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Trends in Aesthetic Medicine

By: Sharon McQuillan, MD
Posted: August 21, 2008, from the September 2008 issue of Skin Inc. magazine.
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Facial injectables continue to dominate the medical aesthetic treatment market. Botulinum toxin and hyaluronic acid injections were the top two nonsurgical cosmetic procedures according to the American Society for Aesthetic Plastic Surgery (ASAPS) National Data Bank Statistics. Many of the injectable manufacturers, such as Allergan and Medicis Pharmaceutical Corporation, have initiated direct-to-consumer marketing campaigns to further substantiate their market position. These include branded messages and products, such as print advertisements, television commercials and patient brochures. A recent example of these campaigns would be Allergan’s “Express Yourself” promotion featuring its product Botox Cosmetic.

There are currently two botulinum toxin Aproducts undergoing U.S. Food and Drug Administration (FDA) trials. Medicis has recently submitted a biologics license application for Reloxin, which has been rejected by the FDA due to administrative deficiencies. The company refiled biological license application in March 2008. The typical response time frame is 10 months for approval. Mentor Corporation recently announced the approval from the FDA for phase III clinical trials for its botulinum toxin product PureTox. A unique feature of PureTox is its stability and ability to be stored at room temperature. PureTox is expected to receive FDA approval in late 2009 or early 2010.

There are many hyaluronic acid fillers currently undergoing FDA trials. These include a small gel particle filler, a filler specifically designed for lip enhancement and a large particle-size gel used for facial fat loss replacement. There are a number of hyaluronians formulated with lidocaine currently under trial and other long lasting hyaluronians are under consideration, as well.

Focus on resurfacing

Aesthetic patients are becoming more focused on the texture and pigmentary issues of their skin. Laser skin resurfacing is the fifth most popular nonsurgical cosmetic procedure, according the ASAPS National Data Bank Statistics. Fractional resurfacing continues to dominate the aesthetic laser market. Fractional resurfacing involves the creation of multiple microthermal zones that affect a fractional volume of tissue. The treated areas are surrounded by viable tissue that offers epidermal stem cells for rapid recovery. This innovative concept provides resurfacing with less risk and less downtime. There are two types of fractional resurfacing: ablative resurfacing, in which multiple microthermal zones are vaporized; and nonablative resurfacing, in which microthermal zones are coagulated.

Ablative. Ablative fractional resurfacing involves the excision or vaporization of columns of tissue. The untreated viable tissue offers epidermal stem cells that provide for more rapid healing. Additionally, the reduction in tissue volume allows for tightening to occur.