Top Five Aesthetic Trends: DIY is Out and Physicians are In!

As published in SurgiStrategies, August 17, 2010
By Jeff Russell
http://www.surgistrategies.com/articles/2010/08/top-five-aesthetic-trends-diy-is-out-and-physicia.aspx

The International Association for Physicians in Aesthetic Medicine (IAPAM) has surveyed its membership, its medical advisory board, and has consulted with numerous experts in aesthetic medicine, to report on the top five aesthetic medicine treatments or trends physicians and patients are seeing in 2010. Ultimately, botox training, brilliant smiles, and embracing new technologies will spell success.

Consumers want to invest in their appearance again.  The evidence can be found in surveys, like the American Society of Plastic Surgeons’ (ASPS’s) 2010 Report of the 2009 Statistics.  The ASPS reports that, even in an economic downturn, “minimally-invasive procedures increased 1 percent, to nearly 11 million procedures in 2009, and minimally-invasive procedures are up 99 percent since 2000.  The largest contributor to the increase in procedures over the past decade has been the advent of injectable wrinkle fighters and other minimally-invasive procedures.”

“Skin is in,” says Michael McGuire, MD, ASPS president. “Chemical peels and soft tissue fillers like hyaluronic acid are up 9 percent, microdermabrasion is up 8 percent- these are the procedures that patients are opting for despite the economy.”  McGuire continues, “cosmetic surgical procedures decreased 9 percent, with more than 1.5 million procedures in 2009.”

Moreover, there have been encouraging reports from companies like Botox manufacturer, Allergan.  Allergan Inc.’s first-quarter earnings soared on climbing sales for Botox and other aesthetic products, reinforcing the message that people are ready to reach into their pockets to look better in this recovering economy.

Coupled with this market surge, physicians are finding that the recent U.S. healthcare reform bill has created huge interest in non-insurance covered medical procedures like medically supervised weight loss and minimally invasive aesthetic procedures. Doctors looking to grow their healthcare businesses are wise to consider the addition of cosmetic services, not covered by Medicare or Medicaid.  Such offerings might include aesthetic medicine treatments as well as medical weight management.

Therefore, aesthetic procedures from Botox to ultrasound fat reduction will continue to out perform surgical options in 2010.  Beverly Hills plastic surgeon, Payman Simoni, MD, agrees.  “With no light at the end of the tunnel for our troubled economy, the year 2010 features a very clear shift toward noninvasive procedures, because these procedures are lower cost, and the recovery time is much less.  People will be concerned about taking too much time off of work in an economy that isn’t synonymous with job security,” emphasizes Simoni.  Therefore, by focusing on growth treatment areas, employing proven business marketing techniques and engaging in continuing education, doctors can look forward to growing their healthcare businesses in 2010 and beyond.

Decline of DIY

The IAPAM’s Aesthetic Medicine Consumer Study surveyed women across the United States, ages 21-60, on their perception of various aesthetic medicine procedures. As an apparent reaction to the unregulated medical spa industry, 78 percent of women rated medical credentials as very important when choosing an aesthetic treatment provider. The results clearly indicate that most women are concerned about their safety when choosing aesthetic procedures, which is a huge opportunity for physicians who wish to expand their practice with aesthetic treatments.

Couple this with the recent rash of DIY debacles reported in the media, and the forecast is for more and more patients to seek out trained physicians to provide minimally-invasive procedures like: botox, dermal fillers, laser hair removal, chemical peels, medical microdermabrasion, etc.

Incidents such as with the woman in Texas, Laurie D’Alleva, who posted ill-fated videos on YouTube that described how to inject oneself, show the public that these are medical procedures, and there is no safer place to receive these treatments, than at a properly trained physician’s aesthetic practice. The Texas attorney general sued D’Alleva and her business, claiming that she marketed cosmetic enhancement devices and prescription drugs over the Internet. Injectables like these are only available via a prescription and are dangerous in the wrong hands.  That is why in 2010, physician-lead organizations like the IAPAM are increasing the spaces available to training doctors.  After completing training of the calibre of the IAPAM’s Aesthetic Medicine Symposiums and Botox Dermal Filler Bootcamps or other professional associations, doctors are positioned to offer these procedures to both their existing patient base, as well as capturing that growing portion of the anti-aging market who fear the risks associated with DIY medicine.

Cosmetic Injectables:  Still the Procedures of Choice Over the Scalpel

Theodore Corwin, MD, a widely recognized plastic surgeon from California, offers this excellent summary regarding the continued success of injectables:  “While cosmetic surgery procedures slowed significantly in 2009 and we are not seeing much change for 2010, the minimally invasive procedures like Botox and fillers, will continue at a steady pace.” Corwin continues, “In spite of the terrible economy patients seem to be able to find that few extra dollars for their Botox fix.”

Simoni builds on Corwin’s observation:  “The competitive job market may force many individuals to seek help from cosmetic surgery to look more youthful and refreshed; therein lies the popularity of injectables like Botox.”

Interestingly, while Botox is still “king,” there is more competition on the horizon.  In 2009, Dysport was approved for cosmetic use in the U.S., offering a choice to consumers interested in a botulinum toxin product.  Moreover, two more competitive products could be approved in 2010:  Purtox and Xeomin.

Corwin also adds that fillers have been very successful this year and will probably continue to be next year. “An interesting change in fillers is the amount in the syringe.  Radiesse is now available in 0.4cc, 0.8cc and 1.5cc, so patients can choose whether they want a little touch up or a big change,” Corwin adds. “Also, Juvederm says it is are going to add a local anesthetic to their filler which will make the injections a little less painful.”

Finally, fillers like the 2009 approved Sculptra, will allow doctors to perform virtually non-surgical facelifts. “More non surgical procedures using fillers will be developed so that patients have a non-surgical option for nearly every need, from rhinoplasty to breast augmentation,” says Keith Veseleny, editor of American Health and Beauty.

Medical Weight Loss Management: Key Growth Area for Physicians

Globally, the World Health Organization (WHO) estimated that 400 million people were obese, and 78 million Americans are classified as obese.  This number is projected to increase to 700 million world-wide by the year 2015. To address this universal epidemic, medical weight management will be offered by more and more physicians internationally.  People tired of yo-yo diets and special meals, are looking to physicians to assist in permanent weight loss. So doctors are in a unique position to capture this market with effective weight loss strategies, since they already have the trust of their patients.

Therefore, to address this anticipated market growth, organizations like the IAPAM are proactively offering training to doctors in medical weight management programs in 2010.  Medically supervised programs, like the IAPAM’s, include overviews of hCG program protocols and best practices; VLCD/LCD diet programs; meal replacement diet programs; ketogenic based diet programs; utilizing B6/B12 injections in weight loss; and using prescription appetite suppressants  and lipase inhibitors in weight loss (XenicalTM, MeridiaTM,etc.).

Body Shaping:  New Non-invasive Technologies Offer Tremendous Advancements

Mitchell Chasin, MD, medical director of the Reflections Center for Skin and Body, believes that the new year will see a new frontier in body shaping. From innovative new uses for ultrasound in lipolysis, to the use of cryolipolysis, patients now have a number of non-surgical options for body sculpting.

“There are a slew of cutting-edge devices on the horizon, all with the ability to bring changes to body and skin completely non-invasively. Some of these are already surfacing, like the Zeltiq device, which uses cryolipolysis (cooling of the fat cells) to remove fat cells from the body without damaging the skin, muscles or nerves,” shares Chasin. “Zeltiq is currently FDA approved for skin cooling and should soon receive clearance for fat removal. These and other devices are being used widely this year and represent a clear indication of where aesthetics is heading.  The two things my patients are most concerned with are minimal downtime and getting great results.  Devices like Zeltiq allow us to help them to make a meaningful difference in their appearance and get on with their lives quickly.”

Syneron as well as the potential new competitors, Ultrashape and Liposonix, will provide new options for those who have localized fat deposits and are looking for minor re-shaping of their body.  However, for more effective contouring, the laser-assisted lipolysis machines like the Cynosure SmartLipo, and Palomar SlimLipo and the ultrasound-based Vaser, offer the best results.  We would all like a “zero-invasive” way to re-shape the body, but the results just aren’t there yet with these completely non-invasive options (i.e. Zerona, Ultrashape, VelaShape).

Technological advancements in fat removal equipment will allow this treatment to regain its popularity. From Zeltiq and Zerona to Ultrashape and Liposonix, these new, remarkably non-invasive options will re-position body trimming as one of the more popular aesthetic medicine treatments. “Many companies recently have invested in laser liposuctions that promise a less invasive approach than the traditional liposuction.  I believe that new laser, and other technology-assisted liposuction procedures will be able to bring liposuction back to the No. 1 plastic surgery procedure spot that it once enjoyed,” adds Simoni.

Cosmetic Dentistry:  Advancements Will Capture More of the Aesthetic Medicine Market

Thomas Connelly, MD, a cosmetic dentist based in New York, sees the opportunity for dentists to capture some of the market in aesthetic medicine: “We are seeing rapid advancements in tooth whitening. Usually oxidizing agents have been suspended in glycerin and applied to tooth enamel.  The oxidizing agent, usually a form of peroxide, diffuses into the enamel from the glycerin.  With glycerin performing relatively slow, we are seeing new methods such as paints, sprays and new developments in applicators to speed up the process of getting the oxidizer into the enamel quicker,” Connelly states.

Connelly also finds that with the newer compositions of porcelain for porcelain veneers, crowns and bridges, it allows dentists to make bridges out of all porcelain enhancing the realistic appearance.  As more and more dentists perform cosmetic procedures, the level of excellence, expected by patients, and provided by the top tier of cosmetic dentists, is staggering. “Right now I am using a ceramist out of Paris, France, to stay ahead of my New York competition,” Connelly informs.

Finally, many dentists, who are trained experts in injecting, and in the jawline, neck and lower face, are beginning to offer anti-aging cosmetic injectables to their patients.  Many have used muscle paralytics like botox to offer relief to patients for Temporomandibular Joint (TMJ) Syndrome and other disorders, and dentists are medical professionals with the requisite training to offer these procedures in a clean medical facility.  Success is a matter of training, though.  Just as general practitioners must receive specialized training in administering Botox and dermal fillers, oral surgeons are positioned to offer a similar expertise if properly trained.

Conclusion

A poll of 2,227 U.S. adults released in December 2009, by Harris Interactive on behalf of RealSelf.com, found that more than half of all adults (54 percent) would choose cosmetic work if money wasn’t a concern.  To successfully capture this market, physicians are advised to focus on:  cosmetic injectables, body contouring treatments, non-invasive lipolysis technologies, and medically supervised weight loss programs, and they must ensure they are properly trained in all procedures that they offer.

Jeff Russell is the executive director of International Association for Physicians in Aesthetic Medicine (IAPAM). He can be reached at (800) 219-5108 extension 705 and at info@theiapam.com.