Aesthetic Advances

The desire for healthy skin is having widespread impact in the beauty world, and it’s not only skincare that’s moving away from anti-ageing jargon: the future of cosmetic medicine is following suit. “A full face approach is the way of the future with 
a stronger focus on skin health,” says Sonya Hatangadi, training academy manager at Caci. “Nothing beats great skin, and we’re increasingly aware of factors that influence skin health and the process of ageing.”

Although misconceptions of radically changing your appearance may have once been entwined with cosmetic medicine, founder of The Face Place Dr Catherine Stone says the future will focus on ageing beautifully. Stone says, “We’ve never really talked about anti-ageing – you’re fortunate to age. It’s always been about helping people age beautifully and looking they best they can.”

Prevention is key

The answer to resilient skin is prevention, say the experts, and one of the biggest shifts is a growing awareness of this. 
Dr Sarah Hart, cosmetic doctor and medicine expert at the Skin Institute, believes as a result we’re more motivated to take a hands-on approach to caring for our skin. “If you seek treatment when you first notice your skin ageing, then it can be addressed with gentler treatments, avoiding major procedures later on,” Hart explains. Dermatologist and director of Brisbane Skin Dr Shobhan Manoharan agrees, explaining that, to retain skin health, smaller treatments using energy-based devices and injectables can begin when the first signs of ageing appear.

And although Stone admits that it’s impossible to press pause on ageing completely, you can significantly slow it down. “If you start with baby doses, you can prevent some of the ageing process. Hyaluronic dermal fillers have been shown to strengthen the skin, you can strengthen the ligaments. We’re able to build up collagen supplies before you 
go through the process of using them all, so as you get older you’ve got more of it available. It’s ageing in a beautiful and authentic way.”

Natural beauty

Celebrities may have thrown cosmetic procedures into the spotlight but despite pop culture’s influence on the beauty world, Manoharan says these Hollywood-inspired trends are nothing new. “We’ve had the Monroes, the Twiggys, Zsa Zsa Gabor, all the historical beauty icons – 
that will never change and will always be followed by some people,” he explains. “It’s just instantaneous now, thanks to social media. If a celebrity has a vampire facial, it’s deemed newsworthy, and our phones ring off the hook.”

Celebrities might continue to influence trends to some extent, however cosmetic practitioners agree that natural beauty is making a comeback. “With facial aesthetics we’re definitely reverting to a more natural look,” Manoharan says. “It’s all about volume replacement and redistribution, and 
we’re using more energy-based devices 
for lifting and tightening. We’re looking at ways to turn back the clock in a natural fashion so you don’t get an odd caricature of yourself,” he explains.

Hatangadi says that the desire for a more refreshed look has already arrived 
in New Zealand. “The trick is to look fantastic for your age. We are rejuvenating and enhancing existing structures – not changing or recreating.”

True contouring

Shifting stubborn fat has always been a challenge, but Manoharan is optimistic about a new fat-melting injectable, known as Belkyra or Kybella, that will launch in Australasia this year. “It reduces fat in the submental region under the chin, which is a concern area for lots of patients,” says Manoharan, who will be one of the first practitioners to use the game-changing injectable Down Under. “It’s very exciting for us. You need about three treatments and the improvements are something you keep, based on lifestyle and genetics,” he explains.

The injectable uses a synthetic version of deoxycholic acid, a naturally occurring molecule that assists with the breakdown of dietary fat. “If it lives up to its promises, it will be the beginning of a new era of facial rejuvenation,” says Hart, who’s been selected to treat the first patients in New Zealand, prior to its official release. When Belkyra launches it will be licensed to treat the submental region, but Manoharan says there’s potential for it to be used elsewhere. “Colleagues in America are trialling it in other places where it’s traditionally been very difficult to shift fat.”

The Face Place has been doing platelet-rich plasma-based treatments (PRP) for six years and Stone believes that its benefits are only just beginning to be discovered. The process involves drawing a small amount of blood from the arm that is put in a centrifuge to separate PRP from platelet-poor plasma and red blood cells. While some doctors are using it for wound healing and repair, it’s going to be 
a procedure to watch in beauty. According to Stone, doctors in the US are looking at using PRP for body contouring. “There’s a doctor taking out fat, then injecting it back in with PRP to stimulate muscle growth. The results were stunning; it’s something we haven’t seen before,” she says.

Watch this space

New devices and refined existing tools including pico-second lasers and hybrid wavelengths will mean less downtime and better results, says Manoharan. He adds, “Improvements with devices are making this possible.” Radio-frequency micro-needling is another device-based treatment that we’ll see evolve. “The technology is going to improve dramatically over the next 24 months,” says Manoharan.
Cryotherapy has been used for a long time in sports medicine, but Stone says it’s something we’ll start to see more of in beauty – dry ice facials and facials using chilled implements are a few treatments that could make their way onto treatment menus. “When the cool temperatures are applied blood vessels are squeezed down, then what happens is something called reperfusion, which stimulates blood flow black into the area,” Stone explains.

“Centres are already being set up 
to analyse your genetics and increase 
our life span,” says Stone. As for how genomic analysis will impact on cosmetic medicine, Stone explains it 
will enable more tailored and customised treatments. “With more analysis of the genome and microbiome, it will help 
tell us what treatments are appropriate for individuals.”
It might sound like science fiction, but Stone says there could be a future without doctors as we know them. “It’s going to 
be interesting to see what role artificial intelligence and augmented reality play in cosmetic medicine,” says Stone. While she doesn’t believe robots will be taking over quite yet, she expects technological advances will improve treatments. “I think we’ll see an increased use of tools 
to help us analyse the face better.”

Ask an Expert: Dr Sarah Hart, cosmetic doctor at the Skin Institute.

What trends have you noticed emerging in cosmetic medicine recently?

People are more proactive, seeking out a skilled cosmetic medicine practitioner, 
then forming a long-term relationship with regular visits. Practitioners have become the “go-to” partner for improving ageing skin. Once you find the right practitioner it becomes a partnership. I have patients I’ve treated for more than 15 years now, with small amounts of filler to support sagging, regular micro-needling on platelet-rich plasma to create collagen and tiny amounts of Botox to relax muscles. Add in nourishment with scientifically advanced, doctor-only skincare, prescribed for your skin, and this “little and often” approach can keep your skin looking great as the years pass.

What interesting advances and innovations will we see this year?

I think we’ll see a lot more people discovering the benefits of dermal fillers made from hyaluronan. They are hugely versatile; and emerging new products and techniques are changing the way we use them. Rather than using fillers just for fuller lips or cheeks, we can subtly improve sagging. To achieve this we might place filler in unexpected areas, such as in front of the ear or in the temple, to improve your jowls, for example. This newer, holistic approach won’t leave you looking “done” – just a fresher version of yourself. It’s an international trend, now coming to New Zealand, that I’ve been teaching in Australia and China. I’m now sharing these techniques with our team of nurses here at Skin Institute. It’s exciting.

We are also using lighter, thinner versions of hyaluronan dermal fillers, placed with a special gun into the very top layers of the skin. This is a little like putting a great moisturiser directly under the surface, where it can nourish skin internally. Research shows treatment improves skin hydration, texture and elasticity. The face, neck, décolletage and hands can all be treated. Skin Institute Queenstown is the first in our group to offer the DermaGun treatment and we’re seeing exciting results.

Beauty test run: Clinique Fresh Pressed

Religiously using the same skincare breakthrough day after day and then waiting for several months to see the results has become the norm in the beauty world. So when I caught wind of Clinique’s new innovation Fresh Pressed being touted as “de-ageing for the impatient” it was mixed emotions: naturally a touch of skepticism and eagerness to get my hands on said product, stat.

Vitamin C – the key ingredient in Fresh Pressed – won’t be anything new to beauty enthusiasts; in fact, many of us have been using it in our skincare regimen for years. But those familiar with this powerful antioxidant will also be aware that vitamin C is notoriously difficult to stabilise. Expose it to sunlight and it photodegrades rapidly. “It’s highly unstable,” Tom Mammone, Clinique’s ‎vice president of skin physiology and pharmacology, told me when I visited New York last year to find out more about Fresh Pressed. And, according to Mammone, the vitamin C most of us are using in our routine tends to be a low-concentration derivative. “And that changes efficacy and performance dramatically.”

Why is Fresh Pressed different?

According to Clinique’s senior vice president of product development, Janet Pardo, the idea for Fresh Pressed was inspired by the farm-to-table movement. While other products start degrading the second they’re opened, Fresh Pressed isn’t activated until you decide to use it. The product itself is two-prong: there’s a granular cleanser that can be used once a day, and a Daily Booster serum that contains 10 per cent pure vitamin C. “The vitamin C is in a separate container, in the daily booster it’s in the lid and you press it and it activates it,” explains Mammone. “There are lots of other goodies in the serum – peptides, antioxidants. But we keep it separate and in a stable form, so once it’s activated it’s only fresh for a certain period of time.”

The results

Unsurprisingly I didn’t have to have my arm twisted to take part in Clinique’s Fresh Pressed Seven-Day Challenge – there’s a plethora of science behind the skin benefits of vitamin C, and unlike vitamin A it won’t irritate sensitive skin and is suitable for most skin types. “There are so many benefits. The first one you’re going to notice is clarification, tone and radiance in a really quick time frame,” explains Mammone. 

To start with the products are a joy to use. At first I was concerned that the powder cleanser formula might act as an exfoliant – not something you want to be doing every day – but as soon as it’s mixed with water it foams into a gentle lather. After using it my skin immediately felt softer and appeared smoother.

The most exciting part of Fresh Pressed however, comes in the form of the Daily Booster. Despite packaging technology advancing all the time, I’m always cautious about the stability of high-strength actives – it’s much easier to expose formulations to light and bacteria than you think, plus there’s shelf life to consider. The most ingenious feature of Fresh Pressed is that you get to decide when to activate the ingredients, and therefore you’re aware of how long they’re active for. And while the Daily Booster is supposed to last about seven days, I got ten days out of mine – there’s no wasted product which I love.

As far as results are concerned, they really are visible. Even though I use sunscreen religiously, coming out of summer I felt like I had my fair share of sun spots. My Fresh Pressed 7-day Challenge came at the right time; at the end of the test run my skin is clearer, I’m definitely using less foundation and the foundation I am using doesn’t have to work quite so hard. The quest for radiant, glowing skin seems to be one that most women are on, and while there are oodles of make-up products that promise a solution, you really can’t beat a natural glow that comes from within. When I come to the end of my Daily Booster my skin is noticeably more radiant – in fact, I received compliments and get asked what I’m using at the moment.

Clinique Fresh Pressed is available now. Clinique Fresh Pressed Renewing Powder Cleanser Pure Vitamin C ($70 for a 28-day supply); Clinique Fresh Pressed 7-Day System with Pure Vitamin C ($60 for one booster and seven cleanser sachets); Clinique Fresh Daily Booster with Pure Vitamin C 10% ($130 for four boosters).