News + Trends

The annual meeting of the American Society for Laser Medicine and Surgery (ASLMS) is and always has been considered the premier laser medicine show in the dermatology and aesthetics space—and 2018 was no exception. All laser companies—big and small, public and private, new and legacy—were there showing off their latest toys, technologies and devices—and Star Wars has nothing on this group of innovators.

The newly re-christened Candela (“We are one company and will operate under one vision,” says new CEO Geoffrey Crouse) went all out to introduce the Vbeam Prima at a retro-modern restaurant in the trendy Design District in Dallas. The fete included a violin laser light show as well as a signature cocktail—the Vbeamtini.

The Vbeam Prima is a next-generation pulsed dye laser with 595mm and 1064nm wave lengths, contact and spray cooling, and a smart dye life management tool. All of the innovations are intended to make the device easier to use, safer, and more intuitive, and three abstracts presented at the meeting illustrate its efficacy in treating, rosacea, leg veins, and facial aging.

It's got a lot of the perks that will make it a true workhorse, says Eric Bernstein, MD, Director of Mainline Center for Laser Surgery in Ardmore, PA. Dr. Bernstein holds the distinction of being the first physician to use the new V-Beam Prima. “The new laser enables a 15mm beam-diameter, a very big spot size for a vascular laser,” says Dr. Bernstein, also the new ASLMS President.

“There's a gauge when the dye needs to be replaced, but the dye lasts so much longer, and the Prima only needs to be calibrated once a day,” he shares. “It's like the energizer bunny. The dye lasts much longer than previous laser. It will make my day a lot easier.”

BTL also came out of the gate strong with HIFEM technology to address muscle and fat including the Emsculpt for abs and buttocks and Emsella for strengthening the pelvic floor.

“This is the first time that we have actually been able to address muscle,” says Bruce E. Katz, MD, Clinical Professor Icahn School of Medicine at Mt Sinai, Director, Juva Skin & Laser Center, Director, Cosmetic Surgery & Laser Clinic Mt. Sinai Hospital in New York City. “Until now, we could tighten skin or take away fat minimally invasively or noninvasively but we have never had anything to address the muscles.”

Emsculpt treatment is akin to doing 20,000 sit-ups in 30 minutes. “When you are working out, you are not pumping fat, you are pumping muscles and as you do that, you break down fat to fuel the muscles,” he explains.

HIFEM is also helping to lift buttocks, and in the future may shape and sculpt other areas, such as the thighs.

Lumenis had a soft roll out of their Legend Pro, a tripollar radiofrequency (RF) device with RF-assisted microneedling that can resurface the upper layers of the skin and generate collagen and elastin below the skin's surface using a smart tip design for an even distribution of energy.

Paying homage to the expression, “Go big or go home,” Cutera went big for their 20 year anniversary, celebrating the occasion at the Dallas Cowboys Stadium. They also announced the global launch of the enlighten SR, a new picosecond platform for skin revitalization and the treatment of benign pigmented lesions.

Sciton unveiled a new and improved Halo Hybrid Fractional Laser with such bells and whistles as Tempo technology for even treatment; new software templates for off-face treatments; Adjustable Beam Placement technology to treat areas with distinct edges or smaller zones; and Customizable Pass Selection, which allows control of the treatment speed and energy density.

More than just lasers…

A topical that can delete or fill wrinkles as well as injectables is considered a holy grail in aesthetics—and Dyve biosciences' technology may pave the way toward such advancement. The company developed a hydrophilic molecule that gets through the skin barrier where it absorbs water and expands. It fills from the inside out to thicken the dermis, and while still in its early days, the company is looking at ways to harness the technology to treat hyperpigmentation, fat, and wrinkles.

But first the company is introducing topical lidocaine that can be delivered using their technology. Dyve Comfort (the next generation of what was previously Procicept),is an FDA-cleared topical analgesic. Melanie Palm, MD, founder of the Art of Skin MD in Solana Beach, CA, shared positive results from a blinded comparison of Dyve Comfort versus compounded lidocaine/tetracaine (23 percent/7 percent) for pain reduction during Ultherapy treatments. The Company is rolling out the product now in some very unique ways.

Another relative newbie, Pulse Biosciences also made waves at ASLMS. The company presented the first multi-center study of its Nano-Pulse Stimulation (NPS) technology for the treatment of seborrheic keratosis lesions (SKs) in humans.

The technology, delivered via micro needles, induces delayed cell death. In pre-clinical research models, this gentler method of slowly killing cells was shown to also trigger an immune response that teaches the immune system to recognize the offender, when it is reintroduced—resulting in a vaccine-like effect that prevents recurrences of new cancer cell introductions

NPS offers cellular specificity. “Unlike non-specific thermal technologies which affect everything they touch, NPS targets cellular structures and doesn't affect tissue types that don't have cells,” says Ed Ebbers, Vice President and General Manager of its dermatology products. On a histological level, the cell membrane is intact, but the nuclei disappear. “The cell is not viable, but it's not expelling its contents and triggering a severe inflammatory response,” he explains.

This cell specificity has the potential to reduce the collateral damage that can occur when treating lesions that are surrounded by less cellular dermal tissue.

“The assumption currently is that a single treatment is all we need for most common lesions, though there may be other skin targets that might benefit from multiple exposures, or where NPS might be tested as an adjunct to other therapies,” Mr. Ebbers says. “We are beginning with an NPS skin technology platform that accommodates a wide variety of spot sizes and microneedle depths for a variety of skin targets, and our scientific engineers have a vision of future forms of the technology that access difficult to reach tumor targets.”

Restylane Lyft Now FDA-Approved for Hands

The FDA has approved Restylane Lyft for use on the dorsal hands of people older than 21, making it the first hyaluronic acid (HA) injectable gel approved for this use.

Radiesse (calcium hydroxylapatite) is also approved for the correction of lost volume in hands.

“As we age, we lose volume in the back of the hands, causing the appearance of tendons, wrinkles, and veins to become more pronounced,” says Ellen Marmur, MD a board-certified dermatologist in New York City and clinical trial investigator for Restylane Lyft in the hands, in a news release. “Many of my patients start to notice their youthful-looking faces aren't matching their aging hands, and ask me what they can do about it. I am now pleased to be able to offer them Restylane Lyft.”

The FDA nod was based on a multi-center, randomized, evaluator-blinded, split-hand study investigating safety and efficacy of Restylane Lyft for use in the dorsal of the hands. Eighty-nine patients age 22 and older were enrolled in the trial. The study met its primary endpoint, showing a clinically meaningful improvement in the correction of volume deficits of treated hands for up to six months. Restylane Lyft was shown to be both safe and well-tolerated, for the correction of volume deficit in the dorsal hand. After initial treatment, injection site responses (swelling, tenderness, redness, bruising, pain, itching, impaired hand function) were predominantly mild in intensity, and temporary.

“Restylane Lyft is now the first and only dermal filler with 3 FDA-approved treatment areas—the midface/cheek area, nasolabial folds, and now the back of the hands,” says Alisa Lask, General Manager and Vice President, US Aesthetic Business Unit at Nestlé Skin Health.

Jury Still Out on Cosmetic Uses of PRP

Most studies evaluating platelet-rich plasma (PRP) injection for facial rejuvenation and other cosmetic procedures have reported positive results, but the research evidence supporting PRP for facial aesthetic procedures has important limitations—especially a lack of standardized PRP preparation and injection techniques, according to a review in the May issue of Plastic and Reconstructive Surgery.

Researchers analyzed 22 published studies of PRP for specific types of facial aesthetic procedures. Fourteen studies evaluated the use of PRP for facial rejuvenation. All studies reported positive aesthetic outcomes with PRP injection, on its own or combined with fat grafting. Reported benefits of PRP included improvements in the volume, texture, and tone of the facial skin and decreased appearance of wrinkles.

Six studies using PRP to treat androgenic alopecia reported good results in terms of hair regrowth. “Androgenic alopecia is perhaps the most convincing indication for treatment with PRP,” according to Alexes Hazen, MD, and colleagues of the Hansjörg Wyss Department of Plastic Surgery at NYU Langone Health, New York.

Another two studies found positive results with the use of PRP to treat facial acne scars.

But despite these encouraging results, the review highlights several limitations of the evidence on PRP for facial aesthetic procedures. Methods of PRP preparation and injection varied considerably; some reports provided no information on the preparation technique. The studies also lacked standardized, objective assessments of skin quality before and after PRP treatment. Other issues included a lack of control groups and follow-up to determine whether the benefits of PRP persist over time.

“More studies are needed to optimize PRP treatment techniques. Until that time, our paper may be useful in guiding clinical practice,” Dr. Hazen says. “To date, the question of whether PRP's cocktail of growth factors generates a more youthful appearance has not been definitively answered,” the researchers write. They note that PRP injection appears to be safe, with a low complication rate.

Dr. Hazen and coauthors emphasize the need for formal randomized, controlled trials of PRP of facial cosmetic procedures—including standardized preparation techniques, standard outcome measures, and longer follow-up.

New Leaders for ASAPS and ASERF

Grant Stevens, MD, FACS, a board-certified plastic surgeon in Marina del Rey, CA, is the new President of the American Society for Aesthetic Plastic Surgery (ASAPS).

A dedicated ASAPS member for 24 years, Dr. Stevens is currently on the editorial board of the Aesthetic Surgery Journal, the Aesthetic Surgery Education and Research Foundation's Board of Directors, and has served on the ASAPS Board of Directors since 2011.

Dr. Stevens plans to expand the reach of The Aesthetic Society and grow the organization. His goals include attracting more new, young members to ASAPS and attracting more female plastic surgeons as more women are becoming plastic surgeons than ever before. Part of the recruitment efforts will also include expanding ASAPS' resident education offerings, thereby increasing the number of candidates for membership. Expansion of ASAPS' body of international members will also be a focus to enhance and exchange knowledge within the global aesthetic community.

“It is a distinct honor to assume the role of president. I look forward to continuing to work with my peers, the top board-certified aesthetic plastic surgeons in the industry, to grow our membership and expand our organization's diversity on every level—gender, age, geographic locale, culture and beyond,” says Dr. Stevens.

Other newly named Aesthetic Society officers serving on ASAPS' Executive Committee include: Charles H. Thorne, MD of New York, NY as Vice President; Herluf G. Lund Jr., MD of St. Louis, MO as Vice President; William P. Adams, Jr., MD of Dallas as Treasurer; and Jennifer L. Walden, MD of Austin, TX as Secretary.

The Aesthetic Surgery Education and Research Foundation (ASERF) elected Las Vegas-based board-certified plastic surgeon Julio Garcia, MD as its new President.

ASERF is the philanthropic research and education arm of ASAPS. Its mission is to identify and pursue those issues relevant to the advancement and the safety and effectiveness of aesthetic medicine through independent, unbiased, directed research and groundbreaking education. ASERF is currently celebrating its 25th year.

As President of ASERF, Dr. Garcia will leverage 21st century technologies to produce innovative research, including bench research that will directly apply to the future capabilities within the specialty of aesthetic plastic surgery.

He plans to examine many aesthetic procedures to continue to establish improved safety parameters. Dr Garcia is going to continue working with ASERF leadership to develop mentorship programs and courses to assist individuals who have not previously conducted formal research. By enabling more aesthetic surgeons to contribute to the field, ASERF will expand its reach and continue to improve the specialty.

“It is an honor to be President of ASERF in 2018. ASERF has grown over the last 25 years as my own private practice has over 30 years, almost in lock step. The direction, education, and opportunities that ASERF now offers its members have grown considerably along with the sophistication of aesthetic surgery worldwide,” says Dr. Garcia.

James P. Hartman is Alastin's Chief Commercial Officer

James P. Hartman is the new Chief Commercial Officer of Alastin Skincare, Inc. Mr. Hartman recently served as Vice President & General Manager at Solta Medical, a division of Valeant Pharmaceuticals. Prior to Solta, he was at Merz Aesthetics where he was the Vice President and US Head of Aesthetics and OTC. Mr. Hartman also served as Vice President, Global Marketing and Business Development at Obagi Medical.

Sinclair To Market, Distribute Silhouette InstaLift in US

Silhouette Lift, Inc., a Sinclair Pharma Company, is now handling all of the commercial aspects of the Silhouette InstaLift portfolio of resorbable skin lifting sutures, including sales and marketing, and order fulfillment. They are also relaunching the Silhouette InstaLift.

In February, Thermi, an Almirall S.A. company and Sinclair Pharma mutually agreed to terminate their collaboration for the marketing of Silhouette Instalift.

Going forward, Sinclair in North America will retain the current team of Silhouette InstaLift specialists across the US while rapidly growing the sales force to service Silhouette InstaLift providers, which includes more than 1,000 who have received product and technique education.

Sciton Names New Leadership Team

Sciton has an all new leadership team:

• Aaron Burton, Chief Operating Officer
• Todd Sternbach, Vice President of Strategic Sales Initiatives
• David Percival, Vice President / General Manager of Sciton International
• Lacee Jacobson Naik, Marketing Director & Public Relations

“Coming off a record year, we believe now is the time to create new positions at Sciton in order to help drive growth, new products, leadership development and many other new initiatives,” says Jim Hobart, Sciton CEO, in a news release.

Carrie Strom is Allergan's New Senior VP, US Medical Aesthetics

Carrie Strom is Allergan's new Senior Vice President, US Medical Aesthetics, a portfolio of brands including Botox Cosmetic (onabotulinumtoxinA), Juvéderm Collection of Fillers, Natrelle collection of breast implants, Alloderm, SkinMedica, and CoolSculpting.

Ms. Strom will report to Allergan's Chief Commercial Officer, Bill Meury. She joined Allergan in 2011. Most recently she was Vice President of Marketing, Plastic Surgery and Regenerative Medicine. Ms. Strom also served as Vice President of Marketing for SkinMedica, leading the brand's digital evolution to a new e-commerce platform.

RealSelf Financing Round Raises $40 Million

RealSelf, Inc. raised $40 million in its first financing round since 2008. This brings the company's total capital raised since it was founded in 2006 to $42 million.

The round was led by Elephant, a venture capital firm focused on the consumer internet, mobile and enterprise software markets, with participation from funds managed by one of the world's leading investment management firms. Andy Hunt, Elephant co-founder, who also co-founded Warby Parker in 2010, will join the RealSelf board of directors. Hunt follows the recent appointment of Barney Harford, chief operating officer of Uber and former CEO of Orbitz. The board also includes RealSelf founder and CEO Tom Seery; Christine Petersen, CEO of TimeOut Digital; Rich Barton, founder of Expedia, Zillow and Glassdoor; Mike Slade, former Apple executive and co-founder of Second Avenue Partners.

RealSelf also announced the hiring of its first Chief Marketing Officer. Tanja Omeze most recently headed marketing for the Amazon Video store and previously led marketing at Weight Watchers, Verizon Wireless, and Scholastic.