ascher1Advances in body contouring, the dawn of personalized aesthetic medicine, and a host of new products and delivery systems took center stage at the 17th Annual International Master Course on Aging Skin (IMCAS).

More than 5,500 participants from 80 countries gathered at Le Palais des Congres de Paris in Porte Maillot, France, for the 4-day event. Enthusiasm was palpable and the mood was buoyant at IMCAS due to the exponential growth of the worldwide aesthetic market. The already robust $3B global facial aesthetics market will experience steady growth in terms of injectables and cosmeceuticals, and is expected to reach $5.5B in the next 5 years, according to the Millennium Research Group. North America continues to lead the pack, but Asia is the fastest-growing market in this category.

Body contouring—including nonsurgical body shaping; high-intensity, focused ultrasound; and Kythera’s ATX101 for the reduction of submental fat—is the most exciting growth sector. The global energy-based device market is now valued at $1.8B, and the male aesthetic market has the greatest potential, [sidebar float=”right” width=”350″]?“The noninvasive fat lipolysis/fat destruction market is ?growing exponentially. Our research shows that 51% of women are interested in this category of treatments.” —Syneron-Candela Chairman Shimon Eckhouse, PhD[/sidebar]

It Takes a Village

Millennium Research Group reports.

Syneron-Candela Chairman Shimon Eckhouse, PhD, agrees. “The noninvasive fat lipolysis/fat destruction market is growing exponentially. Our research shows that 51% of women are interested in this category of treatments,” he says.

Mergers and acquisitions are also taking this space by storm, says Jean-Yves Coste, senior director of the Switzerland-based Michael Dyens & Co. There has been a double-digit growth rate in terms of number of transactions and a compound annual growth rate of 68% (up from 24%). “The sector maintains its strength,” Coste says. “The United States is the most active market, followed by the European Union. Technology and science remain key catalysts,” he says. “Big pharma players are the clear winners. We are seeing an increase in the average size of acquirers,” he says.

Regenerative Medicine Boom

All major skin care players have cell regeneration and stem cells, Coste adds. Male skin care treatments and advanced Hyaluronic acid formulation with new purification levels, higher efficacy, potency, and safety are other growth drivers.

And there is still room for more growth, says Allergan Vice President Paul Navarre, who heads up the company’s operations in Europe, Africa, and the Middle East. He cited a recent survey that showed only 2.7% of patients are actually using BOTOX® Cosmetic or dermal fillers, and discussed how the industry can unlock this opportunity. A recent survey of 2,000 women in the UK that investigated what makes them reluctant to have treatments identified some key barriers to Botox use, including:

  • Fear of the process;
  • Fear of being judged by society; and
  • Concerns about the practitioner.

“The consumer needs to have a first good impression,” Navarre says. “She wants information, not just an appointment. We have seen that this is a slow process, and it can be 10 years until she sees the inside of a clinic.”

Middle East Master Classconfroom28

Kuwait dermatologist Sahar Ghannam, MD, chaired the launch of a new program devoted exclusively to treating Middle Eastern skin. “In the Middle East we do have deviated skin color, reacting intensely with the UV rays that are present 365 days per year. People have their own culture and habits, which differ from other parts in the world,” she says.

“The topics were all focused on the peculiarities of Middle Eastern skin and the difference between it and European and Asian skin—for instance, there is a difference in the demand of tissue augmentation and neuromodulator injections, and how to deal with various hyperpigmentation disorders,” she says. “We also explored the different indications of evidence-based dermatology and techniques to use them safely without complications,” Ghannam says.

For the first time, IMCAS focused on the importance of cosmeceuticals in aesthetic medicine and surgery with ?the “Cosmeceuticals Village.” Physicians in some European and Middle Eastern countries can’t dispense products in ?their clinic. To get around this regulation, many will have a separate facility or ?store, or they partner with a spa. Beauty salons, however, can sell anything they want.

“This field is growing tremendously,” says Munich dermatologist Tatjana Pavicic, MD. “For me, the most important role of the cosmeceuticals for the future is the complementary effect when combined with other cosmetic procedures. The combination with evidence-based dermatology in darker skin types is of special interest.”

Face Forward

There was much ado at IMCAS about how advances in personalized medicine are changing the way surgeons approach the aging face.

“I think that nowadays, the keyword in facial rejuvenation is ‘refinement’ in both concepts and techniques,” says Nelly Gauthier, MD, a Parisian cosmetic doctor. “We are taking rejuvenation to a higher level with a critical eye and the benefit of the hindsight from our past results.”

Comprehensive data from longitudinal studies on facial aging using 3D technology show us what has happened to the patient’s face with age. “We can tailor exactly the best strategic way to refresh the face without breaking the harmony and losing the natural charm of the individual,” she says. “Finally, we can target safely and more precisely the tissue(s) that need restoration in order to restore youthfulness to the face.”

Filler Frenzy

The Teosyal Pen was among the most innovative tools officially launched at IMCAS, says Dubai dermatologist Hassan Galadari, MD. “Having used the pen for the past year and a half, the device has become a mainstay in my own practice. In addition to the three speeds and drop mode, I believe that the most useful aspect of the Pen is the ability to inject ambidextrously,” he says.

“Those hard-to-reach areas become accessible. The pressure of flow, given its consistency throughout the injection process, makes the tool not just painless to use, but a painless experience for the patient.”
[sidebar float=”right” width=”250″]”?The Teosyal Pen was among the most innovative tools
officially launched at IMCAS.”—Hassan Galadari, MD[/sidebar]

Restoration Robotics ARTAS Hair Studio made its European debut at IMCAS, launching its interactive 3D patient consultation tool that uses patient photographs to allow the physician to create a simulated hair transplant model. A customized plan is then developed with the patient’s input, eliminating any surprises.

Below the Belt

Vulvovaginal procedures also generated some buzz at IMCAS. Laguna Beach, Calif, urogynecologist Red Allinsod, MD, introduced the upcoming launch of, which explores a new treatment using ThermiRF technology. “ThermiVa is the first and only temperature-controlled radio frequency system designed for women who want results without surgery,” he says. “ThermiVa treatments deliver controlled thermal energy to the external (labial) and/or internal (vaginal) areas. The procedure includes three treatments over a period of 3 months,” he says. US Food and Drug Administration (FDA) and CE Mark clearance are anticipated in spring of 2015.

Colombian plastic surgeon Alfredo Hoyos, MD, discussed “4D lipo” in ?men. “The key areas for men are the ?latissimus dorsi, pectorals, and arms,” Hoyos explains. “Men desire a V-shape to look athletic. Abs are the summit of what men want to achieve.” He also reinjects fat into the muscle to create more robust muscles.

Cold Wars

Cryolipolysis systems also took center stage at IMCAS 2015. There are more than 10 cryolipolysis systems now marketed in France alone, reports dermatologist Michael Naouri, MD, from Nogent-sur-Marne, France.

Zeltiq® Aesthetics is now FDA cleared to perform the CoolSculpting® procedure at lower temperatures. And its newest applicator, CoolSmooth PRO, treats nonpinchable fat bulges, says dermatologist Klaus Hoffman, MD, from Bochum, Germany.

Surgical Innovations

Olivier Gerbault, MD, a plastic surgeon in Vincennes and Paris, France, presented his Ultrasonic Rhinosculpture technique. He collaborated with medical equipment manufacturers to develop miniaturized instruments specifically designed for rhinoplasty that are driven by an ultrasonic motor (piezo-electric). These instruments perform very fast, precise micromovements back and forth to rasp, trim, or thin out the bones. The ultrasonic instruments are much less traumatic than conventional instruments because they cannot damage the delicate, soft tissues around the bones, which results in minimal ecchymosis after rhinoplasty. Patients can return to work after a week, he says.imcastribune2015

Milan, Italy-based plastic surgeon Daniel Cassuto, MD, discussed his method for performing a noninvasive lower blepharoplasty under local anesthesia. “I use an optic fiber to melt the fat, which leaves behind a few drops of oil. No aspiration is needed, which avoids trauma,” he says.

“The same wavelength (1470 nm) is similar to fractionated laser. I then disconnect the fiber and connect the scanner and treat the skin externally. The heat stimulates long-term tissue quality improvement so patients keep improving for 2 years after the procedure.” Cassuto also combines this technique with upper blepharoplasty and other procedures as needed.

Marketing Mojo

“In the United States, the use of the web, social media, advertising tools, etc, to improve success and patient-related services is very common,” Pavicic says. “In Europe, we are far behind; a lot of practices don’t even have a home page, social media and digital communication almost doesn’t matter, and there is no office manager in most clinics.”

There is a lot that European doctors need to learn, Pavicic says. “This is partly due to different regulations, but also due to the different attitude. I believe practice management is almost as important for the future of aesthetic practice as the further development of products, techniques, and devices,” she says.

All in all, “we are very proud of this 17th edition: we have had a record number of participants this year, and the feedback that we have received regarding the scientific sessions has been outstanding. Nevertheless, we still have numerous projects under way, and we hope that the best is yet to come,” says Paris plastic surgeon Benjamin Ascher, MD, IMCAS course director.

WendyLewis300dpi fmtWendy Lewis is president of Wendy Lewis & Co Ltd, Global Aesthetics Consultancy, ?, founder/editor in chief of, and a contributing editor to Plastic Surgery Practice. She can be reached at [email protected].
[sidebar float=”left” width=”450″]?For information about upcoming IMCAS programs, visit[/sidebar]