Wendy Lewis interviewed eight doctors on their top picks

Wendy Lewis is Founder/President of Wendy Lewis & Co Ltd, Global Aesthetics Consultancy since 1997, author of 13 books, Editor in Chief of beautyinthebag.com, and frequent presenter on the International stage. Her first textbook, Aesthetic Clinic Marketing in the Digital Age (CRC Press) will debut a second edition in 2023. email: [email protected]

Undoubtedly, medical aesthetics is all about new, new, new. Practitioners and patients alike are perpetually looking for bigger, faster, better, smarter, and safer treatments and technologies. For this special exclusive PRIME  Journal series, we reached out to some savvy doctors from around the world to find out what has their attention this year and why. 

Nezih Karaca, MD,
Istanbul, Turkey

HairGen Booster, Genosys

I am particularly excited about using HairGen Booster in my practice. HairGen Booster is an automatic LED microneedling device for alopecia and hair treatment. Microneedling and irradiation LED ensure an ideal environment for the active ingredients to penetrate to the required depth. The Hairgen Booster is used to help the HR3 Matrix Hair Solution, which includes a hair solution containing growth factors, penetrate into the scalp, and should be used twice a week for 20 weeks for a total of 40 sessions.

The use of low-level laser therapy (LLLT) and microneedling (0.22 μm) allows for the sterile infiltration of a solution containing several growth factors, including human growth hormone (GH), epidermal growth factors (EGF), vasoactive intestinal peptide (VIP), and several polypeptides (sh-Polypeptide-7, sh-Oligopeptide-1, sh-Polypeptide-71), glycerin, lecithin, polysorbate 60, sodium citrate, citric acid, phenoxyethanol, and water.

Microneedling causes subcutaneous injury. When microneedles are inserted into the skin, microwounds are formed. The microneedling process stimulates the natural production of collagen and elastin as well as supports angiogenesis and the formation of new vessels. More oxygen and nutrients are able to reach the hair follicles, creating a healing response in the body.

LED light is absorbed by the mitochondria of the hair follicles, stimulating the production of energy in the hair cells, which prolongs the hair growth phase. The LED light component helps stimulate anagen re-entry into telogen hair follicles, prolongs the duration of the anagen phase, and increases proliferation in active hair follicles. LED light also helps prevent the early development of the catagen hair phase.

Blue light, with a wavelength of 423 nm, functions as a microbiological control, reducing the size of the sebaceous gland and reducing the production of scalp oil. It also activates the keratin found in the hair shaft. 

Red light, with a wavelength of 640 nm, supports cell metabolism, and also improves blood circulation and strengthens the hair. 

While mesotherapy can be applied at the same time as microneedling, strengthening the treatment with light therapy saves time. The functionality and ease of use of the device provide a great advantage over other devices. The patient can even practice at home.

I prefer using the HairGen Booster along with the Matrix Hair Solution during hair mesotherapy sessions with my routine patients in the clinic. This is where I find it most effective. However, I also recommend its use to my patients who live far away for use at home.

Vivian Bucay, MD,
San Antonio, TX, USA

150K Hair Follicle Serum, DefenAge®

As a longtime fan of DefenAge, I knew it was just a matter of time before this technology was leveraged to treat hair loss. The 150K Hair Follicle Serum is a water-based formulation that contains age-repair defensins paired with other ingredients (including organic pea sprout, azalea-isolated yeast extract, and microalgae extract) to optimise the environment surrounding hair follicles. 

I was impressed by the pilot study results that showed a 64% decrease in hair shedding after 3 months, along with an increase in the percentage of anagen hairs of 25% at baseline to 85% at 3 months. This combination of decreased shedding with an increase in the percentage of actively growing hair leads to visible improvement in anyone suffering from hair loss or thinning. I also like that this serum can be combined with other proven topical treatments, such as Minoxidil, Rogaine and others. 

Another benefit that patients appreciate with this product is that it is a true multi-tasker. It can be used effectively for treating the beard area, thinning eyebrows, and helps to rejuvenate the scalp and skin under the hair. It is lightweight, gentle on the scalp and hair, non-irritating even for patients who are sensitive, and easy to apply. 

The unique DefenAge serum is patent-protected and contains the BioSerum-level of Defensin-molecules, which is the brand’s hero product. It contains 48 proven natural ingredients that have been shown to have clinical efficacy on the scalp and hair. 

The serum is supplied in an elegant silver ampule that looks very chic. Our patients are committed to using this formulation long-term because it is user-friendly and they see results.

Macrene Alexiades MD, PhD, Dermatologist
New York City, US

Profound Matrix™, Candela® Medical

Candela’s Profound Matrix system using the Matrix Pro applicator is a cutting-edge radiofrequency microneedling device that combines the sophistication and science of the original deeper version I pioneered called Profound®, with the ease and comfort of superficial penetration. I am credited as having single-handedly brought RF microneedling to market and partnered with Candela to conduct the basic science and clinical research trial on the new Matrix Pro. 

One of the features that sets it apart from all other microneedling devices is the ability to target multiple depths in one insertion. This means I can treat an acne scar or deep wrinkle, or cellulite at all levels of skin in a single pulse, which translates to better efficacy and results.

What makes it stand apart is its unique design, innovative features, new functionality (wavelength, technology, etc.), ease of use, and amazing results. The system is also delegatable to staff and very cost-effective. The Matrix Pro has several best-in-class features. One is the ability to penetrate the needles deeply and to fine-tune the depth of penetration. Another benefit is that with a single insertion, we can program the device to have the needles slowly withdraw and release energy in successive pulses, therefore targeting multiple pre-defined depths with a single insertion. This means when treating a deep wrinkle, deep acne scar or cellulite, I can target the sub-cuticular junction, deep dermis and superficial dermis all in one pulse. This translates into a much higher positive predictive value of attaining a desired clinical improvement. 

Another key feature is the sophisticated impedance measurements which are carefully recorded to ensure that the pulse is being well delivered to our target. 

In my practice, I treat the face and body as well as a range of target audiences, including men and millennials. We can safely treat all skin types, colours and conditions, and it can be used as an adjunct to other treatments. The Matrix Pro has quickly risen to be one of the most advanced, versatile and creative devices in my practice. I can adjust my targeted depths rapidly with each insertion to customise the treatment for each patient. This system allows aesthetic professionals to take their skin rejuvenation practices to the next level. 

The global rollout of the Matrix Pro system will start in 2023. 

Sherina Balaratnam, MBBS, MRCS, MSc (UCL), Medical Director, S-Thetics Clinic
Buckinghamshire, UK

EMFACE®, BTL Aesthetics

EMFACE is the latest treatment introduced to my practice for non-invasive facial rejuvenation. Combining HIFES (High-Intensity Focused Electrical Stimulation) muscle contraction technology and transcutaneous synchronised radiofrequency for skin and connective tissue heating, I refer to this as ‘Emsculpt Neo for the face’.

HIFES induces an electrical field to selectively contract facial muscles such as the Frontalis, Zygomaticus Major and Minor, and Risorius to supramaximal levels, not achievable through normal facial contractions. The result: fuller, higher cheeks, an elevated brow, a slimmer and well-defined jawline and global facial rejuvenation in a quick 20-minute treatment. A protocol of 4 treatments delivers long-term results.

We have never been able to target the facial muscle layer in this way until now. To be able to do this non-surgically, needle-free, fast and pain-free is a game-changer. 

EMFACE’s unique features are many. Its synchronised technology, which blends HIFES with radiofrequency, has shown to promote neocollagenesis, neovascularisation, and address muscle laxity, improving skin quality while lifting the brow and face. I am seeing this result consistently in patients of all ages and skin types. My male patients are very open to having this as they enjoy feeling their facial muscles having a workout and notice results immediately with no downtime.

The robust clinical data with over nine clinical publications gives me assurance as a doctor that I have selected the right investment for my practice to deliver results. I can assure my patients of the efficacy by sharing Dr. Brian Kinney’s muscle histology studies which show a 19.2% increase in muscle density and a 19.8% increase in the number of muscle fibres. These are significant results.

EMFACE is perfectly positioned for patients of every age group within my practice: from millennials desiring prejuvenation, to older patients requiring more correction, lift, structure and volume, as well as post-facelift patients looking for longevity post-surgery. EMFACE stands well as a treatment on its own and alongside topicals, other energy devices, and facial injectables. With combination treatments, timing is everything to deliver the best outcome in collagenesis and new muscle fibre growth. Hence consultation, assessment, and detailed treatment planning are key.

Ashraf Badawi, MD, PhD, Professor of Dermatology NILES, Cairo University, Egypt

SP Dynamis Pro, Fotona

The SP Dynamis Pro laser from Fotona is my arms and legs. I insist on having it in all clinics I work in around the world. It has two wavelengths and can treat over 150 different applications. This system gives me a free hand to treat any condition I want to address. From my point of view, it is the best available laser system currently in the market.

There are many applications I can treat with this device, but the one I use most frequently is the non-ablative rejuvenation application which I perform using a technique called 4D. With this technique, I use two types of lasers, the Nd:YAG 1064nm and the Er:YAG 2940 nm lasers. This technique leads to very effective skin tightening as well as new collagen formation. What is unique about this 4D treatment is that it is associated with no pain or downtime for patients, which they appreciate. There is no downtime for patients and all skin types can be treated safely. 

We typically do three sessions at intervals of one month apart. Each session starts with intraoral treatment to tighten the skin from under the surface with the objective of improving the nasolabial folds and marionette lines. This is followed by using a super extended long pulse with the Nd:YAG laser to tighten the skin from the skin’s surface. Then I will use the short pulse Nd:YAG laser to stimulate new collagen formation and, finally, a very superficial peeling of the skin’s surface with the Er:YAG laser. 

In some cases, I will combine this treatment with additional procedures, including microneedling RF to address enlarged pores or acne scars, as well as with PRP in cases in need of skin rejuvenation.

Uliana Gout, MD,
Aesthetic Medical Doctor, LAM Clinic, London, UK 

Lumina®, Lynton Lasers

I am a huge believer in mixing technologies, techniques and products in a single session to get the most out of each modality and treat a number of issues at the same time. We are seeing an uptick in requests from patients seeking redness, pigmentation and hydration management to be addressed simultaneously in one session. This is most likely due to the fact that people are increasingly time-poor. After three years of Covid disruption, their skincare routines have been disrupted, and as such, the above skin issues have manifested significantly. The return of wearing masks during the colder months has also given rise to redness and dehydrated skin alongside skin congestion. 

My latest combination treatment is based on the Lynton Lumina IPL 650nm/585nm with Fractional 2940nm. By utilising this technology, we are able to target redness, broken capillaries, pigmentation, texture, tone, and pore size. We can also embark on skin re-texturisation and address fine wrinkle softening. 

We can then bring in other modalities to assist with volumisation, wrinkle reduction, and facial shaping. A personal favourite of mine to combine during the course of the above devices is the integration of Dermalux Tri-Wave MD (blue 415nm, red 633nm, infrared 830nm) to target redness, spots, and collagen boosting pre and post-treatment with my IPL/Fractional lasers). We may also add Profacial (a combination of aqua-peeling, multipolar RF, ion lifting and ultrasound to maintain the results achieved) in some cases. 

With these models, we are able to control patients’ downtime, and most importantly, patients report great results and are very pleased with the experience! Rejuvenation is a journey, and the key is to make each step comfortable, predictable and controlled for us as well as for our patients.

Judith Hellman, MD
New York City, US

Morpheus 8, InMode

I am very excited about using the new Morpheus 8 3D body tip. The 40-pin tip can be set to reach from one to seven millimetres deep into the skin or eight millimetres if you consider the heat effect. The treatment aims at improving the appearance of cellulite, utilising radiofrequency to tighten the skin and induce neocollagenesis. It can also reach the subcutaneous fat and tighten the fibrous septae. When the septae straighten out from their haphazard state, they reduce the bulging fat and undulating areas corresponding to cellulite seen in the epidermis. We have seen impressive clinical success with this modality, even in older patients.

The revolutionary 3D configuration ensures an even distribution of the RF during the treatment, thus eliminating the chance of arching. The treatment involves minimal downtime, consisting of tiny needle marks present on the skin for a few days after each treatment. In some patients, as a result of the substantial depth of penetration into the skin, an actual reduction in fat cells can result. Patients appreciate this extra benefit.

Since RF is safe for even the darkest skin colour, this treatment is popular with patients of all Fitzpatrick types. It is easily tolerated, and results are impressive even after just two treatments. It is quickly becoming one of my favourite treatments to do in my practice.

The technology features the ‘burst mode’, where three different depths in the skin can be treated with RF with just one penetration of the needle during the withdrawal of the pins. For example, 7-5-3 mm or 6-4-2 mm, etc. This allows for less mechanical trauma from the pins, with an increased distribution of the thermal effect. It also saves time for the operator and patient because it is like doing three passes with just a single pass. In my hands, this is an advanced technology delivered in a quick, safe, and effective manner.

Jason Pozner, MD, FACS
Plastic surgeon
Boca Raton, Florida, US

ellacor®, Cytrellis

The ellacor system from Cytrellis is a novel system that features Micro-Coring™ technology designed to remove the skin without scarring. Ellacor is the first and only device designed to eliminate excess skin on the microscale. 

 My group conducted two of the clinical studies for FDA approval. The system is currently indicated for use by medical professionals for the treatment of moderate and severe wrinkles in the mid and lower face for Fitzpatrick skin types I-IV. In my experience, it works very well for skin tightening, which is what patients are asking for.  

It offers a unique, minimally invasive way to improve age-related changes without surgery, which many patients are looking for. Our protocol is a series of two to three treatments depending on the patient’s goals and degree of laxity and facial ageing. I had one treatment done myself, and the healing was very quick. I am planning on a second treatment in the near future. 

Some patients who have more severe signs of ageing may request or require ongoing maintenance treatments. Generally, it is a good idea to bring patients back for an annual touch-up to maintain results and stay on top of the ageing process. In our experience, we are seeing that the tightening improvements from these treatments last, but the patient continues to age. Ellacor is also great for patients who are not yet ready for a facelift or those who are post-facelift when the patient has some residual laxity. 

We are seeing that patients have some bruising for about one week. It may be red and/or black and blue, depending on their skin type and condition and the extent of the treatment. After 4-5 days, most patients can go out and engage in social activities.