Jan. 3, 2023
The Future Looks Beautiful: A Discussion of What Lies Ahead in Plastic Surgery & Aesthetic Medicine
What's in store for the future of medical aesthetics? Dr. Bass gives an inside look at where we are right now and his expert predictions.
Injectable fillers and neuromodulators began to gain momentum in the 1990’s, and the rate of innovation with these technologies has been expanding ever since. These advances in non-surgical treatments will continue to decrease the need for big restorative surgery and revolutionize aesthetic medicine.
As technology continues to improve, we can expect to see the use of artificial intelligence and imaging tools to help people visualize their potential results and and help plastic surgeons better tailor treatments for their patients’ individual needs.
The timing of breakthroughs cannot be accurately predicted, but expect an emphasis on biologicals and possibly stem cells or other cell-based therapies to play a significant role in helping people maintain a youthful and healthy appearance by “reprogramming” the skin to act as if it were younger.
About Dr. Lawrence Bass
Innovator. Industry veteran. In-demand Park Avenue board certified plastic surgeon, Dr. Lawrence Bass is a true master of his craft, not only in the OR but as an industry pioneer in the development and evaluation of new aesthetic technologies. With locations in both Manhattan (on Park Avenue between 62nd and 63rd Streets) and in Great Neck, Long Island, Dr. Bass has earned his reputation as the plastic surgeon for the most discerning patients in NYC and beyond.
To learn more, visit the Bass Plastic Surgery website or follow the team on Instagram @drbassnyc
Subscribe to the Park Avenue Plastic Surgery Class newsletter to be notified of new episodes & receive exclusive invitations, offers, and information from Dr. Bass.
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Welcome to another episode of
Park Avenue Plastic Surgery Class,
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the podcast where we explore controversies
and breaking issues in plastic
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surgery. I'm your co-host Doreen Wu.
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And I'm excited to be here
with Dr. Lawrence Bass park
avenue, plastic surgeon,
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educator, and technology innovator.
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The title of today's episode
is "The Future Looks Beautiful:
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A Discussion of What Lies Ahead in
Plastic Surgery and Aesthetic Medicine."
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Dr. Bass, we want all our
beauty dreams to come true.
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We're always hoping for a new
treatment that will work miracles.
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That's what I call the magic
wand treatment, Doreen. No risk,
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no recovery, perfect
result. That being said,
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aesthetic physicians, people in the
core four, like plastic surgeons,
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facial plastic surgeons, dermatologists,
and oculoplastic surgeons.
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These are the doctors who as
part of their training learn
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aesthetic treatments,
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work extensively with
the aesthetic industry,
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the pharmaceutical and medical device
companies to create advancement by
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imagining new options,
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doing research and teaching the science
to others in the medical profession.
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And these aesthetic
physicians have had an immense
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amount of success along with the
aesthetic industry in bringing the field
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of aesthetic medicine forward over
the last two or three decades.
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And this is what I've spent a lot of
my time doing both during my clinical
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training and ever since.
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And it's really been an
incredible experience to see
the immense changes taking
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place in the field of plastic
surgery and aesthetic medicine
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over the past few decades.
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On this podcast, we always like to talk
about history a little bit. Dr. Bass,
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can you give us a recap of where cosmetic
medicine has come since the 1980s and
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when the big explosion in
aesthetic innovation really began?
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So there have been a number
of things taking place,
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but particularly with
devices, injectable fillers,
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and neuromodulators,
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and all of this really
started to gain momentum in
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1990 and the rate of innovation,
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the rate of introduction
of new technologies and the
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volume of care using these
technologies has just been
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expanding ever since. And there
were a couple of reasons for this.
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There were a few technological
breakthroughs in our
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understanding of laser tissue
interaction that let us
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design and engineer devices to
have certain particular parameters,
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amounts of energy,
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amount of time that a
laser pulse came out.
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But in addition to that
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we have backtracked and gone
to bulk heating or long pulse
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exposures after exploring a number of
options with short pulse exposures.
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We've technologically
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created the ability to have
extremely short pulse exposures
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with not just thousandth or
millionth of a second pulses,
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but trillionth of a
second pulse technologies.
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So we've really explored both sides
of really short energy exposure
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and really long energy exposure.
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And a number of other things
have happened to address
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other things besides the skin to
get heat under the skin. With that,
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longer heating allows us to treat fat,
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to treat connective tissue elements
that support the skin and work on
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body skin smoothing in ways
we weren't able to before.
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So that's really a big
thing about how we've
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expanded along with the ability
to create fractionated treatments,
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where an injury or an energy exposure or a
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mechanical exposure is
performed in a tiny pin prick
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sized area of skin
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and all of those dots of exposure
accumulate to 10 or 20 or
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30% of the total skin
area that's being treated.
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But that allows you to do things to the
skin that were you to do it over the
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entire area,
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might create too much damage
or not heal in a favorable way,
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but the body accepts that kind
of exposure in the very small
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pinpoint. And that allows
us in a very tricky way,
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with much less risk and much less recovery
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to rejuvenate photo damaged skin,
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or create other effects even
extending under the skin.
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It sounds like in such a short amount
of time, we've really come a long way.
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And now we have this vast array of
treatments that are available today.
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My grandmother's cold cream is pretty
much nothing compared to the technology
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available to keep me looking young
and otherwise enhance my appearance,
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but I feel like it could always be
better. What is on the horizon, Dr. Bass?
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Is it possible for you to put on your
reading glasses and tell me what the
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shadows in the crystal
ball are suggesting?
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What aesthetic medicine will look like
in, let's say 10 and 20 years from now?
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Well, it's always hazardous to try
to predict the future. And of course,
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if anyone thinks they know
what the future will bring,
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they're probably not as smart as they
think they are. That being said, though,
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there are clearly certain trends.
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A number of things are are
happening that take advances we've
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already developed in this
historical period that I just
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discussed and extend them, or
bring them into a new arena.
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So some of the fractionated
treatments being extended into
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what are called micro-coring technologies,
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where instead of using a
laser and vaporizing tissue,
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which always leaves a zone of thermally
damaged tissue in each of the little
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pinpoint areas,
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there are technologies
that are under development
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to create micro-coring,
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mechanically taking out a tiny
pinpoint of tissue that then
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cumulates to a certain
amount of tissue reduction,
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heals in a few days without a scar, and
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takes advantage of this altered mode
of healing when you do something
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fractionally.
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And that's despite fractional
treatments being nearly 20 years old,
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that's something that really
has not been exploited up until
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this point in time. And so those
technologies are on the way.
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There are very short pulse technologies,
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even shorter than the trillions of a
second pulses that are in development.
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And it's not clear where
that's going to bring us,
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but they're reconstructive applications.
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And we'll see if that also
brings us aesthetic applications
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there have been use of
multiple modalities to treat
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body skin in ways that
we haven't been able
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to previously and body
skin smoothing for a
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long time has been an unsolved
problem in plastic surgery.
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And there are reasons it's
very difficult. I mean,
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you're talking about very large skin
areas compared to something like the face
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and neck.
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You're talking about a lot
more weight on the skin.
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So the mechanical forces work against
you much harder than on the face and
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neck.
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And the metabolism of body skin
is not as good as face skin.
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It doesn't remodel as well.
It doesn't heal as quickly,
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and this has made this a tough problem,
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but there are newer technologies
using microwaves that may
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bring more more outcome,
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more results than what
we've achieved up till now
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using radio frequency technologies.
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There are technologies that use shock
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and various other
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short pulse technologies that create a
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neovascularization creation
of new blood supply and a
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neogenesis development of
new collagen in the skin to
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create more youthful looking
and behaving skin and
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using a lot of these things in
combination often will let us
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amplify the result rather than just
trying to hit harder in a small number of
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treatments with one modality.
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Using biological and pharmacologic
options in conjunction
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with technologies is another thing
we're going to see a big expansion of,
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I believe in the future.
So many technologies,
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particularly the fractional lasers
and other fractional devices,
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fractional microneedling,
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open channels into the skin.
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And that allows you to put
a medicine into the skin
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in high doses in a way that you could
not take systemically because it wouldn't
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be safe or wouldn't be well tolerated.
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And in a way that you can't get into
the skin just by applying a skin cream,
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because the skin is our natural
barrier against the outside world.
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So these are a few of the ways I
think we'll be moving forward into
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new horizons in the future.
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Speaking of modalities, you mentioned
devices, pharmaceutical medicines,
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biologicals, treatments,
and even surgery. Dr. Bass,
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were we likely to see some revolutionary
change in the coming years?
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First,
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let's talk about the issue of
evolutionary change versus revolutionary
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change. So of course,
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evolutionary change is something we've
already got that we make a little bit
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better, kind of the new and improved
version of what we already have.
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Revolutionary change is something that
takes us to a whole different place that
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we really haven't worked in before.
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Evolution change is a lot easier to
predict than revolutionary change because
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we know ways we might explore
improving what we've got,
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but when we're going to
make a holy novel discovery,
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something new that nobody
thought of or did before,
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is much harder to predict. You know,
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you can't schedule innovation. You know,
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the breakthrough is scheduled
for Tuesday at 10:00 AM.
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That's not how science works. Of course
we'd like it if it worked that way,
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but we have to wait
until lightning strikes.
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Certainly we're going to
see a whole host of improved
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devices,
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evolutionary change but
there are some novel
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devices and modalities that are
poised to launch that again,
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pivot in a significant
way from previously,
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things like micro-coring,
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things like the muscle
stimulation technologies
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using electro mechanical stimulation
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and so forth. And those
are really changes.
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We're going to see revolutionary
change in biologics.
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We really don't have a lot of biologics
in aesthetic medicine that we're using
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to reprogram the biology of skin.
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We are using biologics like injectable
fillers and neuromodulators,
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but we're going to see more
biologics that reprogram the behavior
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of skin.
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More like the program skin was
following when we were younger.
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When that's going to come is not clear.
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And it's not around the
corner in the next year or so,
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but there's going to be a point in the
next 10 or 15 years where there's likely
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quite a bit more of
that. I think the other
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change is going to be the approach
that we take to treatments and to
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aesthetic surgery.
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And that is going to evolve
to a different place.
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So not revolutionary, but evolutionary.
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Based on our discussion today,
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it's safe to say there are exciting
times ahead for cosmetic medicine.
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Before we conclude Dr. Bass,
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I would like to ask you to share some
important takeaways for our listeners.
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Sure. And you know, this is
something I think about a lot,
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every time we run into some problem
we can't treat well or every time
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patients find it frustrating to have
to keep coming back for something
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or not quite get where they hope to get.
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We put our thinking caps
on and ask how we might
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get to a better place with this.
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And I think the approach and
management style is going to
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change. I've said several
times on the podcast,
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that beauty is a process,
not an event and so
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easy, quick,
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no recovery ways of maintaining skin is
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going to overtake what
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previously was the almost
exclusive restoration of skin that
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was failing to take care of
itself due to aging changes.
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As I said,
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we're going to see more emphasis on
biologicals and possibly stem cells or
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other kinds of cell-based therapies.
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There are things that are not stem
cells that are mature cells that may
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increasingly be incorporated
in aesthetic therapies.
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And big restorative surgery
will become less common,
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small surgical procedures done
earlier in the game before
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the need for a major
restorative surgery will become
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increasingly common.
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And we are going to use
more tracking and planning
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tools, tools that show us
what aging changes are taking
place and how things are
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changing over time and how
successful we're being with
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a given treatment or a given
program of treatments in
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restoring the appearance.
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We're going to have much more
sophisticated tools utilizing artificial
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intelligence and improved
imaging and other
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objective assessments
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to tailor our treatment
for patients in the future.
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And I'm fairly certain we're going
to see that and see that soon.
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Of course,
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disruptive breakthroughs are hard to
predict when they're going to happen,
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00:16:08,360 --> 00:16:12,440
but I'm sure there'll be a few
pleasant surprises in that regard,
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00:16:12,880 --> 00:16:16,840
in terms of new things that
really change the whole game.
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Thank you, Dr. Bass for sharing
your insight and expertise with us,
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and thank you to our listeners
for joining us today,
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to hear about the future of aesthetic
medicine and plastic surgery,
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00:16:27,350 --> 00:16:32,010
the field is constantly evolving and we
will bring you new updates as they come.
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00:16:32,450 --> 00:16:35,850
I hope you found this episode as
fascinating and informative as I did.
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00:16:36,310 --> 00:16:39,570
If you think of other exciting
developments or trends
in plastic surgery that
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00:16:39,571 --> 00:16:42,130
you would like us to discuss
in upcoming episodes,
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00:16:42,131 --> 00:16:45,410
please reach out by email or
Instagram. We'll see you next time.
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This is Doreen Wu,
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00:16:47,811 --> 00:16:51,730
thanking you for joining Dr. Bass and
me for this discussion of the future of
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00:16:51,731 --> 00:16:55,370
aesthetic medicine and plastic
surgery. Be sure to tune in next time.
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00:16:55,371 --> 00:16:57,170
And don't forget to
subscribe to our podcast,
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00:16:57,710 --> 00:17:00,890
to stay up to date with all of the
exciting content that is coming your way.
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00:17:01,420 --> 00:17:05,410
Thank you for joining us in this episode
of the Park Avenue Plastic Surgery
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00:17:05,500 --> 00:17:10,010
Class podcast with Dr. Lawrence
Bass Park Avenue plastic surgeon,
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00:17:10,810 --> 00:17:12,690
educator, and technology innovator.
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00:17:13,030 --> 00:17:15,570
The commentary in this
podcast represents opinion.
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00:17:15,800 --> 00:17:18,210
This podcast does not
present medical advice,
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00:17:18,550 --> 00:17:22,570
but rather general information about
plastic surgery that does not necessarily
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00:17:22,630 --> 00:17:25,730
relate to the specific conditions
of any individual patient.
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00:17:26,070 --> 00:17:30,690
No doctor-patient relationship
is established by listening
to or participating
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00:17:30,750 --> 00:17:31,583
in this podcast,
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00:17:32,000 --> 00:17:36,090
consult your physician to advise you
about your individual healthcare.
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00:17:36,350 --> 00:17:37,810
If you enjoyed this episode,
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00:17:37,990 --> 00:17:42,130
please share it with your friends and
be sure to subscribe to our podcast on
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00:17:42,131 --> 00:17:46,010
Apple Podcasts, Google, Spotify, Stitcher,
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00:17:46,011 --> 00:17:48,530
or wherever you listen to podcasts.
00:00:00,470 --> 00:00:04,320
Welcome to another episode of
Park Avenue Plastic Surgery Class,
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00:00:04,660 --> 00:00:08,200
the podcast where we explore controversies
and breaking issues in plastic
3
00:00:08,201 --> 00:00:10,720
surgery. I'm your co-host Doreen Wu.
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00:00:10,980 --> 00:00:15,200
And I'm excited to be here
with Dr. Lawrence Bass park
avenue, plastic surgeon,
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00:00:15,880 --> 00:00:17,520
educator, and technology innovator.
6
00:00:18,340 --> 00:00:21,640
The title of today's episode
is "The Future Looks Beautiful:
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00:00:22,160 --> 00:00:25,840
A Discussion of What Lies Ahead in
Plastic Surgery and Aesthetic Medicine."
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00:00:25,841 --> 00:00:30,680
Dr. Bass, we want all our
beauty dreams to come true.
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00:00:30,890 --> 00:00:34,120
We're always hoping for a new
treatment that will work miracles.
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00:00:35,020 --> 00:00:39,040
That's what I call the magic
wand treatment, Doreen. No risk,
11
00:00:39,340 --> 00:00:43,460
no recovery, perfect
result. That being said,
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00:00:43,461 --> 00:00:48,140
aesthetic physicians, people in the
core four, like plastic surgeons,
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00:00:48,141 --> 00:00:52,540
facial plastic surgeons, dermatologists,
and oculoplastic surgeons.
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00:00:52,541 --> 00:00:56,740
These are the doctors who as
part of their training learn
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00:00:57,050 --> 00:00:58,300
aesthetic treatments,
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00:00:59,730 --> 00:01:02,620
work extensively with
the aesthetic industry,
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00:01:02,760 --> 00:01:07,740
the pharmaceutical and medical device
companies to create advancement by
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00:01:07,770 --> 00:01:09,140
imagining new options,
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00:01:10,690 --> 00:01:15,360
doing research and teaching the science
to others in the medical profession.
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00:01:16,140 --> 00:01:20,960
And these aesthetic
physicians have had an immense
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00:01:20,961 --> 00:01:25,960
amount of success along with the
aesthetic industry in bringing the field
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00:01:25,980 --> 00:01:29,440
of aesthetic medicine forward over
the last two or three decades.
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00:01:30,460 --> 00:01:35,110
And this is what I've spent a lot of
my time doing both during my clinical
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00:01:35,350 --> 00:01:36,390
training and ever since.
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And it's really been an
incredible experience to see
the immense changes taking
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00:01:41,311 --> 00:01:46,110
place in the field of plastic
surgery and aesthetic medicine
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00:01:46,860 --> 00:01:48,350
over the past few decades.
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00:01:49,730 --> 00:01:53,790
On this podcast, we always like to talk
about history a little bit. Dr. Bass,
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00:01:53,930 --> 00:01:58,470
can you give us a recap of where cosmetic
medicine has come since the 1980s and
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00:01:58,471 --> 00:02:01,430
when the big explosion in
aesthetic innovation really began?
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00:02:03,060 --> 00:02:06,580
So there have been a number
of things taking place,
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00:02:07,020 --> 00:02:10,620
but particularly with
devices, injectable fillers,
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00:02:11,780 --> 00:02:12,900
and neuromodulators,
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00:02:13,620 --> 00:02:18,100
and all of this really
started to gain momentum in
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00:02:18,860 --> 00:02:22,020
1990 and the rate of innovation,
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00:02:22,380 --> 00:02:26,100
the rate of introduction
of new technologies and the
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00:02:27,900 --> 00:02:32,300
volume of care using these
technologies has just been
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00:02:33,100 --> 00:02:36,300
expanding ever since. And there
were a couple of reasons for this.
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00:02:36,620 --> 00:02:41,300
There were a few technological
breakthroughs in our
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00:02:41,980 --> 00:02:45,140
understanding of laser tissue
interaction that let us
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00:02:46,700 --> 00:02:50,860
design and engineer devices to
have certain particular parameters,
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00:02:52,460 --> 00:02:54,580
amounts of energy,
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00:02:55,860 --> 00:02:58,580
amount of time that a
laser pulse came out.
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00:02:58,940 --> 00:03:00,880
But in addition to that
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00:03:04,150 --> 00:03:08,990
we have backtracked and gone
to bulk heating or long pulse
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00:03:09,990 --> 00:03:14,230
exposures after exploring a number of
options with short pulse exposures.
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00:03:15,150 --> 00:03:16,390
We've technologically
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00:03:18,550 --> 00:03:23,190
created the ability to have
extremely short pulse exposures
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00:03:24,630 --> 00:03:29,500
with not just thousandth or
millionth of a second pulses,
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00:03:29,980 --> 00:03:32,940
but trillionth of a
second pulse technologies.
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00:03:33,860 --> 00:03:38,380
So we've really explored both sides
of really short energy exposure
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00:03:39,260 --> 00:03:41,100
and really long energy exposure.
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00:03:42,340 --> 00:03:46,220
And a number of other things
have happened to address
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00:03:47,500 --> 00:03:51,460
other things besides the skin to
get heat under the skin. With that,
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00:03:51,780 --> 00:03:54,820
longer heating allows us to treat fat,
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00:03:55,540 --> 00:04:00,260
to treat connective tissue elements
that support the skin and work on
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00:04:00,580 --> 00:04:03,820
body skin smoothing in ways
we weren't able to before.
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00:04:05,300 --> 00:04:09,980
So that's really a big
thing about how we've
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00:04:10,700 --> 00:04:15,220
expanded along with the ability
to create fractionated treatments,
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00:04:15,900 --> 00:04:20,740
where an injury or an energy exposure or a
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00:04:21,020 --> 00:04:25,460
mechanical exposure is
performed in a tiny pin prick
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00:04:26,820 --> 00:04:29,060
sized area of skin
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00:04:31,490 --> 00:04:35,810
and all of those dots of exposure
accumulate to 10 or 20 or
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00:04:36,570 --> 00:04:39,290
30% of the total skin
area that's being treated.
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00:04:39,430 --> 00:04:44,130
But that allows you to do things to the
skin that were you to do it over the
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00:04:44,230 --> 00:04:45,090
entire area,
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00:04:45,460 --> 00:04:49,810
might create too much damage
or not heal in a favorable way,
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00:04:50,670 --> 00:04:55,330
but the body accepts that kind
of exposure in the very small
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00:04:55,331 --> 00:04:59,330
pinpoint. And that allows
us in a very tricky way,
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00:04:59,360 --> 00:05:03,410
with much less risk and much less recovery
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00:05:04,670 --> 00:05:07,330
to rejuvenate photo damaged skin,
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or create other effects even
extending under the skin.
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00:05:12,650 --> 00:05:16,310
It sounds like in such a short amount
of time, we've really come a long way.
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And now we have this vast array of
treatments that are available today.
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My grandmother's cold cream is pretty
much nothing compared to the technology
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00:05:25,511 --> 00:05:29,110
available to keep me looking young
and otherwise enhance my appearance,
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00:05:29,890 --> 00:05:33,630
but I feel like it could always be
better. What is on the horizon, Dr. Bass?
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Is it possible for you to put on your
reading glasses and tell me what the
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00:05:37,191 --> 00:05:39,270
shadows in the crystal
ball are suggesting?
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00:05:39,300 --> 00:05:44,070
What aesthetic medicine will look like
in, let's say 10 and 20 years from now?
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00:05:45,070 --> 00:05:49,840
Well, it's always hazardous to try
to predict the future. And of course,
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00:05:49,900 --> 00:05:52,440
if anyone thinks they know
what the future will bring,
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00:05:52,910 --> 00:05:57,640
they're probably not as smart as they
think they are. That being said, though,
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00:05:57,880 --> 00:05:59,760
there are clearly certain trends.
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00:06:00,640 --> 00:06:05,480
A number of things are are
happening that take advances we've
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00:06:05,790 --> 00:06:10,440
already developed in this
historical period that I just
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00:06:10,470 --> 00:06:14,360
discussed and extend them, or
bring them into a new arena.
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00:06:16,140 --> 00:06:20,720
So some of the fractionated
treatments being extended into
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00:06:21,110 --> 00:06:23,920
what are called micro-coring technologies,
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00:06:24,290 --> 00:06:27,880
where instead of using a
laser and vaporizing tissue,
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00:06:28,450 --> 00:06:33,360
which always leaves a zone of thermally
damaged tissue in each of the little
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00:06:33,800 --> 00:06:34,640
pinpoint areas,
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00:06:35,130 --> 00:06:39,360
there are technologies
that are under development
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00:06:39,940 --> 00:06:41,000
to create micro-coring,
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00:06:42,560 --> 00:06:47,000
mechanically taking out a tiny
pinpoint of tissue that then
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00:06:47,070 --> 00:06:50,160
cumulates to a certain
amount of tissue reduction,
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00:06:50,730 --> 00:06:53,280
heals in a few days without a scar, and
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00:06:55,650 --> 00:07:00,320
takes advantage of this altered mode
of healing when you do something
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00:07:00,880 --> 00:07:01,713
fractionally.
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00:07:02,860 --> 00:07:07,200
And that's despite fractional
treatments being nearly 20 years old,
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00:07:08,020 --> 00:07:12,800
that's something that really
has not been exploited up until
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00:07:12,830 --> 00:07:17,080
this point in time. And so those
technologies are on the way.
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00:07:19,530 --> 00:07:22,280
There are very short pulse technologies,
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00:07:23,110 --> 00:07:28,000
even shorter than the trillions of a
second pulses that are in development.
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00:07:28,900 --> 00:07:31,880
And it's not clear where
that's going to bring us,
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00:07:32,220 --> 00:07:36,300
but they're reconstructive applications.
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00:07:36,560 --> 00:07:40,660
And we'll see if that also
brings us aesthetic applications
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00:07:43,510 --> 00:07:48,420
there have been use of
multiple modalities to treat
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00:07:49,410 --> 00:07:54,390
body skin in ways that
we haven't been able
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00:07:54,391 --> 00:07:59,270
to previously and body
skin smoothing for a
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00:07:59,271 --> 00:08:04,270
long time has been an unsolved
problem in plastic surgery.
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00:08:05,170 --> 00:08:07,510
And there are reasons it's
very difficult. I mean,
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you're talking about very large skin
areas compared to something like the face
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00:08:11,530 --> 00:08:12,363
and neck.
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00:08:12,490 --> 00:08:16,710
You're talking about a lot
more weight on the skin.
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00:08:17,050 --> 00:08:21,870
So the mechanical forces work against
you much harder than on the face and
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00:08:21,871 --> 00:08:22,704
neck.
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00:08:23,290 --> 00:08:27,510
And the metabolism of body skin
is not as good as face skin.
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00:08:28,010 --> 00:08:30,950
It doesn't remodel as well.
It doesn't heal as quickly,
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00:08:31,650 --> 00:08:33,510
and this has made this a tough problem,
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00:08:33,730 --> 00:08:38,390
but there are newer technologies
using microwaves that may
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00:08:38,480 --> 00:08:42,470
bring more more outcome,
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00:08:42,500 --> 00:08:47,190
more results than what
we've achieved up till now
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00:08:47,480 --> 00:08:49,550
using radio frequency technologies.
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00:08:50,920 --> 00:08:53,230
There are technologies that use shock
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00:08:56,170 --> 00:08:57,430
and various other
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00:08:59,850 --> 00:09:04,400
short pulse technologies that create a
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00:09:06,260 --> 00:09:11,000
neovascularization creation
of new blood supply and a
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00:09:13,570 --> 00:09:18,280
neogenesis development of
new collagen in the skin to
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00:09:18,281 --> 00:09:23,160
create more youthful looking
and behaving skin and
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00:09:23,370 --> 00:09:28,120
using a lot of these things in
combination often will let us
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00:09:28,270 --> 00:09:33,040
amplify the result rather than just
trying to hit harder in a small number of
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00:09:33,041 --> 00:09:34,920
treatments with one modality.
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00:09:38,650 --> 00:09:43,360
Using biological and pharmacologic
options in conjunction
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00:09:43,470 --> 00:09:47,680
with technologies is another thing
we're going to see a big expansion of,
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00:09:47,880 --> 00:09:51,080
I believe in the future.
So many technologies,
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00:09:51,480 --> 00:09:55,560
particularly the fractional lasers
and other fractional devices,
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00:09:56,040 --> 00:09:58,610
fractional microneedling,
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00:10:00,690 --> 00:10:02,580
open channels into the skin.
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00:10:02,720 --> 00:10:06,620
And that allows you to put
a medicine into the skin
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00:10:07,740 --> 00:10:12,480
in high doses in a way that you could
not take systemically because it wouldn't
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00:10:12,481 --> 00:10:14,880
be safe or wouldn't be well tolerated.
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00:10:15,700 --> 00:10:20,640
And in a way that you can't get into
the skin just by applying a skin cream,
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00:10:20,710 --> 00:10:24,920
because the skin is our natural
barrier against the outside world.
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00:10:25,540 --> 00:10:29,680
So these are a few of the ways I
think we'll be moving forward into
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00:10:30,580 --> 00:10:32,360
new horizons in the future.
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00:10:33,600 --> 00:10:38,520
Speaking of modalities, you mentioned
devices, pharmaceutical medicines,
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00:10:38,910 --> 00:10:42,240
biologicals, treatments,
and even surgery. Dr. Bass,
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00:10:42,241 --> 00:10:45,600
were we likely to see some revolutionary
change in the coming years?
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00:10:46,480 --> 00:10:46,831
First,
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00:10:46,831 --> 00:10:51,510
let's talk about the issue of
evolutionary change versus revolutionary
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00:10:51,690 --> 00:10:53,190
change. So of course,
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00:10:53,191 --> 00:10:57,990
evolutionary change is something we've
already got that we make a little bit
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00:10:57,991 --> 00:11:02,830
better, kind of the new and improved
version of what we already have.
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00:11:03,460 --> 00:11:07,950
Revolutionary change is something that
takes us to a whole different place that
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00:11:07,951 --> 00:11:09,670
we really haven't worked in before.
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00:11:11,060 --> 00:11:15,710
Evolution change is a lot easier to
predict than revolutionary change because
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00:11:16,450 --> 00:11:20,870
we know ways we might explore
improving what we've got,
159
00:11:21,130 --> 00:11:24,790
but when we're going to
make a holy novel discovery,
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00:11:24,980 --> 00:11:27,870
something new that nobody
thought of or did before,
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00:11:29,010 --> 00:11:31,030
is much harder to predict. You know,
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00:11:32,490 --> 00:11:34,950
you can't schedule innovation. You know,
163
00:11:35,170 --> 00:11:38,230
the breakthrough is scheduled
for Tuesday at 10:00 AM.
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00:11:38,231 --> 00:11:42,950
That's not how science works. Of course
we'd like it if it worked that way,
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00:11:43,050 --> 00:11:46,150
but we have to wait
until lightning strikes.
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00:11:47,780 --> 00:11:52,310
Certainly we're going to
see a whole host of improved
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00:11:52,580 --> 00:11:53,400
devices,
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00:11:53,400 --> 00:11:58,040
evolutionary change but
there are some novel
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00:11:58,390 --> 00:12:02,560
devices and modalities that are
poised to launch that again,
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00:12:02,570 --> 00:12:05,520
pivot in a significant
way from previously,
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00:12:07,270 --> 00:12:08,610
things like micro-coring,
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00:12:09,290 --> 00:12:13,730
things like the muscle
stimulation technologies
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00:12:14,260 --> 00:12:18,010
using electro mechanical stimulation
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00:12:19,510 --> 00:12:22,250
and so forth. And those
are really changes.
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00:12:23,850 --> 00:12:28,680
We're going to see revolutionary
change in biologics.
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00:12:29,000 --> 00:12:33,760
We really don't have a lot of biologics
in aesthetic medicine that we're using
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00:12:35,750 --> 00:12:39,390
to reprogram the biology of skin.
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00:12:39,910 --> 00:12:44,350
We are using biologics like injectable
fillers and neuromodulators,
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00:12:45,470 --> 00:12:50,230
but we're going to see more
biologics that reprogram the behavior
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00:12:51,430 --> 00:12:52,263
of skin.
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00:12:53,390 --> 00:12:57,790
More like the program skin was
following when we were younger.
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00:12:59,270 --> 00:13:01,070
When that's going to come is not clear.
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00:13:01,070 --> 00:13:04,990
And it's not around the
corner in the next year or so,
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00:13:05,270 --> 00:13:10,070
but there's going to be a point in the
next 10 or 15 years where there's likely
185
00:13:10,390 --> 00:13:14,280
quite a bit more of
that. I think the other
186
00:13:15,800 --> 00:13:20,480
change is going to be the approach
that we take to treatments and to
187
00:13:21,160 --> 00:13:21,993
aesthetic surgery.
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00:13:23,160 --> 00:13:27,240
And that is going to evolve
to a different place.
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00:13:27,520 --> 00:13:30,120
So not revolutionary, but evolutionary.
190
00:13:31,330 --> 00:13:32,800
Based on our discussion today,
191
00:13:33,190 --> 00:13:36,960
it's safe to say there are exciting
times ahead for cosmetic medicine.
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00:13:37,500 --> 00:13:39,200
Before we conclude Dr. Bass,
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00:13:39,320 --> 00:13:42,360
I would like to ask you to share some
important takeaways for our listeners.
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00:13:43,150 --> 00:13:46,000
Sure. And you know, this is
something I think about a lot,
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00:13:46,890 --> 00:13:50,800
every time we run into some problem
we can't treat well or every time
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00:13:50,801 --> 00:13:55,640
patients find it frustrating to have
to keep coming back for something
197
00:13:55,700 --> 00:13:57,760
or not quite get where they hope to get.
198
00:13:57,860 --> 00:14:02,800
We put our thinking caps
on and ask how we might
199
00:14:04,090 --> 00:14:05,710
get to a better place with this.
200
00:14:05,810 --> 00:14:10,790
And I think the approach and
management style is going to
201
00:14:10,810 --> 00:14:14,350
change. I've said several
times on the podcast,
202
00:14:14,351 --> 00:14:17,870
that beauty is a process,
not an event and so
203
00:14:19,390 --> 00:14:20,320
easy, quick,
204
00:14:20,700 --> 00:14:25,680
no recovery ways of maintaining skin is
205
00:14:25,681 --> 00:14:29,000
going to overtake what
206
00:14:31,200 --> 00:14:36,120
previously was the almost
exclusive restoration of skin that
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was failing to take care of
itself due to aging changes.
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As I said,
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we're going to see more emphasis on
biologicals and possibly stem cells or
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other kinds of cell-based therapies.
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There are things that are not stem
cells that are mature cells that may
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increasingly be incorporated
in aesthetic therapies.
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And big restorative surgery
will become less common,
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small surgical procedures done
earlier in the game before
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the need for a major
restorative surgery will become
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increasingly common.
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00:15:18,300 --> 00:15:23,120
And we are going to use
more tracking and planning
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tools, tools that show us
what aging changes are taking
place and how things are
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changing over time and how
successful we're being with
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00:15:33,880 --> 00:15:38,340
a given treatment or a given
program of treatments in
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restoring the appearance.
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We're going to have much more
sophisticated tools utilizing artificial
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intelligence and improved
imaging and other
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00:15:52,120 --> 00:15:52,953
objective assessments
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to tailor our treatment
for patients in the future.
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00:15:58,360 --> 00:16:01,640
And I'm fairly certain we're going
to see that and see that soon.
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00:16:03,320 --> 00:16:04,153
Of course,
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00:16:04,480 --> 00:16:07,320
disruptive breakthroughs are hard to
predict when they're going to happen,
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00:16:08,360 --> 00:16:12,440
but I'm sure there'll be a few
pleasant surprises in that regard,
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in terms of new things that
really change the whole game.
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00:16:18,260 --> 00:16:21,570
Thank you, Dr. Bass for sharing
your insight and expertise with us,
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00:16:21,630 --> 00:16:23,850
and thank you to our listeners
for joining us today,
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to hear about the future of aesthetic
medicine and plastic surgery,
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00:16:27,350 --> 00:16:32,010
the field is constantly evolving and we
will bring you new updates as they come.
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00:16:32,450 --> 00:16:35,850
I hope you found this episode as
fascinating and informative as I did.
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00:16:36,310 --> 00:16:39,570
If you think of other exciting
developments or trends
in plastic surgery that
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00:16:39,571 --> 00:16:42,130
you would like us to discuss
in upcoming episodes,
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00:16:42,131 --> 00:16:45,410
please reach out by email or
Instagram. We'll see you next time.
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This is Doreen Wu,
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00:16:47,811 --> 00:16:51,730
thanking you for joining Dr. Bass and
me for this discussion of the future of
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00:16:51,731 --> 00:16:55,370
aesthetic medicine and plastic
surgery. Be sure to tune in next time.
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00:16:55,371 --> 00:16:57,170
And don't forget to
subscribe to our podcast,
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00:16:57,710 --> 00:17:00,890
to stay up to date with all of the
exciting content that is coming your way.
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00:17:01,420 --> 00:17:05,410
Thank you for joining us in this episode
of the Park Avenue Plastic Surgery
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00:17:05,500 --> 00:17:10,010
Class podcast with Dr. Lawrence
Bass Park Avenue plastic surgeon,
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00:17:10,810 --> 00:17:12,690
educator, and technology innovator.
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00:17:13,030 --> 00:17:15,570
The commentary in this
podcast represents opinion.
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00:17:15,800 --> 00:17:18,210
This podcast does not
present medical advice,
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00:17:18,550 --> 00:17:22,570
but rather general information about
plastic surgery that does not necessarily
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00:17:22,630 --> 00:17:25,730
relate to the specific conditions
of any individual patient.
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00:17:26,070 --> 00:17:30,690
No doctor-patient relationship
is established by listening
to or participating
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00:17:30,750 --> 00:17:31,583
in this podcast,
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00:17:32,000 --> 00:17:36,090
consult your physician to advise you
about your individual healthcare.
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00:17:36,350 --> 00:17:37,810
If you enjoyed this episode,
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00:17:37,990 --> 00:17:42,130
please share it with your friends and
be sure to subscribe to our podcast on
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00:17:42,131 --> 00:17:46,010
Apple Podcasts, Google, Spotify, Stitcher,
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00:17:46,011 --> 00:17:48,530
or wherever you listen to podcasts.