Pliaglis: Wide Availability Spurring Quick Adoption

Nuvo Research and Galderma Pharma launched Pliaglis (lidocaine and tetracaine) Cream 7%/7% in Europe, recently, not long after the agent's March 2013 launch in the US.

Pliaglis is a topical local anesthetic cream that forms a pliable peel on the skin when exposed to air. It comes as “a thick toothpaste-like paste that is applied in a thick layer to areas prior to injection or laser treatments,” explains Erin Gilbert, MD, PhD. After 15-20 minutes, the dried paste can be peeled off in a single layer.

“Pliaglis is an alternative to any classical topical anesthetic used for cosmetic or medical dermatologic procedures. I find that its benefits are its consistency—it is easy to apply to focal areas—it doesn't leave a greasy film and patients find that it provides superior anesthesia,” Dr. Gilbert says, adding that she uses it for her own injections. She notes that the product can be slightly “crumbly” if removed too early. “Allow the product to dry adequately; otherwise it is hard to remove,” she advises. “I apply it with my fingers. I then remove it with a cotton tip applicator by rolling it off and I find that it comes off quite smoothly.”

Dr. Gilbert reports that the product provides excellent pain inhibition. “Pliaglis is extraordinary for use on areas where the skin is thinner or is more intensely innervated such as the tear trough or the lips. I inject my vasovagal patients in these areas and they have no problems whatsoever!”

New Book Plumbs the Conscious, Subconscious of Beauty

Exploring the intersections of beauty, culture, and business, Subliminally Exposed, a new book written by Modern Aesthetics Co-Editor Steven Dayan, MD, is now available nationwide. Based on ten years of research in the fields of neuroscience, evolutionary biology, and aesthetic medicine, Subliminally Exposed pushes beyond theory and speculation to prove that strategic and covert clues within the face and body have a tangible impact on relationships, careers, health, and potentially even happiness. “It is my belief that aesthetic physicians are sure to gain a pearl or at least be sparked to think a little bit differently about how they use their talents and skills to better meet patient demands,” says Dr. Dayan. Subliminally Exposed is available through all major bookstores and retail outlets. For more information, visit

AAFPRS Offers New Educational Features

The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) relaunched their website ( featuring a new member-benefit portal called LEARN, which stands for Lifetime Educational And Research Network. Created by the Educational and Research Foundation for the AAFPRS, LEARN is an educational portal where members can get accreditations, discover new practices, and share information, including CME courses, webinars, articles, and online case logs. The highlight of the site is CME360, which members can use to build an educational curriculum, maintain a printable transcript of completed activities, and print certificates of completion.

Quality of LiFe Improves in Patients Who Undergo Minimally Invasive Procedures

As the popularity of minimally invasive cosmetic procedures continues to rise, it is perhaps no surprise that new data suggest that quality of life for patients receiving these procedures improves in the posttreatment period. Investigators examined 40 female adult patients who voluntarily underwent selected minimally invasive procedures (filling with hyaluronic acid and botulinum toxin injection) for facial rejuvenation. They followed the patients for six months, evaluating them with the use of questionnaires, the DLQI questionnaire, the EPM/Rosenberg self-esteem scale of Rosenberg, and a pain scale. They found that minimally invasive procedures resulted in improvement in quality of life and self-esteem, which were stronger the first three months after the procedures but remained at a higher level than before treatment, even after six months. Also of note, in terms of pain, the researchers observed that hyaluronic acid with lidocaine in the formula is more comfortable for the patient, as it makes the injection less painful.
—Aesthetic Plast Surg. 2013 Jun;37(3):497-503.

Fractional CO2 Laser Treatment Found Safe, Effective in Patients with Previous Volume Treatments

For facial skin with previous volume injections, the 10,600-nm C02 laser may prove to be both safe and effective. Researchers examined 14 patients who had previous facial volume restorations—eight patients had hyaluronic acid injections prior to the laser session; two patients had fat injection; two had silicone injections, and one patient had a facial thread lift. Post-treatment analyses showed no granulomatous reactions, no facial shape deformation, and no asymmetry in any of the patients. In addition, side effects included pain during the laser treatment, post-treatment scaling, post-treatment erythema, and hyperpigmentation, which spontaneously resolved within a month. These results would suggest that fractional CO2 lasers may provide good efficacy and no additional safety risks in patients that have received various volumizing treatments.
—J Cutan Aesthet Surg. 2013 Jan;6(1):30-2.

Study Finds Low Frequency of Complications with HA Fillers

While it is important for physicians to be aware of adverse events associated with treatment with hyaluronic acid dermal fillers, new research finds that undesirable effects with HA treatment are not frequent and can be improved if treated properly. Examining HA complications within their clinic over the last three years, researchers divided the cases with complications into three categories: immediate, early, and late-onset. In total, 23 patients presented with complications after HA treatment over three years: 10 with immediate-onset complications, eight with early onset complications, and five with late onset complications. Treatment of the first group consisted of hyaluronidase injection, massage, and topical antibiotics. Early- and late-onset complications were treated with intralesional triamcinolone acetonide. The researchers noted that all patients improved, with the exception of a woman with recurrent granulomas.
—J Drugs Dermatol. 2013 Apr 1;12(4):E59-e62.