet MD, OBGYN surgeon, Florida. “FemiLift is a highly acceptable procedure among patients who desire top-quality, efficiency, and lasting results.”

Sciton Introduces the Halo Laser

Sciton introduced the Halo, a hybrid fractional laser that applies tunable non-ablative and ablative wavelengths in a single pass to maximize results and reduce downtime. Halo delivers both ablative and non-ablative wavelengths to the same microscopic treatment zone: 1470nm for coagulation and 2940nm for ablation. The 1470nm wavelength is used for delivering between 100 and 700 microns of coagulation to the epidermis and dermis, where solar damage exists. The 2940 nm wavelength is used to deliver from 0 to 100 microns of ablation to the epidermis of the skin. This gives Halo the unique ability to provide separate treatments for the epidermis, which heals quickly, and dermis, which remodels more slowly over time. The operator may choose one of three coverage-base treatment levels, and Halo calculates the exact amount of energy necessary to complete a safe and effective treatment. Intelligent energy delivery, combined with Dynamic Thermal Optimization, ensures precise and even treatments, each and every time. The benefits of a Halo treatment include both epidermal and deeper dermal pigmentation and tone and texture in the skin.

"Sciton's Halo is the first real innovation in lasers in the last decade," says Plastic Surgeon Jason Pozner, MD, FACS. "Hybrid Fractional Lasers are the next logical evolution in fractional resurfacing. With Halo, I can achieve results which I would have only expected from an ablative fractional laser, but get downtimes that I would normally see with a non-ablative fractional laser. It really is the best of both worlds."

Halo is available on the JOULE platform, which offers multiple modules to treat a wide range of indications.

Research Briefs: Could Botox Help Patients with Depression?

To determine the antidepressant effect of onabotulinumtoxinA (OBA) treatment of corrugator and procerus muscles in patients with major depressive disorder, a double blind, randomized, placebo-controlled trial was conducted. In an outpatient clinical research center, 85 subjects with DSM-IV major depression were randomized to receive either OBA (29 units for females and 40 units for males) or saline injections into corrugator and procerus frown muscles (74 subjects were entered into the analysis). Subjects were rated at screening, and three and six weeks after OBA treatment. The primary outcome measure was the response rate, as defined by ≥50 percent decrease in score on the Montgomery–Asberg Depression Rating Scale (MADRS). Response rates at six weeks from the date of injection were 52 percent and 15 percent in the OBA and placebo groups, respectively (Chi-Square (1) = 11.2, p < 0.001, Fisher p < 0.001), according to the study. The secondary outcome measure of remission rate (MADRS score of 10 or less) was 27 percent with OBA and 7 percent with placebo (Chi-square (1) = 5.1, p < 0.02, Fisher p < 0.03). Six weeks after a single treatment, MADRS scores of subjects were reduced on average by 47 percent in those given OBA compared to 21 percent in those given placebo (Mann–Whitney U, p < 0.0005). The researchers concluded that a single treatment with OBA to the corrugator and procerus muscles appears to induce a significant and sustained antidepressant effect in patients with major depression.

—J Psychiatr Res. 2014 May;52:1-6.