News and Trends: January/February 2021

“New Frontiers in Cosmetic Medicine and Medical Dermatology Symposium” Turns 10

By Wendy Lewis

The 10th Annual New Frontiers in Cosmetic Medicine & Medical Dermatology Symposium (NFCMMD) went virtual in 2020, but that didn’t stop the organizers from condensing two days of the latest developments, procedures, and techniques in cosmetic and medical dermatology into a one-day format with top-tier speakers.

“I’m very proud to have watched this meeting grow and reach this milestone of 10 years. Although we couldn’t meet in person for our most recent symposium, our team worked very hard to provide an interactive educational environment with roundtable discussions, question and answer panels, and innovative live patient demonstrations. Attendees were able to access the NFCMMD virtual platform for 30 days after the conference, which added value for our sponsors,” says David J. Goldberg, MD, JD, Founding Director of NFCMMD. “We guaranteed that attendees would leave with a new skill, technique, or strategy that they could put into practice on Monday morning, and from all accounts we succeeded.”

Medical dermatology topics included new twists on treatment options for acne, psoriasis, atopic dermatitis, scars, and wounds. The live patient workshops and video demonstrations were a big draw for attendees to pick up pearls about minimally invasive treatments for facial rejuvenation combining neurotoxins, fillers, and energy-based devices.

Among the highlights of this virtual event, New York City dermatologist Bradley S. Bloom, MD educated the audience on what millennials really want and how to satisfy this emerging demographic in the aesthetics market. His lecture, entitled “Aesthetics in the Era of Millennials,” covered millennial behaviors, demands, and spending habits, with tips for providing treatments for what he referred to as “Generation Botox.”

“New Frontiers is one of my favorite meetings in dermatology that has grown in shape and stature over 10 years. Expert faculty can dive deeply into their selected topics to share indepth knowledge and experience with the audience,” says Nashville dermatologist Michael Gold, MD, whose comprehensive lecture, “Update on Fillers and Neuromodulators” covered the scope of products on the market and the next generation coming in 2021 and beyond.

Live chats were implemented for select lectures where attendees could ask questions throughout the sessions, which served as the next best thing to being there. New York Dermatologist Bruce Katz, MD presented about the emergence of PRP in dermatology and shared his experience using novel techniques for body contouring, including threads, magnets, and lasers.

Two important sessions focused on updates on cosmeceuticals were presented by New York dermatologists Kseniya Kobets, MD and Noelani Gonzalez, MD. Especially during COVID-19, when many practices were operating at a lower capacity, the ability to sell physician-dispensed skincare was a good source of revenue as many practices implemented free shipping, curbside pickup, and upped their digital marketing presence.

“This year’s virtual platform was seamless and easy to use. We will all look forward to being back ‘live’ in 2021,” says Dr. Gold. The 2021 meeting will be held in November: cosmeticfrontiers.com.

AAFPRS Survey: Plastic Surgery Zoom Boom Likeley Here to Stay

According to the 2020 statistics from the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), 70% of AAFPRS surgeons report an increase in bookings and treatments over the course of the COVID-19 pandemic, with nine out of 10 facial plastic surgeons indicating an increase of more than 10 percent.

More than 80 percent of AAFPRS members say the “Zoom effect” is a major contributing factor to this growth, while patients having more disposable income due to not spending it elsewhere is a strong second. And the uptick is expected to continue.

“We will still be looking at ourselves on Zoom in the coming years, and as more people get vaccinated and feel safer, we should see this upward trend for some time,”says Paul J. Carniol, MD, AAFPRS President andfounder of Carniol Plastic Surgery in Summit, NJ.“Unlike selfies and video editing apps like TikTok and Reels on Instagram, the video conferencing used for school, work, and ZOOMing with family and friends does not allow for filtering capabilities, making it a particularly easy lens for self-scrutiny.”

And today’s facial plastic surgery patients are choosing surgeries over minimally invasive procedures, he says. Fully three-quarters of the work done by AAFPRS members in 2020 was facial plastic surgery. Rhinoplasty (78 percent), facelifts (69 percent), eye lifts (65 percent), and neck lifts/treatments (58 percent) increased most notably in 2020.

Patients age 56 or older represent a lower percentage of patients overall in 2020, perhaps due to concerns about COVID-19, while demand in the under 30 age group remains strong, even during a pandemic, AAFPRS reports. The most common procedure among patients under 34 years old is rhinoplasty, which remains consistent from 2018 and 2019.

Patients’ top concerns regarding surgery changed a lot in the last year, with cost topping the consideration chart for the first time. Other top concerns included looking unnatural and recovery time, which was unsurprisingly down from 2019 as people worked from home and socialized less.

For the first time in years, AAFPRS members report non-surgical treatment demand decreasing in 2020. The average amount of minimally invasive procedures was down by nine percent compared to 2019, driven by a decline in skin treatments (down 29 percent) and fillers (down eight percent). Neurotoxins and Botoxremained consistent with 2019 demand.

Fillers may continue to see a dip due to reports of facial swelling in filler patients who have received COVID-19 vaccines, he says. “Our patients are all asking about this so it makes sense that the ones who are staying home are also concerned,” he says. Putting time between fillers and vaccinations makes sense for some patients, he adds. This potential side effect tends to resolve quickly when treated with antihistamines or steroids.

The annual member survey also found that many patients are still after that real-life filtered look, with 75 percent of surgeons detailing patients seeking cosmetic procedures to look better in selfies—up 33 percent overall since the AAFPRS first identified this ‘selfie awareness’ trend in 2016.

Women continue to be the most likely patients for facial plastic surgery, with neurotoxins (72 percent), fillers (61 percent), and rhinoplasty (52 percent) topping the 2020 wish list. Hair transplantation is the only procedure for which men far surpass women. While most neurotoxin/Botoxtreatments were for female patients, last year saw a 27 percent increase in AAFPRS members reporting these injectables as one of the top three treatments for male patients.

Otoplasty has the most gender equality, with 55 percent of survey participants saying the procedure is gender balanced. Coincidentally, “We’ve been hearing from a lot of patients that ears are a feature that stand out to them on video conferencing calls,” shares Dr. Carniol.

As for celebrity influence, 83 percent of surgeons indicate that everyone from A-Listers to vloggers to reality stars have a moderate-to-high level of influence on patient requests for facial plastic surgery — about the same as 2019, which saw an increase of 21 percent compared to 2016.

The 2020 AAFPRS annual member survey was conducted in December 2020 byACUPOLL Precision Research, Inc.through an online survey from a select group of the organization’s 2,200 members.

Merz and Candela Collab

Merz Aesthetics and Candela Corporation are joining forces. As part of the partnership, sales representatives from each company will now have the ability to promote products from both organizations. The companies are not formally changing their structure or formally integrating service. Each company will continue to manage their own business and teams. Those teams will be working together to make sure customer needs are met. Customers will be able to work with their existing relations for access to either portfolio.

The new commercial collaboration will start in North America with the intention to expand the combined device, injectable, and skincare portfolios globally.

Allergan Aesthetics Enters Into Option to Acquire Cypris Medical

Allergan Aesthetics, an AbbVie company, has entered into a warrant agreement with Cypris Medical, a privately held, medical device company based in Chicago.

Following the completion of a clinical trial to be initiated in 2021, Allergan Aesthetics will have the right to exercise an option to acquire Cypris Medical, including the company’s Xact device. The planned clinical trial will evaluate the safety and effectiveness of Xact in treating midface descent as well as for neck lifts.

Replacing the scalpel, Xact is designed to allow for lifting and suturing of the superficial muscular aponeurotic system (SMAS), the same tissue mobilized in a facelift, but in a minimally-invasive manner. The innovative technology intends to provide patients surgery-like results in the office with little to no downtime.

Candela Rolls Out Frax Pro

Candela’s Frax Pro system is now available. This platform features Frax 1550 and the novel Frax 1940 applicators. The Frax 1940 handpiece delivers a 1940nm wavelength laser beam for a shallow, epidermal approach, with focal reach extending to approximately 200μm in depth.The 1550nm wavelength of the Frax 1550 handpiece penetrates deeper, with histological analysis showing up to 800 μm penetration.

Clinical studies demonstrate high rates of textural improvement and patient satisfaction with the Frax 1550 and Frax 1940 handpieces.

Both the Frax 1550 and Frax 1940 technologies are also available on, and interchangeable with, the Nordlys platform. This addition makes the Nordlys system the first to provide dual fractional 1550nm and 1940nm wavelengths, as well as IPL and Nd:YAG capabilities.

Allergan Aesthetics Introduces CoolSculpting Elite

Allergan Aesthetics, an AbbVie company, is launching CoolSculptingElite, its next generation fat reduction system with applicators designed to complement the body’s natural curves.

The system will launch with a new applicator collection, which includes seven different shapes and sizes. The new C-shaped applicators are designed to complement the body’s natural curves for improved fit and comfort during initial tissue draw and features up to an 18 percent larger cooling area as compared to the previous generation CoolSculpting applicators.

CoolSculpting Elite is FDA cleared to treat visible fat bulges in nine areas of the body including the thigh, abdomen, and flank, along with bra fat, back fat, underneath the buttocks, upper arm, and the submental and submandibular areas.

Revance: ePosters Showcase Data for DaxibotulinumtoxinA and RHA Line at Maui Derm

Three ePosters presented at the Maui Derm for Dermatologists 2021 meeting feature data for daxibotulinumtoxinA for injection and the RHA Collection of hyaluronic acid based dermal fillers, both from Revance Therapeutics.

Revance reported on the posters, which present findings from the open-label Phase 2 study evaluating daxibotulinumtoxinA for injection for the simultaneous treatment of moderate to severe upper facial lines (glabellar lines, forehead lines, and lateral canthal lines), as well as data demonstrating the progressive effects of daxibotulinumtoxinA for injection on static/resting, glabellar lines with repeated treatment as a secondary analysis of data from the SAKURA Phase 3 program. Additionally, results of an in vitro study evaluating the ability of recombinant hyaluronidase to degrade the RHA Collection of hyaluronic acid based dermal fillers, alongside a number of other commercially available HA fillers will be shared.

“At Maui Derm 2021, we are excited to present positive results from our Phase 2 upper facial lines study and data from the SAKURA Phase 3 program on static glabellar lines, in addition to the first in vitro data describing the sensitivity of the RHA Collection to hyaluronidase degradation,” says Roman Rubio, Senior Vice President of Clinical Development at Revance.

Belotero Balance(+) with Lidocaine Launches

Merz Aesthetics is introducting Belotero Balance(+) with Lidocaine.

“Healthcare providers can now rely on the well-known rheological properties and performance of Belotero Balance with the time savings and consistency of a pre-mixed lidocaine formulation,” says Patrick Urban, North America President, Merz Aesthetics.

FDA Greenlights Restylane Defyne for Chin Augmentation

RestylaneDefyne is now FDA approved for the augmentation and correction of mild to moderate chin retrusion in adults over the age of 21. The hyaluronic acid (HA) dermal filler was first approved in 2016 by the FDA for mid-to-deep injection into the facial tissue for the correction of moderate to severe deep facial wrinkles and folds, such as nasolabial folds, in people older than 21.

Results of a pivotal Phase 3 clinical trial showed that 74 percent of patients experienced significantly improved chin projection for up to one year as measured by the Galderma Chin Retrusion Scale (GCRS). Positive aesthetic outcomes were demonstrated through high levels of subject satisfaction in FACE-Q and Global Aesthetic Improvement Scale (GAIS) questionnaires.

Ninety-nine percent of patients reported improvement in the appearance of their chin projection, while 96 percent of injectors said treatment improved the appearance of patients’ chin projection up to one year. Restylane Defyne had a proven safety and tolerability profile—86 percent of patients did not experience any adverse events; 96 percent of adverse events were mild, with only one moderate event of injection site pain.