I N T R O D U C T I O N TO A E S T H E T I C SJ U L Y 2 8 T H , 2 0 2 1

W I L L K I R B Y , D . O . , F A O C D

W I L L K I R B Y, D. O . , FA O C D• Chief Medical Officer, LaserAway

• Fellow, American Osteopathic College of Dermatology

• Clinical Assistant Professor and Cosmetic Director, Western University of Health Sciences Dermatology Residency Program

• Expert Reviewer, Osteopathic Medical Board of California, Division of Dermatology

• Editorial Advisory Board Member, Journal of Clinical and Aesthetic Dermatology

• Editorial Advisory Board Member, The Dermatologist

• Health and Beauty Reporter, Life & Style Magazine

W H Y A E S T H E T I C S ?

T H E B A S I C S

• Cosmetic Distance!

• Communication Counts!

• Patient selection is imperative!

• Realistic expectation comes from patient education!

• Patients become your advocates!

Q U A N T I F I C AT I O N O F R E S U LT S• Realistic expectations

• Minimal, Moderate, Significant results

• Most treatments work best with lifestyle modification

• Some treatments do a better ”maintaining” rather then “gaining” results

• Some treatments give prolonged results but nothing is truly permanent

HOW TO C L ASSIF Y AESTHETIC TREATM ENTS

• Clinical Indications VS. Mechanism of Action VS. Most Popular Brand Names

• Clinical Indications: Laser Hair Removal, Laser Tattoo Removal, Body Contouring, Skin Rejuvenation, Skin Revitalization, Skin Rejuvenation, Botox Injections, Lip Augmentation, Etc.

• Mechanism of Action: Laser, Radiofrequency, Ultrasound, Neuromodulator, Cryolipolysis, Etc.

• Patient Demographics: Age, Gender, Budget, Geography, Etc.

• Most Popular Brand Names: Botox Cosmetic, CoolSculpting, Thermage, Potenza, Etc.

S I X C AT E G O R I E S1) LASERS

2) SKIN REVITALIZATION/REJUVENATION

3) SKIN TIGHTENING/FIRMING

4) BODY CONTOURING

5) INJECTABLES

6) PROFESSIONAL GRADE SKINCARE

1 ) L A S E R S

• Laser Hair Removal

• Laser Tattoo Removal

üMultiple treatments

üNo Consumable

üWord of Mouth Referrals

üGraduation

L A S E R H A I R R E M O VA L

• Shaving, Waxing, Depilatory Creams, Threading

• Lasers are gold standard

• IPL vs. Diode vs. Long Pulse YAG: Nd

• Wavelength: 1064nm vs. 755nm

• Realistic Expectations

L ASER TATTO O REM OVAL• Surgery, Cryotherapy, Thermo Destruction, Acid, Dermabrasion, Salabrasion

• Laser is Gold Standard

• QS Nanometer Technology vs. Picosure Technology

• Different Ink Colors Respond to Different Wavelengths of Light

üBlack – 1064nm

üRed- 532 nm

üBlue – 694nm Ruby

üGreen – 755nm Alexandrite

• Kirby – Desai Scale

2 ) S K I N R E V I TA L I Z AT I O N / R E J U V E N AT I O N

• Mainly Work On: Tone, Texture, Color

• Multiple MOAs (Typically Laser and IPL/BBL [But Also Acid, Microdermabrasion, Microneedling, Etc.])

• No Gold standard!

• Brands Include: Clear + Brilliant, Fraxel, CO2, Icon, Etc.

• Multiple treatments are typically needed

3 ) S K I N T I G H T E N I N / F I R M I N G

• Multiple MOAs (Radiofrequency, Ultrasound, Etc.)

• No Gold Standard!

• Bulk heating of collagen

• Gain vs. Maintain

• Realistic Expectations

• Multiple treatments are typically needed

4 ) B O DY C O N TO U R I N G• Multiple Mechanism of Actions

• No Gold Standard!

• Only works with lifestyle modification (exercise, diet, etc.)

• Results tend to be minimal

• Energy based Devices: CoolSculpting, SculpSure, Emsculpt, CoolTone, Etc.

• Injectables: Kybella, Qwo, Sculptra

5 ) INJ EC TAB L ES

• Neurotoxins VS. Neuromodulators

• Fillers

• PRP

• Etc.

N E U RO M O D U L AT I O N

• Temporarily prevent communication between nerves and muscles

• Improve both kinetic (dynamic) facial wrinkles (rhytids) as well as static lines

• Very safe (pain, bruising, ptosis)

N E U RO M O D U L ATO R B R A N D Sü Botox Cosmetic (Allergan)

ü Xeomin (Merz)

ü Dysport (Galderma)

ü Jueveau (Evolus)

ü Revance -Pending

ü Hugel US – Pending

ü Others???

• Safety!

F I L L E R S

• Fillers Fill

• Volumeization vs. Restoration

üHyaluronic Acid

üSculptra – Poly-L-lactic Acid (PLLA)

üRadiesse – Calcium Hydroxylaptite (CAHA)

• Safety???

6 ) P RO F ESSIO NAL G RAD E SK INC ARE P RO D UC TS• Categories: Cleansers, serums, lotions, creams, moisturizers, ointments, etc.

• Key ingredients

• Stories

• Keep it simple: Cleanse, Protect, Repair

üCleanse: Cloths, wipes, brushes, washes, etc.

üProtect SPF: Screen VS. Block

üRepair: Retinols

P R E S C R I P T I O N G R A D E S K I N C A R E

• Retinoids

• Hydroquinone

• ???

OT H E R A E S T H E T I C T R E AT M E N T C O N S I D E R AT I O N S

• Cellulite Treatments

• Hair Growth/Restoration

• Spider Veins/Varicose Veins

• Hormone Replacement Therapy

• Medical Weight Loss

• Cosmetic Surgery

• Plastic Surgery

R E C A P O F A E S T H E T I C C AT E G O R I E S1) LASERS

2) SKIN REVITALIZATION/REJUVENATION

3) SKIN TIGHTENING/FIRMING

4) BODY CONTOURING

5) INJECTABLES

6) PROFESSIONAL GRADE SKINCARE

• Etc.

TO B E SUC C ESSF UL IN AESTHETIC S

• Know Your Patient Population!

• Mechanism of Action!

• Education!

• Realistic Expectations

• Results (Minimal, Moderate, Significant)

• MARKET, MARKET, MARKET!

T H A N K YO U !

Q & A