ISAPS: US Still Reigns As Cosmetic Surgery Capital of the World

The US, Brazil, Japan, Italy, and Mexico continue to perform the most cosmetic surgery procedures across the globe, according to 2017 statistics from the International Society of Aesthetic Plastic Surgery (ISAPS). These top five countries account for 38.4 percent of the world's cosmetic procedures, followed by Germany, Colombia and Thailand.

“It's great to see the 2017 results released to see the continued growth in plastic surgery and cosmetic procedures in many different countries around the world,” says Salt Lake City plastic surgeon Renato Saltz, MD, President of ISAPS, in a news release. “The USA still remains in lead position, followed closely by Brazil! It will be very interesting to compare this data with the 2018 results as we're seeing record numbers of patients taking advantage of the latest innovations in cosmetic surgery to look and feel their best.”

There was a four percent increase in surgical cosmetic procedures around the world within the past 12 months, while non-surgical cosmetic procedures decreased by five percent, compared with the 2016 ISAPS numbers.

Vaginal rejuvenation (including labiaplasty) showed the largest increase from 2016, followed by the lower body lift, the buttock lift, and rhinoplasty or nose-reshaping surgery, the statistics show. The most popular non-surgical procedures continue to be injectables, with Botulinum toxin ranking No. 1.

Women continue to drive the demand for cosmetic procedures, accounting for 86.4 percent, or 20,207,190 cosmetic procedures worldwide. The five most popular procedures requested by women are breast augmentation (silicone implant), liposuction, eyelid surgery, abdominoplasty, and breast lift. In 2017, men accounted for 14.4 percent of cosmetic patients (a slight increase from 2016) with 3,183,351 procedures performed worldwide. The top five cosmetic procedures requested by men are eyelid surgery, gynecomastia treatment, rhinoplasty, liposuction, and hair transplant, ISAPS reports.

The survey was sent to approximately 35,000 plastic surgeons in ISAPS' database. The results were compiled, tabulated, and analyzed by Industry Insights, an independent research firm based in Columbus, OH. Data from a total of 1,329 plastic surgeons were compiled for this survey.

FDA Green Lights Galderma's Restylane Lyft for Midface Injection Via Cannula

The FDA approved the use of Galderma's Restylane Lyft with a small, blunt-tip cannula for cheek augmentation and the correction of age-related midface contour deficiencies in patients over the age of 21.

This approval is the second cannula indication for the Restylane family of dermal fillers. Restylane Silk for lip augmentation and Restylane Lyft for the midface are the only hyaluronic acid-based fillers on the market that are FDA-approved for use via cannula.

“I am thrilled that the FDA has approved Restylane Lyft for midface via cannula. I prefer using a cannula vs. a needle when injecting specific areas of the face,” says Anne Chapas, MD, a dermatologist in New York City and clinical trial investigator for Restylane Lyft for midface injection via cannula, in a news release. “In my experience, the use of a cannula may be associated with less potential damage to blood vessels, help minimize patient bruising, help decrease swelling, and allow for minimized downtime.”

“The FDA approval of Restylane Lyft for midface via cannula marks the seventh FDA approval in aesthetics for Galderma in the past four years,” says Alisa Lask, General Manager and Vice President of the US Aesthetic Business at Galderma. “We have increased our investment in research and development this year in order to help grow the aesthetic market. Our goal is to continue to offer new solutions and delivery systems to our customers to help drive new patients in to aesthetic offices.”

A multicenter, open-label, prospective study was conducted to assess the safety and efficacy of Restylane Lyft with Lidocaine for cheek augmentation and the correction of age-related midface contour deficiencies in conjunction with the use of a small blunt tip cannula in the midface. The 16-week study took place in four centers across the US, with 60 male and female subjects 22 years of age or older. At 16 weeks after treatment, 98.3 percent of subjects showed improvement in both the right and left midface based on the treating investigator's assessment using the Global Aesthetic Improvement Scale, a global 7-point scale for aesthetic improvement in appearance.

Following treatment, no severe treatment related adverse events were observed. The majority of reported subject diary symptoms after initial treatment were tolerable (88.3 percent) and resolved within seven days, the study showed.

HintMD Adds Skincare to its Aesthetic Subscription Platform

HintMD is adding medical-grade skin care to the platform that popularized Botox subscriptions earlier this year. HintMD's patent-pending software allows physicians, such as plastic surgeons and dermatologists, to turn any treatment plan into a monthly subscription payment for their patients. By introducing skin care subscriptions, physicians can now offer professional-grade products delivered directly to the patient's door, at no cost, HintMD says. Patients can control the delivery frequency using the app, to truly personalize their aesthetic journey.

“I have over 400 patients using HintMD aesthetic subscriptions, and it has transformed my practice and the patient experience,” says Dr. A. Jay Burns, MD, FACS. “The easy subscription payment allows more of my patients to stay on track with their treatment plan and go for the full correction they are seeking.”

HintMD is launching skin care subscriptions with physician dispensed Alastin Skincare. HintMD practices will be able to offer Alastin's entire line of scientifically proven and clinically-tested skin care formulations, including their newest product, TransFORM Body Treatment with TriHex Technology. Additional medical-grade skincare brands will be available on the HintMD platform in the coming weeks.

“The HintMD platform is perfectly aligned to Alastin's corporate goals of innovation and value creation for aesthetic physicians and their practices. As the fastest growing skin care company in the US aesthetics market, we look forward to continuing our growth with the HintMD team,” says Jim Hartmen, Chief Commercial Officer, Alastin Skincare.

Founded by industry veterans, Aubrey Rankin and Vojin Kos, HintMD says it is solving a number of problems faced by the aesthetics industry, such as commoditization, patient compliance, and perceived barriers to entry by consumers.

“HintMD makes it easier for patients to access the industry's best physicians, medical-grade products, and commit to their doctor prescribed skin care regimen,” says Ms. Rankin, CEO and Co-Founder, HintMD. “This creates better outcomes and more consistent results for patients.”

PRP Reduces Visible Signs of Facial Aging

Platelet-rich plasma (PRP) reduces the signs of aging on the face, according to the first randomized study of PRP.

In the trial, 19 participants received PRP injections to one side of their face and a sham treatment with a saline solution to the other side. Six months after a single treatment, patients reported significantly improved skin texture and wrinkles on the side treated with PRP.

By contrast, expert dermatologist raters did not see significant difference, possibly due to photos not capturing textural change. The findings appear in JAMA Dermatology.

“There was change that patients who know their faces well could see clearly, even six months after the procedure,” says lead investigator Murad Alam, MD, Vice Chair and Professor of Dermatology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician in Chicago, in a news release. “But it was harder to detect for the raters who had to make determinations from photographic evidence. The fine textural change was hard to capture in the photos. The best method of assessing texture is to actually feel it.”

“This study is exciting because it shows that just one treatment of PRP does appear to improve sun-damaged skin for as long as six months, particularly by reducing unevenness and roughness in the skin,” Dr. Alam says.

Side effects of the PRP treatment were short-term and mild, including redness, swelling, and bruising. The study did have its share of limitations. Investigators did not see much improvement in brown and red skin discoloration. They also don't know if repeated treatments would magnify the anti-aging effects of the injections.

CCH Improves Appearance of Cellulite in Buttocks

Endo International plc's clostridium histolyticum (CCH) performed well in two identical Phase 3 studies for the treatment of cellulite in the buttocks.

Subjects receiving CCH showed highly statistically significant levels of improvement in the appearance of cellulite with treatment, as measured by the trial's primary endpoint (RELEASE-1, p=0.006 & RELEASE-2, p=0.002), which was at least a 2-level composite improvement in cellulite severity in the target buttock at Day 71 as compared to subjects receiving placebo.

RELEASE-1 passed eight out of eight key secondary endpoints and RELEASE-2 passed seven out of eight key secondary endpoints. CCH was well-tolerated in the actively-treated subjects with most adverse events (AEs) being mild to moderate in severity and primarily limited to the local injection area.

Fine Water Particle Sprays Improve Facial Skin Moisture

Spraying fine water particles onto the face in winter, when skin is dry, improved skin hydration and softness, according to a new study in Skin Research & Technology.

In addition, water retention remained constant at 360 minutes after spraying, the study showed.

The benefits occurred because the diameter of the sprayed fine water particles was smaller than the intercellular spaces in the skin, and the particles were non-charged. Typical steam and mist humidifiers generate larger water particles and increase indoor humidity that can promote mold growth.

The findings indicate that sprays of non-charged fine water particles may help moisten skin in low humidity environments, the study authors conclude.

High Satisfaction Rates Seen After ‘Adam's Apple' Reduction Surgery

Cosmetic surgery to reduce the appearance of the “Adam's apple” has a high patient satisfaction rate, according to a study in Plastic and Reconstructive Surgery--Global Open.

But plastic surgeons performing this procedure must balance the cosmetic results against the need for caution to prevent irreversible voice changes, according to the outcomes study by Jeffrey H. Spiegel, MD, and colleagues of Boston University Medical Center.

Their study presents a new questionnaire for use in assessing the cosmetic outcomes and quality-of-life impact of Adam's apple reduction surgery in transgender and other patients.

The researchers evaluated patient satisfaction after aesthetic chondrolaryngoplasty or “tracheal shaving.” Chondrolaryngoplasty is performed in patients who want to decrease the masculine appearance of the Adams apple. It is most often performed in transgender women as part of facial feminization surgery, but may be requested by other patients as well. Since 2006, Dr. Spiegel has performed more than 600 chondrolaryngoplasty procedures.

The procedure involves reducing the most prominent part of the thyroid cartilage. Ideally, the surgeon would completely remove the forward-projecting cartilage. However, if surgery is too aggressive, there's a risk that the larynx and vocal cords could be affected, resulting in permanent voice changes.

“This is particularly devastating in transgender females, in whom lowering the voice can be especially traumatic and a difficult handicap to overcome,” Dr. Spiegel and colleagues write. “The aesthetic results must be balanced with the goal of minimizing the risk of over-resection and voice change.”

The researchers created a seven-item questionnaire to assess physical, emotional, and social quality of life after chondrolaryngoplasty. They contacted Dr. Spiegel's first 112 patients, 45 of whom responded to the questionnaire. Sixty percent of patients indicated that they were “very” or “completely” satisfied with the appearance of their neck and Adam's apple. Thirteen percent said that they were “not at all” satisfied; 15 percent felt that the results limited their social or professional appearance.

About 55 percent of patients felt that the appearance of their neck/Adam's apple was the “best that it could be,” while only 25 percent said they were interested in further surgery. None of the patients experienced any long-term voice changes.

Dr. Spiegel and colleagues also performed an anatomical study to evaluate the potential for refining the tracheal shave technique in feminization procedures. Results suggested it might be possible to carry the incision lower so as to further reduce the prominence of the tracheal cartilage. However, at least until further research is carried out, the researchers conclude that this maneuver poses “too strong of a risk.”

Meanwhile, the new outcomes study, using a procedure-specific questionnaire, will be helpful to plastic surgeons in informing patients about the expected results of Adam's apple reduction surgery. “We can tell them that three-quarters of patients have adequate reduction in the size of the thyroid cartilage, and that the majority are very satisfied with their outcome,” Dr. Spiegel and coauthors write.

Candela, VBF Provide Laser Treatments to Families

Candela teamed up with New York City dermatologist Roy Geronemus, MD and the Vascular Birthmark Foundation (VBF) to provide 40 free laser treatments to families with all types of vascular birthmarks and anomalies, including one very special patient.

Every year, the VBF conference offers services and education to those in need. This year, the conference had more than 100 families register and not one was turned away.

Christian, a 16-month old living with his mom, Marjorie, in Utah, has a port wine stain on the right side of his face. After learning about VBF and the conference, and especially that Dr. Geronemus would not be using general anesthesia, Marjorie booked their flights to the conference. While they lovingly refer to Christian's port wine stain as his “superhero dot,” Marjorie still feels helpless and saddened from time-to-time by the reactions her son receives from strangers. After learning about the offerings from VBF and Candela, she finally felt a sense of hope.

Mother and son attended the VBF conference this year (though Christian has received 16 laser treatments to date), where he was able to receive a free Vbeam treatment. Thanks to the conference, Marjorie was able to find support on Facebook and meet other parents experiencing similar worries, concerns and thoughts about their children. She also met a doctor at the conference who will be continuing Christian's treatment in LA. Marjorie plans to take Christian back to the conference in a few years when so that he can meet other kids just like him.

Novel 1060nm Diode Laser Safe and Effective for Hair Removal

A novel 1060nm diode laser system is safe and effective for hair removal and long-term hair reduction in all skin types including darkly pigmented individuals, according to research in Lasers in Surgery and Medicine (LSM).

Sixteen patients who were treated with the chilled sapphire tip (LightSheer Infinity 1060 nm ChillTip ET) showed a mean 68 percent, 82 percent, and 76 percent skin type-independent hair reduction in axillae, shin, and arm, respectively, at 6-month follow-up visit as compared to baseline. Treatment with the large spot size vacuum-assisted handpiece (LightSheer Infinity 1060 nm High Speed) was most effective in axillae and calves, with a 77.9 percent and 78.5 percent hair count reduction, respectively, at the 6-month follow-up visit. Pain was minimal and common post procedural responses included mild to moderate erythema and/or edema.

“Large-spot lasers with suction can provide comfortable hair removal in darker skinned patients,” concludes study author E. Victor Ross, MD, CAPT MC, USN (ret), director of the Laser and Cosmetic Dermatology Center at Scripps Clinic in San Diego.

Cynosure's SculpSure Named Most Innovative Treatment at MyFaceMyBody Awards

The MyFaceMyBody Awards is the largest internationally recognized awards program recognizing and rewarding aesthetic practices and brands for their customer service excellence. SculpSure treatments are FDA-cleared, non-invasive, light-based body contouring treatments that help patients achieve a natural looking, slimmer appearance.

Sinclair Pharma: Acquisition by Huadong Medicine Company Limited Now Complete

Huadong Medicine Company Limited (HMC) has acquired Sinclair Pharma Limited, a global aesthetics company, in a deal worth approximately $222 million. Sinclair will operate as a stand-alone company under the ownership of HMC. The Sinclair management team will remain in place, with Chris Spooner continuing to serve as Chief Executive Officer.