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1 D iscover the Secret Makeover page 3 Regenerative Aesthetics THE Aesthetic Show 2017 Aesthetic Practice Survey Results January/February 2017 Circulation 25,000

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3 Discover Thermi s Secret Makeover By Jeffrey Frentzen, Executive Editor Combination treatment protocols and multifunctional modalities have become standard in aesthetic medicine. Playing off this wellestablished concept, some inventive physicians have modernized the classic Mommy Makeover, by pairing radiofrequency (RF)- based aesthetic platforms from Thermi LLC, an Almirall Company (Dallas, Texas), with popular lifting sutures to create the Secret Makeover, a comprehensive non-surgical treatment regimen that yields effective facial and body rejuvenation with little or no downtime. According to market research published by Medical Insight, Inc. (Aliso Viejo, Calif.), the global market for all body shaping and skin tightening device platforms and disposables was estimated at over $1.3 billion in Through 2020, the overall market will expand by 16.3% per year, driven by rising consumer interest in these procedures. Among the many energy-based aesthetic systems on the market, only a few can be labeled truly multifunctional platforms, delivering many modalities via a single system. Plug and play handpieces can treat a variety of non-surgical indications while touting patient comfort and reduced downtime. Thermi devices provide very specific and controlled heating of tissue that can be personalized for each patient, allowing physicians to deliver consistent, reliable results with pinpoint technical accuracy. Selectively targeting loose tissue and fat pockets results in controlled tissue reduction and collagen remodeling. Product families include ThermiRF and Thermi250, with associated handpieces that can be applied on practically every area of the body. For instance, the ThermiSmooth Face and Body applications are designed for controlled non-invasive tissue heating, as well as temporary reduction in the appearance of cellulite; ThermiVa offers minimally-invasive electrocoagulation; and ThermiTight applications target subdermal tissue remodeling. We have a lot of aesthetic devices, but I can treat almost all areas of the body with this one little ThermiRF platform system, stated Barry DiBernardo, M.D., F.A.C.S., clinical associate professor of plastic surgery at the University of Medicine and Dentistry New Jersey in Newark, N.J. It performs well and does a lot for the body and skin. When Michelle Eagan, M.D., a plastic surgeon in San Francisco, Calif., realized that more patients were seeking non-surgical procedures over surgery, she researched many energy-based technologies before deciding on Thermi. While all of the different systems can do similar things, it really came down to the post-procedure results, she expressed. I noticed a big difference when using ThermiTight. Patients receive wonderful results with little or no visible scars and treatments only take one session. It heats up the dermis and causes cellular changes to stimulate fibroblasts, which produces more collagen and tightening over the course of a year; as long as 15 months in some cases, which is amazing. Barry DiBernardo, M.D., F.A.C.S. Clinical Associate Professor of Plastic Surgery University of Medicine and Dentistry New Jersey Newark, NJ Mitchel P. Goldman, M.D. Medical Director Cosmetic Laser Dermatology Associates San Diego, CA Sabrina Fabi, M.D. Cosmetic Dermatologist San Diego, CA David J. Goldberg, M.D., J.D. Cosmetic Dermatologist Montclair, NJ Michelle Eagan, M.D. Plastic Surgeon San Francisco, CA Brian Kinney, M.D. Plastic Surgeon Medical Advisor Thermi, LLC Beverly Hills, CA Susan H. Weinkle, M.D. Dermatologist Bradenton, FL Julius W. Few, M.D. Plastic Surgeon Chicago, IL THE Aesthetic Guide January/February

4 January/February 2017 Volume 20 Number 1 Features 46 Aesthetic Practice Survey Results 58 Regenerative Aesthetics AAD Product Showcase 80 THE Aesthetic Show 2017 Preview 94 Industry Leader Roundtable Comparison Charts Emerging Technologies 108 Hair Removal 110 Dermal Fillers 112 Vascular Technologies 114 Skin Rejuvenation Acne Tx Devices 118 Physician-Dispensed Topicals 120 Body Shaping Technologies 121 Fractional Technologies 94 Directory 104 Aesthetic Company Directory 4 THE Aesthetic Guide January/February

5 Advertisers Index Advice Media 83 Aesthetic & Medical Dermatology Symposia 111 THE Aesthetic Show , Aesthetic TV ALASTIN Skincare 91 AQ Skin Solutions 43 Ascentium Capital 93 Bellus Medical 85 Biopelle 67 BTL Industries 35 Canfield Scientific 17 THE Certified Aesthetic Consultant Collagen P.I.N. 77 COSMED Dermaceuticals 99 Crystal Clear Digital Marketing 65 DefenAge 79 Eclipse Aesthetics 75 Epionce 63 FotoFinder Systems 97 Fotona 132 Gateway Aesthetic Institute 41 IMCAS 29 InMode 73 Laservision USA 45 Lumenis 131 Contact Information Maui Derm 103 Music City Scale (TSLMS) 107 NewSurg 87 NKP Medical Marketing 101 Oxygenetix 61 Michael Moretti Editor-in-Chief / Group Publisher Leah Morvant Publisher Medical Insight 130 Vantis, Suite 240 Aliso Viejo, California PerfAction Technologies 39 Perigee Medical 23, 25 Quanta Aesthetic Lasers 53 Rohrer Aesthetics 89 Sciton 51 Sesderma USA 55 Solta Medical, a division of Valeant 13 Pharmaceuticals North America Suneva 15 Syneron Candela 2 Thermi, an Almirall Company 11, 49 Jeffrey Frentzen Executive Editor Editorial Staff Erin Velardo Senior Editor Telephone: (949) Facsimile: (949) Subscriptions: Viveve 27 Zimmer MedizinSystems 37 Inserts: Misti Barnes Contributing Editor William T. Kelley Senior Editor, International Anthony J. Varro Contributing Editor Kevin A. Wilson Contributing Editor Advertising Inquiries: THE Aesthetic Show 2017 Aesthetics BioMedical Fotona Galderma Supplement Suneva Supplement Correction of errors: Medical Insight assumes no liability for the information contained in this publication. Every effort has been taken to ensure the accuracy of this information by contacting sources believed to be reliable. Errors, when discovered, will be promptly corrected. Copyright: This publication is protected by U.S. Copyright Law; 2017 Medical Insight Unauthorized reproduction is strictly forbidden by law, the penalty for violation is $100,000 per occurance. THE Aesthetic Guide is a trademark of Medical Insight. THE Aesthetic Guide January/February

6 For Mitchel P. Goldman, M.D., medical director of Cosmetic Laser Dermatology Associates (San Diego, Calif.), the key question during patient consultations is, Which device is best for the patient? Although there s no single device that is good for everyone, the one device that provides the highest patient efficacy is ThermiRF, which offers ThermiTight, he stated. Keep in mind, it is a little bit more invasive than other procedures, but it is virtually painless due to a local infiltration where we employ lidocaine. ThermiRF applications achieve the highest patient satisfaction and offer top efficacy within my practice. In addition, by utilizing Thermi devices physicians can artfully combine applications for maximum results without having to resort to surgery, stated Brian Kinney, M.D., a plastic surgeon in Beverly Hills, Calif., and medical advisor at Thermi. Clever providers are discovering new and innovative ways to use Thermi devices, he said. Much of that is coming from physicians that are combining modalities and therapies for synergistic effects. For instance, there is the newly created, minimally invasive ThermiBreast procedure, which uses ThermiTight to treat laxity, in addition to ThermiVa, which provides minimally invasive electrocoagulation. For the face and neck, a lifting suture that has become very popular in Europe, Silhouette InstaLift, is now being bundled with ThermiTight, which gives physicians the ability to add volume or perform a midface suspension lift to fixate the subdermal cheek tissues in an elevated position. This potent mix of energy-based applications and minimally invasive suturing provides physicians with the tools needed to non-surgically rejuvenate the face and full body in a treatment protocol coined, Secret Makeover. Dr. DiBernardo has seen consistent and positive results using the new ThermiBreast procedure, the concept of which originated from his experience with Thermi devices, as well as what he was hearing from his patients. When I would tell women about a surgical breast lift and the accompanying scars and downtime, many of them didn t want to move forward, he shared. Also, I had looked at photos of some patients in which there was an attempt to lift the upper portion of the breast. I refined this approach further and utilized ThermiTight around the entire breast circumferentially. If you go around the whole breast, you re not actually getting a lift, Dr. DiBernardo explained. As women get older and as the breast begins to fall it becomes squarer. When you tighten, the breast becomes more round again, like a youthful breast. And even though ThermiBreast is non-surgical, in some patients the skin is so tight post-procedure that it actually does look like a surgical result. As Dr. Eagan reported, This procedure truly produces a breast lift with no visible scars. It tightens up the skin around the breast, and if you tighten up the entire skin envelope the breast tissue can look even more firm and uplifted. Depending on the quality of skin and the tissue response to the RF heating, ThermiBreast can lift up to two to five centimeters. Before and after ThermiTight Tx Photos courtesy of Brian Kinney, M.D. Before and one month after ThermiBreast Tx Photos courtesy of Barry DiBernardo, M.D., F.A.C.S. 6 THE Aesthetic Guide January/February

7 Before and six days after one ThermiTight Tx Photos courtesy of Barry DiBernardo, M.D., F.A.C.S. Before and six days after one ThermiTight Tx Photos courtesy of Barry DiBernardo, M.D., F.A.C.S. Patient selection is critical, cautioned Dr. DiBernardo. Don t take every patient with breast ptosis and say you re going to use ThermiBreast on them, he warned. If they have significant laxity then they may need a mastopexy. Make sure to categorize your patients because some of them may need surgery. If someone walks in and their breast is down to their navel, then the ThermiBreast application is not for them. However, we have 30 year-old patients that want to do a breast augmentation. They don t have enough hanging to do a full lift, but they have been good candidates for ThermiBreast. The ideal candidates are women with a large A, B or small C cup size, stated Dr. Eagan. They should have had some laxity and deflation, which is natural with aging or having one or two children after breastfeeding or pregnancy. The breast will deflate after it s been stretched a little bit. If it just needs a few centimeters lift, then they are the perfect candidates. Other potential patients are those who have stated they don t want implants, Dr. Eagan added, But want a little bit more of a natural lift. They keep looking in the mirror and lifting up their areola one or two centimeters saying, I wish they were right here. Those are really good candidates for ThermiBreast. Of course some people are not right for this procedure, stated Dr. Eagan. If someone has really hard, large breasts or really heavy breasts, then I would say it is not for them. If they have Grade 3 ptosis with their nipples pointing down to the floor then I suggest a surgical incision of the excess tissue and even possibly an implant or some other augmentation, she expressed. In addition to performing the ThermiBreast procedure, ThermiTight can also be used in the neck area as part of Thermi s broader Secret Makeover regimen. I choose ThermiTight when I treat a neck that not only has a little bit of skin laxity, but also a bit of subcutaneous fat that the patient wants to get rid of, stated Sabrina Fabi, M.D., a cosmetic dermatologist in San Diego, Calif. We know that with heat, if you expose fat to temperatures of around 50 C for a good minute, you can destroy some fat. Also, I might combine ThermiTight with a little bit of liposuction if I want to obtain some skin tightening. Dr. Goldman concurred, adding that he has had good success with ThermiTight. It destroys the fat at the same time. Incidentally, men tend to respond very well to ThermiTight neck treatments. In addition, Dr. Goldman noted, Usually, we combine ThermiTight of the neck with other technologies or modalities, especially on the face and neck. We achieve the best results when we use multiple modalities. There are always some patients that THE Aesthetic Guide January/February

8 come in wanting treatment X, and we give them what they want, but combination treatments to achieve the best results really is additive. In another example, Dr. Fabi pointed out, Most people that present with some level of skin laxity, at least in sunny states, often have skin damage or superficial skin changes. In these cases I combine ThermiTight with an intense pulsed light treatment to address redness and also use fractionated CO 2 to address the superficial textural changes and the crepiness in the skin that some people experience. Patient satisfaction will be greater with any combination approach versus a single modality, Dr. Fabi maintained. You have to tailor your approach. Patients don t know what they don t know. They want to look better, but they don t recognize that one device can only address one specific thing. So when you re able to tailor a treatment plan based on the anatomy that presents to you, then you can absolutely achieve better results if you re using multiple approaches rather than relying on one modality. Staying with multifunctional solutions, Thermi s recently added Silhouette sutures create volume in the mid-face and help to enhance the results from ThermiTight. These sutures offer a procedure that can mechanically lift tissue in order to restore a patient s natural facial contour, as well as stimulate collagen production. During this minimally invasive treatment, the bidirectional absorbable cones elevate and support tissue in the mid-face. The sutures are used in multiple pairs intended specifically for cosmetic lifting and repositioning of facial tissue, while also improving volume in the cheek dermis by compressing soft tissue in multiple axes. Utilizing polylactic-co-glycolic acid (PLGA) biodegradable medical sutures and bidirectional cones, this technology yields a cosmetic lifting effect. The cones serve as a strong anchor to lift the tissue, while the absorbable sutures provide a controlled, sustained delivery system of substances over time. The device becomes fully encapsulated in collagen, which enhances the procedure s outcome. According to Susan H. Weinkle, M.D., a dermatologist in Bradenton, Fla., The polylactic acid cone can attach to the retaining ligaments in the face. Once you place the suture then you actually pull on it and you feel the cones engage, she stated. Those retaining ligaments and the polylactic acid cones really catch, so you can help to redrape the tissue. Patients may observe some lifting immediately, but the full effect of the threads takes some time. The polylactic acid remains in place along the suture and actually stimulates the fibroblasts and collagenesis, so that you get some continued improvement over the following six to eight weeks, Dr. Weinkle stated. The combination of Thermi applications and sutures produces an excellent synergistic effect on the face and neck, expressed David J. Goldberg, M.D., J.D., a cosmetic dermatologist based in Montclair, N.J. It is not the same degree of tightening as a Before and after ThermiTight Tx Photos courtesy of David J. Goldberg, M.D., J.D. Knees before and after ThermiSmooth Body Tx Photos courtesy of Brian Kinney, M.D. 8 THE Aesthetic Guide January/February

9 Before and after ThermiSmooth Body Tx Photos courtesy of David J. Goldberg, M.D., J.D. Cellulite before and after three ThermiSmooth Body Treatments Photos courtesy of Barry DiBernardo, M.D., F.A.C.S. face-lift, but we achieve terrific facial / neck sculpturing in a one hour procedure. Cheeks and the neck benefit the most from this combination treatment, Dr. Goldberg noted. Though fatter cheeks and very thinned skin individuals can be particularly challenging, overall efficacy is very good. I ve observed the best outcomes in 40 to 50 year-old women with dropped mid-cheek fat pads, deep nasolabial folds, submental fat and neck skin laxity. In my 20 years experience of using a wide variety of different threading techniques, this is the best one that we ve ever used. In all cases, the procedure is a home run with patients. They are extremely satisfied. In addition to Silhouette sutures for facial volume and to augment ThermiTight s results, practitioners also use ThermiSmooth Body to contour the rest of the body as part of the comprehensive Secret Makeover treatment regimen. Powered by the company s Thermi250 multi-use aesthetic platform, ThermiSmooth Body delivers monopolar and bipolar RF energy depending on the handpiece being used. One of the key differences with this system is the lower frequency that allows for deeper penetration of RF-based energy, as well as improved operator control. According to Dr. Kinney, You can achieve higher temperatures at deep levels, but you can do it without having to deal with the same challenges presented by other systems. There are many devices on the market that do not have temperature control, for instance. Or, because temperature is controlled by how fast you move the handpiece, you can get hot spots, which are painful for the patient. With ThermiSmooth Body, you get more consistent treatments and results. Like ThermiTight, ThermiSmooth Body delivers high temperatures over short periods of time, Which helps the body resorb fat and tighten collagen, Dr. Kinney added. You can target spots with comfort and more predictability than with previous techniques. Unlike many other energy-based devices, you do not have to buy custom, disposable handpieces that can be expensive. Some practitioners are actively evaluating Thermi s new Secret Makeover procedure. One such physician, Julius W. Few, M.D., a plastic surgeon in Chicago, Ill., is a veteran user of the Silhouette sutures. Now that they are bundled under the Thermi banner he is looking to bring Thermi s aesthetic devices into his practice as well. I see the addition of these systems working in two scenarios, Dr. Few said. One, in which patients have some excessive fat under the chin that we would break down, with the dual benefit of tightening. The other scenario would be with the patient who is more or less a borderline surgical candidate, but who will not have surgery. They can handle someone placing a small heated probe under the skin, but they don t want anyone making a formal incision. If they want more of a surgical result, then that is where Thermi comes in. We would use Thermi for the tightening and then immediately, within the same session, apply the lifting sutures in the face. These solutions working together take the artistry involved to a whole new level. Referring to the potential for increased artistry leading to improved outcomes, in Dr. Kinney s opinion, utilizing Thermi s tools, Is like handing someone paint, brushes and a canvas, and enabling them to create many options on that canvas, such as the Secret Makeover, in which one can artfully combine Thermi s range of non-surgical applications for maximum results without having to resort to surgery. As Dr. Weinkle concluded, I think that these tools present a very new, exciting addition to our practice, to help us deal more effectively than ever with skin and body rejuvenation. THE Aesthetic Guide January/February

10 SCIENTIFIC ADVISORY BOARD Maurice Adatto, M.D. Medical Director Skinpulse Dermatology & Laser Center Geneva, Switzerland Daniel Cassuto, M.D. Professor of Plastic Surgery University of Catania Catania, Italy Doris J. Day, M.D. Clinical Assistant Professor of Dermatology NYU Langone Medical Center Director Day Dermatology and Aesthetics New York, NY, USA Macrene Alexiades-Armenakas, M.D., Ph.D., F.A.A.D. Assistant Clinical Professor Yale University School of Medicine New Haven, CT, USA Director Dermatology and Laser Surgery New York, NY, USA Henry Chan, M.D., Ph.D., M.B.B.S., F.R.C.P., F.H.K.C.P., F.H.K.A.M. Dermatologist Honorary Professor Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong, China Koenraad De Boulle, M.D. Director Aalst Dermatology Group Aalst, Belgium Red M. Alinsod, M.D., F.A.C.O.G., A.C.G.E. Urogynecologist and Pelvic Reconstructive Surgeon Laguna Beach, CA, USA Gregory W. Chernoff, M.D., F.R.C.S. Plastic Surgeon Medical Director Chernoff Cosmetic Surgery Indianapolis, IN and Santa Rosa, CA, USA Jason B. Diamond, M.D., F.A.C.S. Diplomate American Board of Facial Plastic and Reconstructive Surgery Los Angeles, CA, USA Tina Alster, M.D. Washington Institute of Dermatologic Laser Surgery Washington, D.C., USA Suneel Chilukuri, M.D., F.A.A.D., F.A.C.M.S. Cosmetic and Dermatologic Surgeon Houston, TX, USA Barry DiBernardo, M.D., F.A.C.S. New Jersey Plastic Surgery Montclair, NJ, USA Benjamin Ascher, M.D. Plastic Surgeon Clinique IENA Lecturer and Clinical Assistant Paris Academy Paris, France Hong-Kyu Cho, M.D. Plastic Surgeon NB Plastic Surgery Clinic Seoul, Korea Christine Dierickx, M.D. Medical Director Skinperium Boom, Belgium Peter Bjerring, M.D., Ph.D. Professor of Dermatology Aarhus University Hospital Vejle, Denmark Joon-Yong Choi, M.D. Chief Plastic Surgeon Dream Plastic Surgery Group Seoul, Korea Jason Emer, M.D. Board Certified Dermatologist Spalding Drive Plastic Surgery Beverly Hills, CA, USA Kevin Brenner, M.D., F.A.C.S. Board Certified Plastic and Reconstructive Surgeon ROX Center Beverly Hills, CA, USA Steven R. Cohen, M.D., F.A.C.S. Medical Director FACES+ Plastic Surgery Skin and Laser Center Clinical Professor of Plastic Surgery University of California, San Diego La Jolla, CA, USA Sabrina Fabi, M.D. Board Certified Dermatologist Goldman, Butterwick, Fitzpatrick, Groff & Fabi Cosmetic Laser Dermatology San Diego, CA, USA Gregory Buford, M.D., F.A.C.S. Board Certified Plastic Surgeon Beauty by Buford Englewood, CO, USA Angelo Cuzalina, M.D., D.D.S. Past President American Academy of Cosmetic Surgery, 2011 Diplomate American Board of Cosmetic Surgery Tulsa, OK, USA Klaus Fritz, M.D. Director, Dermatology and Laser Centers Landau, Germany Associate Professor Carol Davila University of Medicine and Pharmacy Bucharest, Romania President, European Society of Laser Dermatology 10 THE Aesthetic Guide January/February

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12 SCIENTIFIC ADVISORY BOARD Takahiro Fujimoto, M.D., Ph.D. Medical Director Clinic F Laser and Skin Centre Tokyo, Japan Pearl E. Grimes, M.D. Director Vitiligo and Pigmentation Institute VPI Cosmetic Center Los Angeles, CA, USA Chang-Hun Huh, M.D., Ph.D. Clinical Assistant Professor Department of Dermatology Seoul National University Budang Hospital Gyeonggi, Korea Ma. Teresita G. Gabriel, M.D., F.P.D.S. Chair Department of Dermatology Research Institute for Tropical Medicine Alabang, Muntinlupa City, Philippines Sanjay Grover, M.D., F.A.C.S. Diplomate American Board of Plastic Surgery Newport Beach, CA, USA Christopher Inglefield, B.Sc., M.B.B.S., F.R.C.S.(Plast) Medical Director London Bridge Plastic Surgery & Aesthetic Clinic London, UK Dore J. Gilbert, M.D. Dermatologist Newport Dermatology & Laser Associates Newport Beach, CA, USA Ka-lam Hau, M.B.Ch.B., M.R.C.P., F.H.K.A.M., F.H.K.C.P., D.C.H. Dermatology Specialist Hong Kong SAR, China Garo Kassabian, M.D., F.A.C.S. Dual Board Certified Plastic and General Surgeon Founder and Medical Director Lift MD Aesthetics Beverly Hills, CA, USA Chee-Leok Goh, M.D., M.B.B.S., M.Med., M.R.C.P., F.R.C.P.E., F.A.M.S. Clinical Professor National University of Singapore Adj. Professor Duke-NUS Graduate School Sr. Consultant Dermatologist National Skin Centre, Singapore Per Hedén, M.D., Ph.D. Associate Professor of Plastic Surgery Karolinska Institutet Founder and Chairman Akademikliniken Private Hospital Group Stockholm, Sweden Bruce Katz, M.D. Clinical Professor of Dermatology Mount Sinai School of Medicine New York, NY, USA Michael H. Gold, M.D. Gold Skin Care Ctr. Tennessee Clinical Research Ctr. Clinical Assistant Professor Vanderbilt University School of Medicine Nashville, TN, USA Gangaram Hemandas, M.B.B.S., M.R.C.P., F.R.C.P., M.Med., F.A.A.M. Head and Consultant Dermatologist Department of Dermatology Prince Court Medical Center Consultant Dermatologist Tropicana Medical Center Petaling Jaya and Kuala Lampur, Malaysia Arielle Kauvar, M.D. Clinical Associate Professor of Dermatology New York University School of Medicine New York, NY, USA David J. Goldberg, M.D. Clinical Professor of Dermatology Mount Sinai School of Medicine New York, NY, USA Alberto Goldman, M.D. Board Certified Plastic Surgeon Clinica Goldman Porto Alegre, Brazil Chanyeong Heo, M.D., Ph.D. Assistant Professor Department of Plastic Surgery School of Medicine Seoul National University Chairman and Chief of the Department of Plastic Surgery Seoul National University Budang Hospital Seoul and Gyeonggi-do, Korea Sindy Hu, M.D. Department of Dermatology Chang Gung Memorial Hospital Taipei, Taiwan Suzanne Kilmer, M.D. The Skin Surgery Center of Northern California Sacramento, CA, USA Beom-Joon Kim, M.D., Ph.D. Dermatologist Head Professor and Chairman Department of Dermatology College of Medicine, Chung-Ang University Seoul, Korea Miles Graivier, M.D., F.A.C.S. Plastic and Reconstructive Surgeon North Atlanta Plastic and Reconstructive Surgery Roswell, GA, USA Peter Huang, M.D. Plastic and Cosmetic Surgeon Director Rebecca Cosmetic Institute Taipei, Taiwan Lorrie Klein, M.D. President Lorrie Klein, M.D. - Dermatology & Laser Center Euro Day Spa, Inc. Laguna Niguel, CA, USA 12 THE Aesthetic Guide January/February

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14 SCIENTIFIC ADVISORY BOARD Malavika Kohli, M.D., D.V.D., D.N.B. Consultant Dermatologist Aesthetic Dermatologist Jaslok Hospital and Research Centre Director Skin Secrets Mumbai, India Joyce Teng Ee Lim, M.B.B.S., F.R.C.P.I., F.A.M.S. Dermatologist Joyce Lim Skin and Laser Clinic Singapore Visiting Consultant National Skin Centre Singapore Rhoda S. Narins, M.D. Clinical Professor of Dermatology NYU Medical Center Medical Director Dermatology Surgery and Laser Center Manhattan and White Plains, NY, USA Taro Kono, M.D. Department of Plastic and Reconstructive Surgery Tokyo Women s Medical University Tokyo, Japan Corey S. Maas, M.D., F.A.C.S. The Maas Clinic for Aesthetic and Facial Plastic Surgery Associate Clinical Professor University of California, San Francisco San Francisco and Lake Tahoe, CA, USA Kei Negishi, M.D., Ph.D. Associate Professor and Chief of Aesthetic Dermatology Division Aoyama Institute of Women s Medicine Tokyo Women s Medical University Tokyo, Japan Marina Landau, M.D. Dermatology Wolfson Medical Center Holon, Israel Daniel Man, M.D. Plastic Surgeon Boca Raton, FL, USA Joseph Niamtu, III, D.M.D. Cosmetic Facial Surgeon Richmond, VA, USA Moshe Lapidoth, M.D., M.P.H. Head of the Laser Unit Rabin Medical Center Tel Aviv, Israel Woraphong Manuskiatti, M.D. Professor Department of Dermatology Siriraj Hospital, Mahidol University Siriraj Skin Laser Center Bangkok, Thailand Andrew P. Ordon, M.D., F.A.C.S. Plastic Surgeon Host CBS talk show The Doctors Beverly Hills and Rancho Mirage, CA, USA Geun-Soo Lee, M.D., Ph.D. Dermatologist Drs. Woo and Hann s Skin and Laser Center Seoul, Korea David Matlock, M.D., M.B.A., F.A.C.O.G. The Laser Vaginal Rejuvenation Institute of Los Angeles Los Angeles, CA, USA Hsien-Li Peter Peng, M.D. Director Dr. Peng s Dermatological Clinic & Cosmetic Laser Center (P-Skin Clinic) Taiwan, Republic of China Wendy W. Lee, M.D. Assistant Professor of Clinical Ophthalmology, Oculofacial Plastic and Reconstructive Surgery Bascom Palmer Eye Institute, University of Miami Miller School of Medicine Co-Director UM Cosmetic Medicine Miami, FL, USA Tess Mauricio, M.D., F.A.A.D. Founder Scripps Ranch Dermatology and Cosmetic Center San Diego, CA, USA Jorge A. Perez, M.D., F.A.C.S. Plastic and Reconstructive Surgeon Perez Plastic Surgery Ft. Lauderdale, FL, USA Hang Li, M.D. Associate Professor Chief of the Dermatologic Surgery Division Department of Dermatology Peking University First Hospital Beijing, China David McDaniel, M.D. Laser Center of Virginia Virginia Beach, VA, USA Miriam Emily Piansay-Soriano, M.D., F.P.D.S. Davao Doctors Hospital Davao City, Philippines Yuanhong Li, M.D., Ph.D. Associate Professor of Dermatology Vice Chairman No. 1 Hospital of China Medical University Shenyang, China Ronald L. Moy, M.D. Dermatologist and Facial Cosmetic Surgeon Moy, Fincher and Chipps Facial Plastic & Dermatology UCLA Medical School Beverly Hills, CA, USA Jason Pozner, M.D., F.A.C.S. Medical Director Sanctuary Medical Aesthetic Center and Sanctuary Plastic Surgery Boca Raton, FL, USA 14 THE Aesthetic Guide January/February

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16 SCIENTIFIC ADVISORY BOARD Nark-Kyoung Rho, M.D. Clinical Assistant Professor Department of Dermatology Samsung Medical Center Director Leaders Aesthetic Laser & Cosmetic Surgery Center Seoul, Korea Gordon H. Sasaki, M.D., F.A.C.S. Clinical Professor Department of Plastic Surgery Loma Linda Medical University Center Private Practice Pasadena, CA, USA Siak-Khim Tan, M.D., B.S. Medical Director The DRx Clinic Singapore Alexander Z. Rivkin, M.D. Facial Cosmetic Surgeon Founder Westside Aesthetics Los Angeles, CA, USA Gerhard Sattler, M.D. Founder and Medical Director Rosenpark Klinik Darmstadt, Germany Mark B. Taylor, M.D., F.A.A.D. Director Gateway Aesthetic Institute and Laser Center Salt Lake City, UT, USA Leif Rogers, M.D., F.A.C.S. Plastic and Reconstructive Surgeon Leif Rogers, M.D. Reconstructive and Cosmetic Plastic Surgery Beverly Hills, CA, USA Kyle Koo-Il Seo, M.D., Ph.D. Clinical Associate Professor BOTOX Clinic Department of Dermatology Seoul National University Hospital Director Modelo Clinic Seoul, Korea William Philip Werschler, M.D., F.A.A.D., F.A.A.C.S. Assistant Clinical Professor of Medicine/Dermatology University of Washington School of Medicine Seattle, WA, USA E. Victor Ross, M.D. Director Cosmetic and Laser Dermatology Unit Scripps Clinic San Diego, CA, USA Ava Shamban, M.D. Laser Institute for Dermatology Santa Monica, CA, USA Assistant Clinical Professor of Dermatology University of California, Los Angeles Los Angeles, CA, USA ChongHyun Won, M.D. Assistant Professor Department of Dermatology Ulsan University School of Medicine Seoul, Korea Mark G. Rubin, M.D. Assistant Clinical Professor of Dermatology University of California, San Diego Private Practice Beverly Hills, CA, USA W. Grant Stevens, M.D., F.A.C.S. Plastic Surgeon Marina Plastic Surgery Clinical Professor of Surgery University of Southern California Marina Del Rey, CA, USA Woffles Wu, M.B.B.S., F.R.C.S., F.A.M.S. Plastic Surgeon Woffles Wu Aesthetic Surgery & Laser Centre Singapore Neil Sadick, M.D. Clinical Professor of Dermatology Weill Cornell Medical College New York, NY, USA Insuck Suh, M.D., Ph.D. Professor Department of Plastic and Reconstructive Surgery College of Medicine, Hallym University Kangnam Sacred Heart Hospital Seoul, Korea Sabine Zenker, M.D. Dermatologist Dermatology Surgery Clinic Munich, Germany Claudine Santos-Roura, M.D., F.P.D.S. Dermatologist and Cosmetic Surgeon Contours Advanced Face and Body Sculpting Institute Manila, Philippines Nantapat Supapannachart, M.D. Dermatologist Clinical Professor Ramathibodi Hospital, Mahidol University Medical School Clinical Staff Bumrungrad Hospital Bangkok, Thailand Guoyu Zhou, M.D. Oral and Maxillofacial Surgeon Deputy Director Medical Laser Centre of Shanghai Jiaotong University Medical College, Ninth People s Hospital Shanghai, China Deborah S. Sarnoff, M.D., F.A.A.D., F.A.C.P. Clinical Professor of Dermatology NYU Langone Medical Center New York, NY, USA Atchima Suwanchinda, M.D., M.S. Consultant Laser and Dermatologic Surgery Unit Ramathibodi Hospital, Mahidol University Director Medisci Biointegrative and Anti-Aging Center Bangkok, Thailand Craig L. Ziering, D.O., F.A.O.C.D. CEO and Medical Director Ziering Medical Worldwide West Hollywood, CA, USA 16 THE Aesthetic Guide January/February

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21 Letter from the Editor Dramatic M&A Strategic Moves Amplify Power of $9 Billion Ax Industry Michael Moretti Editor-in-Chief As we enter 2017 riding on the macroeconomic high points of record-breaking Wall Street stock prices and valuations, buoyed by positive investor optimism due to a new American president who is decidedly pro-business and anti-big government regulations / taxes, our particular industry has never looked more attractive. After years of struggling to fully recover from the lingering global economic recession triggered in 2008, the aesthetic industry is leading other med-tech sectors in terms of growth rates and financial performance metrics. In fact, Medical Insight, Inc. (MII) just released results from their annual practice survey (Page 46), indicating that medical aesthetic providers are overwhelmingly positive about their prospects this year and beyond. As the leading market research firm, MII also confirmed that this sector will exceed $9 billion in 2017 with a CAGR of over 11%. Simultaneously verifying investor and corporate confidence in the aesthetic market, two major acquisitions were announced, which will dramatically change industry dynamics and amplify an already impressive growth rate due to an unprecedented infusion of incredible financial and consumer marketing resources. Specifically, Allergan (NASDAQ: AGN) heralded their proposed acquisition of ZELTIQ Aesthetics (NASDAQ: ZLTQ ) for a stunning $2.5 billion, evincing that the most powerful pharmaceutical company in medical aesthetics, who already owns the top two consumer facing brands, believes that CoolSculpting has amazing longterm upside potential. Allergan will apply its superior marketing skills to fully exploit the consumer demand for non-invasive body contouring, which has already driven over 4 million CoolSculpting treatments. Adding the most popular body shaping procedure to the Allergan portfolio makes sense for investors who clearly supported a deal structure that justified paying a significant premium for a popular public company that had approximately $327 million in peak annual sales in 2016, but no long-term track record of profitability. Obviously this acquisition was very strategic and is a historical milestone for Allergan, a mega-size pharma company that has shied away from all capital equipment due to poor operating margins versus pharmaceuticals. Complementing this latest purchase is the company s previous acquisition of Kythera Biopharmaceuticals and the KYBELLA brand in 2015 for a shocking $2.1 billion based on virtually no commercial sales or full launch of this unique injectable product. Readers who understand the significance of these major strategic investor activities will realize that there is much more change to come as the most powerful brands and companies in our lucrative industry make aggressive moves to grab more market share and influence over their customers. Within days of the Allergan announcement regarding ZELTIQ, one of the oldest and largest aesthetic device companies revealed that they would be acquired at a premium price. Hologic (NASDAQ: HOLX) plans to acquire Cynosure (NASDAQ: CYNO), thus immediately becoming the largest medical aesthetic technology company in the world. Holding a major presence in the OB/GYN distribution channel via current products, Hologic management is focused on the emerging feminine rejuvenation market segment as a primary driver of this strategic decision and sees the MonaLisa laser platform as a key to unlocking this completely new business opportunity. Acquiring Cynosure will accelerate our transformation into a higher-growth company by leveraging our core women s health expertise and OB/GYN channel leadership into an adjacent, cash-pay segment that is expanding at a low double-digit rate, said Steve MacMillan, Hologic s chairman, president and CEO. We had identified medical aesthetics as an attractive and complementary growth opportunity through our strategic planning process, and are pleased to have agreed to acquire Cynosure, the best-in-class company in the space. These most recent acquisitions come on the coat-tails of a running M&A spree, which began in 2008 and has only accelerated and intensified from the sale of Allergan Medical to Activis after a bitter fight with Valeant (NYSE: VRX) for these assets resulting in Valeant s rapid divestment of the Medicis facial injectables portfolio to Galderma allowing them to become the second largest player in facial aesthetics in the U.S. In addition, numerous companies have been quietly acquired by big players, or private equity investors have taken control of these assets with the intent of infusing more financial resources to grow these brands. The most impressive new entrant in the past year is Almirall, the Spanish public company that started with lowprofile investments in strategic assets and purchased Thermi, LLC in 2016 to use their unique technology to balance out the company s medical aesthetic portfolio. Informed readers who understand the significance of these strategic investor activities realize that there is much more change to come as the most powerful brands and companies in our lucrative industry make aggressive moves to obtain more market share and influence over their customers. THE Aesthetic Guide January/Febraury

22 Perigee Medical Offers Innovative Mommy Makeover Technologies By Kevin A. Wilson, Contributing Editor Utilizing the suite of technologies distributed by Perigee Medical (Tracy, Calif.), physicians have an excellent set of tools for providing new moms with a self-image boosting makeover. Stretch marks can be addressed using the INTRAcel RF fractional microneedling device; localized areas of stubborn fat can be reduced using the FuturaPro, which combines ultrasound and muscle re-education technology; and facial and vaginal health and appearance can be restored using Edge VLR (part of the Edge CO 2 platform) and IntraGen fractional RF therapy. All of these technologies are manufactured by Jeisys Medical, Inc. (Seoul, Korea) and marketed in the U.S. under the Perigee umbrella. Stretch marks are a common and much-loathed consequence of pregnancy, according to plastic surgeon Gregory Chernoff, M.D., medical director of Chernoff Cosmetic Surgery (Santa Rosa, Calif. and Indianapolis, Ind.). With its array of 49 insulated RF microneedles delivering energy subcutaneously, directly to the underlying scar tissue at depth to stimulate the remodeling of collagen and elastin, INTRAcel is ideal for treating striae, especially after pregnancy. The beauty of using INTRAcel for post-pregnancy stretch marks on the abdomen and/or breasts is that we can get to them soon after they ve formed, at which time they are much more receptive to treatment, Dr. Chernoff explained. In just a few treatments spaced about four weeks apart, we see dramatic reduction in the appearance of scarring, even virtually eliminating the lesions in some cases. Women really love this because it helps them feel like they re getting their body back. INTRAcel can also be used to tighten and improve skin quality of the horizontal lines (necklace lines) that appear near the neck and vertical dehydration lines in the cleavage, Dr. Chernoff continued. Additionally, it helps to alleviate abdominal skin laxity in conjunction with fat treatment using FuturaPro. Dermatologist Jeanine Downie, M.D., medical director of Image Dermatology (Montclair, N.J.), is thrilled with the way INTRAcel addresses striae. It may take up to eight treatments depending on how well the scar responds, and what the patient decides is a good endpoint, she said. Treatment is safe for all skin types, but it is important that exposed areas be covered with sun block, at least SPF 30, because they will be more photosensitive after treatment. Gregory Chernoff, M.D. Plastic Surgeon Medical Director Chernoff Cosmetic Surgery Santa Rosa, CA and Indianapolis, IN Jeanine Downie, M.D. Dermatologist Medical Director Image Dermatology Montclair, NJ Sherry Thomas, M.D. Urogynecologist Agoura Hills and Beverly Hills, CA Dr. Downie is also a proponent of the painless FuturaPro device, which combines ultrasound-induced apoptosis of adipocytes with transcutaneous electric muscle stimulation to address localized areas of unwanted fat, as well as restore the shape and tone of underlying musculature, which is stretched during pregnancy. Total application time may exceed one hour, up to 45 minutes for the ultrasound The beauty of using INTRAcel for post-pregnancy stretch marks on the abdomen and/or breasts is that we can get to them soon after they ve formed, at which time they are much more receptive to treatment. Stretch marks before and after INTRAcel Tx Photos courtesy of Gregory Chernoff, M.D. THE 22 Aesthetic Guide January/February

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24 Back before and after FuturaPro Tx Photos courtesy of Jeanine Downie, M.D. component with an additional 30 minutes of muscle stimulation. This device is extremely popular because it is very satisfying for patients to undergo treatment, she said. Patients expect pain with the fat treatment, but other than a sensation of pressure, there isn t any discomfort. They also like the feeling of having their muscles worked by the electrical pads afterward. FuturaPro takes inches off the waistline, and the muscle stimulation has been shown to facilitate this by creating an energy deficit in the treated area, providing a need for the metabolism of the fat. We start with INTRAcel at week one, followed by FuturaPro at weeks two and four, then INTRAcel again at week five, Dr. Downie continued. She recommends using the muscle stimulation pads starting at about 70% capacity, raised to tolerance. Dr. Chernoff led research efforts revealing the mechanism of action of FuturaPro. We were able to show that through isometric electrical exhaustion of the muscles, we create an immediate and localized need for fat components recently liberated via ultrasound fat cell disruption. This augments results because the liver doesn t have to do all the work. Women also enjoy the benefits of Edge VLR fractional CO 2 laser treatment of the vagina as a vital component to the mommy makeover, according to Sherry Thomas, M.D., who practices urogynecology and aesthetic medicine in Agoura Hills and Beverly Hills, Calif. It s amazing what a few sessions with this device can do to restore vaginal health and, subsequently, improve women s quality of life after giving birth, she said. The trauma associated with vaginal childbirth stretches tissue of the vaginal wall and vulva. There is a significant drop in estrogen afterward as well after it spikes during pregnancy which contributes to vaginal dryness leading to increased irritation. It s amazing what a few treatments with this device can do to restore vaginal health and, subsequently, improve women s quality of life after giving birth. treatment probe is inserted into the vagina, then laser energy is directed at eight points circumferentially (90 from the axis of insertion) using an octagonal guide for consistent and uniform application. After each full rotation, the probe is withdrawn 1 cm and the cycle is repeated. Sessions last less than ten minutes and no anesthesia is required. The high peak power, coupled with a short pulse, is advantageous for delivering therapeutically adequate energies while preventing unwanted thermal build-up. Women are advised to refrain from sexual intercourse for a day or two afterward. Three treatments at intervals of about four weeks is the norm, she noted, with three passes per session. Younger women bounce back rapidly, especially with a little help from Edge VLR. Older women may require more treatment. IntraGen fractional RF can be used to address pelvic floor laxity as well, Dr. Thomas expressed. It works very well and we re seeing great results. The unique modality places microspots of RF energy in an irregular pattern, which allows for maximum energy deposition with minimum heat buildup. Real time tissue temperature and impedance feedback further optimize treatment. We can also use the IntraGen RF for skin laxity of the neck or abdomen, and to tighten up the labia majora and minora. This gentle, but powerful energy delivery mechanism is great for this sensitive area. We will use benzocaine, lidocaine and tetracain (BLT) to numb the area temporarily so we can use higher settings and obtain better results. This suite of technologies, available through Perigee Medical, is evidence of their commitment to providing the U.S. market with high-quality, powerful, safe and effective aesthetic medical solutions without sacrificing affordability. Edge VLR improves these indications significantly and it s a boon to feminine wellness. Dr. Thomas added. The 24 THE Aesthetic Guide January/February

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26 Dear Practitioners, We at Viveve believe we are in a unique position to positively impact the field of elective medicine. As a company dedicated to women s health and wellness, we focus all our energy literally and figuratively on the technology and clinical science that will efficaciously address common issues that can have a profound effect on a woman s day-to-day life. Our flagship product, the Viveve System, is used to perform the Geneveve treatment, a comfortable, single-session, 30-minute procedure for women that uses deep-penetrating cryogencooled monopolar radiofrequency (CMRF) energy to generate natural collagen remodeling. Many innovative, in-office medical procedures have been developed in this space that represent important advances in patient care. With all emerging technologies physicians deserve, and should require, that the treatments they offer to their patients are supported by sound clinical science specific to the medical condition being addressed. The responsibility of providing this information rests with the companies manufacturing or representing treatment technologies, and to the extent these companies do not follow suit, patient safety and satisfaction can be at risk. To foster the greatest levels of patient safety and efficacy possible, Viveve is committed to an approach that adheres to the highest of standards. The Viveve System is the first, and, to date, the only energy-based technology in the market to garner positive clinical evidence from a rigorous multicenter, randomized, blinded and sham-controlled study in over 150 women from around the world suffering from structural gynecological changes that impact their quality of life. Currently available in more than four dozen countries around the world 1 to treat vaginal laxity and improve sexual function in women, the Viveve System was recently cleared in the U.S. for use in general surgical procedures for electrocoagulation and hemostasis. Viveve has submitted an IDE to the FDA for a multicenter U.S. pivotal trial with the goal of obtaining a new U.S. indication for the improvement of sexual function. Research has confirmed that problems with sexual health and wellness have a direct effect on overall health and well-being, and Viveve is passionately committed to delivering long-overdue solutions for women in this regard. In addition, the company has a vibrant External Research Program for our physician customers that is geared to gleaning deeper and broader insights into how the Viveve technology can provide additional benefits in addressing women s health needs and to cultivating top research methodologies. The use of energy-based devices in the women s health arena is still in its formative years. Already, just as with facial aesthetics, there is an evolution, based on additional research and experience, toward applicationspecific technologies and combination therapies. This is an exciting time for women s health, and we are pleased to contribute to the progress being made. Patricia Scheller CEO and Director Reference: 1. See Viveve.com for a list of countries and their approved indications. Viveve is a registered trademark of Viveve, Inc. Geneveve is a trademark of Viveve, Inc. 26 THE Aesthetic Guide January/February

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28 Versatile SP Dynamis Pro Grows Laser Practices By Kevin A. Wilson, Contributing Editor Adding body sculpting to its already impressive array of indications for the SP Dynamis Pro dual wavelength laser platform, Fotona (based in the U.S. and Europe) continues to expand the capabilities of its flagship system, putting unrivaled versatility in the hands of physicians looking to grow their practice without sacrificing outcomes. John E. Stevens, D.N.P., R.N., N.P.-C., A.N.P.-B.C. denovo Health Center Dallas, TX John E. Stevens, D.N.P., R.N., N.P.-C., A.N.P.-B.C. of the denovo Health Center in Dallas, Texas has been using SP Dynamis for more than a year. The decision to purchase an SP Dynamis laser platform was a difficult one, but I am convinced I made the best choice because of the safety, results and proven versatility in our multidisciplinary practice, he stated. I recently calculated that if we had put every dime of revenue the device has generated exclusively toward the purchase, we d have paid it off in 11 months. Among the more than 40 applications of the SP Dynamis platform, Dr. Stevens said the clinic has relied on three in particular for the most part, but that s evolving. Fotona 4D face and neck tightening is the most popular aesthetic indication, he advised. Fotona 4D makes use of all four modes of the device (SMOOTH, FRAC3, PIANO and SupErficial) to achieve a multi-dimensional global result for skin remodeling. We also use it for gynecology procedures, and for tightening tissue at the back of the throat with the NightLase procedure for our dental arm. These are all popular with our patients. For the last several months we ve been offering TightSculpting also, and the results have been amazing. Simply put, TightSculpting is rapid, comfortable and effective, non-invasive laser fat reduction without downtime or consumables, that s safe for all body areas. Practitioners first employ the super-long pulse Nd:YAG of PIANO mode to deeply heat subcutaneous fatty tissue to stimulate metabolism of fat cells without damaging skin. Then, using the non-ablative Er:YAG SMOOTH mode, powerful yet controlled heating of surface tissue induces collagen remodeling and tightening of skin. This combination tightens and reshapes to improve skin quality and enhance the silhouette of the target area. This is great for toning and reshaping areas that just aren t fatty enough for a modality like Cryolipolysis, Dr. Stevens noted. I ve noticed a change in the fit of my pants from having undergone TightSculpting. One standout benefit associated with SP Dynamis Pro is the lack of consumables associated with its applications. Having no per-treatment consumables cost to pass on to the patient, we can easily create treatment packages or use SP Dynamis with other modalities to create combination applications, Dr. Stevens shared, With price points that reflect our needs and what the market will bear. SP Dynamis has also provided excellent results for scars and stretch marks in Dr. Stevens hands, and he s eager to treat more cases. I ve never had anything that works nearly as well as this for scars and stretch marks. My first client treated was a somewhat demanding patient who was thrilled with the outcome after a single treatment. We know that when something pleases her, there s no doubt about the quality of the result. I am confident that we have a lot to look forward to with this device in terms of safety and results for new applications in the future. I ve never had anything that works nearly as well as this for scars and stretch marks. My first client treated was a somewhat demanding patient who was thrilled with the outcome after a single treatment. We know that when something pleases her, there s no doubt about the quality of the result. Before and after NightLase Tx via the SP Dynamis platform Photos courtesy of H. Shiffman, D.D.S. 28 THE Aesthetic Guide January/February

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30 Body By BTL Reshapes from Head to Toe with No Costly Consumables By Kevin A. Wilson, Contributing Editor Jason R. Lupton, M.D. Dermatologist Medical Director San Diego Dermatology and Laser Surgery San Diego, CA With recent technological leaps forward invigorating an already booming body shaping market, BTL Aesthetics (Boston, Mass.) has answered this growing demand for non-invasive body contouring options with a family of safe, effective and versatile devices. Individually and in combination, they represent a powerful portfolio of products capable of revising the silhouette from head to toe, in bulk or with subtlety. Together, this suite of technologies is known as Body By BTL. The market has changed dramatically over the last few years, with patients seeking less invasive treatments that still deliver results, but without significant cost Suneel Chilukuri, M.D. Medical Director Refresh Dermatology Houston, TX Harold L. Kent, M.D. Surgeon Brunswick, GA or downtime, said dermatologist Jason R. Lupton, M.D., medical director of San Diego Dermatology and Laser Surgery (San Diego, Calif.). Patients often ask about effective body treatments for either fat reduction or tightening/contouring that don t require surgery or liposuction, and they re usually quick to try these noninvasive methods first due to their relative convenience and lower cost. BTL Vanquish ME provides unrivaled debulking ability without pain, downtime or associated consumables. Cleared for circumferential reduction of the abdomen and thighs, the device relies on Selective RF so it never touches the patient. The core applicator treats the abdomen and flanks while the FLEX applicator reduces unwanted fat on the upper legs. BTL Vanquish ME configures the RF field automatically when placed over the surface of the target area. Treatment is specific due to variance in impedance between tissue types and apoptosis of adipocytes can be initiated without damaging skin or other nearby tissue. The spot size is large relative to other non-invasive fat reduction devices. Cellular debris and liberated fat are dealt with by the body naturally through the lymphatic system. A course of treatment typically consists of four to six sessions of about 45 minutes each. In a recent clinical trial the device was shown to reduce the fatty layer of the abdomen by more than 29%. 1 Often used with BTL Vanquish ME, BTL Cellutone requires no per-treatment consumables. Treatment is like a vibrating massage, stimulating circulation and lymphatic drainage. Users swear by BTL Vanquish ME plus BTL Cellutone. It seems to improve the appearance of the treatment area and speeds the onset of the result, said dermatologist and cosmetic surgeon Suneel Chilukuri, M.D., medical director of Refresh Dermatology in Houston, Texas. BTL Exilis Ultra delivers RF simultaneously with ultrasound and is FDA cleared for wrinkles, rhytides and reduction in the appearance of cellulite. The RF heats the skin and underlying subcutaneous fat 2, while the ultrasound provides a mechanical effect that improves consistency and speed to reach temperature targets, making the device less technique dependent. It can literally be used from head to toe with reportedly no pain or Before and after four BTL Vanquish ME Tx sessions Photos courtesy of Jason R. Lupton, M.D. Before and one month after two BTL Exilis Ultra treatments Photos courtesy of Suneel Chilukuri, M.D. 30 THE Aesthetic Guide January/February

31 downtime. BTL Exilis Ultra represents the single best return on investment of any laser or energy-based device I have in my practice, said Dr. Lupton. I have offered it for more than three years and approximately 80% of my patients end up pursuing treatment of other areas because of their satisfaction with results. Historically, the best results have always come from combination treatments, for those who could afford the time, expense and inconvenience associated with them, according to Dr. Chilukuri. We ve come a long way in the last ten years, it s remarkable what we can do without surgery, and a growing number of patients find the downside of surgical options unacceptable. Combination treatments allow physicians to address a problem from multiple vectors and/or create a more well-rounded result by addressing different concerns together, but it can be costly, especially when there are expensive consumables built into treatment. While the revenue per treatment might have been higher, elevated costs inherently limit the patient population by financial wherewithal. When it s less expensive, but still safe and effective, more people can realistically consider treatment, opening up our potential patient base. 38 year old patient before and one week after four weekly BTL Vanquish ME, BTL Exilis Ultra and BTL Cellutone treatments Photos courtesy of Suneel Chilukuri, M.D. Before and one month after two BTL Exilis Ultra and BTL Cellutone treatments Photos courtesy of Suneel Chilukuri, M.D. The lack of consumables is very attractive. Physicians can price based on what the market will bear, create packages and offer free treatments where appropriate without having to accept a restrictive financial burden. For the BTL Vanquish ME bulk reduction technology, there are no consumables; BTL Exilis Ultra requires only an inexpensive grounding pad for each treatment; and the only consumable associated with BTL Cellutone is an exchangeable cartridge. I love treating my patients with different things to see how great the result can be. I ve refined my personal protocols enthusiastically because I continue to discover synergistic nonsurgical approaches, creating unbelievable surgical-type results, Dr. Chilukuri said. Ultimately, the most powerful component of Body By BTL is overall noninvasive fat reduction with BTL Vanquish ME. There are virtually no BMI restrictions, and it treats evenly with no lines of demarcation, divots or shelving. BTL Exilis Ultra can be used to spot treat and refine the overall outcome, with BTL Cellutone further enhancing the result and its speed of onset. The natural look of the reduction is truly remarkable, said Dr. Chilukuri, especially on the leg where an unnaturally uniform shaping would be obvious and unattractive. Surgeon Harold L. Kent, M.D. specializes in bariatric care and uses BTL Vanquish ME with BTL Cellutone, sometimes incorporating cryolipolysis as well. To us the major advantage of using BTL Vanquish ME with BTL Cellutone is the appearance and texture of the skin. Breaking up smaller pockets of fat after BTL Vanquish ME treatment has started the process of destroying fat cells and can result in a smoother appearance of the treated area. Patients can also opt for a stand-alone BTL Cellutone treatment which helps increase lymphatic drainage, treat cellulite and improve the overall appearance of the treated areas. During the consult, patients must be counseled that these are not weight loss treatments, results may not be exactly as they envision them and that several treatments may be needed. Initially we did not promote cryolipolysis strongly among our bariatric patients, as it would require too many treatments and too much money to obtain decent results. BTL Vanquish ME was a different story, and our experience has supported this. For patients with mild fatty bulging who aren t very overweight, cryolipolysis alone may be appropriate, Dr. Kent explained, but for larger and post-bariatric patients, especially those only a few months out of THE Aesthetic Guide January/February

32 surgery, BTL Vanquish ME will provide much greater reductions in fewer sessions. Once the patient reaches the point where they have achieved good weight loss and has only small residual fat pockets, then they may be candidates for cryolipolysis, which targets smaller areas, Dr. Kent added. We also had a patient who had paradoxical hypertrophy from cryolipolysis that we were able to treat successfully with BTL Vanquish ME. The biggest challenge to treating larger patients non-invasively is to achieve noticeable results with relatively few treatments, Dr. Kent continued. This was our main reason for adding BTL Vanquish ME into our practice. There are few contraindications, and I believe our satisfaction rate is high within this patient population because we had a sudden uptick in patients requesting this technology and we re getting Facebook traffic, which indicates that people who are looking at before and after pictures like the outcomes they see. Once we began offering BTL Vanquish ME, bariatric patients who had never requested cryolipolysis started inquiring. Within a few months we went from a few thousand dollars a month with BTL Vanquish ME to more than $20,000 in our best month. Large volume fat reduction is what these patients want initially, Dr. Kent continued. And with BTL Cellutone we can also refine the appearance of our results whether or not we use cryolipolysis. At this point, we believe BTL Vanquish ME is an ideal fit for a bariatric practice because it is something that will pay for itself, attract existing and new patients into the practice, and increase our follow-up of bariatric patients who will show up for a cosmetic treatment as well as re-engage in care with us. Large BMI patient before and after four BTL Vanquish ME treatments Photos courtesy of Harold L. Kent, M.D. Paradoxical hypertrophy from previous Cryolipolysis before and after BTL Vanquish ME Tx Photos courtesy of Harold L. Kent, M.D. Cellulite before and after Body By BTL combination Tx Photos courtesy of Jason R. Lupton, M.D. Treating cellulite with BTL Exilis Ultra or BTL Vanquish ME further expands your potential patient base. Around 90% of women are affected regardless of age, weight or other factors, Dr. Chilukuri stated. The four Fs of cellulite are Fat, Fibers, Fitness and Flow of blood. BTL Exilis Ultra alone or combined with BTL Cellutone can non-invasively address three of these. Fitness is in the hands of the patient, but we can improve tone and blood flow, plus break down the fibrous bands, with BTL Cellutone. We follow that with BTL Exilis Ultra to tighten, then more BTL Cellutone, and cellulite is dramatically improved. If needed we can reduce circumference with the BTL Vanquish ME Flex applicator. There are other useful combination therapies. One example is what s been termed the Liquid Facelift. This involves the use of injectables with BTL Exilis Ultra for a global facial restoration treatment. The four Rs of treatment are Relax, Refill, Repair and Redrape. We use neurotoxin to relax different areas and treat wrinkling, explained Dr. Lupton. This begins to work within days. Next, I perform two to four treatments with BTL Exilis Ultra, especially along the jawline and upper neck, to stimulate collagen and tighten the skin over several weeks. Fillers are used for the finishing touches and to restore volume, and the effect is immediate. This multiphase treatment is wildly popular with patients, he added, because they understand how each component treats a different aspect of the aging face. The way the results manifest 32 THE Aesthetic Guide January/February

33 be called for to address subcutaneous fat 2 and provide more tightening. Neck and mandible before and three months after one BTL Exilis Ultra Tx Photos courtesy of Suneel Chilukuri, M.D. Before and three months after two BTL Exilis Ultra treatments Photos courtesy of Suneel Chilukuri, M.D. synergistically gives patients a gradual, yet visible correction and refreshing effect as well. What the BTL Exilis Ultra adds is in the categories of Repair and Redrape, according to Dr. Chilukuri, who brands a similar protocol under a different name in his practice. BTL Exilis Ultra helps tighten and improve skin quality to aid in creating a more youthful face, but we ve been able to address the face for a while now using injectables. Where we have a real departure from the past is how the device improves the lower face and neck, he added. The result not only reduces the skin laxity of the neck, it helps define the facial-neck border which is a subtle, but powerful effect. It can be noticeable when the face has been made more youthful looking, but the neck is obviously untreated. It s amazing to see the remarkable result we obtain without any cutting. And BTL Exilis Ultra gives patients an easy, non-invasive maintenance option as well. The lower thigh/upper knee region can also be treated. This used to be my least favorite area to address, but now it s a favorite because we can get impressive outcomes, safely, said Dr. Chilukuri. Previous modalities gave us moderate results at best, with too many side effects. I use BTL Cellutone weekly for two weeks before I bring in BTL Exilis Ultra. I think we re getting some toning and neovascularization, perhaps stimulation of neocollagenesis as well, that lays the groundwork for a better result. This is followed by another BTL Cellutone session, possibly combined with microneedling for additional tightening of skin, then an additional session with BTL Exilis before a final treatment with BTL Cellutone. The ability to use other technologies so safely with these BTL modalities is a real plus in situations like these. A month after, a final session with BTL Exilis Ultra plus microneedling caps things off. At this point we see resolution of laxity that is so good, 90% of patients ask about treating other body areas with this protocol. Even the sensitive upper arms can be treated using Body By BTL, Dr. Chilukuri shared. The protocol is the same as for the upper arms, minus the third BTL Exilis Ultra treatment. If the area is flabbier, weekly BTL Exilis Ultra treatments may Growth of the medical aesthetic industry in recent decades has given rise to branding by association with big name technologies, but options like Body By BTL, which work among themselves or with other modalities, allow physicians to brand themselves as experts, moving the focus beyond the technologies, which are merely masters tools. Realistically, nobody can expect to see these kind of wow results from a single treatment or brand; multiple modalities are required, and patients are savvy enough to know this, said Dr. Chilukuri. For Dr. Lupton, most marketing involves display of the outcomes to stoke patient curiosity, coupled with availability of information to satisfy this curiosity and promote action, without external marketing. We pride ourselves on our reputation for having the expertise and the cutting edge treatments that will make best use of it, he said. Our new body shaping business comes from existing patients and referrals. This business model has built a large following of patients that trust we have their best interest front and center at all times. For those with a more aggressive marketing strategy, BTL supports physicians with materials such as the BTLsupport.com to help minimize the leg work required in today s web-based world. I rely on the BTL Toolbox because it saves us time, said Dr. Chilukuri. We don t have to create graphics and illustrations ourselves, they ve done a great job of stocking us with a variety of images to choose from, which improves the efficiency of our marketing efforts, especially on the web or in social media, which are very fluid. References: 1. Hayre N, Palm M, Jenkin P. A clinical evaluation of a next generation, non-invasive, selective radiofrequency, hands-free, body-shaping device. J Drugs Dermatol 2016;15(12): McDaniel D, Fritz K, Machovova A, Bernardy J. A focused monopolar radiofrequency causes apoptosis: A Porcine model. J Drugs Dermatol 2014; 13(11): THE Aesthetic Guide January/February

34 Emerging Aesthetic Technologies Comparison Chart Supplier Product Technology Applications Price Alma Lasers, Ltd. PicoClear FemiLift/Pixel CO 2 Dual Wavelength Q-Switched Nd:YAG with Pico and Nano Modes; 1064 nm, 532 nm Fractional CO 2; Thermal CO 2; Pixel CO 2 Roller Resurfacing of vascular and pigmented lesions and tattoo removal. Intravaginal labia majora, skin and body (various handpieces). Bellus Medical SkinPen Microneedling Improves appearance of fine lines and wrinkles. Skinfuse 90 day post microneedling protocol is formulated specifically for microneedling delivering essential nutrients into skin cells to optimize results of treatment. BTL Industries BTL Protégé Intima FLEX Applicator Monopolar RF; EFC Elite Selective RF Feminine rejuvenation labia remodeling. Deep tissue heating of smaller body areas. Collagen P.I.N. Collagen P.I.N. Automated Microneedling; Single-Use 36/30 Gauge or Single-Use 12/32 Gauge Needle Cartridges; Corded or Cordless; Lifetime/ Forever Warranty Fine lines, wrinkles, acne scars, post surgery scars, skin tightening and retexturizing. Induction Therapies specific post-microneedling products minimize complications and maximize results. $2,995 Eclipse Aesthetics, LLC Eclipse MicroPen Elite Skinfinity RF Firma NEWA dep Patch Crazy Cool Microneedling Non-Ablative RF Non-Ablative RF Non-Ablative RF Microcurrent Self-Cooling Mask Improved appearance of fine lines, scars and texture. Improved appearance of fine lines, scars and stretch marks. Improved appearance of wrinkles and rhytides. Home-use RF to improve appearance of fine lines and wrinkles. Reusable microcurrent patches and mask for in-office and at-home use. Innovative exothermic mask that aids in patient comfort by cooling and hydrating. Fotona IntimaLase 2940 nm Er:YAG with SmoothMode Feminine rejuvenation tightening of internal vaginal tissues. Lumenis FemTouch CO 2 Vaginal rejuvenation. PerfAction Technologies, Ltd. Enerjet, Enerjet2.0 and AirGent2.0 Jet Volumetric Remodeling (JVR) Kinetic lifting, skin regeneration, skin tightening, scar repair: acne scars, keloid and hypertrophic scars, stretch marks, neck lines, dermal thickening and décolleté wrinkle reduction. Perigee Medical, Inc. Jeisys IntraCel NeuViVa Fractional RF Microneedling (FRM) CO 2 Combination FRM bipolar, monopolar, and superficial RF skin treatment. Feminine rejuvenation. Quanta Aesthetic Lasers Discovery Pico Plus Forte Series Picosecond with QuattroPulse emission modes (Picosecond, Q-Switched, OptiPulse, PhotoThermal); 1064 nm, 532 nm, 694 nm Multi-Application Platform: Diode, IPL, Er:YAG, Nd:YAG Tattoo removal. Treatment of benign pigmented lesions, wrinkles, acne scars and mild to moderate inflammatory acne. Hair removal, pigmented and vascular lesions, inflammatory acne, skin resurfacing, pseudofolliculitis barbae (PFB). Sciton diva 1470 nm / 2940 nm Hybrid Fractional Laser (Ablative and Non-Ablative) Improvement of vaginal tissue. Independently configurable delivery of both ablation and coagulation. High Precision Automation (HPA) Technology allows configurable treatment parameters with automatic energy delivery. Strengthened Quartz Dilator (SQD) optimized energy delivery by dilating tissue and providing 360º of laser energy. Syneron Candela Picoway PicoWay Resolve Profound CO 2RE Intima GentleTouch 1064 nm, 532 nm, 785 nm 1064 nm, 532 nm RF Microneedling CO nm + RF Tattoo and pigment removal. Fractional anti-aging and acne scar Tx. Neck, jowls and jawline contouring. Women s intimate health. Hair removal. Thermi ThermiRF ThermiVa Thermi250 Temperature Controlled RF Temperature Controlled RF Temperature Controlled RF Offers a myriad of soft tissue applications. Heats tissue in the vaginal anatomy. Temporary reduction of cellulite. Viveve, Inc. Viveve System Cryogen-Cooled Monopolar RF Non-ablative soft tissue remodeling. Zimmer MedizinSystems ZWave ZCryo Ballistic Radial Pulse Cold Air (up to -22º F) Temporary reduction in the appearance of cellulite. Skin cooling pre, intra and post laser treatments without interfering with the laser beam. Minimizes pain and thermal injury during laser and dermatological treatments. Temporary topical anesthetic relief for injections. Can be used for hair removal, tattoo removal and skin rejuvenation procedures. Note: Data subject to change; please refer to Company Directory for supplier contact information. 34 THE Aesthetic Guide January/February

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36 ZWave Shines in Both Stand-Alone and Adjunctive Applications By Jeffrey Frentzen, Executive Editor I was searching for an effective method to address stand-alone treatment of cellulite, as well as an adjunctive treatment for many of the body contouring procedures that we do. The ZWave fit the bill and has been adopted and used for over two years with great acceptance by staff and patients. Gordon H. Sasaki, M.D., F.A.C.S. Gordon H. Sasaki, M.D., F.A.C.S. Clinical Professor Department of Plastic Surgery Loma Linda Medical University Center Loma Linda, CA Based on radial pulse technology, the ZWave anticellulite treatment device from Zimmer MedizinSystems (Irvine, Calif.) utilizes high energy acoustic waves transmitted through the surface of the skin and dispersed radially into the tissue to affect a large and deep treatment area. Used as a stand-alone procedure, this unit is FDA cleared as a primary treatment for cellulite or as a secondary therapy after other methods of cellulite treatment have been delivered. According to a clinical study from Germany, radial pulse technology works to significantly reduce the perimeter of the thigh, after which the appearance of cellulite can be improved considerably. Amy Taub, M.D. Dermatologist Clinical Professor Northwestern University Medical School, Department of Dermatology Chicago and Lincolnshire, IL Linda Medical University Center in Loma Linda, Calif. The ZWave fit the bill and has been adopted and used for over two years with great acceptance by staff and patients. We have surgical, as well as many other invasive methods for addressing cellulite, Dr. Sasaki continued. There are a number of patients who do not want invasive or even minimally invasive methods, and prefer a non-invasive procedure. ZWave works very well for treating Grade 1 cellulite. Radial pulse therapy is a form of energy that performs similarly to light, explained Amy Taub, M.D., a dermatologist in Lincolnshire, Ill., and assistant clinical professor at Northwestern University Medical School, Department of Dermatology in Chicago, Ill. If you use a smaller spot size, or tip diameter, you obtain a more superficial energy that is denser. This means that the ZWave, which has a bigger spot size, can penetrate to the right depth of fat, but not create inflammation since the fluence isn t so concentrated. Dr. Sasaki employs the ZWave after surgical procedures to help smooth out irregularities and reduce edema that may be present. We start the ZWave treatment as soon as the patient is able to tolerate it, which is usually about three weeks following the surgical procedure, he said. It can help to diminish fluids and to break up internal scars after liposuction. Dr. Taub has employed the device as a post treatment therapy as well, following CoolSculpting. I had heard from colleagues that the ZWave improved CoolSculpting results and decreased side effects, she expressed. Now we use it after every CoolSculpting cycle, as well as in a protocol we have that uses combination therapy for cellulite and non-invasive body shaping. Adding ZWave resulted in improved outcomes and quicker recovery with reduced side effects, Dr. Taub stated. And the device itself is easy to use. The delivery systems are user-friendly and the settings are simple. The ZWave has been a valuable addition to Dr. Sasaki s practice with good return on investment (ROI). It is not so much a cost issue because the cost is low and the disposable is minimal, he said. The main thing about the device s ROI is the number of returning patients. I cannot overemphasize how easy of a treatment it is to deliver and for the patient to receive. I was searching for an effective method to address stand-alone treatment of cellulite, as well as an adjunctive treatment for many of the body contouring procedures that we do, stated Gordon H. Sasaki, M.D., F.A.C.S., clinical professor in the Department of Plastic Surgery at the Loma Before and after ZWave Tx Photos courtesy of Zimmer MedizinSystems 36 THE Aesthetic Guide January/February

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38 AirGent2.0 Propels Needleless Transdermal Skin Remodeling to New Heights By Kevin A. Wilson, Contributing Editor Building on its signature Jet Volumetric Remodeling (JVR) technology, the FDA cleared AirGent2.0 from PerfAction Technologies (Rehovot, Israel) offers even more powerful, minimally-invasive skin remodeling via needle-free pneumatic implantation of therapeutic compounds. This new device incorporates an innovative dosing system, stronger implantation jet stream, lighter applicator and intuitive user interface, translating into better Sabine Zenker, M.D. Dermatologist Munich, Germany Daniel Lanzer, M.D. Cosmetic Surgeon Sydney, Australia results and shorter sessions. Treatment is safe for all skin types, providing both long-term structural benefits that may last a year or more, along with immediate visible improvement in smoothness and hydration. This device is indicated for professional use only. Implanting hyaluronic acid (HA) via JVR technology harnesses a synergistic effect between the HA, which promotes hydration and neocollagenesis, along with stimulation of the skin s natural healing process. This is a direct result of the JVR-powered, 150 meters-per-second implantation mechanism, according to dermatologist Sabine Zenker, M.D. who has a private practice in Munich, Germany. The nanobullets of compound spread evenly beneath the skin up to 6 mm deep. This technology provides a truly safe way to create minimally-invasive microtrauma. Physicians and patients appreciate the long lasting results, minimal downtime, lack of pain and low risk of side effects such as post-inflammatory hyperpigmentation (PIH). This clinically proven non-thermal modality enables a kinetic face-lift for improvement of jawline contour, midface profile and nasolabial folds; lifting of the cheeks, jowls and brow; and tightening of the upper face, as well as improvement in skin quality and smoothing of fine lines and wrinkles. AirGent2.0 is suitable for large areas and even the most delicate areas of skin, such as the décolleté, neck, cheeks, around the eyes, lips, forehead and chin. It also efficiently treats many types of scars, added Dr. Zenker. It is the most effective way to stimulate production of new collagen in a targeted, but skin-friendly manner for acne scars and stretch marks. This device fills a therapeutic gap for which other treatments fail, and it can be used for all skin types regardless of sun exposure, with minimal downtime and risk. Cosmetic surgeon Daniel Lanzer, M.D., of Sydney, Australia likens the effect of JVR technology to that of HA fillers. The same compound which comprises many fillers is literally blown through the skin layers in an almost fractional matrix, for a thickening and rejuvenating effect, he explained. There is nothing else like it in our clinic and it is great for patients with low pain tolerance, as well as those who may be afraid of needles. Dr. Lanzer also uses AirGent for acne scars, stretch marks, fine lines, wrinkles and general rejuvenation. Results for stretch marks are better, compared to the numerous technologies we have in our practice. In addition, the disposable delivery kit can be used multiple times on a single patient, for maximum sterility and safety with manageable cost. Another benefit of the AirGent system is how safely it works with other therapies, according to Dr. Zenker. Combining treatments is key to obtaining the best results, and JVR technology can be easily combined with botulinum toxin, fillers and resurfacing modes, along with other modalities because it is safe and non-thermal. Combining treatments is key to obtaining the best results, and JVR technology can be easily combined with botulinum toxin, fillers and resurfacing modes, along with other modalities because it is safe and non-thermal. Before and 60 days after three AirGent treatment sessions Photos courtesy of Daniel Lanzer, M.D. THE 38 Aesthetic Guide January/February

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40 Novel Surgical Tool Achieves Efficacious Acne Scar Subcision By Mark B. Taylor, M.D. Acne scars before Tx Subcision of acne scars is well established as a useful procedure to release dermal scar bands, thus improving the appearance of depressed or rolling acne scars. Previously, the most common tool used to perform this procedure was an 18-gauge needle with a small slanted blade on the tip. The needle would be inserted in close proximity to the depressed acne scar and with a sweeping motion the scar bands were severed. Extensive acne scars would require multiple insertion points over the entire scarred area. A new acne scar subcision instrument, the Taylor Liberator, is making treatment of dermal scar bands much easier and more efficient. This surgical tool is designed with three slightly blunted tips separated by two grooves, which enables the surgeon to slide the dissecting tip along the dermal / subcutaneous interface to subcise scar bands with decreased risk of puncturing the overlying dermis and epidermis. These points and grooves make the process of subcision easier as less force is required since the pointed tips slide easily through the scar tissue, and the grooves secure the scar bands so released fibers do not slip around the end of the instrument. This novel tool has been researched and perfected over a period of eight years and treatment of more than 800 patients. In the early stages of design, the procedure involved two separate instruments, a blunt tip was used first, followed by a notched tip to release all of the scar bands. The Taylor Liberator allows this process to be completed in a single step. Furthermore, it is slightly curved to accommodate the curvature of cheeks and the forehead, starting with the bevel in an up position and then rolling it to a down position to easily traverse these facial structures. When using the Taylor Liberator the depressed areas of the rolling acne scars should be marked with a permanent marker using tangential lighting. Next the subcutaneous layer of the affected area should be filled with a solution of normal saline containing 2 mg/ml of Lidocaine in an otherwise standard Klein tumescent formula. When treating the forehead and temples, it is important not to fill the orbit with tumescent fluid. Once application of the tumescent fluid is complete, a number 11 blade is used to create a small entry point in the sideburn area to access the cheek and temple with the subcision instrument. For treatment of the forehead a single entry point is made at the center apex just inside the hairline. It is critical to keep the tip of the instrument at the subcutaneous / dermal interface, dissecting along the base of the dermis to avoid damaging vessels or nerves. Physicians new to this type of procedure should be fully trained to decrease the risk of cutting facial nerves or blood vessels and to avoid perforation of the buccal mucosa or other vital structures. Training is available via the Gateway Aesthetic Institute & Laser Center (Salt Lake City, Utah). After Taylor Liberator Tx Photos courtesy of Mark B. Taylor, M.D. Acne scars before Tx After Taylor Liberator Tx Photos courtesy of Mark B. Taylor, M.D. Dr. Taylor is a board certified, world-renowned dermatologist and cosmetic laser surgeon who has been in practice for over 30 years. He is a leader in the field of cosmetic laser surgery, pioneering and teaching many new techniques to over 4,000 physicians worldwide. The Taylor Liberator was recently evaluated and published in Dermatologic Surgery: Taylor, Mark B. MD; Zaleski-Larsen, Lisa DO; McGraw, Timothy A. MD. Single Session Treatment of Rolling Acne Scars Using Tumescent Anesthesia, 20% Trichloracetic Acid Extensive Subcision, and Fractional CO 2 Laser. Dermatologic Surgery: January Volume 43 - Issue - p S70 S74. If you are a physician interested in receiving more information about the Taylor Liberator and/or hands-on training visit 40 THE Aesthetic Guide January/February

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42 AQ Skin Solutions Introduces Growth Factor Induced Therapy results and a quicker recovery period. Growth factors also help stimulate collagen production in connective tissue cells, which will result in better, long lasting benefits. By Ahmed Al-Qahtani, Ph.D. Before Tx After two GFIT treatments using AQ Recovery Serum, Rejuvapen and AQ Active Serum Photos courtesy of AQ Skin Solutions Before Tx After two GFIT treatments with AQ Recovery Serum and AQ Active Serum Photos courtesy of AQ Skin Solutions Human blood is a specialized, vital fluid that travels through the circulatory system to support and maintain our body tissues by supplying oxygen and nutrients to the cells while also transporting metabolic waste. Accounting for 7% to 8% of human body weight, this mixture contains cellular elements such as erythrocytes (RBCs), leukocytes and platelets dispensed within a plasma liquid composed of water, growth factors, clotting factors, proteins, glucose, minerals, carbon dioxide and bodily wastes. Because of the differences in density, sediment rate and size, the components of blood can be separated and isolated via a double centrifugation technique, which separates the red blood cells from the plasma and sequentially isolates the platelet-poor plasma (PPP) from the platelet-rich plasma (PRP). In the early 1990s, PRP was recognized as a breakthrough in the field of tissue engineering and cellular therapy for its biologic potential to stimulate bone and soft tissue healing. Since then, this autogenous preparation of concentrated platelets has made it to the forefront of aesthetic medicine due to the rise of affordable PRP kits and devices. The appeal of PRP depends entirely on growth factor technology. Growth factors, otherwise known as cell signaling molecules, are naturally produced by the body and are critical for the regulation of cell activities and homeostasis. They act on cell membrane receptors using an internal cytoplasmic cascading signal sequence, which encourages natural gene expression. Their ability to easily penetrate skin and enhance the immune system response triggers secretion of other vital growth factors necessary to repair the skin. Products containing growth factors should stimulate a cooling sensation, minimize the risk of scarring, and signal re-epithelialization for better While PRP exhibits clinical potential within the field of medicine, it remains limited and controversial. For example, utilizing PRP for skin rejuvenation has actually proven to yield inferior results in comparison to a simpler growth factor application therapy. The danger of PRP lies in the inconsistency of human blood. The contents of human blood vary day by day, which makes results unpredictable. Even though the blood is autogenous, there is still a possibility of contamination, especially if the blood is not being tested for infections. With the limitations of PRP, AQ Skin Solutions Inc. (Irvine, Calif.) has recently developed a new patented growth factor technology, which so far has passed and exceeded the results we can achieve from PRP. It has shown great results utilizing growth factors without the need for patients blood or kits and centrifuges. This technology differs from PRP in two main aspects: first, it yields more concentrated growth factors. Second, it allows the production of specialized combinations of growth factors thus making them more targeted to specific indications, such as promoting repair or enhancing hair growth. AQ Skin Solutions now refers to their treatment as Growth Factor Induced Therapy (GFIT), which utilizes AQ growth factors in therapy at the physician s office. GFIT has been proven to be safer due to the selectivity of growth factors and its preservation at the appropriate combination within the formulation. It requires no additional equipment while reportedly supplying the highest concentration of growth factors on the market. GFIT is less expensive, less painful and produces consistent results. It is essential for physicians to remain educated on the possibilities of advancing their practice and bettering their results with proper delivery of the correct concentration and combination of growth factors and know they are not limited to PRP. 42 THE Aesthetic Guide January/February

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44 Laservision USA Provides Comprehensive Laser Safeguarding Laservision USA s laser safety eyewear protects physicians, technicians and patients, and is certified to block laser radiation from virtually all laser applications. As advancements in laser treatments accelerate, Laservision USA (Saint Paul, Minn.) continues to keep pace. The company s laser safety eyewear protects physicians, technicians and patients, and is certified to block laser radiation from virtually all laser applications. As an auto-darkening IPL protective eyewear, the Pulse XTR electronically reacts to light pulses and automatically transitions between viewing and protection modes in less than one millisecond for maximum safety. Offering full color visible transmission in viewing mode and a glare reduction factor of 9+ in protection mode, this protective eyewear is an excellent option for physicians performing IPL treatments. For patients, Laservision offers an assortment of reusable and disposable eye shields that offer complete protection. For laser resurfacing or laser surgery, physicians and technicians need clear visibility while staying guarded from the laser s light radiation. Laservision s F29.P5M01 safety eyewear provides excellent color recognition while offering a broad range of protection from lasers such as Nd:YAG, CO 2 and more. Each laser and its application determine the protection needed. The company s Certified Laser Safety Officers are fully committed to providing a greater understanding and awareness of the hazards and safety requirements associated with the use of lasers and will help you match the protective eyewear to your application. All Laservision laser safety products are ANSI-certified. CE-certified options are available as well. The company can also deliver custom solutions to fit your specific requirements. Laservision also provides laser safety training compliant with ANSI regulations. These training programs offer certifications for Medical Laser Safety Officers (MLSOs) as well as Medical Laser Safety Awareness (MLSA) training for typical laser users. Courses are available online and onsite and can be customized to provide tailored training for your staff. Offering full color visible transmission and a 9+ glare reduction factor, Pulse XTR is an excellent safeguard for physicians performing IPL treatments. F29.P5M01 safety eyewear provides excellent color recognition and a broad range of protection from lasers such as Nd:YAG, CO 2 and more. 44 THE Aesthetic Guide January/February

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46 Continued Advancements and Expanding Patient Base BOOST Aesthetic Practices By Michael Moretti, Editor-in-Chief D ue to improving business conditions, as well as the introduction of new technologies, devices and services, aesthetic practices are largely optimistic about the future of our industry as indicated by the latest edition of THE Annual Aesthetic Practice Survey Report by Medical Insight, Inc. (Aliso Viejo, Calif.). This fourth annual report assessed survey results from U.S.-based aesthetic practices, most of which encompass core dermatology, cosmetic surgery and plastic surgery clinics. Results examined existing developments in medical aesthetics compared with prior years and evaluated overarching trends. In addition to analysis of existing trends, this report compared current survey findings from one year ago. 46 THE Aesthetic Guide January/February

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48 Continued Advancements and Expanding Patient Base Boost Aesthetic Practices Anil Rajani, M.D. Cosmetic Surgeon Portland, OR Cheryl Whitman Founder Beautiful Forever Aesthetic Consulting Fort Lauderdale, FL William Philip Werschler, M.D., F.A.A.D., F.A.A.C.S. Assistant Clinical Professor of Medicine / Dermatology University of Washington School of Medicine Spokane, WA Mirroring the composition of most North American based aesthetic practices, a majority of the respondent cohort to this study employs 15 or fewer staff members, treats up to 50 patients per week and earns revenues of up to $1 million. In general, these practices anticipate a continuation of the thriving business conditions previously reported in the 2015 and 2016 survey results. This is further demonstrated in anticipatory staff expansion, addition of new services or equipment, increases in practice revenues and profits, and an uptick in patient volume. As stated by Anil Rajani, M.D., a cosmetic surgeon in Portland, Ore., People can now live longer, but more importantly they live better, meaning that they also want to look better, and they want it now. Aesthetic practices that offer Nordstrom-type levels of service combined with the speed of Amazon delivery will prosper. Most practices will do very well, but if one can combine these two elements there is no limit to the potential, he said. This year s aesthetic practice survey report reflects this sustained progress. Of those surveyed, 86% foresee another year of growth in annual revenue, while only 3% expect a decrease. Many respondents also reported they would grow their practice budgets in Top Uses for Expanded Practice Budget According to Cheryl Whitman, founder of Beautiful Forever Aesthetic Consulting in Fort Lauderdale, Fla., medical aesthetics still has a lot of room to expand. There are still a lot of Baby Boomers coming in to practices for the first time and they have a lot of disposable income, she noted. People are looking for non-invasive alternatives to surgery so physicians need to continue identifying changes in the marketplace and best-of-breed non-surgical procedures and products. Patients respond to low impact, low downtime treatments that maybe even utilize their own body tissues and fat in the process. Source: THE Annual Aesthetic Practice Survey Results, January 2017 Along those lines, among the nearly 75% of respondents that plan to add new aesthetic services in 2017, regenerative aesthetics (platelet-rich plasma, stem cells, new fat transfer modalities, etc.) is most desired, followed by injectable fat reduction (such as Kybella), thread lifting procedures, energy-based body shaping and skincare products. It is important to note that in the prior two years body shaping held the top position so the substantial rise in regenerative aesthetics and injectable fat reduction among practitioners is siginificant. 48 THE Aesthetic Guide January/February

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50 Continued Advancements and Expanding Patient Base Boost Aesthetic Practices Currently, combination treatments are popular and regenerative technologies blend excellently with existing therapies, Dr. Rajani expressed. People just don t have the exact formulas yet, but thought leaders are working on it. I have a new combination myself this year and others in the field are adopting these approaches, as well. Conferences such as THE Aesthetic Show allow all of us to compare notes and make moves to advance this field. Highest Revenue Generating Services Regenerative medicine is the leading edge of a new market segment, agreed William Philip Werschler, M.D., F.A.A.D., F.A.A.C.S., assistant clinical professor of Medicine / Dermatology at the University of Washington School of Medicine in Spokane, Wash. Once we acquire proof positive that regenerative approaches are effective and safe, and there is an enduring effect without side effects, it will be very popular. We have not gotten there yet. Regenerative medicine needs a homerun, like a BOTOX. Just look at how BOTOX took aesthetic medicine beyond breast implants and face-lifts. It was the door opener for the whole medspa office practice, he stated. Among other cutting edge treatments, energy-based feminine rejuvenation services have also shown incremental growth this year. Around one-fifth of surveyed practices added energy-based feminine rejuvenation to their list of services in 2016, which represents slight growth of this nascent market segment over the prior year. Moreover, around 14% said they plan to add energy-based feminine rejuvenation procedures in Currently only 17% of practices offer this vaginal / labial tightening treatment demonstrating the vast potential for growth. In assessing the entire spectrum of aesthetic procedures, new technologies, devices, services and skincare products remain important. However, neurotoxins and dermal fillers are still the most often performed procedures and rank among the highest Source: THE Annual Aesthetic Practice Survey Results, January THE Aesthetic Guide January/February

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52 Continued Advancements and Expanding Patient Base Boost Aesthetic Practices Percentage of Current Patient Volume that are Male revenue generating and most profitable treatments overall, according to the 2017 report. Patient volume among these product categories is likewise growing with 65% of those surveyed reporting a neurotoxin patient volume of 1 to 20 patients per week. Most respondents charge up to $600 per neurotoxin treatment. In addition, around 75% of participants report between 1 to 20 dermal filler treatments per week with 68% of practices charging up to $800 for a single dermal filler session. When looking at device-based procedures performed in 2016, energy-based skin rejuvenation was performed most often, with 58% of practices reporting up to ten weekly treatments. This represents a 7% increase over last year s survey. Energy-based skin tightening with technologies such as radiofrequency, ultrasound, etc., is performed less often, but is becoming more widely used in the field, with nearly 65% of practices performing up to ten weekly procedures. This is a notable 16% increase over 2016 survey results. Source: THE Annual Aesthetic Practice Survey Results, January 2017 You can couple skincare regimens with in-office procedures to create a comprehensive treatment program and you can capitalize on Millennial patients who are more aware of skincare, sunscreen, etc., than earlier generations. In-office sales of skincare products remain a profitable dark horse in aesthetic practices. Close to 87% of respondents currently sell skincare products from their practice, with an overwhelming majority of respondents (95%) reporting revenues of up to $300,000. This area is ripe for additional development, noted Ms. Whitman. The next wave in skincare is a resurgence in private label products of really good standing and quality, she stated. These products offer a huge return on investment. Custom practice-branded labels on every product remind patients of your practice every day. You can couple skincare regimens with in-office procedures to create a comprehensive treatment program and you can capitalize on Millennial patients who are more aware of skincare, sunscreen, etc., than earlier generations. Speaking of Millenials, this emerging patient segment, along with male patients, continue to be an important growth area for aesthetic practices. For instance, a majority of survey respondents report that up to 20% of their patients are male, which points to continued expansion in this market segment. 52 THE Aesthetic Guide January/February

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54 Continued Advancements and Expanding Patient Base Boost Aesthetic Practices A significant number buried in the statistics though, and a possible indication of future trends, is the 6% of practices with over 40% of male patients. Male patients are truly upon us, reported Dr. Rajani. They are loyal, open to our suggestions on treatment options and very happy clients. Skincare and facials may not be their thing, but facial volume, neurotoxins and longer-term products really appeal to them. They feel the social pressures now to look good and these days it is very accepted among their peers to get some work done. Similarly, Millennials are seeking aesthetic procedures in greater numbers, according to the report. Approximately 79% of those surveyed claim up to 30% of their patient base is Millennial age (defined as 20 to 35 years old). The smart practices are positioning themselves for five to ten years down the road, at a time when they will be in the right position with the right branding. As far as Dr. Rajani is concerned, Millennials are, Amazing clients. They want angles, projections and prevention. They realize aging is a choice now. They have no apprehension about the available products and they want to be involved in their outcome as they follow social media figures and popular trends, notably with lips, cheeks, noses and butt lifts. They know no boundaries and anything is possible in their minds. Dr. Werschler puts the market growth of younger patients in perspective. While I think the overall market is still driven by 35 year-old to 55 year-old women, we are starting to tinker around with treating the leading edge of the Millennials, with prevention being the best strategy, he said. We want Millennials to come in for a bit of neurotoxin so they don t get wrinkles, but that s not really when the majority of them will show up at your office. Percentage of Current Patient Volume that are Millennials When they start getting grey hair, lines, visible sun damage and sagging is when a majority of them will seek treatment, Dr. Werschler added. The smart practices are positioning themselves for five to ten years down the road, at a time when they will be in the right position with the right branding. Millennial patients will age into this demographic, but for now they are focused on acne more than wrinkles, he concluded. Source: THE Annual Aesthetic Practice Survey Results, January THE Aesthetic Guide January/February

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56 THE Certified Aesthetic Consultant Program Join over 2,000 Successful CAC Graduates To sign up for a free trial of the new CAC online program or for promotional rates contact Anjail Mitchell or

57 CAC has taken Rejuva Medical Aesthetics to a level of growth and excellence that we are incredibly proud of. The decision to have our entire staff participate in this exceptional program has fostered the development of a confident, productive and resourceful team. This program offers a wealth of knowledge that enables aesthetic practices to flourish. Sherry Leigh Practice Administrator Rejuva Medical Aesthetics Increase practice revenues and growth Master social media and internet marketing Acquire advanced staff management skills Learn how to run a more efficient and profitable practice Enhance your sales and marketing abilities Improve your patient assessment and consultation skills Learn how to deal with patient expectations Understand financial analysis and practice metrics

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59 Regenerative Science Set to Transform Aesthetic Medicine By Jeffrey Frentzen, Executive Editor R egenerative aesthetics is an emerging interdisciplinary field of research encompassing stem cell-based solutions involving stromal vascular fraction (SVF), microfat grafting and volumization technologies, tissue re-engineering, platelet-rich plasma (PRP) treatments, growth factors and the use of amniotic fluid in cosmetic procedures. THE Aesthetic Guide January/February

60 Regenerative Science Set to Transform Aesthetic Medicine Richard M. Goldfarb, M.D., F.A.C.S. Plastic and Reconstructive Surgeon Langhorne, PA Nikolay Turovets, Ph.D. CEO DefenAge Carlsbad, CA Sydney R. Coleman, M.D. Plastic Surgeon New York City, NY Mark Berman, M.D., F.A.C.S. Plastic Surgeon Beverly Hills, CA Farhan Taghizadeh, M.D. Director of Innovation Aesthetics Biomedical, Inc. Phoenix, AZ Allan Wu, M.D., F.A.C.S. Chief Scientific Officer The Regenerative Surgery Institute Rancho Mirage, CA Jason Emer, M.D. Cosmetic Dermatologist Beverly Hills, CA Just as the larger healthcare industry has embraced the concept of regenerative medicine and the innate potential of the human body to heal wounds and rebuild damaged tissue, aesthetic physicians are working on ways to apply this concept to the development of evidence-based applications centered on restoration, replacement and/or rejuvenation of tissues for anti-aging purposes. This new medical landscape offers patients potential breakthrough therapies that rely on the their own tissue and biology to maintain a youthful look and feel, noted Richard M. Goldfarb, M.D., F.A.C.S., a plastic and reconstructive surgeon in Langhorne, Penn. In the past, we wanted to live longer, but now we want to live healthier, look better and feel better. The regenerative approach answers this need and is now entering into mainstream medicine. Medical aesthetics is a logical place for these new technologies to take hold, explained Nikolay Turovets, Ph.D., CEO of DefenAge in Carlsbad, Calif. Molecular and gene-expression pathways are activated in humans in response to inflammation and tissue damage. This is very similar to the body s response to tissue aging. If we activate reparation pathways in aged tissue, then we can stimulate the regenerative response of our bodies and drive old tissues and organs to act revived and younger. A key modality for practitioners in regenerative aesthetics is fat grafting. The world is starting to notice how stem cell and growth factors are associated with fat grafting, said Sydney R. Coleman, M.D., a plastic surgeon in New York City, N.Y. It is amazing how one can stimulate the other to produce that acellular matrix, and when we place it into humans we are bringing along these growth factors and we can stimulate fat to actually repopulate the acellular matrix. The goal is to deliver stem cells into damaged tissues to either stimulate a person s own reparation process or to build new tissue via transplanted stem cells, noted Dr. Turovets. It may be stem cells isolated from adult tissues, such as fat-derived mesenchymal stem cells, stem cells isolated from birth-associated tissues, such as cord-blood and placental stem cells, or stem cells isolated from fetal tissues or pluripotent stem cells. Dr. Coleman further explained, We know that stem cells can precipitate the growth of blood vessels in damaged tissue and transform the blood vessels that are already there. What we don t know is how much the growth factors interact with all that and how essential they are. These are areas that are not only exciting for people in medical aesthetics and reconstruction, but also can affect almost every sort of medical application. As a result, a whole new era of medicine is upon us, stated Mark Berman, M.D., F.A.C.S., a plastic surgeon in Beverly Hills, Calif. We are in the business of helping people look healthier and better. Now you can also keep them physically healthy for longer with regenerative medicine, he said. We have been thinking of anti-aging medicine as giving people supplements, changing diets, exercise plans and approaches that help the patient s cells live longer. We re now looking at what I like to call cell renewal or cell replacement 60 THE Aesthetic Guide January/February

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62 Regenerative Science Set to Transform Aesthetic Medicine therapy. Theoretically people could live into their 100s, 150 or more and be quite healthy. In aesthetic procedures, stem cells are commonly paired with PRP in therapies that involve hair restoration, skin rejuvenation and other anti-aging concerns. Once injected, PRP sends regenerative signals to damaged tissues, delivering active proteins and cytokines, including growth factors. 40 year old male before Tx After autologous fat transfer to the chest and shoulders utilizing high definition lipo treatments and PRP Photos courtesy of Jason Emer, M.D. This is the fastest growing field in aesthetics that will blossom as the technology improves, stated Farhan Taghizadeh, M.D., director of innovation at Aesthetics Biomedical, Inc. (Phoenix, Ariz.). The quality of PRP is getting so good that you don t need to be an expert injector to obtain a great result. Moving forward, PRP and stem cell therapies will improve tremendously, which will create more opportunities for practices to engage in regenerative aesthetics. Even though there is a strong connection between fat grafting, stem cells and PRP, some practitioners may still consider regenerative aesthetics a myth or fake science. Let s go back to basic common sense biology, stated Allan Wu, M.D., F.A.C.S., chief scientific officer at The Regenerative Surgery Institute in Rancho Mirage, Calif. Cells need fuel to grow. Using someone s autologous serum or PRP-conditioned media is in many ways introducing factors that either feed or instruct cells to proliferate, and in some cases produce collagen. As a result, over the last five or so years we have seen an explosion of stem cell creams touting a virtual alphabet soup of critical skin factors, Dr. Wu continued. Whether or not the inducing signal is a protein, cytokine, exosome or growth factor does not matter, he said. What matters is the final clinical effect. One real-world regenerative treatment involves the use of micronized fat (also called nanofat) in dermal fillers, Dr. Coleman revealed. You take the suctioned fat and put it through a mesh strainer that sort of breaks up adipose tissue and also affects the stem cells in the fat. Injecting micro fat along with the structural matrix that holds fat together allows stems cell to grow in the muscles. What s left is matrix and growth factors, he reported. Before Tx Other new approaches include the utilization of amniotic fluid in stem cellbased aesthetic procedures, stated Dr. Goldfarb. That s the big thing happening right now, he said. Amniotic fluid contains rich sources of stem cells with properties in-between embryonic and adult mesenchymal stem cells, which make them attractive for cellular regeneration. We use that for our regenerative medicine aspect in penile indications and in certain areas of the scalp. We re seeing phenomenal results with it. In addition, regenerative aesthetics techniques appear to play well with energy-based, surgical and other modalities. When different approaches target the same response pathway, the results from such combination treatments become multiplied, Dr. Turovets stated. After fat grafting Tx to forehead Photos courtesy of Allan Wu, M.D., F.A.C.S. For instance, microneedling causes multiple wounds across skin, Dr. Turovets continued. The trauma causes our immune system to tell dormant LGR6-positive 62 THE Aesthetic Guide January/February

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64 Regenerative Science Set to Transform Aesthetic Medicine stem cells to wake up and create new basal stem cells in the area of the wound, and to fill that area with new keratinocytes. In other words, microneedling is activating a pathway that says build new skin. Before Tx After breast augmentation utilizing autologous fat transfer Photos courtesy of Jason Emer, M.D. Male patient before Tx After hair transplantation utilizing PRP injections Photos courtesy of Jason Emer, M.D. Such combination treatments have become very attractive to patients, expressed Jason Emer, M.D., a cosmetic dermatologist in Beverly Hills, Calif. As people get older, dermal filler and laser treatments can become overly aggressive, so patients are open to their own body s regenerative capabilities, like stem cells, PRP and microfat injections. Currently, we are combining microfat injections for fine lines and wrinkles of the chest and mouth with non-invasive devices like radiofrequency-based treatments or low-energy lasers. Many aesthetic physicians probably already have these systems. It would not be too far a leap for them to incorporate regenerative approaches, as well. With this in mind, how can practitioners successfully add regenerative aesthetic treatments to their practice? According to Dr. Berman, cosmetic surgeons are the best kind of practitioners to invest in regenerative aesthetics. They can do liposuction to harvest the cells, but at this point in time only a small percentage of people are receiving regenerative and stem cell treatments, he stated. This strikes me as a wide open market for us because we are dedicated to making people look younger and healthier. You could actually build up a multi-specialty team around yourself and have a new aspect of your cosmetic business as it extends into therapeutic medicine. To me that is really exciting. Many practices may already perform regenerative medicine, but do not realize it, stated Dr. Taghizadeh. If you look at the profitability of top aesthetic practices, it is not unusual to see upwards of 40% to 50% of the revenue coming from regenerative medical procedures, he said. Fat grafting, vaginal rejuvenation and PRP hair procedures are supporting some practices, versus breast augmentation or face-lifts. This is because the per-unit profitability of those regenerative therapies is high, as with any new procedure that comes to market where you charge a premium. In the end, the premium becomes a major profit center for the practice. It s not just about adding regenerative procedures here and there, added Dr. Emer. Developing a multi-specialty team is not farfetched, he said. It is so important to do an overall comprehensive analysis on someone who comes to see you for aesthetics. Take the athletic patient that came in for liposuction, but may also have joint pain or ripped a tendon. While I am removing the fat he can receive specialized stem cells that help his joints. So now it s not just lipo he s getting; it is comprehensive care that addresses overall wellness internal and external. This is the wave of the future, Dr. Emer continued. Practitioners need to have a team of experts to build on this comprehensive wellness concept and to be able to really enhance patient treatments over time. If you are adding therapies that use stem cells with PRP for building collagen, facial rejuvenation or to act as a filler, it is forward thinking to implement a preventative maintenance plan for those patients that come in every three months. It is not about line filling, it is about wellness and anti-aging. 64 THE Aesthetic Guide January/February

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66 Regenerative Science Set to Transform Aesthetic Medicine For instance, think about creating a long-term skincare management plan, Dr. Emer suggested. It s like creating an action plan for a child with asthma. Talk to patients about full body wellness. Work out a 12-month treatment plan that incorporates anti-aging with stem cells or skin rejuvenation using PRP, or light therapy, hair treatments, feminine and male rejuvenation. Acne scars before Tx Integrate regenerative aesthetic procedures gradually. Start in small areas where you know you will have success, such as post-procedure healing, Dr. Emer suggested. Patient demand is there, but you need to find out what you can truly do for them long-term. This is why I m partnering with specialists within my practice and outside of it, to determine how these regenerative capabilities can work for people to provide comprehensive care over a lifetime. If this all sounds too good to be true, keep in mind almost all stem cell and regenerative procedures are strictly off-label. The FDA has been very slow to adopt an official regulatory framework surrounding these therapies. A large public meeting held in September 2016 saw hundreds of interested parties answer FDA officials questions and pose aspects of that framework. The agency s response seemed to indicate it is unsure how to act, according to Dr. Berman. After Tx Photos courtesy of Allan Wu, M.D., F.A.C.S. 45 year old male before Tx The joke is that the FDA wants to call stem cell treatments a drug, Dr. Berman said. The problem with that approach is your cells can heal every medical injury you can imagine, and we would be laying claims for every disease possible proving that stem cells work. Calling it a drug is a little ridiculous. I think we will continue to collect more and more data and prove how effective it is. As we move along we will also get better at delivering products. As reported by Dr. Emer, The FDA has a very specific set of guidelines when it comes to fat. You can use fat for regenerative purposes if you do some minimal manipulation, use it homologously, and do same day procedures. In general, the FDA is kind of behind the times on these issues, and is a conservative body. However, they are trying to get up to speed because they know we are lagging behind countries like Japan and Germany. This situation is not surprising, noted Dr. Taghizadeh. Over the past few years, regenerative technologies have been leapfrogging the entire industry. Today, medical device companies are quick to say regenerative aesthetics is limited to things like vaginal rejuvenation, but we know the story doesn t end there. It begins with the devices and it ends with injectables that do the same thing. After butt augmentation utilizing autologous fat transfer, high definition lipo treatments and PRP Photos courtesy of Jason Emer, M.D. The reality is that what happened with facial aesthetics is happening with regenerative aesthetics. Remember how surgical face-lifts were replaced with Juvéderm, Restylane, BOTOX, etc.? Dr. Taghizadeh posed. The same thing is going to happen in regenerative medicine, in which automated systems will allow any practitioner to specialize in this field. The end result is patient outcomes are going to be much better than what we see today. 66 THE Aesthetic Guide January/February

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70 Technologically Advanced HA Fillers Bend with Facial Expressions By Jeffrey Frentzen, Executive Editor While many dermal fillers address facial wrinkles, until now none were designed to adequately flex with the skin to help patients maintain their expressions in motion. Two new products from Galderma, L.P. (Fort Worth, Texas) do just that. Restylane Refyne and Restylane Defyne have also provided a majority of patients in clinical studies with meaningful improvement in wrinkle severity for up to 12 months. Kelly Huang, Ph.D. Vice President and General Manager U.S. Aesthetic and Corrective Division Galderma, L.P. Fort Worth, TX Mitchel P. Goldman, M.D. Board Certified Dermatologist and Cosmetic Surgeon San Diego, CA Restylane Refyne is for mid-to-deep injection into facial tissue for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds. Similarly, Restylane Defyne is for midto-deep injection into facial tissue, but for the correction of moderate to severe, deep facial wrinkles and folds. Both products were developed to address a major consumer need, according to Kelly Huang, Ph.D., vice president and general manager of Galderma s U.S. Aesthetic and Corrective division. These products are backed by unparalleled science, from the gel technology focused on flexibility, to the preclinical Restylane Refyne and Restylane Defyne are unique gel fillers designed for elasticity and support. They provide options for people who crave naturallooking results that allow for organic expression and everyday movement. confirmation of tissue integration and clinical studies that confirm a younger and natural-looking expression, he explained. Also marketed in Europe since 2010 under the brand name Emervel, these fillers utilize a manufacturing process called XpresHAn Technology, which customizes the degree of HA crosslinking in each product, resulting in gels that work to provide natural-looking results for patients exhibiting moderate to severe lines and some sagging or deeper lines that need more lift. Mitchel P. Goldman, M.D., a double-board certified dermatologist and cosmetic surgeon in San Diego, Calif., feels the technological advancements modeled by these fillers should encourage U.S.-based aesthetic professionals to refine their views on patient assessment, experience and satisfaction. My patients want to look better, but are fearful of looking unnatural and fake, Dr. Goldman continued. Restylane Refyne and Restylane Defyne are unique gel fillers designed for elasticity and support. They provide options for people who crave natural-looking results that allow for organic expression and everyday movement, which is a need my clients voice to me every day. As Mr. Huang pointed out, these new fillers are expected to introduce a dialogue between physician and patient about how best to preserve natural expression. This important discussion will also grow the market, he said. It is not good enough to look natural in a photo, but to have natural expression while talking, laughing and smiling is key. While Galderma s internal research shows that around two million women participate in the injectables market, between 15 and 20 million more would like to, but are hesitant. Looking unnatural and not looking like themselves are among the top fears, Mr. Huang reported. Restylane Refyne and Restylane Defyne offer injectors a new level of flexibility, noted Dr. Goldman. With a consistent texture for natural movement and expression that integrates with your skin, these fillers were also designed to mimic the body s own HA production, which gives skin moisture, volume and elasticity for optimal assimilation, he said. Before and after 1.0 ml of Restylane Defyne to nasolabial folds, 1.0 ml Restylane Refyne to marionette lines and 2.5 ml of Restylane Lyft to cheeks Photos courtesy of Galderma, L.P. In addition, Mr. Huang stated that Galderma plans to plow significant investment dollars into training and support for patient consults and facial assessments, which should increase patient satisfaction. 70 THE Aesthetic Guide January/February

71 From March 3 7, 2017, the American Academy of Dermatology (AAD) will bring the best minds in this field together to create the most comprehensive scientific program in medical and aesthetic dermatology. With over 375 expert led courses covering hands-on sessions, simulated patient encounters and trending topics in dermatology; events and networking opportunities; and the latest innovations from over 400 exhibitors, AAD will surely engage and benefit every attendee. THE Aesthetic Guide January/February

72 Ascentium Capital Financing Ascentium Capital is a direct lender that specializes in providing equipment financing and leasing to businesses in the healthcare industry. We offer innovative equipment financing options from $5,000 to $1.5 million as well as Application-Only up to $250,000, credit decisions in two hours or less, flexible terms up to 84 months, custom payments to match cash flow, deferred payment options and online account management. We finance new or used equipment, 100% software and technology. Ascentium s 100% financing program allows for installation costs, shipping, tax and more to be financed. Ascentium Capital, Booth 1036 Collagen P.I.N. Collagen P.I.N. is a new innovation in advanced collagen induction therapy, one of the most effective treatments in aesthetic medicine for fine lines, acne scars and improvement of general skin appearance. Introducing a controlled wound into the skin triggers the release of natural growth factors, new collagen and elastin. Automated microneedling causes less damage to the epidermis than dermal rolling, lasers or other ablative treatments. When utilized with our Induction Therapies clean, clinical products (specifically designed for use post needling) complications are minimized and new skin cell growth is protected, providing quicker healing and longer lasting results. Collagen P.I.N., Booth 1688 ZWave Zimmer s Aesthetic Division manufactures award-winning devices for the treatment of cellulite and to enhance body contouring, as well as skin cooling during laser and other dermatological treatments. Practitioners can Catch the ZWave using Zimmer s non-invasive, radial pulse technology ZWave device to temporarily reduce the appearance of cellulite and as an adjunct to further improve body sculpting results. ZWave s electromagnetic generator creates a ballistic force that is transferred to the applicator. A short, comfortable, minute procedure delivers pulsed radial wave therapy to the treatment area. Enhanced, visible results may be seen after only two to three sessions. A modern, intuitive, color touchscreen makes the ZWave easy to use. Zimmer MedizinSystems, Booth 1361 Tensage Stem Cell Cream and Eye Cream VECTRA WB360 VECTRA WB360 is a 3D whole-body surface imaging solution designed for medical use. The innovative system accurately captures 92 individual photographs of the patient, producing a single high-resolution 3D image that precisely replicates the shape and skin features of the patient s body. Both standard non-polarized and cross-polarized 3D images are provided. The integrated DermaGraphix software helps clinicians map, measure and track pigmented lesions. The tracking of body surface area of distributed skin diseases such as psoriasis and vitiligo is possible. Canfield Scientific, Booth 1927 As a stem cell activator, Tensage Stem Cell Cream and Eye Cream, feature CellPro Technology, a unique ingredient containing signaling proteins extracted from eggs of the Cryptomhphalus aspersa snail, in an exclusive patented process. Clinically proven to assist the natural activity of stem cells, Tensage Stem Cell utilizes this new metabolic pathway to replenish skin cells, reinforce skin s intergrity and restore radiance, firmness, smoothness and a more youthful appearance. Biopelle, a Ferndale Pharma Group Company, Booth THE Aesthetic Guide January/February

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74 Eclipse PRP Eclipse PRP is a proprietary system that is based on blood separation according to density using a proprietary separation gel. The PRP platform is available with an 11 ml PRP collection tube or 22 ml high concentration PRP collection tube. This system allows for the preparation of pure Platelet-Rich Plasma (PRP) with optimal platelet concentrations and cellular content. Virtually all red blood cells (RBC) are eliminated from PRP and the concentration of pro-inflammatory granulocytes (GRs) is highly reduced. The entire preparation process only takes up to 20 minutes. 510(k) number BK Eclipse Aesthetics, Booth 2875 Epionce Daily Shield Lotion Tinted SPF 50 The cosmetically elegant, new Epionce Daily Shield Lotion Tinted SPF 50 sunscreen is launching at the AAD annual meeting. It provides broad spectrum protection that evens out skin tone while imparting a natural-looking healthy glow. Perfect for all skin types even sensitive or allergy-prone skin this water resistant formula is enhanced with botanical ingredients for anti-inflammatory and antioxidant benefits. Providing sheer protection in just the right amount of color to let skin look bare, Epionce Daily Shield Lotion SPF 50 is ideal for daily use alone or under makeup to provide optimum protection from UV exposure. Epionce, Booth 1775 Suneva Medical, Inc. Suneva Medical, Inc., is a privately-held aesthetics company focused on developing, manufacturing and commercializing novel, differentiated products for the general dermatology and aesthetic markets. This innovative leader markets Bellafill, which is uniquely FDA approved for the correction of nasolabial folds and moderate to severe, atrophic, distensible facial acne scars on the cheek in patients over the age of 21 years. The company markets Bellafill in the U.S. and Canada; ArteFill in South Korea and Singapore; and Regenica skincare in the U.S. and Canada. Suneva Medical, Inc., Booth 1667 Mediscope Bodystation FotoFinder Systems will be offering demonstrations of its Mediscope Bodystation, the cutting edge imaging solution for consistent before and after photo documentation of virtually any aesthetic, medical or surgical procedure such as injectables, facial rejuvenation, body contouring, skin tightening or leg vein procedures. This system features the unique Laser Liner for consistent patient positioning at baseline and follow-ups. Every photo is automatically labeled and stored in a patient database for effortless retrieval. The Universe ipad App provides image access at your fingertips in any consultation room. With no need for a floor mat, a small foot print, just one power cord and no loose cables, it is the only truly mobile studio system on the market. FotoFinder Systems, Booth 1969 INTRAcel INTRAcel fractional RF microneedle (FRM ) is a revolutionary system that utilizes monopolar and bipolar radiofrequency combined with 49 insulated microneedles to treat acne scarring, wrinkles, various skin irregularities, large pores, general rejuvenation, stretch marks and collagen stimulation. INTRAcel allows precise and independent control of RF energy delivery, depths and thermal zone in any layer of the skin. Physicians can finely tune treatments by selecting and combining the ideal energy needed to achieve the best results. Perigee Medical, Booth 1581 Halo Halo is a novel Hybrid Fractional Laser that delivers non-ablative and ablative wavelengths to the same microscopic treatment zone. The combination of these two wavelengths generates a robust synergistic effect, resulting in the ablative results patients want without the downtime they expect. The 1470 nm non-ablative wavelength is ideal for treating epidermal and dermal elastosis, including discoloration, poor texture and the appearance of enlarged pores nm Er:YAG provides pure ablation with no bulk heating. This superficial ablation decreases healing time through fast clearance of necrosis and provides improved results due to an enhanced wound healing response. Sciton, Booth THE Aesthetic Guide January/February

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76 Restylane Refyne and Restylane Defyne Restylane Refyne and Restylane Defyne are the latest FDA approved dermal fillers for the treatment of smile and laugh lines (such as nasolabial folds). These are next-generation hyaluronic acid (HA) fillers manufactured with XpresHAn Technology, creating gels that offer a range of flexibility for expression in motion. Restylane Refyne is for the treatment of moderate to severe facial wrinkles and folds, while Restylane Defyne is for the treatment of moderate to severe, deep facial wrinkles and folds. Both of these products have been shown to maintain effectiveness for up to 12 months. Stop by our booth to learn more. Galderma, Booth 1605 Dynamis Pro The Dynamis Pro offers two superior laser technologies to allow for high-precision and efficient procedures. With the recent addition of the new and advanced L-Runner Scanning System, Fotona introduces TightSculpting, a fast, safe and effective non-invasive alternative to laser lipolysis, with no consumables or downtime required for the patient. Combined with such an impressive line of advanced accessories and an intuitive, user-friendly touchscreen, the Dynamis Pro is the true multi-application laser system. Fotona, Booth 1105 Enerjet2.0 Enerjet2.0 joins non-surgical treatments for deep remodeling and long lasting results together with supreme needle-free intradermal compound delivery. JVR technology uses a jet stream to create an even and optimal spread of healing compounds within the skin, achieving a deeper absorption of material and a unique trauma pattern. This technology immediately achieves a smoother, well-hydrated and younger look with long-term structural benefits. It also offers clinically proven solutions for hard-to-treat indications such as acne scars, keloid scars, stretch marks and neck wrinkles. EnerJet2.0 is not sold in the U.S., for more details about models available in the U.S. please visit our booth. PerfAction, Booth 3089 F22.P5M02 Eyewear Laservision USA s lightweight F22.P5M02 laser safety eyewear provides optimal protection during procedures using Nd:YAG lasers. This nearly clear lens offers excellent visibility, allowing for great color recognition while performing laser treatments. The frame s innovative design offers soft gripping tips for a safe and stable fit. It is specially designed to fit comfortably over prescription glasses and offers a wide field of view. Dermatologists prefer using the F22.P5M02 when providing laser treatments for hair removal, skin resurfacing, tattoo removal and more. Laservision USA, Booth 1130 Crystal Clear Digital Marketing Crystal Clear is an industry leader providing digital marketing, software and consulting solutions for the modern medical / aesthetic practice. Over the past 19 years, we ve built the most comprehensive and cost-effective solution that includes multimedia mobile responsive web design, search engine optimization, search engine marketing, social media management, marketing, mobile and text message marketing, virtual staff training, patient relationship management and so much more. We are 100% focused on helping local medical practices effectively find, serve and keep more patients profitably. Crystal Clear Digital Marketing, Booth THE Aesthetic Guide January/February

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78 Clear + Brilliant pélo The Clear + Brilliant pélo laser is a new and innovative laser hair removal technology with a first-in-class mechanism of action that incorporates linear scanning technology to help maximize efficacy, speed and patient comfort, all with just one handpiece. This new device has the largest spot size and scan area within the class of diode hair removal lasers, allowing for full body treatments amongst all skin and hair types. Solta Medical, a division of Valeant Pharmaceuticals North America, LLC, Booth 2005 Spectrum Platform Laser/IPL The Spectrum is a multi-platform work station that can be used to perform most laser and Intense Pulsed Light (IPL) procedures. Currently, the Spectrum features four different lasers: 810 diode for permanent hair reduction and removal; Erbium YAG for skin resurfacing; Q-switched YAG / KTP for tattoo and pigmented lesion reduction; long pulsed YAG for vascular reduction; and an IPL system that includes four filters and can be used for a myriad of non-ablative procedures. The purchase price for the Spectrum is $54,995. Rohrer Aesthetics, Booth 2791 Discovery Pico Series Discovery Pico Series offers powerful picosecond devices, with a max peak power of 1.8 GW double that of any other picosecond device available. Proprietary features like QuattroPulse technology allow the devices to be operated in four separate emission modes: Picosecond, Q-switched, OptiPulse and Photo-Thermal pulse durations, giving you even more treatment options, efficacy and flexibility. The addition of the 694 nm true Ruby laser in the Plus model makes this the premier picosecond laser for skin treatments and tattoo removal. Discover the Quanta difference that is transforming aesthetics. Quanta Aesthetic Lasers, Booth 3063 DefenAge Clinical Power Trio Named one of the biggest breakthroughs in skincare in 2016, DefenAge s exclusive ingredient, Age-Repair Defensins, works via a natural mechanism of action. Clinical studies prove that this revolutionary anti-aging skincare system addresses up to 16 signs of aging in just six weeks. Initial results become visible within the first week of treatment. The technology is patent-pending and can be combined with almost any skincare regimen. Comprehensive multi-center, double-blinded, placebo-controlled clinical studies have been performed by Amy Forman Taub, M.D. (PI), Vivian Bucay, M.D. and Gregory Keller, M.D. DefenAge Skincare, Booth 1286 ThermiRF ThermiRF is a unique temperature controlled radiofrequency technology designed to safely produce excellent aesthetic outcomes through the application of the science of heat. This is a platform technology which combines precision temperature control with advanced real-time temperature monitoring to enable a myriad of soft tissue applications. Such applications are: ThermiTight, for controlled subdermal tissue heating; ThermiRase, for the toxin-free disabling of nerves; and ThermiSmooth Face, for controlled non-invasive tissue heating. Available as an add-on to the ThermiRF device is ThermiVa, which uses a patent pending electrode designed to heat tissue including the vaginal anatomy. Thermi, Booth THE Aesthetic Guide January/February

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81 THE Aesthetic Show 2017 AForecasts Powerful Growth Trends As the premier multidisciplinary conference for plastic and cosmetic surgeons, dermatologists and related specialists, THE Aesthetic Show (TAS) has become the largest and most influential educational forum of its kind driving our $9 billion aesthetic industry forward. Returning to the luxurious Wynn Resort in Las Vegas from July 6 9, 2017, TAS will be led by scientific chairman Andrew P. Ordon, M.D., F.A.C.S., an acclaimed plastic and reconstructive surgeon, and co-host of The Doctors. Owing to TAS scope and influence, attendees not only benefit from direct access to an exceptional faculty of key opinion leaders and experts, top tier scientific educational programming, MBA-level practice management seminars, hands-on training courses and live patient treatment workshops, but also gain experience with the most cutting edge technological innovations and next-generation treatments. It all culminates with THE Aesthetic Awards ceremony, also known as The Oscars of aesthetic medicine, honoring the best clinical outcomes and professionals in the field. THE Aesthetic Guide January/February

82 THE Aesthetic Show Redefines Diverse $9 Billion Industry Over the past 11 years THE Aesthetic Show has attracted the most diverse audience of medical professionals totally focused on advancing the art and practice of medical aesthetics. Now the largest and most influential medical education conference and commercial tradeshow dedicated to our industry, TAS constantly redefines and directs the steady progress of this increasingly mainstream market. In addition to hundreds of scientific presentations over four days, TAS will both measure and forecast the next several waves of powerful macro trends driving new growth for years to come. Attendees will find themselves immersed in educational sessions and treatment demonstrations covering the hottest new topics of Regenerative Aesthetics, Feminine Rejuvenation and Male Aesthetic procedures. And let s not forget about the Millennials who represent the most important demographic entering the patient treatment pool much earlier than their parents. Welcome to your future! Michael Moretti Chairman THE Aesthetic Show Andrew P. Ordon, M.D., F.A.C.S. Scientific Chairman THE Aesthetic Show Pre-Show Educational Sessions Thursday, July 6, 2017 THE Art of Feminine Rejuvenation Symposium* 9:00 am 6:00 pm THE Aesthetic Show presents THE Art of Feminine Rejuvenation symposium featuring the thought leaders who developed this rapidly emerging field. This full day course will cover all aspects of non-invasive and minimally invasive vulvovaginal rejuvenation procedures using energy-based systems and other approaches. Attendees will have the opportunity to learn the latest, most advanced techniques and exclusive tips from experts. In addition, a portion of this course is devoted to live demonstrations of the latest technologies used in these emerging procedures. Lecture topics include: Laser vaginal rejuvenation and the concept of vulvovaginal beauty Minimally invasive energy-based treatments as an adjunct to surgical vaginal repair Treating stress urinary incontinence with energybased devices Labia majora augmentation, including labial or clitoral hood issues The successful treatment of atrophic vaginitis Labia reduction and contouring for improved appearance or balance, including the use of fat injections The G-Spot Connection: Vaginal surgery and sexual satisfaction Non-surgical vulvovaginal rejuvenation using radiofrequency-based systems Controversies in aesthetic vulvovaginal surgery Managing patient expectations following cosmetic vulvar procedures Growing your practice revenues with feminine rejuvenation * Program schedule and faculty subject to change. THE Art of Male Aesthetics Symposium* 9:00 am 6:00 pm THE Aesthetic Show presents THE Art of Male Aesthetics symposium featuring thought leaders who have advanced this rapidly emerging field. This full day course will cover all aspects of the dynamic and fast growing male aesthetics sector from patient consultation approaches to clinical treatment methods and options. Attendees will have the opportunity to learn the most progressive techniques and exclusive secrets to success from the top experts in this field. In addition, a portion of this course is devoted to live demonstrations of the latest technologies used in these emerging procedures. Lecture topics include: The role of non-invasive body shaping as a priority gateway procedure for men Technical approaches to facial rejuvenation that avoid feminization Minimally and non-invasive energy-based skin rejuvenation treatments Optimizing success with non-surgical gynecomastia Penis enhancement without complications via injectables Update on the Man Shot Emerging technologies and treatments that appeal to the male patient Understanding how to achieve desirable body contouring objectives Hair restoration for men Dealing with the expectations and clinical goals of transgender patients Growing your practice revenues via male-oriented procedures and marketing * Program schedule and faculty subject to change. Regenerative Aesthetics Symposium* 9:00 am 6:00 pm THE Aesthetic Show has added a dynamic pre-show session, which will focus on Regenerative Aesthetics, an emerging interdisciplinary field of research for developing evidence-based anti-aging applications. This symposium centers on the restoration, replacement and / or rejuvenation of tissues for anti-aging purposes. Regenerative Aesthetics includes stem cellbased solutions, microfat grafting and volumization technologies, tissue re-engineering, DNA / RNA therapies, platelet-rich plasma (PRP), platelet-rich fibrin (PRF), stromal vascular fraction (SVF), growth factors and more. Lecture topics include: Regenerative medicine in aesthetic surgery A vision for the future or just hype? The new panorama of microfat and SVF applications Stem cell therapy and PRP / PFRM Myth versus reality? Using biologics in the treatment of androgenetic alopecia Micronized fat transfer technologies and techniques Fat grafting versus adipocytic derived stem cells (ADCs) for rejuvenation Harnessing the power of growth factors for tissue rejuvenation Advancements in amniotic stem cell procedures Understanding the limitations of PRP Cell-assisted lipotransfer in facial augmentation How to successfully add regenerative aesthetic treatments to your practice * Program schedule and faculty subject to change. 82 THE Aesthetic Guide January/February

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84 Pre-Show Educational Sessions Thursday, July 6, 2017 Advanced Hands-On Injectable Training Courses Level X 8 CME Credits THE Aesthetic Show presents two hands-on injectable training courses taught by experts. Each of these half-day courses will provide attendees with the opportunity to learn the latest, most advanced injection techniques and tips from experts, as well as the ability to practice these techniques under the guidance of skilled instructors. Participants will receive course materials and 4 CME credits upon completion of each course. Course 1: Advanced Neurotoxin Techniques Level X* Thursday, July 6 9:00 am 1:00 pm Expert Faculty: Lori Robertson, M.S.N., F.N.P.-C., Robert J. Troell, M.D., William Phillip Werschler, M.D., Edward M. Zimmerman, M.D. Lecture topics include: Principles and practices to achieve optimal results for facial shaping, wrinkle reduction and facial rejuvenation using neurotoxins How to treat difficult complications using neurotoxins Discovering the latest off-label techniques Overview of neurotoxins available and the next generation of neurotoxins pending approval Growing your practice revenues with injectables Building confidence as an injector and in assessing patient needs Post-lecture, participants will receive personal instruction and hands-on experience performing the demonstrated techniques and building confidence as an injector. Course 2: Advanced Dermal Filler Techniques Level X* Thursday, July 6 2:00 pm 6:00 pm Expert Faculty: Shino Bay Aguilera, D.O., Michael H. Gold, M.D., Anil Rajani, M.D., William Phillip Werschler, M.D. Lecture topics include: Principles and practices to achieve optimal results for facial shaping, wrinkle reduction and facial rejuvenation using dermal fillers How to treat difficult complications using dermal fillers Discovering the latest off-label techniques Overview of dermal fillers available and the next generation of dermal fillers pending approval Growing your practice revenues with injectables Building confidence as an injector and in assessing patient needs Post-lecture, participants will receive personal instruction and hands-on experience performing the demonstrated techniques and building confidence as an injector. * All products and models are provided at no additional cost to attendees for both injection courses. ** Enrollment is limited. Participants must have previously completed a training course and have at least six months practical experience in order to enroll. THE Certified Aesthetic Consultant Fast Track Certification Program Advanced Techniques for Practice Success Level XI* C C AC C A Certified Aesthetic Consultant THE Aesthetic Show presents THE Certified Aesthetic Consultant Fast Track Certification Program Level XI. Designed as a highly-structured, interactive and intensive one-day platform, participants will have the opportunity to take an examination at the conclusion of the show to receive their level XI certification. Instructors will be drawn from THE Aesthetic Show faculty including experts in practice marketing, patient counseling and office management. 8:30 am Registration and Breakfast 9:00 am 11:00 am Session I: Advanced Marketing Techniques At the conclusion of this session participants should be better able to: Examine their brand and determine how to modify or build their reputation Improve the practice s positioning in the local market Learn ways to improve the success of their internet and digital activities Create a more powerful social media marketing plan Analyze the success of their invertizing and advertising activities to recruit and convert additional patients Obtain methodology to improve all aspects of patient conversion rates 11:00 am 11:15 am Break 11:15 am 1:00 pm Session II: Advanced Practice Metrics At the conclusion of this session participants should be better able to: Develop systems to identify return on investment (ROI) Apply ROI formulas to all aspects of practice profit and loss Analyze pricing strategies to improve profit Learn to minimize waste and excess cost in practice Become acquainted with negotiation tactics to lower costs 1:00 pm 2:00 pm Lunch 2:00 pm 3:45 pm Session III: Advanced Counseling Skills Through the use of role play and feedback, participants will learn to improve their customer service methods when dealing with the following types of patients: The new patient The undecided patient The upset patient The negotiator The shopper The VIP patient The red-flag patient The easy / moderate / hard to upsell patient 3:45 pm 4:00 pm Break 4:00 pm 6:00 pm Session IV: Management Skills At the conclusion of this session participants should be better able to: Deal with the most common performance-related problems Improve team performance Coach and counsel employees for higher levels of performance Conduct a performance review Incentivize key staff Understand the complex legal and risk management issues that confront aesthetic practices and how to avoid them *Program schedule and faculty subject to change. 84 THE Aesthetic Guide January/February

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86 Expert Faculty Shino Bay Aguilera, D.O. Oscar A. Aguirre, M.D., F.A.C.O.G., F.A.A.C.S. Red M. Alinsod, M.D., F.A.C.O.G., A.C.G.E. Bobby Awadalla, M.D. Russell Bartels, M.D., F.A.C.O.G. Mark Berman, M.D., F.A.C.S. Patrick Bitter, Jr., M.D. Monica Bonakdar, M.D. Gregory Buford, M.D., F.A.C.S. Rich Castellano, M.D. Gregory Chernoff, M.D., F.R.C.S. Suneel Chilukuri, M.D., F.A.A.D., F.A.C.M.S. Ritu Chopra, M.S., M.D. Steven Cohen, M.D. Sydney R. Coleman, M.D. Angelo Cuzalina, M.D., D.D.S. Adam DeGraide Paula Di Marco Young, R.N. Jason Emer, M.D. Chad Erickson Rebecca Gelber, M.D. Dore J. Gilbert, M.D. Michael H. Gold, M.D. Richard M. Goldfarb, M.D., F.A.C.S. Jon M. Grazer, M.D., M.P.H. Pearl E. Grimes, M.D. Steven B. Hopping, M.D., F.A.C.S. Elizabeth B. Houshmand, M.D. John Kahen, M.D. Jonathan Kaplan, M.D., M.P.H., F.A.C.S. Kian Karimi, M.D., F.A.C.S. Ramtin Kassir, M.D. Monika G. Kiripolsky, M.D., F.A.A.D. Shelena C. Lalji, M.D. Garry R. Lee, M.D. Harrison H. Lee, M.D., D.M.D., F.A.C.S. Malcolm Lesavoy, M.D., F.A.C.S. Corey S. Maas, M.D., F.A.C.S. David Mandell, J.D., M.B.A. Nasrin Mani, M.D. J.D. McCoy, N.M.D. Craig Mezrow, M.D., M.S., F.A.C.S. Elliott Milstein Gary Motykie, M.D., F.A.C.S. Gregory P. Mueller, M.D., F.A.C.S. Sheila Nazarian, M.D. Joseph Niamtu, III, D.M.D. Andrew P. Ordon, M.D., F.A.C.S. Patti Owens, R.N. Melanie D. Palm, M.D. Samir Pancholi, D.O. Sam Peek Paul Perito, M.D. Christine Petti, M.D., F.A.C.S. David Phillips Anil Rajani, M.D. Alexander Z. Rivkin, M.D. Wendy E. Roberts, M.D. Lori Robertson, M.S.N., F.N.P.-C. Leif Rogers, M.D., F.A.C.S. E. Victor Ross, M.D. Tim Sawyer Jaime Schwartz, M.D., F.A.C.S. Darren Seigel, Esq. Jay Shorr Mara Shorr Lane Smith, M.D., F.A.A.C.S. Farhan Taghizadeh, M.D. George Taylor, M.D. Mark B. Taylor, M.D. Carl R. Thornfeldt, M.D., F.A.A.D. Robert J. Troell, M.D., F.A.C.S. Lisa Wark Greg Washington, Sr. William Philip Werschler, M.D., F.A.A.D., F.A.A.C.S. Cheryl Whitman Allen Yang Wu, M.D. Edward M. Zimmerman, M.D. *Faculty subject to change THE Aesthetic Show 2017 Preliminary Program* Friday, July 7, 2017 Exhibit Hall Hours: 8:00 am 5:00 pm Lafite Ballroom 8:00 am Breakfast in Exhibit Hall Presentations and live demonstrations 9:00 am 11:30 am General Session Welcome Address THE Aesthetic Visionaries Moderator: Michael Moretti Michael Moretti: New Mega Trends in Aesthetic Medicine Sheila Nazarian, M.D.: How to Capture and Manage Millennials Suneel Chilukuri, M.D.: Understanding the New Aesthetic Male Patient Shelena C. Lalji, M.D.: Embracing Women s Health with Technology Solutions Gregory P. Mueller, M.D.: Harnessing the Power of Patient Visualizers David Phillips: The Future of Digital Marketing Revealed Edward M. Zimmerman, M.D.: Defining Regenerative Aesthetics 11:30 am 1:00 pm Lunch in Exhibit Hall Presentations and live demonstrations 1:00 pm 3:15 pm Breakout Educational Workshops Session One: 1:00 pm 2:00 pm Session Two: 2:15 pm 3:15 pm 3:15 pm 4:00 pm Break in Exhibit Hall Presentations and live demonstrations 4:00 pm 6:30 pm General Session I Advanced Body Shaping Technologies This session will provide a comprehensive review of the leading body shaping procedures and technologies. Moderator: Angelo Cuzalina, M.D. Jason Emer, M.D.: High Definition Liposuction and Non- Invasive Technologies Suneel Chilukuri, M.D.: Putting it All Together: Updates on Body Contouring Lori Robertson, M.S.N., F.N.P.-C.: Non-Invasive Fat Destruction: The Real Truth Corey S. Maas, M.D.: Combination Treatments Using Cellfina and Kybella Jaime Schwartz, M.D.: Lipo-Lift Angelo Cuzalina, M.D.: Buttock Augmentation to Match Ethnic Diversity for Best Results Panel Discussion: Practical Evaluation of the Newest Devices and Techniques General Session II Energy-Based Anti-Aging Skin Treatments Part One This session will focus on energy-based skin treatments for resurfacing and anti-aging. Moderator: Christine Petti, M.D. Rebecca Gelber, M.D.: Combining All the Treatments in Your Toolbox for Amazing Results Michael Gold, M.D.: Not All RF is Created Equal: Understanding the Difference Mark B. Taylor, M.D.: How to Evaluate and Selectively Adopt New Technology Christine Petti, M.D.: Neck Rejuvenation Aesthetic Choices to Treat Text Neck and Beyond Panel Discussion: Critical Evaluation of New Technologies: How do You Choose? General Session III Emerging Procedures and Technologies Part One This session will provide a comprehensive review of the emerging technologies and procedures being introduced in the aesthetic industry. Moderator: Richard M. Goldfarb, M.D. John Kahen, M.D.: PRP and the Benefits in Hair Growth With and Without Hair Transplant Surgery Mark B. Taylor, M.D.: Super Diluted Sculptra for Off-Face Skin Rejuvenation Gregory Chernoff, M.D.: Aesthetics of the Future: Subliminal Difference vs. the Full Monty Steven B. Hopping, M.D.: Thigh Gap Phenomenon: Giving Your Patients What They Want with Multimodality Therapies Richard M. Goldfarb, M.D.: The Spydr Lift Minimally Invasive Buttock Lift Using Polypropylene Strands with Resorbable L-Lactide and Glycolide Cones Panel Discussion: Critical Evaluation of New Technologies: What is the Safety Limit? Advanced Injectable Applications and Techniques Course This course will provide attendees with the opportunity to learn the latest, most advanced injection techniques and tips from experts. Advanced Techniques for Practice Success Course This course is designed to assist practices with building, growing and marketing an aesthetic business. 6:30 pm 9:30 pm Sponsor Cocktail Party Events Saturday, July 8, 2017 Exhibit Hall Hours: 8:00 am 7:30 pm Lafite Ballroom 8:00 am Breakfast in Exhibit Hall Presentations and live demonstrations 9:00 am 11:30 am General Session I Next-Generation Anti-Aging Skincare This session will provide insight into the many categories of available products and ingredients commonly used in skincare formulations and cosmeceuticals. Moderator: Farhan Taghizadeh, M.D. Carl Thornfeldt, M.D.: The Real Drivers of Aging, Acne and Skin Disease Bobby Awadalla, M.D.: The Role of Oral Supplements in Skin Protection, Repair and Beauty Panel Discussion: Determining the Product Lines that Your Patients Need General Session II Energy-Based Anti-Aging Skin Treatments Part Two This session will discuss combination energy-based treatments for skin resurfacing and tightening as well as technology for other applications and skin types. Moderator: Craig Mezrow, M.D. E. Victor Ross, M.D.: Technical Evaluation of New Generation Laser and RF Technologies Jason Emer, M.D.: Next-Generation Ultrasound Based Devices for Improved Results Robert J. Troell, M.D.: Evaluating Facial Aesthetic Outcomes Comparing Multiple Skin Resurfacing Modalities Suneel Chilukuri, M.D.: How Combination Energy Sources Work Synergistically Craig Mezrow, M.D.: The Device Based Face-Lift: Is it Real? Panel Discussion: Devices that Really Deliver on Promises General Session III The Future of Plastic Surgery This session will provide a comprehensive review of the future of plastic surgery and new techniques and procedures. 86 THE Aesthetic Guide January/February

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88 Suneel Chilukuri, M.D., F.A.A.D., F.A.C.M.S. Jason Emer, M.D. Michael H. Gold, M.D. Kian Karimi, M.D., F.A.C.S. Shelena C. Lalji, M.D. Sheila Nazarian, M.D. THE Aesthetic Show 2017 Preliminary Program* Moderator: Andrew P. Ordon, M.D. and Ritu Chopra, M.D. Malcolm Lesavoy, M.D.: Demystifying Breast Augmentation Mark Berman, M.D.: How to Integrate Stem Cell Science into Optimal Surgical Results Samir Pancholi, D.O.: New Form Stable Breast Implants Harrison H. Lee, M.D.: The Current State of Affairs in Facial Feminization Surgery Jon M. Grazer, M.D.: Latest Advances in Nanofat Grafting Joseph Niamtu, III, D.M.D.: The Technical Use of Facial Implants Gary Motykie, M.D.: How to Help the Botched Patient Panel Discussion: Managing Patients with Extreme Expectations Advanced Injectable Applications and Techniques Course This course will provide attendees with the opportunity to learn the latest, most advanced injection techniques and tips from experts. Advanced Techniques for Practice Success Course This course is designed to assist practices with building, growing and marketing an aesthetic business. 11:30 am 1:00 pm Lunch in Exhibit Hall Presentations and live demonstrations 1:00 pm 3:15 pm Breakout Educational Workshops Session One: 1:00 pm 2:00 pm Session Two: 2:15 pm 3:15 pm 3:15 pm 4:00 pm Break in Exhibit Hall Presentations and live demonstrations 4:00 pm 6:00 pm General Session I Emerging Procedures and Technologies Part Two This session will continue with the comprehensive review of the emerging technologies being introduced in the aesthetic industry. Moderator: Sheila Nazarian, M.D. Sydney R. Coleman, M.D.: Update on the Coleman Technique of Fat Grafting and the Science Behind Fat Grafting Including Catastrophic Complications Michael H. Gold, M.D.: Customized Vectoring Treatment Methods Using Microfocused Ultrasound Paula Di Marco Young, R.N.: The Use of PRP to Increase Revenue in Your Practice Elizabeth Houshmand, M.D.: Hands: A Complete Makeover Richard M. Goldfarb, M.D.: The Use of Platelet-Rich Fibrin Matrix Combined with Viviscal Showing Improved Results in the Treatment of Hair Loss in Males and Females Sheila Nazarian, M.D.: The Non-Invasive Mommy Makeover Panel Discussion: Where Do New Technologies Fit in Your Practice General Session II The Future of Aesthetic Dermatology This session will cover the therapeutic aspects of dermatology and how to treat different skin conditions. Moderator: Wendy E. Roberts, M.D. Lori Robertson, M.S.N., F.N.P.-C.: Melasma: What You Need to Know Mark B. Taylor, M.D.: Quick Full Face Subcision for Rolling Acne Scars Carl R. Thornfeldt, M.D.: Acne: A New Therapeutic Perspective Pearl E. Grimes, M.D.: An Analysis of Optimal Ethnic Skin Treatments Panel Discussion: What Treatments Do You Use for Challenging Skin Conditions? General Session III The Art of Feminine Rejuvenation This session will provide a comprehensive review of the new technologies and treatments being used for feminine rejuvenation. Moderator: Allan Yang Wu, M.D. Red M. Alinsod, M.D.: Gynecologic Photography for Dummies Oscar A. Aguirre, M.D.: The Aging Vulva Evaluation and Treatment Options Jaime Schwartz, M.D.: Botox for Vaginismus Russell Bartels, M.D.: The Power of Combination Therapy for the Ultimate Vaginal Laxity Treatment Allan Yang Wu, M.D.: Intimate Rejuvenation Panel Discussion: Are New Technologies Safe and Effective? Advanced Injectable Applications and Techniques Course This course will provide attendees with the opportunity to learn the latest, most advanced injection techniques and tips from experts. Advanced Techniques for Practice Success Course This course is designed to assist practices with building, growing and marketing an aesthetic business. 6:00 pm 7:30 pm THE Aesthetic Awards Hosted by Andrew P. Ordon, M.D., F.A.C.S. Sunday, July 9, 2017 Exhibit Hall Hours: 8:30 am 1:00 pm Lafite Ballroom 8:30 am Breakfast in Exhibit Hall Presentations and live demonstrations 9:00 am 12:00 pm General Session I Practice Management and Marketing This session is intended to assist practices with building, growing and marketing an aesthetic business. Moderator: Cheryl Whitman Jonathan Kaplan, M.D.: How to Weed Out Price Shoppers and Tire Kickers Rich Castellano, M.D.: The Secrets to Live Video for Your Practice Monica Bonakdar, M.D.: Branding Your Practice for Success Jay Shorr: The Benefits of Proper Employee Selection: Training, Retaining and Motivating Your Most Valuable Employees Lisa Wark: Avoiding the Pitfalls of Building a Concierge Practice Paula Di Marco Young, R.N.: Should You Add a Live Chat Feature to Your Website? Mara Shorr: Why Your Practice Needs to Up Its Retail Game Adam DeGraide: Managing Your Aesthetic Practice in a Social World Cheryl Whitman: Turn Your Employees into Empowered Sales Agents Panel Discussion: Learning from Real World Success Examples General Session II Advanced Injectable Applications and Techniques This session will provide advanced injectors with a methodology to analyze the face for volume deficits and demonstrate a variety of injection techniques for different areas of the face. Moderator: Edward M. Zimmerman, M.D. Garry R. Lee, M.D.: Prevention and Treatment of Injectable Filler Complications Robert J. Troell, M.D.: Silastic Implants, Fat Transfer and Dermal Fillers Lori Robertson, M.S.N., F.N.P.-C.: How to Fix Mistakes and When to Say No Kian Karimi, M.D.: Microcannulas in Your Injectable Practice: Why You Should Use Them and Tips for Success Gregory Chernoff, M.D.: Anatomical Understanding of Facial Volumizing Patrick Bitter, Jr., M.D.: Techniques for Eliminating Bothersome Lines with Fillers Edward M. Zimmerman, M.D.: The Science of Autologous Injections Panel Discussion: Off-Label Techniques You Need to Know 12:00 pm - 2:00 pm THE Certified Aesthetic Consultant Exam *Program schedule and faculty subject to change. 88 THE Aesthetic Guide January/February

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90 Advanced Injectable Applications and Techniques Courses* 6 CME Credits THE Aesthetic Show presents the Advanced Injectable Applications and Techniques courses. These courses will provide attendees with an opportunity to learn the latest, most advanced injection techniques and tips from experts. Participants will receive 2 CME credits upon completion of each course. Lecture topics include: How to treat difficult complications Discovering the latest off-label techniques Next-generation neurotoxins and dermal fillers pending approval Live demonstrations performed by experts Growing your practice revenues with injectables Building confidence as an injector and in assessing patient needs * Program schedule and faculty subject to change. ** Additional fee to attend. Friday, July 7, :00 pm 6:00 pm Moderator: Joseph Niamtu, III, D.M.D. Michael H. Gold, M.D.: What s in Your Future Next-Generation Injectables Robert J. Troell, M.D.: Permanent Facial Volume Replacement: Facial Implants, Autologous Fat Transfer vs. Dermal Filler Injections Patrick Bitter, Jr., M.D.: Three Keys to Success with Fillers and Optimizing Patient Outcomes Joseph Niamtu, III, D.M.D.: Lip Fillers and Perioral Fillers Saturday, July 8, :00 am 11:00 am Moderator: William Philip Werschler, M.D. Garry R. Lee, M.D.: Pearls and Pitfalls of HA Fillers for Glabella and Tear Trough Mark B. Taylor, M.D.: Super Diluted Sculptra for Off-Face Skin Rejuvenation Corey S. Maas, M.D.: Review of the Newest Lip Fillers William Philip Werschler, M.D.: Treating the Aging Neck Saturday, July 8, :00 pm 6:00 pm Moderator: Kian Karimi, M.D. Monica Bonakdar, M.D.: Growing Your Practice Using Injectables Steven B. Hopping, M.D.: Combination Treatment with Fillers, Neurotoxins and Radiofrequency Therapy Nasrin Mani, M.D.: Complications and Treatment of Permanent Fillers Kian Karimi, M.D.: Lifting and Filling: Synergy of PDO Threads and Injectable Fillers for Facial Rejuvenation Advanced Techniques for Practice Success Courses* THE Aesthetic Show presents the Advanced Techniques for Practice Success courses. These courses are designed to assist practices with building, growing and marketing an aesthetic business. Instructors will be drawn from THE Aesthetic Show faculty including experts in practice marketing, patient counseling and office management. Lecture topics include: Advanced marketing techniques Internet and digital marketing Harnessing the power of new media How to expand your practice and profitability Analysis of your business model Mastering patient consultations Improving staff management skills Real world success examples * Program schedule and faculty subject to change. ** Additional fee to attend. Friday, July 7, :00 pm 6:00 pm Moderator: Jay Shorr and Mara Shorr Jonathan Kaplan, M.D.: How SnapChat Transformed My Practice in Unexpected Ways Adam DeGraide: The Truths and Myths of Digital Marketing Paula Di Marco Young, R.N.: How to Run a Successful Revenue Generating Event Jay Shorr and Mara Shorr: Keeping Your Cool: Dealing with a Difficult Client or Patient Saturday, July 8, :00 am 11:00 am Moderator: Jay Shorr and Mara Shorr Joseph Niamtu, III, D.M.D.: How to Make YouTube Videos and Have Them Work for You Suneel Chilukuri, M.D.: The Path Less Traveled: Creating a Unique Office Patti Owens, R.N.: Aesthetic State Rules, Regulations and Advisory Statements Through the Looking Glass Greg Washington, Sr.: Smart Management of Online Patient Reviews: A Gold Mine Jay Shorr and Mara Shorr: Lead Generation and the Conversion Cascade Do You Really Know Your Ratios and ROI? Saturday, July 8, :00 pm 6:00 pm Moderator: David Phillips Rich Castellano, M.D.: Non-Verbal Communication Skills Will Improve Your Teamwork, Sales and Profitability Cheryl Whitman: What You Should Know About Your Ideal Patient Lisa Wark: Changing the Culture of Your Practice to Success David Phillips: Stop the Games Become a True Player Online 90 THE Aesthetic Guide January/February

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92 Mark Berman, M.D., F.A.C.S. Plastic Surgeon Los Angeles, CA, USA Scientific Advisory Board Corey S. Maas, M.D., F.A.C.S. Board Certified Facial Plastic Surgeon Maas Clinic San Francisco, CA, USA Alexander Z. Rivkin, M.D. Founder Westside Aesthetics Los Angeles, CA, USA Suneel Chilukuri, M.D., F.A.A.D., F.A.C.M.S. Cosmetic and Dermatologic Surgeon Houston, TX, USA Gary Motykie, M.D., F.A.C.S. Board Certified Plastic Surgeon Beverly Hills, CA, USA Wendy E. Roberts, M.D. Board Certified Cosmetic Dermatologist Rancho Mirage, CA, USA Angelo Cuzalina, M.D., D.D.S. Past President American Academy of Cosmetic Surgery, 2011 Diplomate, American Board of Cosmetic Surgery Tulsa, OK, USA Michael H. Gold, M.D. Gold Skin Care Ctr. and Tennessee Clinical Research Ctr. Clinical Assistant Professor Vanderbilt University School of Medicine Nashville, TN, USA Pearl E. Grimes, M.D. Director Vitiligo and Pigmentation Institute VPI Cosmetic Center Los Angeles, CA, USA Joseph Niamtu, III, D.M.D. Cosmetic Facial Surgeon Richmond, VA, USA Andrew P. Ordon, M.D., F.A.C.S. Plastic Surgeon Host of CBS talk show THE Doctors Beverly Hills and Rancho Mirage, CA, USA Melanie D. Palm, M.D. Board Certified Dermatologist Art of Skin MD Solana Beach, CA, USA Leif Rogers, M.D., F.A.C.S. Plastic and Reconstructive Surgeon Leif Rogers, M.D., F.A.C.S. Reconstructive and Cosmetic Plastic Surgery Beverly Hills, CA, USA E. Victor Ross, M.D. Director Cosmetic and Laser Dermatology Unit Scripps Clinic San Diego, CA, USA William Philip Werschler, M.D., F.A.A.D., F.A.A.C.S. Assistant Clinical Professor of Medicine/Dermatology University of Washington School of Medicine Seattle, WA, USA THE Aesthetic Awards THE Aesthetic Show will host the 7th annual THE Aesthetic Awards in Las Vegas on Saturday, July 8, 2017 at The Wynn Resort. THE Aesthetic Awards is a ceremony that showcases the very best procedural outcomes by medical aesthetic physicians. We invite you to become a contestant. This contest offers great exposure to all participants. Winners will receive professional recognition, editorial coverage and valuable prizes. Awards will be presented in the following categories: Best Facial Injectable Enhancement Best Non-Surgical Facial Rejuvenation Enhancement Best Surgical Facial Rejuvenation Enhancement Best Overall Facial Make-Over (combination of procedures) Best Non-Surgical Body Shaping Enhancement Best Surgical Body Shaping Enhancement Best Patient Enhancement Using Lipofilling Best Feminine Rejuvenation Enhancement Best Overall Body Make-Over Enhancement (combination of procedures) Best Overall Patient Enhancement Best Botched Patient Revision Best Male Patient Enhancement Best Hair Restoration Procedure Best Aesthetic Practice Winners will be announced at THE Aesthetic Awards ceremony on Saturday, July 8, 2017, hosted by Andrew P. Ordon, M.D. Winners will also be displayed on THE Aesthetic Show website, receive editorial coverage in THE Aesthetic Guide, participate in a media event and photo shoot and be recognized in an Aesthetic TV webisode. To submit your entry, please visit and click on Awards. Final deadline for submissions is June 9, THE Aesthetic Guide January/February

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94 Clint Carnell CEO Edge Systems, LLC Signal Hill, CA Mark J. Foley President and CEO ZELTIQ Aesthetics, Inc. Pleasanton, CA Jim Hartman Vice President and U.S. Head of Aesthetics and OTC Merz Aesthetics Raleigh, NC 94 THE Aesthetic Guide January/February

95 David Moatazedi Senior Vice President Medical Aesthetics Allergan, Inc. Irvine, CA Chris Spooner CEO Sinclair Pharma, plc London, UK Industry Leaders Predict Growth Drivers for Medical Aesthetics By Michael Moretti, Editor-in-Chief Medical aesthetics is very healthy overall, with market growth continuing at a solid double-digit rate. New sectors have emerged to feed this constant expansion; younger demographics, especially Millennials, have embraced anti-aging treatments, as have increasing numbers of men. For women, feminine rejuvenation procedures have created a new specialty, while advances in regenerative aesthetics and stem cell use are further inspiring the inventors and futurists in our field. THE Aesthetic Guide January/February

96 Industry Leaders Predict Growth Drivers for Medical Aesthetics According to THE Global Aesthetic Market XIV market study published in June 2016 by Medical Insight, Inc. (Aliso Viejo, Calif.), total worldwide sales of aesthetic products are predicted to expand by 11% per year through 2020, to reach $12.8 billion. Emerging products and technologies are expected to experience the largest gains, as well as skin tightening, body contouring and neurotoxins. Editor s note: In this roundtable interview, five industry executives share their knowledge and insights concerning the state of medical aesthetics, as well as powerful new trends. Current megatrends include how to attract Millennials that seek aesthetic procedures. What are your thoughts on this development? David Moatazedi There are about 70 or so million Millennials in the U.S. today; they are under 35 years old and focused on anti-aging. They are the consumer of the future and we are seeing a very high growth rate of Millennials entering the space. One example of this is BOTOX. Over one-quarter of our users are under 35. It is the fastest growing segment within our patient base, so it is a significant catalyst. There are about 70 or so million Millennials in the U.S. today; they are under 35 years old and focused on anti-aging. They are the consumer of the future and we are seeing a very high growth rate of Millennials entering the space. Chris Spooner Clearly, it s a trend we are seeing. I would put a slight caution on it though. It is a very encouraging trend, but physicians and manufacturers need to make sure that appropriate medical products are available to people of that age. Meaning products and services that are not too aggressive and disfiguring or altering in terms of the way they the make the patient look. As an industry, we don t want to be seen as having done so many procedures on 35 year-olds that by the time they are 55 they look overdone. How should we measure the impact of the male market, which continues to expand? Mark J. Foley Non-invasive body contouring appeals to both genders so we have insights across different age groups, and into gender differences. Similar to what the industry is seeing, males represent approximately 20% of our CoolSculpting patient population; though we have seen practices generate as much as 40% of their revenue from males when the procedure is appropriately marketed to this patient segment. Attracting aesthetic neophytes will allow physicians to target the first-time male user market, further expanding their practices. Clint Carnell Once men make the decision to seek more information on aesthetic treatments, they actually convert at the same level as females. And once they are in the office and trust the provider they ask for and are open to hearing about other products and procedures that they had not considered initially. When they are shown options they are not that different than women. They may want to be talked to differently and treated differently, but they have the same desires. Mr. Spooner Males have been receiving treatments for baldness for a long time, thus the concept that men are new to aesthetics is not true. Nonetheless, somehow a cultural, sexist stereotypical barrier 96 THE Aesthetic Guide January/February

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98 Industry Leaders Predict Growth Drivers for Medical Aesthetics against men using facial products as opposed to hair products exists. This barrier seems to be breaking down now. Why shouldn t men use products or obtain anti-aging treatments? In Europe, women outnumber men in procedure volume by about 14 to 1, I think. So, there is an awfully long way to go. Men are clearly going to the dentist for whiter, straighter teeth and to hair restoration clinics, so it is absolutely inevitable that they will adopt facial procedures in far greater numbers than they are right now. Do you consider feminine rejuvenation a new niche for cosmetic dermatologists and plastic surgeons? Mr. Foley The aging female population continues to drive growth in medical aesthetics. In general, there is a cultural shift towards aesthetics and it is increasingly viewed as an enhancement to quality of life versus a vanity play. The growing interest in both surgical and non-invasive feminine rejuvenation speaks to this. Cosmetic dermatologists and plastic surgeons are logically looking to expand their practice offerings and meet this demand. Mr. Spooner You can separate the vaginal rejuvenation market into two segments. The first is acute rejuvenation, meaning surgeries and fillers. One issue with fillers is the sheer volume required, so it can be pretty invasive. The other segment is the long-term vaginal regeneration market, which from a manufacturing and product development perspective will begin to morph into smaller handheld devices and then at-home, over the counter products. Why shouldn t men use products or obtain anti-aging treatments? Men are clearly going to the dentist for whiter, straighter teeth and to hair restoration clinics, so it is absolutely inevitable that they will adopt facial procedures in far greater numbers than they are right now. Another popular topic is regenerative aesthetics, which uses stem cells, PRP, tissue regeneration, biologics and other anti-aging approaches. In your opinion, what does the future hold for this emerging segment? Mr. Moatazedi Regenerative medicine is interesting. We are seeing surgeons and injectors dabbling in this field. The market is a mixed bag. There is an opportunity over time for regenerative medicine to provide value beyond where it is today. For instance, if you look at hair loss treatments that use PRP, injectors generally have limited experience. When you ask them if they are using PRP by itself, they will say they are using it in combination with already proven treatments. Newer products and technologies also continue to provide greater satisfaction, whether through duration of outcomes or other unique benefits over some older products. We continue to push that satisfaction level higher, which in turn continues to drive the market. Jim Hartman I think these new technologies and markets are certainly here to stay. The challenge is how to obtain better diagnostics and a more consistent outcome. I don t think we are there yet. Mr. Carnell Additionally, we need to be really cautious about how we approach stem cells, PRP and other emerging treatment modalities. We don t want regenerative aesthetics to end up being viewed negatively. These new technologies have great potential and we have a sense of duty to ensure that we develop good science, the right techniques, and set the appropriate expectations for patients. 98 THE Aesthetic Guide January/February

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100 Industry Leaders Predict Growth Drivers for Medical Aesthetics With many new and existing patients moving away from surgical procedures and toward non-surgical approaches, we re seeing a long-term annuity market developing for non-invasive treatments. How is this trend changing the industry? Mr. Hartman It has created more opportunity. The non-invasive procedure patient database is enormous compared to those that seek surgery. Eventually, you may seduce them to the scalpel. However, you may not need to because you have done such a great job maintaining a non-surgical regimen. With the rise of regenerative aesthetics there may be a future where it is less and less necessary to do surgery. That would open up a floodgate for the aesthetic market. The more tangible outcomes we have with noninvasive procedures the more people will seek out treatment. Mr. Moatazedi Today is the golden era of plastic surgery. In successful plastic surgery practices, surgeons continue to focus on booking high priced surgeries, but they also operate a larger enterprise by which they bring in multiple injectors and providers for laser treatments. This enables them to provide end-to-end benefits to that consumer. With the rise of regenerative aesthetics there may be a future where it is less and less necessary to do surgery. That would open up a floodgate for the aesthetic market. The more tangible outcomes we have with non-invasive procedures the more people will seek out treatment. With the growth of medspas, consolidation among practices, and increased competition in the field, are we approaching a saturation point in terms of patient volume growth versus the number of providers? Mr. Foley Absolutely not. Take non-invasive fat reduction as an example. Almost all aesthetic practices offer neurotoxins and fillers to a consumer aesthetic market that is drastically smaller than the non-invasive fat reduction opportunity. We estimate that only 15% of practices have adopted a non-invasive fat reduction technology, suggesting that there is still a tremendous growth opportunity and that we are nowhere near saturation. Mr. Spooner There will still be practices and clinics opening very rapidly because the patient volume is coming through. There are few exceptions. In Southern California, you probably don t need another dermatologist. Conversely, Europe is the worst major market in the industry, growing at about 5.1% (Source: THE Global Aesthetic Market Study XIV), and that is procedure volume on the whole, not price. I think the industry is going to continue to grow. What are the new technologies and trends that will further change the industry in the coming years? Mr. Foley With the increase in non-invasive solutions and number of patients that are entering the aesthetic market, clinical efficacy and reproducibility will be key to sustaining a brand position and ensuring that new consumers remain engaged in the aesthetic channel. Patient and provider satisfaction is what drives that commitment to innovation. Mr. Hartman I think we are already starting to see it with any non-invasive slimming technology. Whether it s freezing or heating, the technology will continue to improve. Similarly, facial 100 THE Aesthetic Guide January/February

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102 Industry Leaders Predict Growth Drivers for Medical Aesthetics injectables have become increasingly customized in outcomes and duration, as well. Mr. Carnell I think we will start to move away from individual feature treatment products and more towards understanding the importance of physicians globally assessing their patients, and educating them on the options that will take care of their skin health and beauty needs for life. The most successful physicians already understand this, but I don t think the industry is focused enough on it. Selling health and beauty awareness in combination over a lifetime is a very important macro driver of business. Mr. Moatazedi The body as a whole is of interest to the consumer. There is an important economic dimension when it comes to the body. If you think about the entire body like real estate the face is Park Avenue, but when you get to the body the willingness to spend is a bit different. So, the economics of this market will probably evolve as solutions proliferate for the various unmet patient needs. It is too early to tell how the changing landscape will impact the aesthetic industry. However, with an ongoing focus on reducing costs associated with reimbursed healthcare, we believe that the elective, cash pay field offers encouraging growth opportunities for all. How will the broader political landscape changes (e.g., the populist movement, Brexit in Europe, Trumponomics in the U.S., the dominance of China, reduced regulations and tax changes, etc.) affect our industry? Mr. Foley It is too early to tell how the changing landscape will impact the aesthetic industry. However, with an ongoing focus on reducing costs associated with reimbursed healthcare, we believe that the elective, cash pay field offers encouraging growth opportunities for all. Mr. Carnell People just want these treatments, period. Everywhere I travel, patients are saying the same things to their physicians. I think this phenomenon is more individualized and more about embracing their health and looks, as opposed to being affected by macro issues. Are we in a bullish or bearish economy? I don t know, but I don t think governmental politics affect our field very much. Mr. Moatazedi When I think about risks to this industry I think of it as macroeconomic dislocation like we saw in the last recession. I don t view that as a long-term risk, but as a big speed bump depending on how large the dislocation is. That is probably the biggest danger to this market, but the macro trends are largely favorable as they create an opportunity for companies to diversify or for providers to diversify their practice away from reimbursement. Generally, it is all favorable for us. Mr. Hartman I look at this market as nothing but opportunity. We have an aging population and we also have a population that on a daily basis cares more and more about the way they look. From an industry perspective we need to unite more, not compete more. Hopefully we don t only unite via mergers and acquisitions. 102 THE Aesthetic Guide January/February

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104 Advice Media 1389 Center Drive, Suite 230 Park City, UT (800) telephone (435) facsimile Advice Media is a leader in online digital marketing for medical practices. We offer beautiful websites and proven marketing through SEO, social media, review management and paid search so that we are the last company you will need. Aerolase 777 Old Saw Mill River Rd. Tarrytown, NY (914) telephone (914) facsimile Aerolase is a leader in manufacturing pantented, advanced laser technology for aesthetic and medical dermatology applications. By reinventing and redesigning traditional big-box lasers, Aerolase has developed LightPod lasers to provide new levels of clinical efficacy, versatility, safety and cost-effectiveness to drive high levels of profit and customer satisfaction. ALASTIN Skincare 3129 Tiger Run Court, Suite 108 Carlsbad, CA (844) 858-SKIN (7546) telephone (760) facsimile ALASTIN Skincare is dedicated to developing innovative, clinically-tested skincare products that correct, protect and maintain healthy skin for a lifetime. Our unparalleled Procedure Enhancement and Restore & Renew products are formulated with TriHex Technology, a proprietary combination of key peptides and other synergistic ingredients using the latest technology, and are clinically tested to demonstrate safety and their ability to help reawaken the skin s youthful regenerating processes. Allergan, Inc Dupont Drive Irvine, CA (714) telephone (714) facsimile Allergan Medical provides the most comprehensive, science-based, aesthetic product offerings, including BOTOX Cosmetic; hyaluronic acid and collagen-based dermal fillers; and LATISSE (bimatoprost ophthalmic solution) 0.03%. Allergan Medical also offers the industry s widest range of silicone gel-filled and saline-filled breast implant options for reconstructive and aesthetic breast surgery. Alma Lasers, Ltd. 485 Half Day Road, Suite 100 Buffalo Grove, IL (866) 414-ALMA (2562) telephone (224) facsimile Alma Lasers is a global innovator of laser, light-based, radiofrequency and ultrasound solutions for aesthetic and minimally invasive markets. We enable practitioners to offer safe, effective and profitable aesthetic and surgical procedures, while allowing patients to benefit from state-of-the-art, clinically proven technologies and treatments. Alma Lasers platforms provide solutions for a variety of applications globally including skin imperfections, loose skin, hair removal, the treatment of pigmented and vascular lesions, acne, tattoo removal, psoriasis, vitiligo, wrinkles, acne scars, vaginal tightening, SUI and more. AQ Skin Solutions 390 Goddard Irvine, CA (949) telephone AQ Skin Solutions is a medical grade cosmetic company with patented, cutting edge methods of producing human growth factors (GFs). AQ has made major advancements in GF-technology and therapeutics by developing physician-dispensed serums that contain the ideal types and combinations of GF to produce maximum skin rejuvenation and hair restoration results. Ascentium Capital Highway 59 North Kingwood, TX (281) / (281) telephone (281) facsimile / Ascentium.Info/89a Ascentium Capital is a direct lender specializing in financing and leasing up to $1.5 million for healthcare professionals. Experience a streamlined process that makes financing fast and flexible: a simple, one-page application and instant credit decisions for up to $250,000. Use our 100% finance program to include expenses such as taxes, shipping and other items to avoid out of pocket costs. SBA loans and working capital solutions available. Ask about deferred payments to match cash flow. Contact us today for special finance promotions and a no obligation quote. Bellus Medical 4505 Excel Parkway, Suite 100 Addison, TX (888) telephone (972) facsimile Bellus Medical is a leader in microneedling technology and offers various solutions for medical aesthetic practices in strategic areas of growth. Focused on science, technology and customer service, Bellus continues to provide compelling, differentiated products that enhance the patient experience and represent a significant business opportunity for practice partners. Biopelle, Inc. 780 W. 8 Mile Rd. Ferndale, MI (866) telephone (248) facsimile Biopelle, Inc. provides a global spectrum of skincare with clinically-proven, evidencebased, patented technologies that address multiple metabolic pathways for complete skin rejuvenation and wellness through two main skincare lines: biopelle, featuring Tensage Stem Cell, Tensage Growth Factor and Retriderm; and PRESCRIBEDsolutions, a customizable skincare line with boosters. BTL Industries, Inc. 47 Loring Drive Framingham, MA (866) telephone (888) facsimile Founded in 1993, BTL Industries is a privately owned developer and manufacturer of medical and aesthetic equipment. BTL currently has over 900 employees and direct offices in more than 51 countries. BTL Aesthetics, a division of BTL, has revolutionized non-invasive removal of adipose tissue, currently ranking second among the non-invasive body shaping and tightening manufacturers globally. BTL Aesthetics brands include BTL Vanquish ME, BTL Exilis and BTL Protégé. Canfield Scientific 4 Wood Hollow Rd. Parsippany, NJ (800) / (973) telephone Canfield Scientific is a leading supplier and developer of medical imaging products, including VECTRA 3D imaging and aesthetic simulation systems, VISIA Complexion Analysis Systems, Reveal facial imagers, VEOS dermatoscopes, IntelliStudio full body photography systems and Mirror medical imaging software and practice specific imaging products. Collagen P.I.N. / Induction Therapies Eastpoint Park Blvd., Suite A Louisville, KY (877) telephone (855) facsimile / Collagen P.I.N.: More needles, more power, more depth, more collagen. Advanced collagen induction therapy introduces controlled injuries into the skin triggering natural growth factors and collagen. Microneedling causes less damage to the epidermis than other non-ablative / ablative treatments. Induction Therapies topicals (specifically designed for post needling) minimize complications and accelerate healing. COSMED Dermaceuticals 6342 Grand Hickory Dr., Suite 102 Braselton, GA (866) telephone COSMED Dermaceuticals is a family owned business specializing in cosmeceuticals. An exclusive distributor of Clinicians Complex, a medically oriented skin rejuvenation line sold through clinicians, medical spas and other skincare professionals. We utilize the latest developments in skincare technology. Clinicians Complex products contain the highest quality, anti-aging ingredients backed by science. Crystal Clear Digital Marketing 5750 Major Blvd., Suite 500 Orlando, FL (888) telephone (866) facsimile Crystal Clear Digital Marketing offers a complete digital marketing system: from search engine optimization, search engine marketing, social media engagement, websites, marketing, mobile and text marketing, patient relationship management and so much more. Crystal Clear does most of the work so local practices don t have to. 104 THE Aesthetic Guide January/February

105 DefenAge Skincare 5845 Avenida Encinas, Suite 130 Carlsbad, CA (888) telephone (760) facsimile Named one of the biggest breakthroughs in skincare in 2016, DefenAge s exclusive ingredient, Age-Repair Defensins, works via a natural mechanism of action. Clinical studies prove that this revolutionary anti-aging skincare system addresses up to 16 signs of aging in just six weeks. The technology can be combined with almost any skincare regimen. Eclipse Aesthetics, LLC 5916 Stone Creek Dr., Suite 120 The Colony, TX (800) telephone (866) facsimile Eclipse provides superior solutions to the domestic and international medical and aesthetic communities. The company is known for its portfolio of innovative products including: Eclipse MicroPen, Skinfinity RF, NEWA, dep Patch mask and under eye patches, Eclipse PRP, and Eclipse Topical Analgesic, among others. Epionce W. Emerald Street Boise, ID (866) EPIONCE ( ) telephone (866) facsimile Epionce is a comprehensive and innovative set of products designed to optimize the appearance and health of the skin by working at the core of the skin s own protective and reparative systems. Developed by a clinical dermatologist, the unique approach delivers a blend of active botanical ingredients to deeply penetrate the skin. This helps to improve skin function, restore the natural protective barrier and reverse destructive skin inflammation. Fifteen independent clinical studies comparing the marketed products against leading prescription products have validated the technology of the Epionce line. FotoFinder Systems, Inc Columbia Gateway Drive, Suite 120 Columbia, MD (888) telephone (443) facsimile FotoFinder offers a variety of professional photo solutions for face and body, automatic mole mapping and dermoscopy. Our Mission is to bring the skin into the picture brilliantly and make medical photography high-performance, time saving and intuitive. Fotona 1241 Puerta Del Sol San Clemente, CA (949) telephone (949) facsimile Fotona develops and manufacturers high performance, quality made laser systems. Our wide-range of laser systems purvey quality, reliability, safety and cutting edge innovation in treatment speed and efficiency. Our global network of representatives and reference medical centers guarantees exceptional customer support, as well as technical and clinical training. Galderma Laboratories, L.P N. Freeway Fort Worth, TX (817) telephone Galderma is committed to delivering innovative medical solutions to meet the skin health needs of people throughout their lifetime while serving healthcare professionals around the world. Gateway Aesthetic Institute & Laser Center 440 West 200 South, Suite 250 Salt Lake City, UT (801) telephone (801) facsimile / The Gateway Aesthetic Institute & Laser Center is renowned as one of the world s top cosmetic dermatologic surgery and laser centers. Mark B. Taylor, M.D., has been a leader in the field of cosmetic laser surgery, pioneering and teaching many new laser and surgery techniques to over 4,000 doctors worldwide. InMode 100 Leek Crescent, #15 Richmond Hill, ON L4B 3E6 Canada (855) telephone (855) facsimile InMode is an Israeli-based medical device company that manufactures and markets aesthetic applications. InMode has revolutionary non-invasive options for fractional skin resurfacing and contraction (Fractora and Forma), ultra-fast diode hair removal (Diolaze), skin pigmentation and vascular lesions (Lumecca Photofacial) and cellulite / body contouring (BodyFX). InMode will continue to provide superior quality and innovative technology for the most in-demand procedures patients want. Laservision USA 595 Phalen Boulevard Saint Paul, MN (800) telephone (651) facsimile Laservision designs and manufactures laser safety eyewear to protect doctors, technicians and patients. We help match protective eyewear to your laser application. All laser safety products are ANSI-certified, with CE-certified options available. Laservision delivers custom solutions to fit your specific requirements. We re committed to providing you with informative safety guidance. Lumenis 2033 Gateway Place, Suite 200 San Jose, CA (877) LUMENIS telephone (408) facsimile Lumenis is a global developer, manufacturer and distributor of laser and intense pulsed light (IPL) systems. Surpassing 265 registered patents, 260 FDA clearances, and a presence in over 100 countries, Lumenis products are recognized worldwide as an industry gold standard. Market lead-ing products include UltraPulse and AcuPulse fractional CO 2 lasers; LightSheer Infinity, Desire and Duet hair removal systems; the M22 multi-technology platform with VascuPlus+ ; and the newly introduced FemTouch on Acupulse, a solution for vaginal health related conditions. Lumenis aesthetic systems deliver high standards of excellence, quality and reliability, with premium value and service. Merz Aesthetics 6501 Six Forks Road Raleigh, NC (888) telephone (336) facsimile Merz Global is a specialty healthcare company that develops and commercializes innovative treatment solutions in aesthetics, dermatology and neurology in more than 85 countries. Our ambition is to become a recognized leader in the treatment of movement disorders, as well as aesthetics and dermatology. NewSurg 1934 Hilltown Pike Hilltown, PA (215) telephone NewSurg develops and distributes the next generation of medical lasers and equipment for cosmetic practices. Generous trade-in credit for old Iridex, Laserscope and pulsed dye lasers towards the compact and affordable NS-532 system. This unit provides clinicians with the solution for pigmented and vascular lesions. NKP Medical Marketing 8939 S. Sepulveda Blvd., Suite 320 Los Angeles, CA (866) telephone (800) facsimile NKP Medical Marketing will handle all aspects of your internet marketing. We work with hundreds of clients worldwide. We are experts in SEO, custom website design, responsive and adaptive websites, pay-per-click, patient conversion and much more. Oxygenetix Institute, Inc Santa Monica Blvd., Suite 223 Beverly Hills, CA (888) telephone Oxygenetix is a breakthrough Breathable Foundation to cover, help heal and minimize even eliminate procedural scars. Designed for physicians, Breathable Foundation covers and soothes a wide variety of skin problems, including skin injuries, wounds, rashes, cracked, dry skin, acne scars, rosacea and other skin conditions. On postsurgical scars, patients are reassured and impressed that after care includes safely camouflaging any evidence of surgery. THE Aesthetic Guide January/February

106 PerfAction Technologies 10 Plaut St. Rehovot, Israel telephone facsimile PerfAction Technologies is a medical technology company pioneering new treatment modalities for aesthetic and dermatological applications. The Enerjet and AirGent platforms bring together the company s proprietary Jet Volumetric Remodeling (JVR) technology, which simultaneously delivers kinetic energy and a healing compound to create a unique micro-trauma profile, enabling a controlled deep micro-trauma effect for lifting, scar repair and dermal remodeling. Perigee Medical 2227 N. MacArthur Drive Tracy, CA (844) PERIGEE / ( ) telephone (415) facsimile Perigee Medical supplies high-quality health and beauty medical devices to the North American market. Perigee has a nationwide sales and service network, and offers authorized sales, service and support for Jeisys Medical (Seoul, Korea), Asclepion Laser Technologies (Jena, Germany) and the Futura Pro by Current Beauty. Quanta Aesthetic Lasers 611 Corporate Circle, Suite A Golden, CO (866) telephone Quanta Aesthetic Lasers is transforming aesthetics as the exclusive North American partner for Quanta System S.p.A., designer and manufacturer of Erbium, fractional CO 2, Nd:YAG, KTP, Diode and Alexandrite lasers, as well as IPL systems. Quanta offers world-class technology to help you succeed in laser tattoo removal and aesthetics. Rohrer Aesthetics, LLC 105 Citation Court Homewood, AL (205) telephone (205) facsimile Rohrer Aesthetics was founded by the former Sandstone Medical Technologies management team. The company is dedicated to providing high quality, affordable lasers, IPL and other aesthetic products that will serve the needs of any cosmetic practice and enhance the lives of their patients. Our Flagship product is the Spectrum, a multiplatform work station that provides four lasers (810 nm diode, Q-switched 1064 nm / 532 nm, Long Pulsed YAG and Er:YAG) and an IPL priced under $55,000. The Phoenix CO 2 laser is priced under $35,000 and features a large scan pattern (30 mm x 30 mm). The Phoenix can be used to remove uneven pigmentation and reduce fine lines and coarse wrinkles. All of our lasers include a two year warranty and our exclusive Buy-Back Guarantee. Sciton, Inc. 925 Commercial Street Palo Alto, CA (888) telephone (650) facsimile Sciton is committed to providing best-in-class laser and light solutions for medical professionals who want superior durability, performance and value. Sciton offers superior medical devices for laser-assisted lipolysis, fractional and full-coverage skin resurfacing, hair removal, phototherapy, wrinkle reduction, treatment of vascular and pigmented lesions, scar reduction and acne, all on an expandable platform. The new Halo laser is the first hybrid fractional laser, combining ablative and non-ablative wavelengths for epidermal renewal and deep dermal rejuvenation with non-ablative downtime. Sesderma USA 67 Miracle Mile Coral Gables, FL (800) telephone / Sesderma is a European laboratory that specializes in the encapsulation of active ingredients using Nanotechnology. It covers both the needs of the medical community and the end consumer. The soul of our products is based on the passion of dermatologist, Dr. Serrano, our founder and CEO. For over 25 years he has been continually developing, studying and focusing on the most revolutionary skin treatments, using the highest quality ingredients and equipment in order to ensure the integrity of the skin. Solta Medical, a division of Valeant Pharmaceuticals North America Industrial Boulevard Hayward, CA (877) telephone (510) facsimile Solta Medical, Inc., a division of Valeant Pharmaceuticals International, Inc., is a global leader in the aesthetic medical device industry, providing innovative and effective solutions that are designed to enhance and expand our partner physicians medical practices. With over a decade at the forefront of the aesthetic industry, Solta Medical offers a comprehensive line of aesthetic devices covering a broad spectrum of skincare and body treatment needs. Suneva Medical, Inc Pacific Center Blvd. San Diego, CA (888) telephone Suneva Medical, Inc. is a privately-held aesthetic company focused on developing, manufacturing and commercializing novel, differentiated products for the general dermatology and aesthetic markets. The company currently markets Bellafill in the U.S., Canada and Korea; ArteFill in Singapore; and Regenica in the U.S. and Canada. Syneron Candela 3 Goodyear, Unit A Irvine, CA (866) telephone (949) facsimile Syneron Candela is a global leader in the aesthetic medical device marketplace. We combine a superior level of expertise and customer understanding, offering customers one of the broadest product portfolios, an exceptional global service organization, and an expansive worldwide distribution network. Thermi, LLC 8304 Esters Blvd., Suite 890 Irving, TX (866) telephone (214) facsimile Thermi, an Almirall company, is a leading global manufacturer of temperature controlled radiofrequency technology. The company s flagship product is ThermiRF, a platform technology that uses temperature as a clinical endpoint for various minimally and non-invasive applications (ThermiTight, ThermiRase, ThermiSmooth Face and ThermiVa ). Thermi also offers the Thermi250 device as the newest innovative RF for the body (ThermiSmooth Body) and is the distributor for Silhouette InstaLift (lifting to redefine mid-facial contours). Viveve, Inc. 150 Commercial Street Sunnyvale, CA (408) telephone (408) facsimile Viveve, Inc. is committed to advancing solutions to improve women s overall wellbeing. Their flagship product, the Viveve System, is the only device in its class that is approved in over four dozen countries around the world to treat vaginal laxity in a single, 30-minute session and is backed by randomized, placebo-controlled data. In the U.S., the Viveve System is cleared for electrocoagulation and hemostasis in general surgery. ZELTIQ Aesthetics, Inc Willow Road Pleasanton, CA (925) telephone (925) facsimile ZELTIQ is a medical technology company focused on developing and commercializing products utilizing its proprietary controlled-cooling technology platform. ZELTIQ s first commercial product, the CoolSculpting system, is designed to selectively reduce stubborn fat that may not respond to diet or exercise. Zimmer MedizinSystems 25 Mauchly, Suite 300 Irvine, CA (800) telephone (949) facsimile Zimmer MedizinSystems is a global leader in the aesthetic marketplace. Among other innovative products, Zimmer manufactures award-winning devices for treatment with lasers, cryo therapy and radial pulse therapy. Zimmer s flagship products for aesthetics include the ZWave Radial Pulse Technology unit and the ZCryo line of cold air devices for skin cooling at -22 F. Drawing inspiration from medical science and modern technologies, Zimmer MedizinSystems designs products to meet and exceed the expectations of the end-user. 106 THE Aesthetic Guide January/February

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108 Hair Removal Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Price Accessories Aerolase LightPod Neo 650 ms Nd:YAG 1064 nm Up to 1272 J/cm µs 1.5 ms 30+ applications with single handpiece. No pain / no anesthetic needed, no consumables and no skin contact by handpiece. No routine maintenance. Portable (25 lbs.). All laser accessories, training and marketing package included. Alma Lasers, Ltd. SopranoICE Harmony XL Pro ARION LEDA CW Diode In-Motion AFT Pulsed Light / Alexandrite / Nd:YAG Alexandrite Diode 810 nm, 755 nm nm / 755 nm / 1064 nm 755 nm 808 nm, 980 nm Up to 120 J/cm 2 Up to 120 J/cm 2 / 5 20 J/cm 2 / 1 32 J/cm 2 / J/cm 2 Up to 40 J/cm 2 60 J/cm ,350 ms 1, 3, 30 sec / 3 ms / 10, 15, 45, 60 ms ms 6 60 ms Dual Mode: pulse and In-Motion SHR for virtually painless hair removal. Facial tip for hard to reach areas. Contact cooled or non-cooled module options. Alexandrite: 5 mm and 8 mm tips. Nd:YAG: 2 mm, 6 mm and 10 mm tips with contact cooling. 6, 8, 10, 12, 14, 16 mm. Fotona SP Dynamis XP MAX QX MAX Nd:YAG / Er:YAG Nd:YAG Nd:YAG Q-Switched / Long Pulse 1064 nm 1064 nm 1064 nm, 532 nm, 585 nm, 650 nm Up to 600 J/cm 2 Up to 600 J/cm 2 Up to 160 J/cm ms ms 250 µs S-11: Nd:YAG scanner: 42 cm 2 Tx area. Nd:YAG handpieces: 2-20 mm spot sizes. S-11: Nd:YAG scanner: 42 cm 2 Tx area. Nd:YAG handpieces: 2-20 mm spot sizes. Handpieces: 2-8 mm spot sizes. InMode Diolaze Diode 810 nm 40 J/cm 2 (short), 60 J/cm 2 (long) Single and 1 pps auto repeat Gold standard wavelength with ultra-fast speed / pulsing to tissue and large spot size (50 x 8 mm). No compromising power for pulsing. Virtually painless due to strong built-in cooling (3PC - Pre, Parallel, Post). No consumables. Lumenis LightSheer Duet LightSheer ET LightSheer Infinity LightSheer Desire M22 Lumenis One Diode Diode Diode Diode Multi-Application, Multi- Technology Modular Platform Multi-Application, Multi- Technology Modular Platform 800 nm 800 nm 805 nm / 1060 nm 805 nm IPL: nm / Nd:YAG: 1064 nm IPL: nm / Nd:YAG: 1064 nm / LightSheer Diode: 800 nm HS: J/cm 2 ET: J/cm J/cm 2 HS: J/cm 2, ET: J/cm 2, LR: 5 25 J/cm 2 HS: J/cm 2, ET: J/cm 2, XC: J/cm J/cm 2 / J/cm J/cm 2 / J/cm 2 / J/cm 2 HS: ms ET: ms ms HS: ms, ET: ms, LR: ms HS: ms, ET: ms, LR: ms 4 20 ms / 2 20 ms ms / 2 20 ms / ms Two spot sizes: 22 x 35 and 9 x 9 mm. Vacuum Assist technology. Advanced ChillTip handpiece. Intuitive touchscreen with recommended treatment settings. Advanced ChillTip handpiece. No consumables. Optional cart. Three spot sizes: 22 x 35, 9 x 27 and 9 x 9 mm. Vacuum Assist technology. Advanced ChillTip handpieces. Intuitive touchscreen with recommended treatment settings. Three spot sizes: 22 x 35, 12 x 12 and 9 x 9 mm. Vacuum Assist technology. Advanced ChillTip handpieces. Intuitive touchscreen with recommended treatment settings. Optional cart. Universal IPL Module treats 24 applications, Universal IPL handpiece has two light guides (15 x 35 mm and 8 x 15 mm), with six exchangable Expert Filters: 515, 560, 590, 615, 640, 695 nm. Nd:YAG Module treats five applications, MultiSpot Nd:YAG handpiece has 2 x 4 mm and 6 mm light guides. Optimal Pulse Technology (OPT) and Multiple- Sequential-Pulsing. Continuous contact cooling with SapphireCool light guides on both modules. Optimized presets. Upgradable, expandable, seven IPL filters, OPT for multiple sequential pulsing, optimized presets and patient database, spot sizes. IPL: 15 x 35 and 8 x 15 mm, Nd:YAG: 2 x 4, 6 and 9 mm, LightSheer 9 x 9 mm. Perigee Medical Jeisys SmoothCool Asclepion MeDioStar IPL High Power Diode nm nm Up to 65 J/cm 2 Up to 210 J/cm µs 40 ms Up to 400 ms Contact Perigee Contact Perigee IPL with eight filters, smooth cooling technology controls skin temperature to 1 C. Up to 3,000 W peak power and cell toning pulse mode. Fiber bundle delivery for uniform and comfortable treatment from a high power hair removal laser. Up to 12 Hz operation. Note: Data subject to change; please refer to Company Directory for supplier contact information. Not all devices are FDA cleared for the application(s) indicated. 108 THE Aesthetic Guide January/February

109 Hair Removal Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Price Accessories Quanta Aesthetic Lasers EVO Domino EVO Light Series EVO MDK Series Forte Series Dual Alexandrite (pulsed) / IPL (opt.) Alexandrite (pulsed) / Nd:YAG (pulsed) / KTP (pulsed) / IPL (opt.) Nd:YAG (Q-Switched) / Nd:YAG FD Q-Switched) / Nd:YAG (pulsed) / Alexandrite (pulsed) / KTP (pulsed) / IPL (opt.) Multi-Application Platform 755 nm / 650 nm, 625 nm, 590 nm, 570 nm, 550 nm; nm 755 nm / 1064 nm / 532 nm / 1320 nm / 650 nm, 625 nm, 590 nm, 570 nm, 550 nm; nm 1064 nm QS / 532 nm QS / 1064 nm / 755 nm / 532 nm / 1320 nm / 650 nm, 625 nm, 590 nm, 570 nm, 550 nm; nm Diode 808 nm / IPL HR , HR nm 198 J/cm 2 / up to 25 J/cm J/cm 2 / >300 J/cm 2 / 95 J/cm 2 / 35 J/cm 2 / up to 25 J/cm 2 45 J/cm 2 / 19 J/cm 2 / 300 J/cm 2 / 123 J/cm 2 / 95 J/cm 2 / 35 J/cm 2 / up to 25 J/cm 2 90 J/cm 2 / 5 25 J/ cm 2 / 5 25 J/cm ms / up to 40 ms ms / ms / 2 50 ms / 5 10 ms / up to 40 ms 6 ns / 6 ns / ms / ms / 2 50 ms / 5 10 ms / up to 40 ms ms / ms / ms Air or contact skin cooling systems for pulsed lasers and optional IPL. Alexandrite spot sizes: up to 20 mm. IPL spot sizes: 48x13 mm and 25x13 mm. Air or contact skin cooling systems for pulsed lasers and optional IPL. Alexandrite spot sizes: up to 20 mm, Nd:YAG spot sizes up to 16 mm. IPL spot sizes: 48x13 mm and 25 x 13 mm. Air cooling system for Q-switched lasers. Air or contact skin cooling systems for pulsed lasers and optional IPL. Q-switched spot sizes: up to 5x5 mm; Alexandrite spot sizes: up to 16 mm, Nd:YAG spot sizes: up to 16 mm, IPL spot sizes: 48 x 13 mm and 25 x 13 mm. Portable, upgradeable with up to eight modules; five IPL handpieces, high-speed diode, Er:YAG and Nd:YAG. Advanced contact cooling with Sapphire waveguide which cools to 12 C. Adaptive Pulse Control (APC) adjusts pulse sequence and energy for safe and effective Tx of all skin types. Rohrer Aesthetics, LLC Spectrum Diode Laser 810 nm N/A Adjustable up to 400 ms $54,995 (fully loaded) $29,995 (with single handpiece) Multi-platform laser/ipl features: 810 diode, Er:YAG, Q-switched Nd:YAG, long pulsed YAG and IPL. 810 diode (hair removal) features adjustable pulse duration from 20 ms to 400 ms; safe for all skin types. Large 12 mm x 14 mm spot size combined with adjustable Hz rate from 1 to 10 pulses/sec, allows treatment of large areas (full back, chest or legs) in under 15 minutes. Handpiece includes built-in contact cooling and reduces (usually permanently) dark colored hair after three to five treatments. Sciton JOULE ClearScan YAG ClearScan ALX BBLs BBL Forever Bare BBL Laser and Light Platform Nd:YAG Alexandrite BroadBand Light BroadBand Light BroadBand Light Various 1064 nm 755 nm nm nm nm Up to 400 J/cm 2 Up to 400 J/cm 2 Up to 400 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm ms, 1 10 sec Up to 200 ms Up to 200 ms Up to 200 ms Up to 200 ms Up to 200 ms Configurable up to ten modules. Computerized scanner; 30 x 30 mm Tx; integrated cooling. Same as above. Table top system, SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. FB BBL technology is in motion. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. Solta Medical, a division of Valeant Pharmaceuticals North America Clear + Brilliant pélo Diode 808 nm Up to 750 J/cm ms $74,999 Linear scanning technology maximizes efficacy, speed and patient comfort. Large spot size and scan area. Integrated contact cooling. Syneron Candela GentleMax Pro GentleLase Pro-U GentleYAG Pro-U GentleTouch elōs Plus with Motif LHR Applicator elōs Plus with Motif HR Plus Applicator elōs Plus with Motif HR Applicator Long Pulse, Dual Wavelength Alexandrite / Nd:YAG 755 nm / 1064 nm Long Pulse Alexandrite 755 nm Long Pulse Nd:YAG 1064 nm Alexandrite Plus RF 755 nm / RF Dual Energy Multi-Application 810 nm Platform: Optical Energy / RF (elōs), Electrical Energy, Pulsed Dye Multi-Application nm Platform: elōs, Electrical Energy, Pulsed Dye Multi-Application nm Platform: elōs, Electrical Energy, Pulsed Dye Up to 600 J/cm 2 / up to 600 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm 2 Up to 46 J/cm 2 / up to 40 J/cm 3 Light Fluence: up to 50 J/cm 2 RF Energy: up to 50 J/cm 3 Light Fluence: up to 35 J/cm 2 RF Energy: up to 25 J/cm 3 Light Fluence: up to 45 J/cm 2 RF Energy: up to 25 J/cm ms ms ms Up to 100 ms 3 Hz Up to 3 Hz 1 Hz Standard Tx spot sizes from 6-18 mm; new, large spot delivery system handpiece provides 20, 22 and 24 mm Tx spots; finger and foot switch pulse control; unique, patented Dynamic Cooling Device (DCD) maximizing patient comfort and Tx efficacy; gentle hair removal for all skin types. Same as above. Ideal for skin types I IV. Nd:YAG system upgrade to GentleMax Pro available. Same as above. Treats all skin types I VI. Alexandrite system upgrade to GentleMax Pro available. Small, Large and Zoom tips up to 18 mm with EverCool contact cooling. Spot size: 12 x 12 mm; tip cooling temp: 5 C. Spot size: 35 x 14 mm; tip cooling temp: 5 C. Spot size: 25 x 12 mm; tip cooling temp: 5 C. Note: Data subject to change; please refer to Company Directory for supplier contact information. Not all devices are FDA cleared for the application(s) indicated. THE Aesthetic Guide January/February

110 Dermal Filler Product Comparison Chart Manufacturer Product(s) Key Component Description Physician Price Regulatory Status Adoderm VARIODERM Fine Line VARIODERM Basic VARIODERM Plus VARIODERM Subdermal VARIODERM Lips and Medium VARIODERM Mesolift VARIOFILL Body Contour Hyabell Lips Hyabell Basic Hyabell Deep Hyabell Ultra Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid 6 mg/ml; for superficial wrinkles and lip augmentation. 12 mg/ml; for medium wrinkles and lip contour. 18 mg/ml; for deep wrinkles and volume. 27 mg/ml; for volume augmentation and facial contouring. 12 mg/ml; special formulation for lip augmentation and medium wrinkles mg/ml; effective smoothing of superficial wrinkles. 10 ml; for various indications on the body surface. 12 mg/ml; for lip augmentation and lip contour. 16 mg/ml; medium wrinkles and lip contour. 20 mg/ml; deep wrinkles, especially of the face. 24 mg/ml; very deep wrinkles, face contouring, volumizing. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. Allergan CosmoDerm CosmoPlast HydraFill Softline HydraFill Softline Max Juvéderm ULTRA 2 Juvéderm ULTRA 3 Juvéderm ULTRA 4 Juvéderm VOLUMA Juvéderm HYDRATE Purified Human-based Collagen + Lidocaine Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid + Lidocaine Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Purified human-based collagen 35 mg/ml. Purified human-based collagen 35 mg/ml, cross-linked with glutaraldehyde. *All collagen products contain 0.3% lidocaine. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. *All Juvéderm ULTRA products contain 0.3% lidocaine. Non-animal, cross-linked cohesive hyaluronic acid 20 mg/g mg/g plus mannitol 0.9%; 1 x 1 ml syringe. $205 $235 $200 $225 $200 $225 $200 $225 $200 $225 $245 Worldwide Worldwide CE marked. CE marked. CE marked. CE marked. CE marked. CE marked for facial volume restoration. CE marked. Galderma Restylane Restylane Lyft Restylane Silk Restylane Refyne Restylane Defyne Sculptra Aesthetic NASHA XpresHAn Technology Injectable Poly L-Lactic Acid (PLLA) NASHA gel a non-animal hyaluronic acid, stabilized with BDDE. The differentiation is in the size of the NASHA particles, to assure a tissue-tailored range of products. Flexible gels with a concentration of 20 mg/ml, varied cross-linking that allows for flexibility and support with consistant textures and smoothness. Volumizer. Restylane is approved worldwide with the exception of Japan. FDA approved in December Approved as Emervel Classic and Emervel Deep outside of U.S. FDA approved. Merz Aesthetics Belotero Balance 22.5 mg/ml Radiesse Radiesse (+) Hyaluronic Acid CaHA CaHA Non-animal double phase cross-linked hyaluronic acid via biofermentation with CPM (Cohesive Polydensified Matrix) technology. Radiesse injectable implant is a sterile non-pyrogenic, semi-solid, cohesive implant, whose principle component is synthetic calcium hydroxylapatite suspended in a gel carrier of sterile water for injection, glycerin and sodium carboxymethyl cellulose (1.5 cc, 0.8 cc). Radiesse (+) injectable implant is an opaque, sterile non-pyrogenic, semi-solid, cohesive implant, whose principle component is synthetic calcium hydroxy-lapatite suspended in a gel carrier of glycerin, sodium carboxymethyl cellulose 0.3% lidociane hydrochloride and sterile water for injection (1.5 cc, 0.8 cc). CE marked in Europe. FDA approved. CE marked in Europe. FDA approved. Suneva Medical, Inc. Bellafill Purified Bovine Collagen and PMMA 80% purified bovine collagen and 20% polymethyl-methacrylate (PMMA) microspheres and 0.3% lidocaine. FDA approved for the correction of nasolabial folds and moderate to severe, atrophic, distensible facial acne scars on the cheek in patients over the age of 21 years. Health Canada approved for nasolobial folds. Note: Data subject to change; please refer to Company Directory for supplier contact information. Not all devices are FDA cleared for the application(s) indicated. 110 THE Aesthetic Guide January/February

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112 Vascular Technology Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Price Accessories Aerolase LightPod Neo LightPod V ms Nd:YAG 650 ms Nd:YAG 1064 nm 1064 nm Up to 1272 J/cm 2 Up to 1272 J/cm µs 1.5 ms 650 µs 1.5 ms 30+ applications with single handpiece. No pain / no anesthetic needed, no consumables and no skin contact by handpiece. No routine maintenance. Portable (25 lbs.). All laser accessories, training and marketing package included. No pain / no anesthetic needed, no consumables and no skin contact by handpiece. No service contracts. Portable (25 lbs.). All laser accessories, training and marketing package included. Alma Lasers, Ltd. Harmony XL Pro VascuLife AFT Pulsed Light / Nd:YAG / ClearLift Q-switched / Nd:YAG / Dye-VL AFT Pulsed Light / Alexandrite Diode nm / 1064 nm / 1064 nm / nm / 755 nm 1470 nm 30 J/cm 2 / J/cm 2 / up to 1200 J/cm 2 / up to 25 J/ cm 2 / 1 32 J/cm 2 Up to 15 W 10, 12, 15 ms / 10, 15, 45, 60 ms / 20 ns / 5, 10, 25 ms / 3 ms ms Contact cooled version or non-cooled module options. Nd:YAG: 2 mm, 6 mm and 10 mm tips with contact cooling. Alexandrite: 5 and 8 mm tips. Unique robotic pullback fiber system; 1470 nm radial emitting diode for complete and accurate treatment of great and small saphenous veins (GVS, SSV). BTL Industries, Inc. Exilite IPL nm Up to 40 J/cm ms IPL handpiece with 11 x 40 mm saphire light spot and five filters (480, 530, 560, 640, 690 nm); integrated contact cooling. Poly Peak Pulse (PP Pulse) technology and optimized presets. Fotona SP Dynamis XP-2 Focus XP MAX QX MAX SP Spectro XP Spectro XS Dynamis XP Focus Nd:YAG / Er:YAG Nd:YAG Nd:YAG Nd:YAG Q-Switched / Long Pulse Nd:YAG / Er:YAG Nd:YAG / Long Pulse Er:YAG Nd:YAG / Long Pulse 1064 nm / 2940 nm 1064 nm 1064 nm 1064 nm, 532 nm, 585 nm, 650 nm 1064 nm / 2940 nm 1064 nm 2940 nm 1064 nm Up to 600 J/cm 2 Up to 300 J/cm 2 Up to 600 J/cm 2 Up to 160 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm 2 Up to 500 J/cm 2 Up to 600 J/cm ms ms ms 5 20 ns, 250 µs N/A ms ms ms F-Runner, fractional Er:YAG scanner: 250 μm spot size, 168 mm 2 Tx area. S-Runner, Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. S-11: Nd:YAG scanner: 42 cm 2 Tx area. Er:YAG handpieces: mm spot sizes; Nd:YAG handpieces: 2-20 mm spot sizes. Nd:YAG handpieces: 2-10 mm spot sizes. S-11: Nd:YAG scanner: 42 cm 2 Tx area. Nd:YAG handpieces: 2-20 mm spot sizes. Handpieces: 2-8 mm spot sizes. F-Runner, fractional Er:YAG scanner: 250 μm spot size, 168 mm 2 Tx area. S-Runner, Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. S-11: Nd:YAG scanner: 42 cm 2 Tx area. Er:YAG handpieces: mm spot sizes; Nd:YAG handpieces: 2-20 mm spot sizes. S-11 Nd:YAG scanner: 42 cm 2 Tx area. Nd:YAG handpieces: 2-20 mm spot sizes. F-Runner, fractional Er:YAG scanner: 250 μm spot size, 168 mm 2 Tx area. S-Runner, Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. Er:YAG handpieces: mm spot sizes. Standard handpiece: R31/R32 with 2-8 mm spot sizes; Nd:YAG handpieces: 2-20 mm spot sizes. Lumenis M22 Lumenis One Multi-Application, Multi-Technology Modular Platform Multi-Application, Multi-Technology Modular Platform IPL: nm, Nd:YAG: 1064 nm IPL: nm, Nd:YAG: 1064 nm, LightSheer Diode: 800 nm J/cm 2, J/cm J/cm 2, J/cm 2, J/cm ms, 2 20 ms ms, 2 20 ms, ms Universal IPL module treats 24 applications, Universal IPL handpiece has two light guides (15 x 35 mm and 8 x 15 mm), with six exchangable ExpertFilters: 515, 560, 590, 615, 640, 695 nm. Nd:YAG module treats five applications, MultiSpot Nd:YAG handpiece has 2 x 4 mm and 6 mm light guides. Optimal Pulse Technology (OPT) and Multiple-Sequential-Pulsing. Continuous contact cooling with SapphireCool light guides. Optimized presets. Upgradable, expandable, seven IPL filters, OPT for multiple sequential pulsing, optimized presets and patient database, spot sizes. IPL: 15 x 35 mm and 8 x 15 mm, Nd:YAG: 2 x 4, 6 and 9 mm, LightSheer 9 x 9 mm. NewSurg NS-532 Laser System Solid State Diode Pumped 532 nm Green Light Laser 532 nm 3 or 5 W 0.5 2,000 ms Compact and portable. FDA cleared. Adjustable spot size through flexible fiber delivery. Perigee Medical Jeisys QuadroStar Pro Yellow Diode 578 nm 5 W 1 ms 95 sec; CW Contact Perigee Scanning technology 15x15 mm, fiber delivered. Jeisys SmoothCool Asclepion MeDioStar IPL High Power Diode nm nm Up to 65 J/cm 2 Up to 210 J/cm µs 40 ms Up to 400 ms Contact Perigee Contact Perigee IPL with eight filters, smooth cooling technology controls skin temperature to 1 C. Up to 3,000 W peak power and cell toning pulse mode. Fiber bundle delivery for uniform and comfortable treatment from a high power hair removal laser. Up to 12 Hz operation. Note: Data subject to change; please refer to Company Directory for supplier contact information. Not all devices are FDA cleared for the application(s) indicated. 112 THE Aesthetic Guide January/February

113 Vascular Technology Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Price Accessories Quanta Aesthetic Lasers EVO Light Series EVO MDK Series Forte Series Nd:YAG (pulsed) / KTP (pulsed) / IPL (opt.) Multi-Application Platform: Nd:YAG (Q-Switched) / Nd:YAG FD (Q-Switched) / Nd:YAG (pulsed) / Alexandrite (pulsed) / KTP (pulsed) / IPL (opt.) Multi-Application Platform 1064 nm / 532 nm / 650 nm, 625 nm, 590 nm, 570 nm, 550 nm; nm 1064 nm QS / 532 nm QS / 1064 nm / 755 nm / 532 nm / 1320 nm / 650 nm, 625 nm, 590 nm, 570 nm, 550 nm; nm IPL: VLPL nm 300 J/cm 2 / 95 J/cm 2 / up to 25 J/cm 2 45 J/cm 2 / 19 J/cm 2 / 300 J/cm 2 / 123 J/cm 2 / 95 J/cm 2 / 35 J/cm 2 / up to 25 J/cm J/cm ms / 2 50 ms / up to 40 ms 6 ns / 6 ns / ms / ms / 2 50 ms / 5 10 ms / up to 40 ms ms Air or contact skin cooling systems for pulsed lasers and optional IPL. Nd:YAG spot sizes: up to 16 mm. IPL spot sizes: 48 x 13 mm and 25 x 13 mm. Air cooling system for Q-switched lasers. Air or contact skin cooling systems for pulsed lasers and optional IPL. Q-switched spot sizes up to 5x5 mm, Alexandrite spot sizes: up to 16 mm, Nd:YAG spot sizes: up to 16 mm, IPL spot sizes: 48x13 mm and 25x13 mm. Portable, upgradeable with up to eight modules; five IPL handpieces, high-speed diode, Er:YAG and Nd:YAG. Advanced contact cooling with Sapphire waveguide which cools to 12 C. Adaptive Pulse Control (APC) adjusts pulse sequence and energy for safe and effective Tx of all skin types. Rohrer Aesthetics, LLC Spectrum YAG Laser 1064 nm 50 J/cm 2 Adjustable up to 10 ms $54,995 (fully loaded); $29,995 (with single handpiece) Multi-platform laser/ipl features: 810 diode, Er:YAG, Q-switched Nd:YAG, long pulsed YAG and IPL. Nd:YAG features adjustable spot size (1.5 mm and 3 mm); built-in contact cooling; safely removes facial and leg veins and small angiomas on the body without bruising. Sciton JOULE ClearScan YAG ClearScan ALX Pro-V BBLs BBL Laser and Light Platform Nd:YAG Alexandrite Nd:YAG BroadBand Light BroadBand Light Various 1064 nm 755 nm 1319 nm nm nm Up to 400 J/cm 2 Up to 400 J/cm 2 Up to 400 J/cm 2 Up to 50 Watts Up to 30 J/cm 2 Up to 30 J/cm ms, 1 10 sec Up to 200 ms Up to 200 ms N/A Up to 200 ms Up to 200 ms Configurable up to ten modules. Computerized scanner; 30 x 30 mm Tx; integrated cooling. Same as above. Endovenous and transcutaneous laser Tx of varicose and other veins. Uses non-proprietary fibers. Table top system, SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. Syneron Candela elōs Plus / LV and LVA, SR Plus, SRA Plus and SRA Mini Applicators Vbeam Perfecta GentleMax Pro GentleLase Pro-U GentleYAG Pro-U Multi-Application Platform: elōs, LV/LVA: Diode/RF Electrical Energy, SR/ SRA: Optical Energy/ RF Electrical Energy, SRA Mini: Optical Energy/RF Electrical Energy High-Output Pulsed Dye Laser Long Pulse, Dual Wavelength Alexandrite / Nd:YAG Long Pulse Alexandrite Long Pulse Nd:YAG LV/LVA: 915 nm; SR/SRA Plus: nm (SR), nm (SRA); SRA Mini: nm 595 nm 755 nm / 1064 nm 755 nm 1064 nm Light Fluence: LV/LVA: up to 140 J/cm 2, J/cm 2 ; SR/SRA Plus: nm (SR), nm (SRA); SRA Mini: nm RF Energy: LV/LVA: up to 100 J/cm 3 ; SR/SRA Plus: up to 25 J/cm 3 ; SRA Mini: up to 25 J/cm 3 Up to 40 J/cm 2 Up to 600 J/cm 2 / up to 600 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm 2 N/A ms ms ms ms 8 x 5 mm spot size at 1 Hz pulse rep. rate (LV/LVA); 35 x 14 mm spot size at 3 Hz (SR/SRA Plus); and 15 x 14 mm at 1 Hz (SRA Mini) for treatment of smaller, more focused areas. Six spot sizes up to 12 mm, including 3 x 10 elliptical and two pigmented lesion handpieces; unique, patented Dynamic Cooling Device (DCD); maximizing patient comfort and Tx efficacy. Standard Tx spot sizes from 6-18 mm; new small spot delivery system handpiece provides 1.5, 3 and 3 x 10 mm Tx spots; finger and foot switch pulse control; unique, patented DCD maximizing patient comfort and Tx efficacy; excellent system for recalcitrant port-wine stains, telangiectases, spider veins and other vascular lesions. Standard Tx spot sizes from 6-18 mm; new small spot delivery system handpiece provides 1.5, 3 and 3 x 10 mm Tx spots; finger and foot switch pulse control; unique, patented DCD maximizing patient comfort and Tx efficacy; excellent system for recalcitrant port-wine stains. Nd:YAG system upgrade to GentleMax Pro available. Standard Tx spot sizes from 6-18 mm; new small spot delivery system handpiece provides 1.5, 3 and 3 x 10 mm Tx spots; finger and foot switch pulse control; unique, patented DCD maximizing patient comfort and Tx efficacy; excellent system for telangiectases, spider veins and other vascular lesions. Alexandrite system upgrade to GentleMax Pro available. Note: Data subject to change; please refer to Company Directory for supplier contact information. Not all devices are FDA cleared for the application(s) indicated. THE Aesthetic Guide January/February

114 Skin Rejuvenation Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Price Accessories Aerolase LightPod Neo LightPod Era 650 ms Nd:YAG Er:YAG 1064 nm 2940 nm Up to 1272 J/cm 2 Up to 1400 mj 650 µs 1.5 ms 300 µs 30+ applications with single handpiece. No pain / no anesthetic needed, no consumables and no skin contact by handpiece. No routine maintenance. Portable (25 lbs.). All laser accessories, training and marketing package included. No per treatment consumables and no skin contact by handpiece. No service contracts. Portable (22 lbs.). All laser accessories, training and marketing package included. Alma Lasers, Ltd. Harmony XL Pro AFT Pulsed Light nm 30 J/cm 2 10, 12, 15 ms Contact cooled version or non-cooled module options. SINON PicoClear EXCIMER 308 Nd:YAG ClearLift Q-Switched / Nd:YAG Dye-VL AFT Pulsed Light Alexandrite Ruby Q-Switched Q-Switched Nd:YAG with Pico and Nano Modes EXCIMER Laser 1064 nm 1064 nm nm 755 nm 694 nm 1064 nm, 532 nm 308 nm J/cm 2 Up to 1200 J/cm 2 Up to 25 J/cm J/cm J/cm mj 1 J 50 6,000 mj/cm 2 10, 15, 45, 60 ms 20 ns 5, 10, 25 ms 3 ms 20 ns 600 ps 2 ns N/A 2 mm, 6 mm and 10 mm tips with contact cooling. 5 mm and 8 mm tips. Dual wavelength device featuring both pico and nano modes for tattoo removal, skin resurfacing, vascular and pigmented lesions. 2 mm 15 mm spot size. Coming soon: 4D nonablative skin resurfacing via a new refractive handpiece. Utilizes standard 110 V power and ready to treat in under two minutes. BTL Industries, Inc. BTL Protegé Elite BTL Exilis Elite Exilite Eclipse Aesthetics, LLC Skinfinity RF Firma NEWA Fotona SP Dynamis XS Dynamis XP MAX QX MAX SP Spectro XP Spectro XP Dynamis Focused Monopolar RF N/A Focused RF N/A IPL RF RF RF Nd:YAG / Er:YAG Er:YAG Nd:YAG Nd:YAG Q-Switched / Long Pulse Nd:YAG / Er:YAG Nd:YAG / Long Pulse Nd:YAG / Long Pulse nm N/A N/A N/A 1064 nm / 2940 nm 2940 nm Up to 50 W Up to 90 W Up to 40 J/cm W 65 W N/A 1064 nm Up to 600 J/cm nm, 532 nm, 585 nm, Up to 160 J/cm nm 1064 nm / 2940 nm Up to 600 J/cm nm 1064 nm Up to 600 J/cm 2 Up to 500 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm 2 N/A N/A ms N/A N/A N/A ms ms ms 5 20 ns / 250 µs N/A ms ms Impedance intelligence and square spectrum energy profiling handpiece prevents sparking or tissue burn. No consumables. Multi-application RF platform for treatment of most body areas; real time temperature monitoring; controlled cooling for patient comfort. Impedance intelligence and square spectrum energy profiling handpiece prevents sparking or tissue burn. No consumables. IPL handpiece with 11 x 40 mm sapphire light spot and five filters (480, 530, 560, 640, 690 nm.) Integrated contact cooling. Poly Peak Pulse (PP Pulse) technology and optimized presets. Ever Pulse Rollers and reusable stamp. Options: ifine, Fine, Small, Shape and Large. FDA cleared, in-home, handheld RF device. F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area S-Runner, Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. S-11: Nd:YAG scanner: 42 cm 2 Tx area. Er:YAG handpieces: mm spot sizes; Nd:YAG handpieces: 2-20 mm spot sizes. F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area S-Runner, Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. Er:YAG handpieces: mm spot sizes. S-11: Nd:YAG scanner: 42 cm 2 Tx area. Nd:YAG handpieces: 2-20 mm spot sizes. Handpieces: 2-8 mm spot sizes. F-Runner fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area. S-Runner Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. S-11 Nd:YAG scanner: 42 cm 2 Tx area. Er:YAG handpieces: mm spot sizes; Nd:YAG handpieces: 2-20 mm spot sizes. S-11 Nd:YAG scanner: 42 cm 2 Tx area. Nd:YAG handpieces: 2-20 mm spot sizes. Same as above. InMode Lumecca Forma Fractora Spectrum Shifted IPL Bipolar RF Bipolar RF nm, nm N/A N/A J/cm 2 Up to 65 W Up to 62 mj / Pin 5 30 ms N/A Up to 2 pps Delivers 40% of total energy between nm. Provides a photofacial in one to three treatments. Powerful peak power: 3,000 W/cm 2. No comsumables. Non-invasive subdermal heating for collagen remodeling and contraction. RF current flows uniformly between the electrodes for a comfortable and safe Tx. ACE technology features built-in temperature controls to attain clinically proven optimal epidermal temperature, and exclusive capability for prolonged exposure at therapeutic temperatures. Variable pin tip configurations (20, 24 coated, 24, 60, 126) and Tx depths allow for a Designer Dermis approach to Tx. Safe on ethnic skin. No pulse counter limitations. Lumenis M22 M22 ResurFX M22 Q-Switched Nd:YAG Lumenis One Multi-Application, Multi- Technology Modular Platform 1565 nm Erbium Fiber Laser Q-Switched Nd:YAG Multi-Application, Multi- Technology Modular Platform IPL: nm / Nd:YAG: 1064 nm 1565 nm N/A IPL: nm / Nd:YAG: 1064 nm / LightSheer Diode: 800 nm J/cm 2 / J/cm mj per microbeam J/cm J/cm 2 / J/cm 2 / J/cm ms / 2 20 ms N/A 6 8 ns ms / 2 20 ms / ms Universal IPL module treats 24 applications, Universal IPL handpiece has two light guides (15 x 35 mm and 8 x 15 mm), with six exchangable ExpertFilters: 515, 560, 590, 615, 640, 695 nm. Nd:YAG module treats five applications, MultiSpot Nd:YAG handpiece has 2 x 4 mm and 6 mm light guides. Optimal Pulse Technology (OPT) and Multiple-Sequential-Pulsing. Continuous contact cooling with SapphireCool light guides. Optimized presets. Single pass CoolScan scanner for non-sequential scanning, continuous contact cooling for increased patient comfort and protection of epidermis. No disposables; 600 combinations of shape, size and density. Homogenous Top-Hat beam profile. Multiple disposable and non-disposable tips, multiple spot sizes: 2, 2.5, 3.5, 5 and 6 mm Upgradable, expandable, seven IPL filters, OPT for multiple sequential pulsing, optimized presets and patient database, spot sizes: IPL: 15 x 35 mm and 8 x 15 mm, Nd:YAG: 2 x 4, 6 and 9 mm, LightSheer: 9 x 9 mm. Note: Data subject to change; please refer to Company Directory for supplier contact information. Not all devices are FDA cleared for the application(s) indicated. 114 THE Aesthetic Guide January/February

115 Skin Rejuvenation Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Price Accessories Lumenis - continued UltraPulse (with ActiveFX, DeepFX, TotalFX and SCAAR FX) AcuPulse MultiMode Fotona QX Max (distributed by Lumenis) Fractional and Full Ablative CO2 Fractional and Full Ablative CO2 Q-switched Nanosecond / Accelera sub-millisecond 10,600 nm 10,600 nm 1064 nm, 532 nm, 585 nm, 650 nm / 1064 nm Proprietary, unique UltraPulse technology: Up to 225 mj per single pulse (short pulse duration). Avg. power up to 60 W, peak power up to 240 W Average power up to 40 W, peak power up to 200 W 1600 mj, 600 mj, 340 mj, 220 mj / 5,000 mj Unique 225 mj in less than 2 ms SuperPulse pulses less than 0.3 ms N/A Two scanners: CoolScan (CPG) delivers UltraPulse telecentric, collimated scanning with 1.3 mm spot size. DeepFX micro-scanner delivers energy with 0.12 mm spot size, up to 4 mm penetration depth. Collimated single spot energy delivery and focused incisional handpieces. SCAAR FX fractional mode delivers 150 mj per pulse, deep treatment up to 4 mm in a single pulse and optimal ablation/coagulation ratio. 34 FDA cleared aesthetic indications. Ten modes: FeatherTouch, SilkTouch, FineTouch, ToeTouch, Paint, Superficial, Deep, Combo, StretchTouch and Bleph. Two scanners: AcuScan120 for fractional resurfacing and SurgiTouch for full resurfacing. Three handpieces for use with SurgiTouch scanner and one incisional handpiece. 34 FDA cleared indications. Five laser sources in one system, high single-pulse energy for more efficiency. Advanced performance guarantees efficacy at larger spot sizes, uniform beam profiles with VCT, OPTOflex arm increases precision and accuracy. Wider range of treatments including FRAC3; wireless footswitch. NewSurg NS-532 Laser System Solid State Diode Pumped 532 nm Green Light Laser 532 nm 3 or 5 W 0.5 2,000 ms Compact and portable. FDA cleared. Adjustable spot size through flexible fiber delivery. Perigee Medical Jeisys EDGE Jeisys SmoothCool Jeisys IntraGen Fractional CO2 IPL Grid Fractional RF, Focused RF 10.6 µm nm N/A Proprietary peak power >200 W Up to 65 J/cm W 100 µs CW 100 µs 40 ms N/A Contact Perigee Contact Perigee Contact Perigee Fractional handpiece with variable spot size, finder tip controls on handpiece, Superpulse mode, wide-range of parameters; surgical and vaginal handpieces. IPL with eight filters, smooth cooling technology controls skin temperature to 1 C. Up to 3,000 W peak power and cell toning pulse mode. Grid fractional radiofrequency energy optimized for each treatment by a real time impedance checking system with multi-pulse energy profiling. Quanta Aesthetic Lasers Forte Series YouLaser CO2 Multi-Application Platform Fractional and Full Ablative CO2 IPL: SR nm / Er:YAG: 2940 nm 10,600 nm Up to 25 J/cm 2 / up to 95 J/cm 2 Up to 30 W ms / 1, 1.2, 1.5 ms ms Upgradeable with up to eight modules; five IPL handpieces, high-speed diode, Er:YAG and Nd:YAG. Advanced contact cooling with sapphire waveguide cools to 12 C. Adaptive Pulse Control (APC) adjusts pulse sequence and energy for safe and effective Tx of all skin types. Lightweight, ergonomic scanner has nine different fractional patterns varying in shape, size and density of spot. Industry leading metal RF excited tube provides greater stability and reliability over glass tubes. Rohrer Aesthetics, LLC Phoenix CO2 Laser Spectrum CO2 Er:YAG 10,600 nm 2940 nm Adjustable up to 200 mj / point 1000 mj Adjustable up to 20 ms 300 ms $34,995 $54,995 (fully loaded) $29,995 (with single handpiece) Incisional handpiece and ergonomic, microthermal zone scanner. Pixelated scanner features unique scanning technology to customize treatment for individual patients. 30 mm x 30 mm pattern size allows resurfacing of both hands in under 2 minutes. Can also be used to improve vaginal health. Multi-platform laser/ipl features: 810 diode, Er:YAG, Q-switched Nd:YAG, long pulsed YAG and IPL. Er:YAG features adjustable spot size from 1.5 mm to 6 mm and adjustable Hz rate from 1 to 5 pulses/sec allowing treatment of a full face in under 15 minutes. Safe to treat the neck and chest; removes fine lines, wrinkles and pigmentation (including melasma); and can safely be used on most skin types. Sciton JOULE Halo ClearScan YAG Contour TRL ProFractional ThermaScan BBLs BBL Nd:YAG / Er:YAG / BroadBand Light / Alexandrite Hybrid Fractional Laser (ablative and non-ablative) Nd:YAG Tunable Resurfacing Laser (TRL) Er:YAG Nd:YAG BroadBand Light BroadBand Light Various 1470 nm / 2940 nm 1064 nm 2940 nm 2940 nm 1319 nm nm nm Up to 400 J/cm mj/mtz, 50 mj/mtz Up to 400 J/cm 2 Up to 40 W Up to 400 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm ms, 1 10 sec Up to 5 ms Up to 200 ms Up to 50 ms Variable Up to 200 ms Up to 200 ms Up to 200 ms Configurable up to ten modules. Delivery of ablative and non-ablative wavelengths in single pass. Dynamic Thermal Optimization (DTO) for precise energy delivery. Roller tip adaptors; optical navigation; integrated Zimmer cooling advanced mode for precise and independent control of depth and density. Pre-programmed modes and integrated smoke evacuation system. Computerized scanner; 30 x 30 mm Tx; integrated cooling. Computerized scanner, smart user interface, MicroLaserPeel, Tunable Resurfacing Laser. Expandable module / density 1.5% 26%. Computerized scanner; 30 x 30 mm Tx; integrated cooling. Table top system, SkinTyte II, 420, 515, , 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters. 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. Solta Medical, a division of Valeant Pharmaceuticals North America Fraxel re:pair SST Fraxel DUAL 1550 / 1927 Fraxel 1550 Clear+Brilliant Clear+Brilliant Perméa CO2 Laser 1550 nm Erbium Fiber / 1927 nm Thulium Fiber Laser 1550 nm Erbium Fiber Laser Diode Laser Fractional Diode Laser 10,600 nm 1550 nm / 1927 nm 1550 nm 1440 nm 1927 nm Up to 70 mj/mtz Up to 70 mj/mtz / up to 20 mj/mtz Up to 70 mj/mtz Up to 9 mj/mtz 5 mj N/A N/A N/A N/A N/A Four plug-and-play handpieces with fractional and surgical applications. Built-in smokeless evacuation system. Intelligent Optical Tracking system (IOTS) with roller tip. Over 240 pre-programmed Tx settings for targeted indications. Two non-ablative lasers. IOTS adjusts to hand speed and ensures uniform Tx. Maximized lesion depth for chosen pulse energy. Variable optical spot size with telescope. Zimmer cooling integrated into handpiece. IOTS adjusts to hand speed and ensures uniform Tx. Variable optical spot size using telescope. Zimmer cooling integrated into handpiece. Precise dosimetry increases patient comfort for targeted indications. Desktop system with ergonomic handpiece and roller tip. IOTS adjusts to hand speed and ensures uniform Tx. Same as above. Note: Data subject to change; please refer to Company Directory for supplier contact information. Not all devices are FDA cleared for the application(s) indicated. THE Aesthetic Guide January/February

116 Skin Rejuvenation Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Price Accessories Syneron Candela Profound PicoWay Resolve elōs Plus with SRA applicator elōs Plus with SRA Plus applicator elōs Plus with SRA mini applicator elōs Plus with SR applicator elōs Plus with SR Plus applicator CO2RE GentleMax Pro GentleYAG Pro U Alex TriVantage Vbeam Perfecta Bipolar RF 460, 5 khz Holographic Fractional Picosecond Module Multi-Application Platform: Optical Energy/RF (elōs), Electrical Energy, Pulsed Dye Multi-Application Platform: elōs, Electrical Energy, Pulsed Dye Multi-Application Platform: elōs, Electrical Energy, Pulsed Dye Multi-Application Platform: elōs, Electrical Energy, Pulsed Dye Multi-Application Platform: elōs, Electrical Energy, Pulsed Dye CO2 Resurfacing System Long Pulse, Dual Wavelength Alexandrite / Nd:YAG Long Pulse Nd:YAG Three wavelength Q-switched and Long Pulse Laser High Output Pulsed Dye Laser N/A 532 nm / 1064 nm nm nm nm nm nm 10,600 nm 755 nm / 1064 nm 1064 nm 755 nm Alexandrite / 1064 nm Nd:YAG / 532 nm KTP Nd:YAG 595 nm Max. output voltage N/A 84 VRMS Up to 1.5 mj/μbeam / 375 ps / 450 ps up to 3.0 mj/μbeam Light Fluence: up to 1 Hz 45 J/cm 2 / RF Energy: up to 25 J/cm 3 Light Fluence: up to 35 J/cm 2 / RF Energy: up to 25 J/cm 3 Light Fluence: up to 35 J/cm 2 / RF Energy: up to 25 J/cm 3 Light Fluence: up to 45 J/cm 2 / RF Energy: up to 25 J/cm 3 Light Fluence: up to 35 J/cm 2 / RF Energy: up to 25 J/cm 3 Up to 396 J/cm 2 Up to 600 J/cm 2 / up to 600 J/cm 2 Up to 600 J/cm 2 Up to 18 J/cm 2 (QS Alexandrite), up to 70 J/cm 2 (microsecond 755 nm) / up to 10 J/cm 2 (QS Nd:YAG) / up to 5 J/cm 2 (QS KTP Nd:YAG) Up to 40 J/cm 2 Up to 2 Hz Up to 1 Hz 1 Hz Up to 2 Hz 20 3,000 µs ms ms 50 ns ms Single use, sterile treatment cartridge with either five (dermal) or seven (subq) independently controlled, bipolar microneedle pairs. Treats jawline, jowls and neck. 100 μbeams, 6 x 6 mm array per Tx area. Spot size: 12 x 25 mm; tip cooling temp: 5 C. Spot size: 35 x 14 mm; tip cooling temp: 5 C. Spot size: 15 x 14 mm; tip cooling temp: 5 C. Spot size: 25 x 12 mm; tip cooling temp: 5 C. Spot size: 35 x 14 mm; tip cooling temp: 5 C. Exclusive Fusion Tx mode treats superficial and deep skin layers simultaneously. Multi-use featherweight delivery system, multiple Tx spots, full length fractional, short fractional and tapered surgical handpieces, 10.4" high-resolution color LCD, touchscreen user interface, footswitch. Standard spot sizes from 6-18 mm; new, small spot delivery system handpiece provides 1.5, 3 and 3 x 10 mm Tx spots; finger and foot switch pulse control; unique, patented Dynamic Cooling Device (DCD) maximizing patient comfort and Tx efficacy; rejuvenation, wrinkle reduction, treats vascular and other dyschromia for all skin types. Same as above. Alexandrite system upgrade to GentleMax Pro available. 2, 3, 4 and 5 mm Tx spots. Six spot sizes up to 12 mm, including 3 x 10 elliptical and two pigmented lesion handpieces; unique, patented DCD, maximizing patient comfort and Tx efficacy. Note: Data subject to change; please refer to Company Directory for supplier contact information. Not all devices are FDA cleared for the application(s) indicated. PRODUCT PROFILES M22 ResurFX The ResurFX module of M22 is a true, one-pass, fractional non-ablative treatment technology. Unlike other fractional technologies, ResurFX needs only one pass to be effective, saving you time and protecting the patient s skin. ResurFX uses a 1565 nm fiber laser and a very advanced scanner, which enables you to choose from more than 600 combinations of shape, size and density for optimal treatment results. Even better, your practice wins as there are no consumables or recurring procedure fees. Restylane Refyne and Restylane Defyne Restylane Refyne and Restylane Defyne are approved for the treatment of nasolabial folds in patients over the age of 21. Restylane Refyne is approved for treatment of moderate to severe facial wrinkles and folds and Restylane Defyne is approved for treatment of moderate to severe, deep facial wrinkles and folds. These next-generation HA dermal fillers use XpresHAn Technology to help patients maintain natural expression in motion and are proven safe. Galderma Laboratories, L.P.: or visit Lumenis: 877-LUMENIS ( ) or visit Alma Harmony Alma Harmony combines a full spectrum of aesthetic indications, advanced technologies and excellent clinical results to create complete aesthetic harmony. This system is upgradable and expandable, allowing you to specialize in any aesthetic segment and expand your clinical offerings as your practice grows. Alma Harmony offers powerful treatment solutions for six major indications: skin remodeling, vascular and pigmented lesions, tone and texture, hair removal, acne scars and tattoo removal simultaneously. Harmony XL Pro users are able to serve more skin types in a superior and often virtually painless way. Alma Lasers: (866) 414-ALMA (2562) or visit THE Aesthetic Guide January/February

117 Acne Tx Device Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Price Accessories Aerolase LightPod Neo 650 ms Nd:YAG 1064 nm Up to 1272 J/cm µs 1.5 ms 30+ applications with single handpiece. No pain / no anesthetic needed, no consumables and no skin contact by handpiece. No routine maintenance. Portable (25 lbs.). All laser accessories, training and marketing package included. Alma Lasers, Ltd. Harmony XL Pro Pixel CO2 vshape EXELO2 AFT Pusled Light / Fractional Er:YAG Pixel / Nd:YAG Fractional CO2 System Pixel RF Fractional CO2 System nm / 2940 nm / 1320 nm 10,600 nm RF, mhz 10,600 nm Up to 25 J/cm 2 / 300 2,500 mj/p / 5 40 J/cm 2 70 W Up to 80 W 3 40 W 30, 40, 50 ms / short, medium, long / 30, 40, 50 ms CW Superpulse N/A ms plus CW Pixel tips are 11 mm 2 with 1 x 7, 7 x 7 and 9 x 9 arrays. Er:YAG tips are 1 mm and 4 mm. Nd:YAG: 6 mm tip. Pixel tips are 11 mm 2 with 1 x 7, 7 x 7 and 9 x 9 arrays, surgical handpieces are 50 mm and 100 mm. 25 mm Roller Tip, 12 mm stationary tip. Fotona SP Dynamis XS Dynamis QX MAX SP Spectro XP Spectro XP Dynamis Nd:YAG / Er:YAG Er:YAG Nd:YAG Q-Switched / Long Pulse Nd:YAG / Er:YAG 1064 nm / 2940 nm 2940 nm Nd:YAG / Long Pulse 1064 nm Nd:YAG / Long Pulse 1064 nm 1064 nm, 532 nm, 585 nm, 650 nm 1064 nm / 2940 nm Up to 600 J/cm 2 Up to 500 J/cm 2 Up to 160 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm ms ms 5 20 ns, 250 µs Accelera Pulse N/A ms ms F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area. S-Runner, Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. S-11: Nd:YAG scanner: 42 cm 2 Tx area. Er:YAG handpieces: mm spot sizes; Nd:YAG handpieces: 2-20 mm spot sizes. F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area. S-Runner, Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. Er:YAG handpieces: mm spot sizes. Handpieces: 2-8 mm spot sizes. F-Runner fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area. S-Runner Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. S-11 Nd:YAG scanner: 42 cm 2 Tx area. Er:YAG handpieces: mm spot sizes; Nd:YAG handpieces: 2-20 mm spot sizes. S-11 Nd:YAG scanner: 42 cm 2 Tx area. Nd:YAG handpieces: 2-20 mm spot sizes. Same as above. Quanta Aesthetic Lasers Forte Series EVO Light Series Multi-Application Platform Nd:YAG (pulsed) / IPL (opt.) IPL: AC nm 1320 nm / nm 5 15 J/cm 2 35 J/cm 2 / up to 25 J/cm ms 5 10 ms / up to 40 ms Portable, upgradeable with up to eight modules; five IPL handpieces, high-speed diode, Er:YAG and Nd:YAG. Advanced contact cooling with Sapphire waveguide cools to 12 C. Adaptive Pulse Control (APC) adjusts pulse sequence and energy for safe and effective Tx of all skin types. Air or contact skin cooling systems for pulsed lasers and optional IPL. Nd:YAG spot sizes: up to 16 mm. IPL spot sizes: 48 x 13 mm and 25 x 13 mm. Sciton JOULE ThermaScan BBLs BBL Contour TRL Laser and Light Platform Nd:YAG BroadBand Light BroadBand Light Tunable Resurfacing Laser (TRL) Various 1319 nm nm nm 2940 nm Up to 400 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm 2 Up to 40 W ms, 1 10 sec Up to 200 ms Up to 200 ms Up to 200 ms Up to 50 ms Configurable up to ten modules. Computerized scanner; 30 x 30 mm Tx; integrated cooling. Table top system. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. Computerized scanner, smart user interface, MicroLaserPeel, Tunable Resurfacing Laser. Solta Medical, a division of Valeant Pharmaceuticals North America Isolaz 2 Acne Therapy Photopneumatic: Vacuum and Broadband Light nm Up to 60 J/cm 2 Up to 25 ms Protective eyewear for patient and physician. Small and large tips available to access different areas with ease. 400 or 580 nm options based on skin type; safe for all skin types. Syneron Candela elōs Plus; AC Applicator Vbeam Perfecta PicoWay Resolve Multi-Application Platform: Optical Energy/RF (elōs), Electrical Energy, Pulsed Dye High-Output Pulsed Dye Laser Holographic Fractional Picosecond Module nm 595 nm 1064 nm Light Fluence: up to 18 J/cm 2 RF Energy: up to 25 J/cm 3 Up to 40 J/cm 2 Up to 3.0 mj/μbeam N/A ms 450 ps 25 x 12 mm spot size at 1 Hz pulse rep rate. Six spot sizes up to 12 mm, including 3 x 10 elliptical and two pigmented lesion handpieces; unique, patented Dynamic Cooling Device (DCD) maximizing patient comfort and Tx efficacy. 100 μbeams, 6 x 6 mm array per Tx area (for acne scar Tx). Note: Data subject to change; please refer to Company Directory for supplier contact information. Not all devices are FDA cleared for the application(s) indicated. THE Aesthetic Guide January/February

118 Physician-Dispensed Topicals Comparison Chart Manufacturer / Supplier Acne Tx Collagen Stimulation Exfoliation Firming Peel Post-Procedure Tx Scar Reduction Skin Lightening Sun Protection Wrinkle Reduction Website ALASTIN Skincare AQ Skin Solutions Bellus Medical Biopelle, Inc. Collagen P.I.N. / Induction Therapies / COSMED Dermaceuticals DefenAge Skincare Eclipse Aesthetics Epionce Obagi Medical, a division of Valeant Pharmaceuticals North America Oxygenetix Sesderma USA / SkinMedica, an Allergan Company Regenica by Suneva Medical, Inc. Syneron Candela Note: Data subject to change; please refer to Company Directory for supplier contact information. 118 THE Aesthetic Guide January/February

119 PRODUCT PROFILES NANOPORE stylus 1 NANOPORE stylus 1 is the next generation in micro exfoliation technology, promoting skin health through a non-invasive proprietary dermatological device that offers a comprehensive solution for skin rejuvenation, allowing specialists to customize skincare to fit the needs of every patient. First, it removes superficial skin through superior exfoliation, removing dead cells; then, it micro exfoliates the stratum corneum, increasing the absorption of active cosmetic ingredients. Visibly aids in reducing the appearance of fine lines, photo-aging and pores. Also helps improve clarity, firmness and skin tone. Tensage Stem Cell Cream & Eye Cream Skincare s only stem cell activator, Tensage Stem Cell Cream and Eye Cream, feature CellPro Technology, a unique ingredient containing signaling proteins extracted from the eggs of the Cryptomphalus aspersa snail, in an exclusive, patented process. Clinically proven to assist the natural activity of stem cells, Tensage Stem Cell utilizes this new metabolic pathway to replenish skin cells, reinforce skin s integrity and restore radiance, firmness, smoothness and a more youthful appearance. Sesderma USA: or visit or Eclipse Skinfinity RF Infinitely better skin is at your fingertips. Introduce your clients to the benefits of the Eclipse Skinfinity RF. This innovative fractional ablative radiofrequency technology is designed for overall skin revitalization. It s fast, effective, safe for most skin types and can be customized to meet your client s skincare needs. Ask about scheduling a demonstration with an Eclipse representative to learn how you can incorporate Skinfinity RF s dramatic results into your practice. Biopelle, Inc.: or visit Eclipse Aesthetics, LLC: or visit Epionce Anti-Aging Lip Renewal Epionce Anti-Aging Lip Renewal incorporates therapeutic Epionce anti-inflammatory and barrier-repair renewal technology into an aesthetically elegant treatment moisturizer for the lips. Soft-focus technology diminishes the appearance of fine lines and wrinkles around the unique lip area to reveal noticeably smoother, more hydrated, youthful-looking lips. Ideal for daily use alone or as a primer under lipstick to enhance color longevity. Episciences: 866-EPIONCE ( ) or visit EDGE The EDGE fractional laser offers a superior solution for rejuvenating and resurfacing skin and tissue. EDGE can be used to treat fine lines and wrinkles, acne and surgical scars, skin pigmentation and discoloration, sun damage, uneven skin texture and atrophy. EDGE offers a selection of fractional spot sizes for optimal energy delivery, along with convenient controls on the handpiece for adjusting pattern shape and size. Advice Media Advice Media is a leader in online digital marketing for medical practices. We offer beautiful websites and proven marketing through SEO, social media, review management and paid search so that we are the last company you will need. Perigee Medical: 844-PERIGEE ( ) or visit Advice Media: or visit THE Aesthetic Guide January/February

120 Body Shaping Technologies Comparison Chart Manufacturer Device Energy Source Mechanism of Action Regulatory Status (Europe and USA) Alma Lasers, Ltd. VShape Ultra Alma Ultra Soprano ICE ClearTite HarmonyXL ClearTite LipoLife Bipolar (with focused RF technology); UniPolar (with focused RF technology); UniForm; Pixel RF Ultra; Bipolar (with focused RF technology); UniPolar (with focused RF technology); UniForm; Pixel RF Near-Infrared Pulsed Near-Infrared 980 nm / 1470 nm Heat generated by tissue resistance (impedance) to radiofrequency induced current. Acoustic pressure selectively destroys the fat cells with a combination of focused RF technology. Heat-induced collagen shrinkage and micro-thermal injury. Same as above. Patented 360º lipolysis technology with simultaneous lasing and suction capabilities. CE cleared. FDA cleared. CE cleared. FDA pending. CE cleared. FDA cleared. CE cleared. FDA cleared. CE cleared. FDA cleared. Price BTL Industries, Inc. BTL Exilis Elite BTL Vanquish ME Exilis Ultra BTL Cellutone Focused Radiofrequency Selective Radiofrequency Focused RF and Ultrasound Mechanical Vibration Focused RF energy with variable surface cooling delivers precise volumetric heating of tissue for wrinkles, laxity, cellulite and body contouring. Exilis patented applicators deliver maximum thermal effect without costly consumables. Proprietary Selective Field RF with broad field applicator delivering uniform energy for circumferential reduction of the abdomen. Simultaneous delivery of Focused RF and Ultrasound energy with variable surface cooling delivers precise volumetric heating of tissue for wrinkles, laxity, cellulite and body contouring. Exilis patented applicators deliver maximum thermal effect without costly consumables. Transmits pulses of oscillating waves into the treatment area without any skin damage. CE cleared. FDA cleared. CE cleared. FDA cleared. CE cleared. FDA cleared. CE cleared. FDA cleared. Eclipse Aesthetics Firma ZWave Non-Ablative RF Concentrated radiofrequency. Electromagnetic Ballistic Radial Pulse Mechanical impact. FDA cleared for the reduction of wrinkles and rhytides. FDA Class 1 exempt. Contact Eclipse Contact Eclipse Fotona SP Dynamis XP-2 Focus XP Dynamis SP Spectro XP Spectro Nd:YAG 1064 nm, Er:YAG 2940 nm Nd:YAG 1064 nm Nd:YAG 1064 nm Nd:YAG 1064 nm, Er:YAG 2940 nm Nd:YAG 1064 nm Laser assisted lipolysis, treatment of wrinkles; Photothermal - heat generated by laser light. Same as above. Same as above. Same as above. Same as above. CE cleared. FDA cleared. CE cleared. FDA cleared. CE cleared. FDA cleared. CE cleared. FDA cleared. CE cleared. FDA cleared. InMode BodyFX RFAL Bipolar Radiofrequency, Negative Pressure, Mechanical Massage, Ace Technology RF Targets fatty tissue for body and cellulite Tx. RF provides precise, CE cleared. FDA cleared. optimal heating of skin for contraction and body shaping using A.C.E. (Acquire, Control, Extend) technology to optimize maximal energy. Vacuum massage with gentle pressure allows maximum depth. Tissue temperature and impedance monitoring achieves and maintains optimal Tx temperature endpoints for enhanced safety and reduced risk of thermal injury. No consumables. RF assisted lipolysis. Dual electrode configuration allows both CE cleared. FDA cleared. internal coagulation (fat) and external skin contraction. ACE technology prevents overheating. Pergiee Medical Current Beauty Futura Pro Ultrasound / Electrical Current Sonophoresis and Transtim electrical. 510(k). Contact Pergiee Sciton SkinTyte II ProLipo PLUS CelluSmooth Infrared Light 1319 nm Nd:YAG / 1064 nm Nd:YAG 1319 nm Deep dermal heating to stimulate new collagen production. Laser-assisted destruction of fat cells and collagen remodeling. Cutting fibrous septae, emulsifying fat and tightening the dermis to improve the appearance of lumpy and dimpled skin. CE cleared. FDA cleared. CE cleared. FDA cleared. CE cleared. FDA cleared. Solta Medical, a division of Valeant Pharmaceuticals North America Thermage CPT Liposonix VASERlipo VASERshape PowerX Monopolar RF coupled with Patented monopolar delivery enables RF energy to penetrate advanced Comfort Pulse Technology deep into the dermis and subcutaneous tissue to tighten existing collagen and stimulate new growth. High-Intensity Focused Ultrasound (HIFU) Ultrasound Non-Invasive Ultrasound and Massage Power-Assisted Liposuction Non-invasive fat reduction system utilizing state-of-the-art HIFU to permanently destroy subcutaneous adipose tissue and provide Custom Contouring capabilities. Intended use and indications for use: The Liposonix system delivers HIFU energy that can disrupt subcutaneous adipose tissue (SAT) to provide a non-invasive approach to body contouring to achieve a desired aesthetic effect. Ultrasonic energy selectively emulsifies fatty tissue through Acoustic Streaming, while preserving nerves, blood vessels, collagen and fat cell viability. Emulsified fat is removed via specially designed, atraumatic, suction cannulas. Small vacuum-assisted massage handpiece coupled with an ultrasound transducer directs a double beam of 1 MHz ultrasound energy to shape the body by temporarily reducing the appearance of cellulite. A powered handpiece on the VASERlipo system rotates the attached cannula based on predetermined angle and speed settings, allowing physicians to quickly debulk large areas of fat and reduce physician fatigue. CE cleared. FDA cleared for non-invasive Tx of wrinkles and rhytides; incl. upper / lower eyelids; temporary improvement in appearance of cellulite (with vibration). CE cleared. FDA cleared. U.S.: Indicated for non-invasive waist circumference reduction (i.e., abdomen and flanks). E.U.: Indicated for trunk and lower extremities excluding the lower leg (i.e., abdomen, flanks, hips, thighs and buttocks). Canada: Indicated for abdomen, flanks, hips, thighs and buttocks. CE cleared. FDA cleared. CE cleared. FDA cleared. CE cleared. FDA cleared. Note: Data subject to change; please refer to Company Directory for supplier contact information. Not all devices are FDA cleared for the application(s) indicated. 120 THE Aesthetic Guide January/February

121 Body Shaping Technologies Comparison Chart Manufacturer Device Energy Source Mechanism of Action Regulatory Status (Europe and USA) Syneron Candela VelaShape II VelaShape III UltraShape UltraShape Power Bipolar RF, Infrared Light and Mechanical Massage Bipolar RF, Infrared Light and Mechanical Massage Selective Pulsed Focused Ultrasound Selective Pulsed Focused Ultrasound Combined energies known as elōs precisely target and heat CE cleared. FDA cleared. fatty tissue within treatment area. Vacuum and tissue manipulation evens out skin to reveal a smoother, tighter figure. Combination of modalities: IR heats tissue up to 3 mm in depth, CE cleared. FDA cleared for bi-polar RF heats tissue up to 15 mm in depth and vacuum temporary reduction in circumference of the technology ensures precise delivery of energy, and causes deep heating of the adipocytes, their surrounding connective fibrous abdomen and thighs, and the septae and the underlying dermal collagen fibers. Efficient heating of the adipocytes is achieved by higher output of the RF. appearance of cellulite. Mechanical, non-thermal ultrasound. CE cleared. FDA cleared. Mechanical, non-thermal ultrasound. CE cleared. FDA cleared. Price Thermi ThermiRF Thermi250 Temperature Controlled RF Temperature Controlled RF Temperature Controlled Radiofrequency energy for percutaneous treatment of soft tissue. Temperature Controlled Radiofrequency for the temporary reduction of cellulite. FDA cleared. FDA cleared. ZELTIQ CoolSculpting Cryolipolysis Non-invasively reduces fat through exclusively licensed Cryolipolysis-based technology. Cryolipolysis is based on the principle that fat cells are more vulnerable to energy extraction (cooling) than surrounding tissues. A non-invasive applicator is attached to the targeted procedure area to extract energy from the underlying fat tissue, while protecting the skin, nerves, muscles and other tissue. The cooled fat cells undergo apoptosis (controlled cell death) and are gradually eliminated (phagocytosis), reducing the thickness of the fat layer. CE marked, Class IIA. FDA cleared. Zimmer MedizinSystems ZWave Electromagnetic Ballistic Radial Pulse Mechanical impact: radial pulse technology temporarily CE cleared. FDA cleared. reduces the appearance of cellulite. Electromagnetic generator creates ballistic force that is transferred to the applicator. Pulsed radial wave therapy is delivered to the treatment area for cellulite Tx and enhanced body shaping. Note: Data subject to change; please refer to Company Directory for supplier contact information. Not all devices are FDA cleared for the application(s) indicated. Fractional Technologies Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Price Accessories Aerolase LightPod Era Er:YAG 2940 nm Up to 1400 mj 300 µs No per treatment consumables and no skin contact by handpiece. No service contracts. Portable (22 lbs.). All laser accessories, training and marketing package included. Alma Lasers, Ltd. Harmony XL Pro Platform Pixel CO2 VShape EXELO2 BURANE Pulsed UV Light / AFT Pulsed Light / IN-Motion AFT Pulsed Light / Pulsed NIR / Alexandrite / Q-Switched Nd:YAG with KTP / Nd:YAG / Pixel 2940 Er:YAG / ClearLift Q-Switched /Nd:YAG / Dye-SR AFT Pulsed Light / Dye-VL AFT Pulsed Light Fractional CO2 System Pixel RF Fractional CO2 System Er:YAG UVB / UVA, nm / nm, nm, nm / Near-Infrared / Near-Infrared / 755 nm / 532 nm, 1064 nm / 1064 nm, 1320 mm / 2940 nm / 1064 nm / nm / nm 10,600 nm RF, mhz 10,600 nm 2940 nm 2,000 5,000 mj/cm 2 / 30 J/cm 2, 30 J/cm2, 30 J/cm2 / 5 20 J/ cm 2, 1 7 J/cm 2 / 1 7 J/cm 2 / 1 32 J/cm 2 / mj/p / J/cm 2, 5 40 J/cm 2 / 300 2,500 mj/p / up to 1200 J/cm 2 / up to 15 J/cm 2 / up to 30 J/cm 2 Up to 70 W Up to 80 W 3 40 W Up to 2.5 J 30, 40, 50 ms / 10, 12, 15 ms, 10, 12, 15 ms, 10, 12, 15 ms / 30, 40, 50 ms, 1, 3, 30 sec / 10, 30, 90 sec / 3 ms / 20 ns / 10, 15, 45, 60 ms, 30, 40, 50 ms / Short, Medium, Long / 20 ns / 10, 12, 15 ms / 5, 10, 25 ms CW Superpulse N/A ms plus CW Up to 260 ms AFT Pulsed: contact cooled version or non-cooled module options. IN-Motion AFT: contact cooled version or non-cooled module options. Pulsed NIR: ST module with large 40 x 16 mm spot. Alexandrite: 5 mm and 8 mm tips. QS Nd:YAG: 3 mm and 5 mm tips. Nd:YAG: 2 mm, 6 mm and 10 mm tips with contact cooling; 1320 nm: 6 mm tip. Pixel 2940: Pixel tips are 11 mm 2 with 1 x 7, 7 x 7 and 9 x 9 arrays. Erbium tips are 1 mm and 4 mm. ClearLift QS: 5x5 tip. Pixel tips are 11 mm 2 with 1 x 7, 7 x 7 and 9 x 9 arrays, surgical handpieces are 50 mm and 100 mm. 25 mm Roller Tip, 12 mm stationary tip. Variable, 1-6 mm; 7 x 7 fractional handpiece. SINON Ruby Q-Switched 694 nm 2 14 J/cm 2 20 ns Eclipse Aesthetics Eclipse Skinfinity RF Fractional Ablative N/A N/A W Ever Pulse Rollers and reusable stamp. Fotona SP Dynamis XS Dynamis Nd:YAG / Er:YAG Er:YAG 1064 nm / 2940 nm 2940 nm Up to 600 J/cm 2 Up to 500 J/cm ms ms F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area. Er:YAG handpieces: mm spot sizes. Same as above. Note: Data subject to change; please refer to Company Directory for supplier contact information. Not all devices are FDA cleared for the application(s) indicated. THE Aesthetic Guide January/February

122 Fractional Technologies Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Price Accessories InMode Fractora Bipolar Fractional Radiofrequency RF Up to 62 mj/pin Up to 2 pps Variable pin configurations (20, 24 coated, 24, 60, 126) and Tx depths allow for a Designer Dermis approach to treatment. Safe on ethnic skin. No pulse counter limitations. Lumenis UltraPulse (with ActiveFX, DeepFX, TotalFX and SCAAR FX) AcuPulse MultiMode M22 ResurFX Fractional and Full Ablative CO2 Fractional CO nm Erbium Fiber Laser 10,600 nm 10,600 nm 1565 nm Proprietary, unique UltraPulse technology: up to 225 mj per single pulse (short pulse duration). Avg. power up to 60 W, peak power up to 240 W Average power up to 40 W, peak power up to 200 W mj per micro-beam Unique 225 mj in less than 2 ms SuperPulse pulses less than 0.3 ms N/A Two scanners: CoolScan (CPG) delivers UltraPulse telecentric, collimated scanning with 1.3 mm spot size. DeepFX micro-scanner delivers energy with 0.12 mm spot size, up to 4 mm penetration depth. Collimated single spot energy delivery and focused incisional handpieces. SCAAR FX fractional mode delivers 150 mj per pulse, deep treatment up to 4 mm in a single pulse and optimal ablation/coagulation ratio. 34 FDA cleared aesthetic indications. Ten modes: FeatherTouch, SilkTouch, FineTouch, ToeTouch, Paint, Superficial, Deep, Combo, StretchTouch and Bleph. Two scanners: AcuScan120 for fractional resurfacing and SurgiTouch for full resurfacing. Three handpieces for use with SurgiTouch scanner and one incisional handpiece. 34 FDA cleared indications. Single pass CoolScan scanner for non-sequential scanning, continuous contact cooling for increased patient comfort and protection of epidermis. No disposables; 600 combinations of shape, size and density. Perigee Medical Jeisys EDGE CO µm Up to 300 mj pulse; up to 300 W peak power ,000 ms Contact Perigee 120, 350, 800 µm spot size fractional; variable pattern and pattern size selection on handpiece. Quanta Aesthetic Lasers YouLaser CO2 Fractional and Full Ablative CO2 10,600 nm Up to 30 W ms Advanced, lightweight scanner is ergonomically designed with the clinician in mind and has nine different fractional patterns that vary in shape, size and density of spot. Making it a device for use on the face with minimal patient downtime. Metal RF excited tube provides greater stability and reliability over glass tubes. Rohrer Aesthetics, LLC Phoenix CO2 Laser CO2 10,600 nm Adjustable up to 200 mj/point Adjustable up to 20 ms $34,995 Incisional handpiece and ergonomic, microthermal zone scanner. Pixelated scanner features unique scanning technology to customize treatment for individual patients. 30 mm x 30 mm pattern size allows resurfacing of both hands in under 2 minutes. Can also be used to improve vaginal health. Sciton ProFractional Halo diva Er:YAG Hybrid Fractional Laser (ablative and non-ablative) Hybrid Fractional Laser (ablative and non-ablative) 2940 nm 1470 nm / 2940 nm 1470 nm / 2940 nm Up to 400 J/cm mj/mtz / 50 mj/mtz 150 mj/mtz, 200 mj/mtz Variable Up to 5 ms Up to 5 ms Expandable module/density 1.5% to 26%. Delivery of ablative and non-ablative wavelengths in single pass. Dynamic Thermal Optimization (DTO) for precise energy delivery. Roller tip adaptors; optical navigation; integrated Zimmer cooling advanced mode for precise and independent control of depth and density. Pre-programmed modes and integrated smoke evacuation system. Hybrid Fractional Laser Technology for the improvement of vaginal tissue. Independently configurable delivery of both ablation and coagulation. High Precision Automation (HPA) Technology allows configurable treatment parameters with automatic energy delivery. Strengthened Quartz Dilator (SQD) optimized energy delivery by dilating tissue and providing 360º of laser delivery. Solta Medical, a division of Valeant Pharmaceuticals North America Fraxel DUAL 1550/1927 Laser System Fraxel re:pair Laser System Fractional Laser with Zimmer Cryo 6 Skin Cooling System CO2 Fractional Laser 1550 nm / 1927 nm 10,600 nm Up to 70 mj /MTZ (1550 nm) / 20 mj / MTZ (1927 nm) Up to 70 mj/mtz N/A N/A $129,000 $139,000 Intelligent Optical Tracking System (IOTS); single operator cooling. FMDA: 600 micron (superficial treatments); FDDA: 135 micron (deep treatments); 0.2 mm surgical incisional handpiece; 2.0 mm surgical ablative handpiece. Syneron Candela Profound ematrix Sublative Rejuvenation elōs Plus Sublative Applicator etwo Sublative Applicator CO2RE PicoWay Resolve Bipolar RF 460, 5 khz N/A Fractional Bipolar RF N/A Multi-Application N/A Platform: Optical Energy/ RF (elōs), Electrical Energy, Pulsed Dye Multi-Application N/A Platform: elōs, Electrical Energy, Pulsed Dye CO2 Resurfacing System 10,600 nm Holographic Fractional Picosecond Module 532 nm / 1064 nm Max. output voltage 84 VRMS Up to 62 mj/pin RF energy: up to 62 mj/pin Up to 100 J/cm 3 Up to 396 J/cm 2 Up to 1.5 mj/ μbeam / up to 3.0 mj/μbeam N/A N/A 1 Hz Up to 200 pulses 20 3,000 μs 375 ps / 450 ps Sublime energy: up to 100 J/cm 3. Single-use, sterile Tx cartridge with either five (dermal) or seven (subq) independently controlled bipolar microneedle pairs. Tip with spot size 12 x 12 mm, composed of 64 or 144 electrode pins, three year warranty. Tx area: standard 64: 12 x 12 mm; pulse rep. rate: 1 Hz. Exclusive Fusion Tx mode to treat superficial and deep skin layers simultaneously. Multi-use featherweight delivery system, multiple treatment spots, full length fractional, short fractional and tapered surgical handpieces, 10.4" high-resolution color LCD, touchscreen user interface, footswitch. 100 μbeams, 6 x 6 mm array per Tx area. Note: Data subject to change; please refer to Company Directory for supplier contact information. Not all devices are FDA cleared for the application(s) indicated. 122 THE Aesthetic Guide January/February

123 PRODUCT PROFILES InMode InMode has revolutionary non-invasive options for fractional skin resurfacing and contraction (Fractora and Forma), ultra-fast diode hair removal (Diolaze), skin pigmentation and vascular lesions (Lumecca Photofacial) and cellulite/body contouring (BodyFX). InMode will continue to provide superior quality and innovative technology for the most in-demand procedures patients want. InMode: or visit The Taylor Liberator The Taylor Liberator is considered the best instrument for performing acne scar subcision. This slightly blunted, 3-tip patent-pending device provides the greatest efficiency and safety when performing extensive acne scar subcision and undermining of facial skin. It was invented and perfected by Mark B. Taylor, M.D., after more than ten revisions over a period of eight years, and performing more than 700 rolling acne scar subcision treatments. Order online for $299 at GatewayLaserCenter.com/store.html. ALASTIN Skincare ALASTIN Skincare is dedicated to developing innovative, clinically-tested skincare products that correct, protect and maintain healthy skin for a lifetime. Our unparalleled Procedure Enhancement and Restore & Renew products are formulated with TriHex Technology, a proprietary combination of key peptides and other synergistic ingredients using the latest technology, and are clinically tested to demonstrate safety and the ability to help reawaken the skin s youthful regenerating processes. Gateway Aesthetic Institute & Laser Center: or visit ALASTIN Skincare: or visit Spectrum The Spectrum is a multi-platform laser / IPL that features: 810 diode (hair removal), Erbium YAG (skin resurfacing), Q-switched Nd:YAG (tattoo removal), long pulsed YAG (vascular reduction) and IPL (hair removal, vascular and pigmented lesion reduction and acne reduction). The Spectrum can be purchased fully loaded for $54,995. Rohrer Aesthetics: or visit DefenAge Clinical Power Trio Named one of the biggest breakthroughs in skincare in 2016, DefenAge s exclusive ingredient, Age-Repair Defensins, works via a natural mechanism of action. Clinical studies prove that this revolutionary anti-aging skincare system addresses up to 16 signs of aging in just six weeks. The initial results become visible within the first week of treatment. The technology is patent-pending and can be combined with almost any skincare regimen. Oxygenetix Oxygenetix is a breathable foundation / camouflage designed to help heal and conceal a wide variety of skin conditions. Founded in Beverly Hills, Calif., Oxygenetix is used daily on and off the set by Hollywood s elite. This post-procedure cover-up reduces and eliminates social downtime following aesthetic procedures the main reason many patients choose not to proceed with laser, peel, needling or dermabrasion treatments thereby increasing your consultation to procedure conversion rate. DefenAge Skincare: or visit Oxygenetix Institute, Inc.: or visit THE Aesthetic Guide January/February

124 PRODUCT PROFILES Crystal Clear Digital Marketing Crystal Clear Digital Marketing offers a complete digital marketing system: from search engine optimization, search engine marketing, social media engagement, websites, marketing, mobile and text marketing, patient relationship management and so much more. Crystal Clear does most of the work so local practices don t have to. SkinPen The Bellus Medical SkinPen is a medical grade, state-of-the-art microneedling device designed to improve the appearance of fine lines and wrinkles on the face and body. Bellus Medical is raising the bar on standards for safety, quality and technology with SkinPen. Ask for it by name and know what makes it the best choice for delivering results. Crystal Clear Digital Marketing: or visit F22.P5M02 Eyewear Laservision s lightweight F22.P5M02 laser safety eyewear provides optimal protection during procedures using Nd:YAG lasers. This nearly clear lens offers excellent visibility, allowing for great color recognition while performing laser treatments. The frame is specially designed to fit comfortably over prescription glasses. Dermatologists prefer using the F22.P5M02 when providing laser treatments for hair removal, skin resurfacing, tattoo removal and more. Bellus Medical: or visit Laservision USA: or visit NS-532 Laser System The NS-532 Laser System is a compact, portable and affordable FDA cleared 532 nm laser system for the safe and effective treatment of pigmented and vascular lesions on all skin types. NewSurg offers honest value and generous trade-in credit for old Iridex, Laserscope and Pulsed Dye Lasers, towards the NS-532 Laser System. This system sets a new standard in the evolution of simple and efficient aesthetic laser treatments. NewSurg: or visit Clear + Brilliant pélo Clear + Brilliant pélo is a new and innovative laser hair removal technology with a first-in-class mechanism of action which incorporates linear scanning technology to help maximize efficacy, speed and patient comfort, all with just one handpiece. This new device has the largest spot size and scan area within the class of diode hair removal lasers, allowing for full body treatments amongst all skin and hair types. Ascentium Capital Finance nearly anything for your practice with Ascentium Capital. You have access to affordable finance, lease and loan options up to $1.5 million. Our 100% financing program enables you to finance equipment plus costs such as shipping, tax and maintenance to avoid upfront expenses. Ascentium also extends a streamlined process with flexible terms up to 84 months, deferred payments and instant credit decisions. Ask for a no obligation quote today: or online at Ascentium.Info/89a. Solta Medical, a division of Valeant Pharmaceuticals North America LLC: or visit Ascentium Capital: or visit THE Aesthetic Guide January/February

125 PRODUCT PROFILES BTL Vanquish ME Further improving on its patented non-invasive Vanquish technology to reduce stubborn fat around the midsection, BTL Aesthetics introduces its newly engineered BTL Vanquish ME (Maximum Energy). This latest iteration takes body contouring to the next level with increased tuning performance, more concentrated thermal energy and less scatter to non-fatty tissue than previously possible. The result is a more homogeneous heating leading to higher overall temperature elevation. A large spot size is designed to treat the whole abdomen from flank to flank during one session. Bellafill Bellafill is the only dermal filler FDA approved for the correction of nasolabial folds and moderate to severe, atrophic, distensible facial acne scars on the cheek in patients over the age of 21 years. This smooth, collagen-based filler is comprised of 80% bovine collagen gel and 20% polymethylmethacrylate (PMMA) microspheres. The collagen immediately volumizes smile lines or atrophic acne scars, lifting them to the level of surrounding skin. The PMMA microspheres form a matrix that supports production of endogenous collagen, which replaces the injected collagen over time. Suneva Medical: or visit BTL Industries: or visit AirGent2.0 AirGent2.0 is a needle-free injection system designed for the administration of various medicines to the skin by a high velocity jet. Various clinical publications show extraordinary, effective results with treatment of skin dermal remodeling on face, hands and neck 1, treatment of neck wrinkles 2, treatment of acne scars 3 and more. 1. Int J Dermatol Dec;49(12): doi: /j x. Clinical results of skin remodeling using a novel pneumatic technology. Levenberg A1, Halachmi S, Arad-Cohen A, Ad-El D, Cassuto D, Lapidoth M. 2. Dermatol Surg Sep;37(9): doi: /j x. Epub 2011 Jun 2. Subdermal minimal surgery with hyaluronic acid as an effective treatment for neck wrinkles. Han TY1, Lee JW, Lee JH, Son SJ, Kim BJ, Mun SK, Kim MN, Lee CK. 3. J Drugs Dermatol Jan;14(1):74-6. Effective treatment of acne scars using pneumatic injection of hyaluronic acid. Patel T, Tevet O PerfAction Technologies: or visit CLINICIANS COMPLEX Under Eye Repair This clinical strength product is formulated to instantly reduce the appearance of dark circles and puffy tissue under the eyes as well as promote long-term healing of the main causes of these problems. Light diffusing ingredients instantly modify visible dark circles and puffy eye tissue by creating invisible particles of mineral pigment that reflect and emit light, making imperfections temporarily disappear. Long-term healing is facilitated by several breakthrough active ingredients that address the main causes of these problems. Hesperidin methyl chalcone is a flavonoid derived from citrus that helps eliminate the blood originated pigments responsible for the dark circle color under the eye area. COSMED Dermaceuticals, Inc., An Exclusive Clinicians Complex Skin Care Distributor: or visit Bodystudio ATBM with Aesthetics Software The revolutionary Bodystudio ATBM for automated total body mapping keeps getting better and better. Now the additional FotoFinder aesthetics software allows for consistent before and after documentation of aesthetic treatments. Within minutes your staff can map an entire patient who comes in for total body mapping and then take brilliant, consistent before and afters of cosmetic treatments. The perfect all-in-one photo system for your office that covers all your imaging needs. Viveve System The Viveve System is a non-ablative device that remodels soft tissue in a single, 30-minute procedure. This system uses patented cryogen-cooled, monopolar radiofrequency (CMRF) technology to create a reverse thermal gradient that penetrates deep tissue while protecting surface layers. FotoFinder Systems: or visit Viveve, Inc.: or visit THE Aesthetic Guide January/February

126 PRODUCT PROFILES ThermiRF ThermiRF is a platform technology that uses temperature as a clinical endpoint for various minimally and non-invasive aesthetic applications (ThermiTight, ThermiRase, ThermiSmooth Face and ThermiVa ). When combined with external infrared imaging, ThermiRF applications have been shown to be safe. Halo Halo is the world s first Hybrid Fractional Laser that delivers a non-ablative and ablative wavelength to the same microscopic treatment zone. Combining these two wavelengths creates a strong synergistic effect, resulting in ablative results with non-ablative downtime. The non-ablative wavelength of 1470 nm is tunable from 200 to 700 microns, the optimal depth for treating the epidermis and papillary dermis. The 2940 nm Er:YAG laser provides pure ablation with no bulk heating, tunable from 20 to 100 microns. Thermi, LLC: or visit Discovery Pico Series The Discovery Pico Series are powerful picosecond devices, featuring QuattroPulse technology that allows the devices to be operated in four separate emission modes: Picosecond, Q-switched, OptiPulse and Photo-Thermal pulse durations, giving you even more treatment options, efficacy and flexibility. The addition of the 694 nm true Ruby laser in the Plus model makes this the premier picosecond laser for skin treatments and tattoo removal. Discover the Quanta difference that is transforming aesthetics. Sciton: or visit Quanta Aesthetic Lasers: or visit ZWave The Zimmer ZWave constitutes the latest development in the treatment of cellulite. The ZWave utilizes an electromagnetic generator to create a ballistic force that is transferred to the applicator. Utilizing soft pulse technology to enhance patient comfort, it delivers pulsed radial wave therapy to the treatment area. The ZWave is designed to temporarily reduce the appearance of cellulite. Average or typical patient treatment time is minutes. Zimmer MedizinSystems: or visit Dynamis Pro This all-in-one, anti-aging laser platform allows fast, precise and efficient procedures with reduced recovery times. With fully customizable settings, the system achieves true third-generation Er:YAG resurfacing. The Nd:YAG wavelength is a gold standard in wrinkle reduction, acne, pigmented and vascular treatments. Nd:YAG and Er:YAG scanner compatibility further enhances treatment speed, safety and efficacy, especially for large treatment areas. The SP Dynamis combines popular aesthetic applications with additional minimally invasive surgical procedures (laser lipolysis, etc.). Fotona: or visit Collagen P.I.N. Collagen P.I.N. is a new innovation in advanced collagen induction therapy that introduces a controlled wound into the skin triggering the release of natural growth factors, new collagen and elastin. Automated microneedling causes less damage to the epidermis than dermal rolling, laser or other ablative treatments. Utilizing Collagen P.I.N. with our Induction Therapies clean, clinical products (specifically designed for use post microneedling) minimizes complications and provides quicker healing and longer lasting results. More needles. More power. More depth. More collagen. Collagen P.I.N.: or visit / THE Aesthetic Guide January/February

127 PRODUCT PROFILES LightPod Neo Aerolase 650 ms laser technology offers a new approach for highly effective, long lasting results for treating active acne including problematic conditions such as nodulocystic acne and acne conglobata. This new treatment option offers an efficacious solution for patients who have not been able to use or have not responded to traditional therapies. Aerolase laser technology allows immediate results, is uniquely gentle and sanitary, and offers maximum versatility for both adolescent acne and adult acne. VECTRA H1 VECTRA H1 is a flexible, high quality 3D imaging solution that can be used in any location for a wide-range of purposes. Face Sculptor software provides aesthetic simulation tools for facial contouring, skin rejuvenation, rhinoplasty, chin augmentation and more. Analytic tools enable measurements of volume and contour plus visualization of texture, vascularity and pigmentation. VECTRA H1 software enables automatic stitching of multiple captures into a single, high resolution 3D image. Aerolase: or visit Growth Factor Induced Therapy (GFIT) with AQ Recovery Serum The AQ Recovery Serum contains our highest concentration of natural growth factors, proteoglycans and glycosaminoglycans. Recovery Serum is designed to enhance the skin s natural process of regeneration by promoting collagen production, supporting healthy circulation and encouraging cellular renewal. The serum is ideal for post-operative care and post-spa procedures, as well as a wrinkle-reduction agent used in conjunction with modalities such as microneedling (AQ GFIT). Canfield Scientific: or visit AQ Skin Solutions: or PicoWay The PicoWay picosecond workstation has three wavelengths, 532 nm, 785 nm and 1064 nm for comprehensive removal of multicolor tattoos on the widest variety of skin types. With the shortest pulse duration (300 ps 450 ps), the PicoWay can disrupt the smallest pigment, thus clearing tattoos faster. The addition of fractional dual wavelength handpieces adds anti-aging, pigmentation and acne scar treatment options with almost zero downtime. Syneron Candela: or visit Phoenix CO 2 The Phoenix CO 2 is priced under $35,000 and can be used to remove uneven pigmentation and reduce fine lines and coarse wrinkles. Depending on which handpiece is attached, the Phoenix-15 can cut, coagulate and vaporize soft tissue. The Phoenix CO 2 features one of the largest scan patterns in the industry and can resurface both hands in under two minutes. Eclipse PRP Eclipse PRP is a proprietary system that is based on blood separation according to density using a proprietary separation gel. The PRP platform is available with an 11 ml PRP collection tube or 22 ml high concentration PRP collection tube. This system allows for the preparation of pure Platelet-Rich Plasma (PRP) with optimal platelet concentrations and cellular content. Virtually all red blood cells (RBC) are eliminated from PRP and the concentration of pro-inflammatory granulocytes (GRs) is highly reduced. The entire preparation process only takes up to 20 minutes. 510(k) number BK Rohrer Aesthetics: or visit Eclipse Aesthetics, LLC: or visit THE Aesthetic Guide January/February

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