Profiles In Innovation: Bruce E. Katz, MD

Tell us about your first laser.

In the early 1990s when lasers first started coming out, I purchased a CO₂ laser and I quickly realized this was going to be the future. I knew this was just the beginning of a major revolution and that energy-based devices would be the way to go for our specialty and other specialties.

How did this first purchase change your practice?

We were using dermabrasion to treat acne scars and wrinkles, and it was a messy procedure. We had to freeze patients’ faces and wear helmets so the blood wouldn’t splatter, and it still got all over our surgical gowns.

How did things evolve from there?

When we started using other lasers for vascular lesions and pigments, such as the pulsed dye laser and the Q-switched Nd:YAG laser, we started to notice cosmetic benefits as well as being able to improve telangiectasias, port wine stains, angiomas, and other facial vascular lesions.

How many energy-based device trials Have you participated in or rUn over the years?

I have run 80 or 90 trials on energy-based devices over the years. I have a sixth sense about technology and can feel which will work and which won’t. I know what we need and don’t need and what has potential. Still, there is a lot of luck involved in figuring out which devices to go ahead with and develop, which is why I do the trials to see which ones have the greatest potential.

What happens after you pick a winner?

We start with a prototype and try to finesse it from there. We determine whether the applicator is too large, doesn’t give enough energy, doesn’t fit the area of the body it is adapted for or if there is a pain issue. I try new devices on family and staff first and then, if we feel it is worthwhile, we develop a potential design protocol with the company and do the study.

You were one of the pioneers of laser-assisted Lipo. Tell us about that experience.

We knew that laser was a good way to melt fat, but it also held great potential for skin tightening. Liposuction is a highly effective way to remove pockets of fat, but the patient was left with loose skin. I realized that the potential of adding a laser to liposuction was huge. I convinced Cynosure to license Smart Lipo from Deka and I did the first US FDA trials. We found that the technology precisely targets larger areas on the body, causes less bleeding, swelling and bruising, and dramatically tightens skin around the treated area. This is when I realized devices were the future of ibody contouring.

What was the next big thing?

We started to realize that we could use radiofrequency (RF) energy tor non-invasive skin tightening and also developed technologies for non-invasive fat removal including cryolipolysis, radiofrequency, and laser energy. This led to energy-based treatments for fat removal, skin tightening, and cellulite treatments.

Where are we now?

Now we have entered the fourth frontier in body contouring with the advent of muscle stimulating technology.

When BTL’s EmSculpt came to market, it was exciting as no other device targeted muscles. We realized that muscle toning was the one area we hadn’t addressed with energy and now we can. This was another revolution that has taken the industry by storm.

What’s next?

There are always new frontiers such as Endo’s collagenase clostridium histolyticum (CCH) for the treatment of cellulite in the buttocks, which is now under review by the FDA.

With all of these new devices, is surgery ever necessary?

More and more plastic surgeons are doing what dermatologists do with lasers, devices, fillers, and toxins and this has lessened the need for surgery. As people are having treatments earlier and earlier, they aren’t going to get to the point where they have severe laxity because they had these non-invasive procedures early on. The future will get less invasive and even less painful for sure.