What is new in aesthetic dermatology?


Dr Davin Lim is on the  steering committee for the aesthetic section of the Australasian College of Plastic Surgeons.   The nonsurgical meeting was recently held from the 3 June 2016, to 5 June 2016, in Melbourne.    I am privileged to be part of the  steering committee for the aesthetics and laser section of the Australasian College of Plastic Surgeons.   The plastic surgeons and aesthetic dermatologists work hand in hand for the best outcomes in facial rejuvenation.      Highlights of this years 2016 meeting include the following:
1.   Patients are now seeking procedures that have minimal downtime and maximal results.    Is laser resurfacing a treatment of the past? I do not think so, not at least in Queensland.   Due to our extensive sun damage, laser resurfacing can address the skin texture and also sun spots as well as reduce pigmentation.   I do not believe that this will be replaced; however, laser resurfacing only treats one aspect of skin aging, namely skin texture.   Skin volumisation and skin tone can make the biggest difference in the perception of skin ageing given the fact that makeup can cover pigmentation.   The use of fillers for volumisation and improvement of skin tone increasing by over 40% compared to 2015.    2.   Skin tightening devices are now recognised as part of low downtime/no downtime skin rejuvenation and can help improve skin tone in selected patients.   The ideal candidate for noninvasive skin tightening are patients in the early 30s to late 40s dependent on skin laxity.   Essentially these patients are one step back from a mini face lift.   First generation machines such as thermage provide radiofrequency.   However, Dr Steve Weiner, has shown excellent results with his technique using INFINI radiofrequency for three dimensional volumisation.    Other speakers including myself believe that radiofrequency devices such as thermage and INFINI do provide good skin retraction in some individuals; however, newer devices such as high intensity focus ultrasound/Ultherapy is the way of the future.   This is due to the fact that HIFU is a much more direct focus and acute placement of energy which will also tighten up the layer called the SMAS which is just above the muscle layer.   This in turn causes contraction both of the SMAS and also the collagen layers of the skin resulting in skin tightening.   The results for selected individuals can be quite dramatic and natural.   Skin tightening should not be used in isolation and the balance of skin texture, tone and volume should always be considered for best outcomes for any individual.    3.   The future looks bright with newer fillers on the horizon.   There has been talk of combination filling techniques together with stem cell replacement.   I predicted this event would happen two years ago in a meeting in Las Vegas when I gave a talk on the future of facial aesthetics and rejuvenation.   Stem cells can be harvested from fat or PRP.   This can be combined with HA fillers which are synthetically produced.   A combination of both of these factors can then be mixed and injected into the key areas of the face resulting in revolumisation but also a change in the skin texture.   This can reduce the need for laser resurfacing and hence, downtime will be kept to a minimum (one day at most).    The world of aesthetic medicine is moving at a quick pace, newer technologies and procedures are being developed every month and specialists need to be abreast on surgical, filling and laser techniques together with cutting edge technology such as stem cell replacement for the best outcome for the patients.   The future looks bright.
Dr Davin LimBrisbane, Australia. 
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Brisbane Dermatologist