“As co-founder and co-host of the Inside Aesthetic podcast, I am continually researching the latest trends and products,” reported cosmetic doctor and facial aesthetic injector, Jake Sloane, MD (Sydney, Australia). “One of the biggest trends in Australia that we saw in 2023 was a large drop in the number 
of volumizing hyaluronic acid (HA) fillers being used, due to an increase in the variety of newer injectables and a maturation of aesthetic trends.”
Dr. Sloane anticipates a newer class of injectables known as polynucleotides (PNs) to stand out in upcoming year. “Rejuran® (PharmaResearch Products Co. Ltd) is the only product to be approved here so far,” he reported. “In line with this trend of moving away from high volumes of structural HA fillers, we should see more products that improve skin quality. It is speculated that Allergan’s new hybrid filler HArmonyCa™ may launch in Australia in late 2024. The combination of HA and calcium hydroxyapatite delivers immediate volumization and longer-term biostimulatory results. Other biostimulatory products that may become available include Gouri (DEXLEVO); a novel liquid polycaprolactone (PCL) and Aesthefill (Regen Biotech); a powder-made polylactic acid (PLA) product that will rival Sculptra (Galderma, Fort Worth, Texas).”
In addition, the continued rise in demand for treatments like the Botox® (Allergan Aesthetics, an Abbvie Company) ‘lip flip’ and ‘baby botox’, along with fillers and biostimulators, may indicate a cultural shift that sees injectables as alternatives to more invasive procedures, paving the way for continued innovations in this field. Dr. Sloane added that providers should keep their eye on the newer class of botulinum toxins such as prabotulinumtoxinA- xvfs, daxibotulinum toxin, and Galderma’s relabotulinum toxin A. He anticipates that this further competition and choice among the existing toxin brands may lead to a price war, making 2024 an interesting time for injectors.
According to cosmetic dermatologist Chytra Anand, MD, founder of Kosmoderma Skin Clinics (Bengaluru, Karnataka), the continued popularity of minimally invasive treatments like fillers, peels and non-invasive fat reduction techniques underscores a growing demand in India for cosmetic improvements as well as enhanced skin health. “Novel formulations with polynucleotides, antioxidants and peptides is ushering in a new realm to skin rejuvenation through injectables,” she reported. “Advancements in injection techniques and technology are being used to enhance the precision of filler placement, including the use of microcannulas, advanced imaging technologies and combination treatments to achieve more natural-looking results. Digital and artificial intelligence (AI) integration will further customize treatment planning tailored to individual anatomical needs and enhance patient experiences.”
While the new year will see many updates and changes, Steven Dayan, MD, facial plastic surgeon and founder of DeNova Research (Chicago, Ill.), believes that skin health, rejuvenation and patient education will drive the aesthetic landscape in 2024. “In my opinion, updates will be based on what we already have, but we will evaluate patients differently as we start to create scales to measure improvement in skin quality.” He added that with social media and AI coming together, physicians and providers should also be more judicious and consultative to properly manage patient expectations.
Regenerative Aesthetics
Rungsima Wanitphakdeedecha, MD, a dermatologist in Bangkok Noi, Thailand, who specializes in dermatologic laser and cosmetic surgery, pointed out the rise of regenerative aesthetics. “We are likely to witness a sustained interest in platelet-rich plasma (PRP) therapy with advancements in concentration techniques and delivery methods,” she reported. “Stem cell treatments are expected to gain traction, especially in facial aesthetics and hair restoration, as advancements continue to unfold in this promising field. Providers may explore innovative combination therapies, synergizing different regenerative agents such as exosomes, stem cells and growth factors.”
In line with the regenerative aesthetics theme, thread lift technologies are continually being updated and upgraded to reposition skin and trigger collagen regeneration for long-term results. “In the dynamic field of thread lifts, providers can anticipate several positive advancements in 2024,” reported Dr. Wanitphakdeedecha. “Notably, ongoing improvements in thread materials are expected, focusing on enhancing biocompatibility, longevity and overall effectiveness. The minimally invasive nature of thread lifts, combined with reduced downtime and quicker recovery remain key selling points, offering patients a less intrusive alternative to traditional facelift surgeries. Additionally, the trend of combining thread lifts with other aesthetic procedures, such as dermal fillers or neurotoxins, is expected to persist, allowing providers to tailor treatments for individualized and comprehensive facial rejuvenation.”
Nicole Kanaris, MD, founder of Med Aesthetique (Johannesburg, South Africa) sees an overarching trend that favors healthy, radiant skin and notices a trend in biostimulators for body contouring. “There appears to be a notable shift away from the trend for larger buttocks, paving the way for a new approach in body contouring. This shift in preference might steer practitioners towards utilizing more Sculptra compared to traditional fat transfer procedures,” shared Dr. Kanaris. “Sculptra’s rising popularity indicates a departure from relying solely on fat transfers for augmenting buttock size. Its collagen-inducing properties offer a compelling alternative, potentially reshaping the landscape of body sculpting by providing a more controlled and versatile option for enhancing contours and achieving desired buttock shapes.”
Dr. Dayan feels that regenerative technologies may be key in 2024 for certain patients in the U.S. “I think the most pressing issue we will deal with in the upcoming year will be the “Ozempic” face, faces of people that are having a significant amount of weight loss from Semaglutide, which is an extremely popular drug for weight loss. We are starting to see the ramifications of it, and I think there will be a significant drop in the number of fat reduction and sculpting treatments because of this new drug.”
“These patients may be losing some of the reticular fat and it is possible those fat cones have a protective effect or benefit to the skin. Reticular fat is an extension of the subcutaneous fat and when lost, it has an impact on the appearance of the skin. I think we are going to have to do things to replace that,” Dr. Dayan theorized.
“There is a lot of new science and thinking that our fillers and biostimulators are working by stimulating the adipose stem cells within those fat cones,” Dr. Dayan continued. “Fillers and biostimulators may be working on the stem cells within the deeper dermis and the superficial subcutaneous tissue, so I think we are going to see that will be an area for research and an area of excitement.”
Surgical Outlooks
P. Daniel Ward, MD, medical director and chief executive officer (CEO) at Form Derm Spas (Salt Lake City, Utah), feels that rather than moving away from aesthetic surgical options, patients will be more discerning about which nonsurgical options are used. “There has been a lot of discussion over the past year that in some cases, nonsurgical treatments can lead to problems and affect the results of future procedures,” Dr. Ward pointed out. “For example, if a patient is considering a rhinoplasty, they might refrain from doing a nonsurgical treatment to their nose as it may alter the outcome of surgery. Similarly, some nonsurgical treatments for the face may cause scarring under the skin, which can complicate future procedures like a facelift.
“As far as surgeries, one of the biggest changes that happened in 2023 was the growth of the deep neck lift,” Dr. Ward continued. “I think the deep neck lift and jawline enhancement will continue to expand over the next few years.” He added that in addition to the deep neck lift, other procedures like surgical facial contouring where the buccal fat is removed or transferred to another area in the face will continue. “I also think that chin augmentation and maybe even jawline augmentation will increase. People have learned that filler injections and nonsurgical treatments can lead to some improvement, but surgery offers a lot more bang for your buck.”
Regardless of a rise in demand for noninvasive procedures with less downtime, Dr. Ward believes the traditional facelift will remain popular. “One of the biggest changes going on in the facelift world is the push towards more minimally invasive incisions. I certainly have adopted more of an endoscopic approach to my facelift patients and have been very pleased with their degree of improvement and the minimization of scarring,” Dr. Ward shared.
Product and Technology Updates
The StarWalker® PQX from Fotona (Farmers Branch, Texas) is the newest addition to the high-performance StarWalker laser family. It delivers high pico power and energy with a selection of sophisticated state-of-the art accessories to offer an exceptional combination of speed and precision. Picosecond laser technology is considered an effective tool for skin pigment removal without damaging surrounding tissue or causing unwanted side effects. Additionally, picosecond laser pulses induce skin remodeling in a photoacoustic, completely non-thermal way, making it a safe option for all skin types. With just one device, practitioners can offer a wide range of treatment possibilities in one device, including acne scar revision, pigmented lesions, wrinkle reduction and tattoo removal. The system’s advanced technology is suitable for both firsttime users and advanced practitioners, providing an intuitive user interface, preset treatment parameters, and an integrated history of successful treatment outcomes.
Glowpin™ by PDO Max (Liverpool, N.Y.) is a micro-infusion applicator, micro-channeling device and a professionally engineered derma stamp in a single, compact package. A tip lined with 19 evenly spaced 0.5 mm surgical steel needles attaches to an airless press pump that can hold a topical skin booster of choice, while the press pump remains under the control of the user. Glowpin’s primary function is superficial tissue infusion, using a reduced needle length for improved comfort with zero downtime and a procedure time of 20 minutes or less. Thanks to the collagen induction effect, it can treat many patient concerns, especially when paired with PDO Max AfterGlo, a polydioxanone and HA skin boosting serum.
Congela Biocosmetics (Miami, Fla.) incorporates cutting-edge biotechnology and decades of research with JuveXO®, a topical serum that harnesses the power of exosomes. Rich in HA, collagen, elastin, other essential proteins, and over 100 billion exosomes, JuveXO is a biocosmetic that targets damaged and aging tissue at the cellular level with a line of premium topical serums designed to significantly improve the appearance of skin and enhance aesthetic procedures. Launching in 2024 is JuveXO-H which combines the rejuvenating properties of JuveXO with proprietary recombinant proteins specifically for hair. JuveXO-H is a premium secretome designed to target common hair concerns, delivering visibly stronger, thicker and healthier hair.
Nutritive Complex Poli Revitalizing (NCPR) by Toskani Med (Fort Lauderdale, Fla.) is a mesotherapy complex designed to work in tangent with microneedling to act on the skin’s surface and in the deeper layers of the extracellular epidermis. Indicated to improve hydration and strengthen the skin’s protective barrier, NCPR blends HA, vitamins C, E and A, amino acids and coenzymes to help revitalize and encourage cell proliferation. According to the manufacturer, NCPR is clinically tested and fragrance free with no declarable allergenic ingredients. It is designed to help physicians provide immediate skin hydration and longterm dermal elasticity through improved collagen and elastin stimulation thanks to its bioidentical composition.
PCA Skin® (Scottsdale, Ariz.) is introducing their dynamic duo Bright & Even Peel and HydraBright to combine the power of a professional peel and a daily use moisturizer for immediate hydration. Their Bright & Even Peel effectively brightens and resurfaces skin to improve uneven tone for all Fitzpatrick skin types with key ingredients such as L-mandelic and lactic acid, citrus lemon peel extract, emblica and milk thistle. HydraBright includes squalane and a trio of the brightening actives – niacinamide, bio-stable gallic acid and smart melanin microalgae – to target rough texture and uneven skin tone. Together, providers can treat patients both in-office and athome for longer lasting and more dramatic results.
Before and after treatment with LC Cell from Love Beauty Pro & Medical
Photos courtesy of Love Beauty Pro & Medical
AnteAGE (Irvine, Calif.) is unleashing a new era in aesthetic care with AnteAGE MDX Targeted Exosomes – a revolutionary hybrid sourced treatment solution designed to specifically target hair regrowth and brightening needs. Each treatment is infused with 10 billion exosomes, sourced from stem cells from bone marrow and umbilical Wharton’s Jelly. MDX Hair Exosomes harness their unique approach to enhancing the cell culture conditions resulting in upregulated wingless/integrated (WNT) signaling. MDX Brightening calls on tranexamic acid and n-acetyl glucosamine for a corrective approach to uneven skin tone.
Love Beauty Pro & Medical (Woburn, Mass.) is excited to announce the newest additions to their family, the LC Cell skin and hair products. The Company’s exclusive U.S. sales, training and distribution teams are ready to bring this cutting-edge professional product system to aesthetic practices with clinical skin and hair solutions that go beyond the treatment room. Manufactured in the U.S. and specifically formulated for physicians, LC Cell takes human stem cell technology for the aesthetic world to the next level with advanced active ingredient technologies and innovative botanically sourced ingredients. This blend of science and nature delivers a continuum of optimal results from the clinical treatment room to the daily home regimen.
References:
- Saul, Derek. Ozempic Sales Up 58% As Drugmaker Novo Nordisk Nets Record Profits. Forbes Business, 2 Nov. 2023, www.forbes. com/sites/dereksaul/2023/11/02/ ozempic-sales-up-58-as-drugmaker- novo-nordisk-nets-recordprofits/? sh=5e64a91f4bf7.
