The world’s most beautiful minds gathered at The Aesthetic Society’s annual meeting to give us a glimpse into the future. What awaits? Knife-free necklifts, a shot for cellulite and more.
Facelift Lite?
Two minimally invasive technologies are aiming to deliver tighter skin without surgery. Through a series of micro-core excisions, the Cytrellis device removes 5 to 10 percent of skin on the face in a 20-minute procedure, and could earn FDA-approval by year’s end. A similar modality from Recros Medica, rotational fractional resection (RFR) drills out segments of loose submental skin with spinning “scalpets” and sucks away fat with a rotating cannula to contour the jawline. Rockville, MD dermatologist Hema Sundaram, MD, clinical investigator in the U.S. FDA study, said 99 percent of subjects were unhappy with their necks and jawlines before treatment; by 90 days post-treatment, 82 percent were satisfied with their appearance.
Muscle Bound
Last year marked the arrival of Emsculpt— and the addition of “supramaximal contractions” to our beauty lexicon. Using high-intensity focused electromagnetic energy, the BTL Aesthetics device activates muscles in a way ordinary sit-ups and squats cannot. While originally approved for strengthening the abs and glutes, new applicators for the arms, thighs and calves are rolling out. In a study of the upper arms, four treatments over two weeks delivered a measurable volume increase, notes Montclair, NJ plastic surgeon Barry DiBernardo, MD. And “by increasing biceps and triceps, lax skin filled out as well in some patients.” (The company is now debuting Emtone, which attacks cellulite with monopolar radio frequency and targeted pressure energy.) Muscling its way in, Allergan’s CoolTone received FDA-clearance in June. According to Shreveport, LA plastic surgeon Simeon Wall, Jr., MD, the magnetic stimulation it induces “may recruit more muscle cells than Emsculpt, possibly making it a stronger tool.”
Dimple Disruptor
Could the elusive cure for cellulite lie in a syringe? Presently under investigation is collagenase clostridium histolyticum (CCH), an enzyme that breaks down collagen. “By injecting it into the cellulite dimples, we can dissolve or loosen the collagen-rich fibers tethering the skin to underlying muscles, allowing dimples to float up, and creating a smoother, more level skin surface,” explains New York plastic surgeon Lawrence Bass, MD. Based on study protocol, one can expect to need three appointments, involving up to 12 shots per treatment area, spaced roughly 21 days apart. Look for CCH in dermatologist and plastic surgeons’ offices toward the end of 2020.
Red Ridder
Tranexamic acid continues to stir excitement. “We have not really seen these types of improvements from anything other than devices,” says Dr. DiBernardo, referring to results achieved by U.SK Under Skin from pharma company the NC Group. In a six-week trial, the physician-dispensed formula diminished pigmentation and redness. “Our instruments showed a marked reduction in red blood vessels; it’s very unusual to see this from a topical,” he says, adding that tranexamic acid has been proven in separate studies to decrease certain markers related to the growth of vessels.
Big Shot
Lipo has long been a prerequisite for fat injections, but Renuva may be changing the game. New York plastic surgeon Haideh Hirmand, MD describes the injectable as a “sterile and preserved matrix derived from donated fat that possesses the qualities needed to make new fat and blood vessels.” (It’s approved and regulated as a transplant tissue, not a medical device.) With no actual living fat cells in the formula, it cannot be rejected, she notes. Developed by the nonprofit tissue bank MTF Biologics, the matrix was originally studied for correcting small irregularities, like cellulite divots, but is now being explored as a potential volumizer for the face. “It shows promise as an alternative to autologous fat and hyaluronic acid fillers. I can’t say we’ve struck gold yet, but I’m very excited about Renuva,” says Dr. Hirmand. “We need bigger long-term studies to sort out its nuances for aesthetic use.”
Middle-Whittler
Irony of ironies: The fat-reduction category continues to expand. EonFR is an FDA-cleared, non-contact laser device “that preferentially heats up and kills fat cells, allowing them to be excreted over time,” explains Salt Lake City plastic surgeon Renato Saltz, MD. During the 15-minute procedure, the machine scans the topography of the patient before delivering a personalized treatment. As of press time, results of the 36-subject clinical trial were not available, but outcomes “are already equivalent to another well-known device on the market,” says Dr. Saltz, “and [may] improve with further development of the treatment protocol.”
—Medically reviewed by La Jolla, CA plastic surgeon Robert Singer, MD and Eugene, OR plastic surgeon Mark Jewell, MD
