NEWS AND ANALYSIS

RealSelf list reveals cosmetic procedures with highest patient satisfaction

Sleeve gastrectomy has been named the “most worth it” cosmetic procedure of 2020 by cosmetic treatment information resource and consumer review website RealSelf.

The website released its 2021 Most Worth It Ranking list of the top 20 highest-rated procedures last year. Sleeve gastrectomy weight-loss surgery, whereby a large portion of the stomach is removed to reduce its original size, came out on top, with 100% of patients from 63 eligible reviews saying it was “worth it”.

Breast procedures appeared most frequently on the list, accounting for eight of the surgeries in the top 20 – gynecomastia surgery, implant removal, breast reduction, breast implants, breast augmentation, Natrelle (“gummy”) breast implants, breast reconstruction and the “mommy makeover” which typically includes breast enhancement.

Other procedures in the top 20 included arm lift, FUE hair transplant, lip augmentation, lower facelift, Dysport injections, tummy tuck, septoplasty, eyelid surgery, Botox injections and facelift.

To be recognised in the top 20 a procedure had to have more than 50 reviews written between 1 January and 31 December 2020 and have earned a minimum cumulative “worth it” rating of 90% in that period.

RealSelf chief executive James Coyle commented, “During an unprecedented year, consumers relied on RealSelf more than ever to gain valuable insights they can trust, including how satisfied real patients are with their cosmetic procedure results.”

“Our annual Most Worth It list highlights the best of the best, with a straightforward look at the top-rated aesthetic procedures — based solely on Worth It Ratings from real patients.”

Jawline contouring is in while “foxy eyes” are out in 2021, says The Aesthetic Society

The Aesthetic Society has released its 2021 plastic surgery trend predictions. The US-based membership organisation, made up of more than 2,600 board-certified plastic surgeons, was unsurprisingly influenced by mask-wearing and an uptick in video calls when making its predictions.

The Society tips jawline contouring to gain popularity thanks to increased screen time leading to poor positioning of the head and neck and causing patients to become acutely aware of extra skin or fat under the chin or on the neck.

It also expects liposuction to overtake breast augmentation in 2021, influenced by decreased access to gyms and exercise facilities for those living under lockdown. For men specifically, The Aesthetic Society says subtle surgeries with high impact like blepharoplasty will be the focus, helping men look younger as masks continue to make eyes the focal point of the face. However, body contouring and liposuction will remain extremely popular with men, as many can now recover easily at home and, for those who feel a level of embarrassment about having surgery, no one need know they’ve been under the knife.

When it comes to those procedures likely to drop off in demand, the Society says that “foxy eyes” – where threads are used to lift the eyebrows and elongate the corners of the eyes to achieve an almond shape – should be phased out. As a “trendy” procedure popularised by celebrities such as Kendall Jenner and Bella Hadid, the Society says its members advise against altering facial features according to make-up trends.

New type of dermal filler ready for UK launch

A new dermal filler product made from silk fibroin lixivium has received CE approval ahead of its UK launch.

Hy-Silk, billed to be the first silk fibroin lixivium filler, is a hydrogel combined with hyaluronic acid inside a carrier of phosphate buffered saline. Silk fibroin is widely used in tissue engineering and “has the fundamentals of being highly biocompatible and negligible immunogenicity”.

In the formula, the silk fibroin lixivium and hyaluronic acid cross-link naturally under ultrasonication, negating the use of BDDE. The final Hy-Silk hydrogel is thixotropic, meaning that it reduces in viscosity when shear stress is applied to it, like when pushing through a needle or cannula, converting it to a liquid solution. Practitioners can therefore use a very thin needle to maximise patient comfort and improve tissue placement precision. The product itself comes with 34G needles.

Hy-Silk is also self-healing and therefore reforms into its original state once placed inside the tissue when shear force has stopped being applied. It is available in Light, Deep and Ultra Deep. The product lasts for between 12 and 18 months and is fully dissolvable in alkaline salt solution.

UCL to run global first MS Aesthetics programme

University College London (UCL) is to launch two new Masters courses in aesthetics this year. Becoming the first global academic institution to offer such a programme, the two new courses will launch in September 2021 and are MS Aesthetics (Aesthetic Surgery) and MS Aesthetics (Minimally-Invasive Aesthetics).

Part of UCL’s Division of Surgery and Interventional Science, the programme will be led by Professor Afshin Mosahebi and Dr Eqram Rahman. The two courses will comprise a mix of lectures, tutorials, expert forums and workshops, with a blend of online learning, self-study and intensive simulated operative skills training.

MS Aesthetics (Minimally-Invasive Aesthetics) will include principles and practice of aesthetics and research context, epigenetics and regenerative aesthetics, fundamentals of minimally-invasive facial aesthetics, minimally-invasive aesthetic practice and advanced minimally-invasive aesthetic practice. Applicants must have an undergraduate qualification (BDS) in dentistry or be an advanced nurse practitioner registered with the NMC (Nursing and Midwifery Council), or a prescribing pharmacist registered with the GPhC (General Pharmaceutical Council).

The MS Aesthetics (Aesthetic Surgery) course will cover the above in addition to advanced aesthetic surgery of the breast and torso and advanced aesthetic surgery of the head and neck. Applicants must be medical graduates with a primary medical qualification and a minimum of two years’ training in general, plastic or dermatological surgery.

The British Association of Aesthetic Plastic Surgeons (BAAPS) is lending its support to the programme, with Professor Afshin Mosahebi a council member. Past BAAPS presidents Mr Rajiv Grover and Mr Paul Harris have been involved in developing content and running the modules, while current BAAPS president Miss Mary O’Brien is the external examiner.

Professor Mosahebi said, “As this sector of medicine is outside of the NHS in the UK, its governance and standards of care have been the focus of much debate over recent years.

“In an attempt to put some rigour into this area, there is a growing push to fully legitimise this sector of medicine, with The British Association of Aesthetic Surgeons advising patients to ensure that their surgeon or practitioner is fully licensed and accredited – and they are in full support of the UCL programme.”

Antibiotic gives promising results for rosacea sub-type

Oral sarecycline, part of a class of antibiotics known as tetracycline antibiotics, is effective at treating papulopustular rosacea, found a pilot study. The study, conducted by JDR Dermatology Research and presented at the South Beach Symposium Medical Dermatology Summit in February 2021, found that oral sarecycline is efficacious in contributing to clearer skin, lessening lesion count and reducing dryness in patients with papulopustular rosacea.

In the prospective parallel group study, researchers analysed 97 patients with moderate to severe papulopustular rosacea. 72 people were randomly assigned to receive sarecycline while 25 received a control multivitamin.

Both groups experienced a reduction in IGA scores, but the sarecycline group yielded a greater IGA (Investigator Global Assessment, for clear or almost-clear skin) reduction compared with the multivitamin group (P < .0001) as well as a statistically superior total inflammatory lesion count reduction at week 12 compared with the multivitamin group (P < .0001). Further analysis showed sarecycline was well tolerated and yielded significant reductions in dryness (P = .01), peeling (P = .02), skin burning (P = .01) and pruritus (P < .001) by week 12.

“Results of this pilot study demonstrate that oral sarecycline is efficacious as early as four weeks and safe for the treatment of papulopustular rosacea in adults based on IGA assessments, total inflammatory lesion reductions, [Subject Global Assessment] outcomes and safety evaluations,” said Dr James Del Rosso and colleagues, suggesting that additional studies be conducted to further evaluate the use of oral sarecycline for rosacea treatment.

The third-generation antibiotic was FDA-approved for the treatment of acne in 2018. Read more about papulopustular rosacea in our rosacea article on pages 28-31.

Pandemic’s effect on consumer buying habits to impact beauty industry in 2021

Beauty routines that help to combat stress and value-added experiences are among the trends set to impact the global beauty and personal care industry in 2021, predicts market analyst Mintel.

According to Mintel’s Global Beauty and Personal Care Trends for 2021 Report, the coronavirus pandemic has impacted beauty consumers’ buying habits, with more behavioural drivers towards wellbeing, value, technology and surroundings.

“Brands that successfully highlight the use of beauty routines as a way to combat stress and anxiety and bring normality during uncertain times will drive long-term value for consumers,” stated the report. “Broadcasting stringent safety guidelines will help instil confidence and attract new customers seeking assurance in their desire to reconnect with retail experiences.” The analyst also said that beauty manufacturers, brands and professionals will need to educate consumers on the future of holistic wellness with self-care that touches on the mind-body-spirit connection.

As spending comes under scrutiny, product functionality and purpose will drive usage. Value will be measured in quality, convenience and impact rather than currency. In the report, the analyst said: “Brands wishing to encourage consumers to trade-up will need to redefine value beyond just cost – through the impact of purchase, as well as convenience with an emphasis on quality.

“‘Flexitarian’ behaviour will become more extreme as shoppers trade up and down across categories. Those wishing to succeed will need to tune into what really resonates with consumer groups in order to reduce customer acquisition costs and increase lifetime value,” said the report.

Bariatric surgery can lower severity of covid-19, finds research

Recent studies found a link between disproportionate fat distribution and severity of covid-19, which doubles the risk of hospitalisation and death from coronavirus.

One study carried out by the Cleveland Clinic in the US on 4,300 patients with covid-19 found that those patients who had weight-loss surgery were less likely to be hospitalised.

“More than half of our clinic’s patients have obesity-related diseases. Some of these can lead to fatal conditions, such as heart attacks or strokes, and are extremely problematic when it comes to catching and treating the coronavirus”, said professor Almantas Maleckas, a bariatric surgery expert at the Nordbariatric Clinic in Lithuania. In these cases, bariatric surgery can be a life-saving procedure, and some of our patients have already expressed gratitude for becoming more resilient in the face of the virus.

“Obesity is becoming more common around the globe. It is a delicate subject matter that requires a sensitive approach, especially when considering the raging pandemic. If every other method of weight-loss fails, surgical weight-loss procedure may be a solution that will improve the overall quality of life and prevent serious complications.”

Research paves the way for injectable skin cancer treatment

A potential new injectable treatment for skin cancer shows “exceptional promise”, according to Yale University scientists.

A team led by Dr Michael Girardi and Dr Mark Saltzman transplanted squamous cell carcinoma cells just under the skin on the backs of mice. Once the tumours had grown to approximately 5mm, they injected them with polymer-based bioadhesive nanoparticles (BNPs) carrying the chemotherapy agent camptothecin (CPT).

The BNPs bound to the tumours, remaining attached long enough to kill a significant number of cancer cells. One injection lasted a long time, so the BNPs could slowly release the chemotherapy. The mice treated with chemotherapy but without BNPs and the control mice had far less retention of the chemotherapy.

The BNP-CPT treatment significantly delayed tumour growth compared to the control groups for up to 70 days post-injection and 20% of tumours reached the “histologic cure” stage.

World’s first touchless, robotic body-contouring device nears commercialisation

Dominion Aesthetic Technologies has closed a $23m (£16.51m) Series B financing deal to accelerate the commercialisation of EON, the world’s first touchless, intelligent body-contouring device. EON is an FDA-cleared 1064nm robotic laser device used for touchless, external noninvasive lipolysis of the abdomen. As no part of the device directly touches the patient, it is unique in its class. There are no disposables or treatment applicators.

EON’s treatment head combines a laser, which heats adipose tissue to induce apoptosis, with a jet-inspired impingement cooling system that protects the skin and provides patient comfort.

The microprocessor-controlled articulated robotic arm delivers consistent applications of laser energy over the designated treatment area. EON delivers superior fat reduction results of the full abdomen in 60 minutes without the need for post-procedure massages.

NEWS IN BRIEF Merz Aesthetics UK and Ireland launches Facebook pageMerz Aesthetics UK and Ireland has launched a Facebook page, @merzaesthetics.uki, to provide a platform for customers to stay up to date with the brand. The page will announce new and upcoming events as well as the latest clinic support material. It will also publish recent articles written by Merz Innovation Partners and top tips from industry experts on social media and business support.Transform Hospital Group commits to LGBTQ+ inclusionIndependent cosmetic surgery hospital group Transform has been awarded the Pride 365 Certification to recognise its commitment to achieving LGBTQ+ inclusion in the workplace. Transform’s pledge sees the company set to launch an LGBTQ+ Ambassador Programme across each of its locations. It is also working with transgender charity Sparkle through event sponsorship and other inclusion activities in 2021.Galderma’s Restylane Defyne FDA-approved for chin augmentationGalderma’s Restylane Defyne dermal filler has been approved by the FDA for the augmentation and correction of mild to moderate chin retrusion for adults over the age of 21. Restylane Defyne is a HA dermal filler, produced using Galderma’s XpresHAn technology, which creates a smooth injectable gel that integrates into the skin for natural, dynamic movement.Harpar Grace launches Consult & ConciergeAesthetics brands distributor Harper Grace has introduced a Consult & Concierge service to its integrated e-commerce platform. Featuring e-newsletters created on behalf of practitioners and clinics, sales opportunities and order fulfilment systems, Consult & Concierge enables practitioners and clinics to use the expertise of Harpar Grace skin specialists and offer virtual consultations on their behalf. Harper Grace hopes the service will generate additional income for practitioners and clinics without the costs, time and resource required to manage sales fulfilment.Cutera invests in supportAesthetic technology manufacturer Cutera has introduced additional practice development managers to support UK customers, helping them build a strong marketing, business and clinical foundation, maximising results and profitability. “We understand the needs of our customers to have a 360-degree post-sale support and are dedicated to providing the knowledge and confidence to make their investment a success,” said Cheri Summers, senior practice development manager at Cutera UK.BMLA announces virtual conference and new executive board directorThe British Medical Laser Associations 2021 Virtual Conference is set to take place from 6-7 May 2021. The BMLA conference is a platform for the exchange of knowledge, ideas and recent advances in the field of lasers. The BMLA has also announced Kerry Belba as a new executive board director. Belba has over 15 years of experience using lasers & IPLs for aesthetic application and is the owner and company director of Laser Skin Solutions in Bournemouth.Lynton sets up internal charity donation initiativeLynton has launched a company initiative offering donations to employee-nominated charities. The successful charities were selected by the Lynton board of directors. Charities which have benefited so far include Thrombosis UK and The Autistic Society.CorrectionIn the article Healing rays in the February 2021 issue of Aesthetic Medicine, we used images of LED devices ithat were not medical-grade and featured yellow light, which is not indicated for wound healing. We apologise for this error and re-iterate that the article was a serious clinical work referring only to those medical-grade LED devices with regulatory clearance for dermal wound-healing in the UK.