As 2015 comes to an end we could reflect on a year of political, economic and social upheaval or could marvel at one of the most dynamic years in the history of aesthetic medicine. Threads and all things thread-lifting have become commonplace in 2015 and have added a new dimension to our world of aesthetics. Where to from here? I have examined all the major facets of our industry and these are my predictions of what is hot and what is not for 2016:
1. Botulinum toxin:
Botulinum toxins will continue to be the number 1 seller in the aesthetic market. I predict that as the other toxins gain their FDA approval, that they start to rival Botox® (by Allergan) that has ruled the industry for the last 15 years. We will then see that different sized botulinum toxin molecules can have different results in different muscles. This will optimize the results that we currently get from using one botulinum product.
Hyaluronic acid fillers will continue to be the mainstay of tissue filling due to their safety profile and anti-oxidant action. Where Botox® works as a muscle relaxant, fillers fill up cracks and defects. However new generation collagen stimulating fillers like Sculptra, Radiesse and Elanse will make more of an impact in 2016 with better skin strengthening effects. With these we are able to do enhanced skin support that we had only previously dreamed of.
Threads have already moved from new player to major force in the aesthetics industry. They lift and support collagen in a way that botulinum toxin and Fillers will never be able to. Their real value is seen when we combine them with fillers and botulinum toxin to achieve advanced lifts in the face. Watch this space for excitement as the public starts to realize exactly how good the results can be when these products are combined together.
Mesotherapy is the technique of needling tiny aliquots of ingredients just under the skin to give a very natural rejuvenation of the skin. There is still a space for mesotherapy but it has been somewhat flattened with the excitement for what advanced needles like the dermapen can do for the skin and what blood injections like PRP can do for the skin. 6 months ago I would have said that someone needed to step up to the plate to breath new life into the world of mesotherapy. That somebody is a company called Mondial. They have developed a beautiful ‘Vital Injector Gun ‘ that sucks the skin up and injects very light filler (or whatever else you want) just into the skin with a punch of 5 tiny needles. The results are fabulous and this gun is bringing the world of fillers and mesotherapy together as one.
5. Skin peels:
Skin peels have not changed for years. We started with deep chemical peels that took a month to recover from and moved to the gentle fruit acid peels that had no downtime and gently rejuvenated the skin. Not much happened after that, but recently there has been a trend to go where we previously feared to tread. The training always used to be that if you peel the skin and then punch it full of holes with a dermaroller, make sure that you have removed all the peel first or you may get a nasty peel reaction down the holes that the needles had made. There is now a trend to place stronger peels (TCA medium depth peels) deeper into the skin by flushing them down the holes made by derma-rollers. It used to be felt that this was too much of an irritant and would cause itching and hypersensitivity underneath the skin. This fear seems to have melted away and replaced instead with an excitement that that very irritation of the skin could stimulate collagen reactions giving a stronger skin.
This does not at all mean that the less-is-more school of thinking is wrong. One of the mainstays of maintaining a healthy skin should be the rebuilding effect that we get from regular gentle skin peels.
6. Skin products:
High quality vitamin C serum in the day and a retinol cream at night is still the standard skin cream approach in the aesthetics industry. They both stimulate collagen, decrease skin cancer risk and may even stimulate new cell (fibroblast) formation in the skin. People will dress this up with the frills of hydration, SPF and hydroxy acids but these 2 vitamins given transdermally still remains the basis of skin care.
Growth factors in skin creams have been the darling of the industry for the last few years. I am not seeing any real growth in this side of the skin cream market apart from a couple of companies that are identifying specific growth factors that may help with specific collagen stimulation.
One of the more puzzling marketing angles that companies have tried to spin the public is the one about plant stem cells. For some reason they felt that giving us Swiss Apple stem cells might somehow change into human stem cells in our skin and rebuild new skin. The truth is that the best that they can do is act like anti-oxidants and protect our own stem cells (and all other cells) from damage.
For the past 15 years we have played with lasers and the different wavelengths and depths that these lasers can affect the skin. If a tad expensive they have nevertheless proven over the years to be effective skin tighteners, rejuvenators and pigment removers. However this industry seems to have stalled and there is nothing particularly new or exciting coming onto the market that hasn’t already been done before. Whether it is because the industry is moving toward more natural approaches (fat transfer, needling and PRP blood mesotherapy), or that there is a concern that the infrared heat that every laser emits damages cells, laser companies do not seem to be currently attracting investors. What the laser industry needs is a laser that tightens the skin, without damaging your cells or your pocket.
Finally, my personal favourite for 2016…
8. Fat transfer.
Taking out fat from the abdomen and putting the healthy fat back into the face or breast is a growing industry and can achieve results that other treatments only dream of. The new generation fat-removal machines make fat extraction easy and non-painful. Although you are advised to take the day off from work, this is almost becoming a lunch-time procedure. Fat that is transferred back into the skin also comes with growth factors and stem cells. After 2 months the results do not just plump up the skin but give a glow to an older skin from the transferred stem cells. Watch this procedure become much more common in the over-50 year old clients. Watch the results as this procedure is combined with threads and skin needling.
Overall I predict that 2016 will continue to move in a more natural direction with the 3 main growth areas being: gentler filler and thread combinations, needle stimulation (the Vital Injector) of growth factors and fat transfer to the face.
Have a wonderful new year,
Dr Duncan Carmichael