Faculty Bibliography

BACKGROUND AND OBJECTIVES/OBJECTIVE:Melasma may be related to aberrant blood vessels, but there has been no report on the utility of dynamic optical coherence tomography (D-OCT) in studying vessel characteristics in melasma. We studied the characteristics of cutaneous blood vessels in melasma and the effects of oral tranexamic acid (TXA) with D-OCT. STUDY DESIGN/MATERIALS AND METHODS/METHODS:Six patients with moderate to severe melasma had a D-OCT scanning of the areas on the face affected by melasma and not affected by it. Three of them had scans within 3 months after starting oral TXA and at a follow-up visit. Blood flow at different depths of the skin and vessel diameter were compared between the melasma and normal skin. For those taking oral TXA, we compared the percent change of blood flow and diameter between the melasma and normal skin. RESULTS:Dermal blood flow and vessel diameter were greater in the melasma skin than in the normal skin. Oral TXA reduced dermal blood flow in both the melasma and normal skin, but the reduction was more dramatic in the lesional melasma skin. CONCLUSIONS:D-OCT findings that (i) dermal blood vessels in melasma are increased in size and flow and (ii) oral TXA reduced the vessel size and flow, providing evidence supporting the relationship between melasma and cutaneous blood vessels. D-OCT may be utilized in measuring response to treatments targeting melasma. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

This commentary examines the growing popularity of cosmetic procedures in men. With the recent increase in aesthetic procedures across the nation, it is important for physicians to understand trends as they evolve, which can help to optimize clinical training, business operations, and practice management. Although the popularity of cosmetic procedures in men has increased, available data on consumer behavior is limited. Our data fills this gap by examining the patterns of cosmetic procedures in men. Due to hormonal and anatomic differences, the pathophysiology of cutaneous aging differs between sexes, which can have significant implications for treatment. Our data demonstrates a positive trend in recent years and also breaks it down by individual procedures.

In recent years, the popularity of fillers has risen significantly. Traditionally, women have undergone the vast majority of cosmetic procedures, but men have steadily shown increasing interest. Recently, significant research has been dedicated to understanding the anatomic differences between male and female facial structures and their clinical aesthetic implications, especially for filler placement. In order to compare actual treatment data to evidence these discussions, we randomly selected 100 cases each of men and women, who were matched for age, and documented their filler placement locations. Facial heat maps were constructed to provide readers with visual evidence. Male cheeks were more inferiomedial, while female cheeks were more superolateral. Men had more jawline fillers, while women had more lip and perioral fillers. Our study builds upon gender-specific considerations. It is important for physicians to be knowledgeable regarding the unique approaches to fillers in men and women in order to deliver more effective, tailored, and high-quality care.

This commentary examines the utility of arnica in cosmetic dermatology. For many years, arnica has been used to reduce the morbidity associated with various procedures, including surgeries and treatments with laser and other energy-based devices. Arnica is a traditional homeopathic remedy that can reduce post-procedural edema and bruising. Although it has been used clinically by many physicians and is widely and readily available to patients, the available data is limited and often conflicting. We reviewed the relevant information on arnica and offer our own insights into its use in order to shed more light on its peri-procedural utility.

BACKGROUND:Non-invasive body contouring has experienced recent growth. To meet demand, medical spas and non-physician operators have grown. Insights into their practice can provide information on their impact. OBJECTIVE:Our study investigated the current market distribution of body contouring providers in the aesthetic field. MATERIALS AND METHODS/METHODS:For the 30 most populous cities, data was collected for non-invasive body contouring providers in medical spas and physician practices. Descriptive ratios were calculated, and various local factors were examined. RESULTS:The cities with the greatest number of body contouring providers were New York (138), Los Angeles (106), and Houston (87). Population size had a significant relationship, while median household income did not. For number of body contouring providers per 100,000 persons, the top cities were Austin (4.87), Houston (3.74), and Las Vegas (3.41). The mean ratio of providers in medical spas to physician practices was 1.81. In total, 70.0% of cities had equal or more body contouring providers in medical spas than physician practices. CONCLUSION/CONCLUSIONS:Certain cities have experienced an unequal distribution of body contouring providers, and many cities favor medical spas over physician-based practices.