Skintelligent

Dr. Zelickson Clinical Report.pdf (367.21 kb)

Three innovative non-invasive cosmetic therapies that may become available soon

The past few years have seen an explosion of new non-invasive therapies for repairing and rejuvenating the skin. More are in the pipeline—and may become available very soon.

I spoke about several of these up-and-coming therapies earlier this month in a keynote address I gave at an international meeting for dermatologists and plastic surgeons in Madrid, Spain. I began by talking about two companies that are working on alternative methods to reduce facial lines around the eyes and forehead.

One company, Revance Therapeutics, is developing a process that will change the way botulinum toxin (BT) medications like Botox and Dysport are delivered. They’ve found a way to dose medications through the skin—in other words, without injections. Early studies have shown excellent reduction in the lines around the eyes with a simple topical application of BT lasting several months. Ongoing research is being done to determine the duration of this effect.

Myoscience is the second company looking for a way to get the “Botox effect” without Botox. They’re using cryotherapy, or cold, to temporarily reduce the nerves that contract the muscles that cause wrinkles in the forehead and around the eyes. No drugs. They’re into their clinical trials, and have shown an immediate positive effect after a single treatment lasting for several months. 

While both of these therapies show excellent initial results, it may be several months before either treatment receives FDA approval.

I also spoke in my keynote address about the efforts of Kythera to reduce small pockets of fat, especially fat in the double chin. Kythera has been working on standardizing a method wherein a fat-dissolving agent is injected directly into the fat of the double chin. They’ve shown excellent results with a series of four monthly injections. Look for this, too, to be approved within the next few years. 

Ulthera: A Great New Non-Surgical Option for Tightening Skin 

More and more people are opting for minimally invasive skin treatments rather than face-lifts and other full-blown surgical procedures. 

As the Wall Street Journal reported earlier this fall, “a widening array of minimally invasive treatments are making facial work more accessible to many people, and becoming part of their regular upkeep.” 

One of the latest of these popular procedures is Ulthera, which uses ultrasound technology to tighten and lift the skin, particularly the brow. It works by delivering focused amounts of low-level heat into the dermis (the underlying layer of skin tissue), causing the skin to contract and, over time, new collagen to form. And it does this without damaging the epidermis, or the outer layer of skin.

I’ve been impressed with the device’s results. I was involved in its early clinical trials, and was the first physician in the Upper Midwest to offer it to patients when it received the U.S. Food and Drug Administration’s approval last fall.

Those trials, by the way, found that 89 percent of patients treated with Ulthera experienced a noticeable lifting, firming and tightening of their skin. Furthermore, the improved appearance was found to last an average of 10 to 12 months.

Although safe (side effects are minimal—mostly some temporary redness and swelling), the Ulthera procedure itself can be discomforting, which is why you want to make sure you receive the treatment by someone trained and experienced in its use. At Zel Skin & Laser Specialists, we have developed a careful treatment protocol to ensure our patients are comfortable with the procedure as well as with its results.

Zeltiq Can Be a Great Bulge Contouring Option

It’s been almost a year now since I became the first physician in the United States to use the Zeltiq system outside of clinical trials to reduce unwanted pockets of body fat. (I had previously participated in the device’s clinical trials.)

I remain impressed with this non-invasive technology.

Developed by a respected team of Harvard Medical School dermatologists, Zeltiq cools fat cells in a controlled way, a process that then causes them to break down. Gradually, the cells are eliminated from the body through natural processes.

The typical treatment takes about an hour, and requires no anesthesia. Nor is there any recovery time. Side effects are minimal, and mostly involve some skin redness and minor bruising (from the suction device used during the procedure).

Of course, not everyone is the right candidate for this kind of fat reduction treatment. Zeltiq is for people who are at their ideal weight and toned, but who can’t seem to get rid of isolated pockets of fat (such as “love handles”). Because this fat-reduction solution is not for everyone, it’s important that you have a thorough evaluation and consultation with your physician before starting treatment. Ask about all your options.

You should also be aware that although the U.S. Food and Drug Administration has approved Zeltiq for other medical uses, the agency has not yet endorsed it as a way of losing fat. The device is used for that purpose in Europe, however. Using Zeltiq “off label” is legal in the United States (I wouldn’t be offering it if it wasn’t), but doing so requires some wise judgments from the treating physician. Again, seek care from someone who’s experienced in using the technology.

One final thing: The similarity between the device’s name and my last name is purely coincidental. I have no proprietary interest in the device. Still, given the similarity, I’m glad the device is one that I’ve found to be effective.

H.N.,

Thank you for your questions. Lipodissolve is not like liposuction. Liposuction is a surgical procedure that actually removes fat through a suction cannula that is inserted into the fat. Lipodissolve is preformed by injecting chemicals that "dissolve" the fat and leaving the chemically altered fat in the body to be resorbed.

The Zeltiq procedure in a non-invasive treatment which uses cold to alter the fat. Fat is more susceptible to cold then the skin so that when exposed to very well controlled temperatures a portion of the fat cells treated will be resorbed. This treatment is not a substitute for liposuction but is good for reducing small bulges of fat. It is FDA cleared for skin cooling and used off label for fat reduction.

Best,

Dr. B. Zelickson

In response to an article released by the FDA (posted on our fb Wall) warning about the dangers of lipodissolve, I'd like to state that Zel has never performed this therapy. We have always been concerned about serious complications. We understand that there are always risks to all the procedures we perform; yet with so little data on lipodissolve, in my opinion, the benefits do not yet outweigh the risks.

The FDA states that it has had multiple adverse incident reports from clients of medispas in Indiana, Pennsylvania, Florida, Minnesota, Idaho, and Maryland who underwent fat melting injections. This procedure is not FDA approved and can lead to infections and hard tender lumps under that skin.

In light of those reports, the FDA has sent warning letters to those medispas to stop their advertising claims that this therapy is safe and effective as there is no scientific data to support these statements.

Dr. Brian Zelickson