Dermatologists share reasons for combining minimally invasive cosmetic procedures

CHICAGO — Four experienced physicians with backgrounds in cosmetic dermatology shared their tips and reasons for “cosmetic mega-combination” treatments at the American Society for Dermatolgic Surgery annual meeting.

“The mega-combination session included reports from four people who end up doing a lot of combination treatments together,” Tina S. Alster, MD, who was a session moderator along with Jean D. Carruthers, MD, told Healio.com. “Starting with the face and neck area, where we [perform filler and laser treatments] and [neurotoxin] injections, and going down the body, [with] body contouring treatments, including CoolSculpting (cryolipolysis, Zeltiq) and ultrasound and Cellfina [cellulite treatment], and body shaping with various fractional lasers and microneedling.”

Sabrina G. Fabi

Alster focused on lower body combination, Sabrina G. Fabi, MD, focused on upper body combination, while Carruthers and Rebecca Fitzgerald, MD, focused on face and neck combination treatment.

“There are multiple facets to the aging face and body,” Fabi told Healio.com. “We’re not only losing volume both bony and fat, but we’re also losing collagen at about 1% for each year of life not only at the level of the dermis, but every single place there is collagen which includes the retaining ligaments … that keeps our skin tight. So, we have to consider all those different layers when we’re rejuvenating a face.”

“So, the ideal way to truly achieve optimal results is through combination modalities, whether it’s neuromodulators, fillers and lasers and devices, ideally all on the same day but at least in a step-wise approach so we can comprehensively address the complaints that bring [ES1] in our patients to our practices and hopefully increase patient satisfaction and retention, as well.”

Physicians should perform the noninvasive treatments on the same day, or close to each other, to optimize clinical results, Alster said.

“The correct order of treatments will optimize final results,” she said.

Alster said she’s seen new approved procedures or “ingredients” being added to the aesthetics mix, including Kybella (deoxycholic acid, Kythera/Allergan), which has changed facial rejuvenation to include more than the upper portion of the face and will focus more on the lower face and the neck, and helping the neck contour. With the body sculpting, treatments such as Cellfina, a more modern version of subcision in which physicians can release cellulitic bands, is a new product to use. – by Bruce Thiel

Reference:

CS115. Cosmetic Mega-combination by the Masters. Presented at: ASDS Annual Meeting; Oct. 15-18, 2015; Chicago.

Disclosure: Alster reports speaking honoraria and receiving free or discounted equipment from Merz, receiving research grants from Cynosure and Merz and maintains ownership interest in Home Skinovations. Fabi serves as a consultant for Merz, Ulthera, Galderma and Valeant and is a member of the speakers bureau and received honoraria from Ulthera, Lumenis, Merz, Allergan, CoolSculpting, and Biopelle and received research grants from Revance, Ulthera and Kythera. Carruthers serves as consultant for and received a research grant and honoraria from Allergan, Merz, Kythera, Revance and Alphaeon and maintains an ownership interest in Kythera; Fitzgerald serves as consultant for Valeant, Galderma, Allergan, Merz and Medicis, and received speaking honoraria from Galderma, Allergan and Medicis.

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