The Future of the Body Contouring Market

Let’s face it, North America, particularly the U.S., is getting fatter. With rising obesity rates comes an increased demand in the body contouring market. Patients are seeking at latest ways to get their body in shape, and doctors are increasingly adapting to advancements in body contouring technology.

A recent article from BusinessWire.com predicts how the introduction of new devices, as well as the recession, will have an effect on the body contouring market over the next few years. There have been numerous devices approved since 2008 in the way of laser-assisted liposuction(LAL) and cryolipolysis that have recently become more available to consumers.

Despite the rising frequency of body contouring devices, the price of treatment may deter patients during the recession. Doctors have to earn back their investment on said devices, which cost upwards of $100,000, and do so through the cost of the treatment to patients. The cosmetic surgery industry is currently facing many obstacles; however, as patients postpone or even forego these elective procedures in order to conserve funds.

Despite the decline in device sales from 2008 to 2009, Millennium Research Group predicts an economic revival of the body contouring market to be reported for 2010.

SmartLipo MPX, the first dual-wavelength LAL device available in the market, was launched in Canada and the U.S. in 2008. Other big launches to take place in 2009 included CoolLipo by CoolTouch, SlimLipo by Palomar Medical Technologies, Syneron’s LipoLite, Sciton’s ProLipo PLUS and SmoothLipo by Elem Medical.

The first transdermal ultrasound device to be available in Canada was UltraShape’s Contour 1. In 2009, Medicis’ LipoSonix, which has had difficulty getting FDA approval, received Health Canada approval. To date, there are no transdermal ultrasound devices available in the U.S. In the way of cryolipolysis, Coolsculpting by Zeltiq has been available for off-label fat removal since last summer.

Even with the threats of the recession affecting the body contouring market, the obesity problem in North America guarantees a growing number of prospective patients available.  Furthermore, as body contouring technology advances there will be a growing consumer demand and market growth.

Cosmetic Surgery is No Cure for Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) has been getting a lot of attention in the media recently.  The condition, which drives people to constantly alter their appearance in a desire to be perfect, is oftentimes linked to plastic surgery. But do BDD sufferers actually benefit emotionally by undergoing plastic surgery? A new study’s says ‘no’. Despite these findings, there are surgeons who still provide requested surgeries to BDD sufferers.

The study, which was recently published in the Annals of Plastic Surgery, was spearheaded by Katharine A. Phillips, MD, is the director of the body image program at Rhode Island Hospital. Phillips defines BDD as “a psychiatric disorder characterized by preoccupation with an imagined or slight defect in appearance which causes clinically significant distress or functional impairment. A majority of these individuals believe they have an actual deformity that can be corrected by cosmetic treatments to fix these perceived defects rather than seeking psychiatric intervention."

Phillips co-authored the study with Canice Crerand, PhD, of the Children’s Hospital of Philadelphia. The researchers reported that previous studies showed BDD to be relatively common among individuals who underwent plastic surgery, accounting for roughly 7-8% American plastic surgery patients. The duo retrospectively studied 200 individuals with BDD. Of the group, 31% sought and 21% received surgical or minimally invasive treatments to remedy their BDD symptoms.

The study found that almost all of the individuals still experienced BDD symptoms, while some even developed new appearance fixations. The researchers also surveyed 265 cosmetic surgeons, of which 65% reported treating patients with BDD symptoms. Only one percent of the reported cases that were treated resulted in symptom improvement.

The most common surgical procedures among the patients were rhinoplasty and breast augmentation, while the most popular non-invasive treatments were dermal fillers and microdermabrasion. Three-quarters of all the desired procedures involved the face, and more than a third of the patients studied underwent numerous different treatments.

In the long-term, only 25% of patients with BDD showed a more positive appraisal of their treated body parts. Not only that, only two percent of treated patients saw a lasting improvement of their overall BDD symptoms.   

Of the patients who sough treatment, 20% did not receive a procedure. Surprisingly, patients with BDD were turned down more often due inability to pay for a procedure than they were for their symptoms. Thirty percent of patients could not undergo their procedure due to financing, while 26% were refused treatment by a doctor. The researchers also found that surgeons were significantly less likely to refuse a cosmetic treatment than other procedures, such as dermatological, dental or otherwise.

"This suggests that many surgeons were not aware of the patient's BDD or do not consider BDD a contraindication to treatment,” says Phillips.  “In a survey of 265 cosmetic surgeons, only 30 percent believed that BDD was always a contraindication to surgery."

While some cases of body dysmorphic disorder are easy to recognize, other cases are not so clear-cut. This study is an indicator that there should be more training and sensitivity in the aesthetic plastic surgery industry to the symptoms of BDD.  While most patients have a healthy desire to simply enhance their features, the crippling symptoms of BDD could be the motive for patients to undergo cosmetic surgery.

2009 International Aesthetic Trends Now Available

For the first time ever, accurate aesthetic plastic surgery statistics are available to the public. The International Society of Aesthetic Plastic Surgery (ISAPS) issued the "ISAPS Biennial Global Survey™" to surgeons in order to gauge aesthetic trends in the top 25 countries and regions for plastic surgery. The Survey represented 75% of all procedures performed in 2009.

Although the ISAPS Biennial Global Survey™ confirmed that the United States remains the country with the most procedures performed annually, there are some countries that are emerging as major centers that may be surprising. Making the top ten list are a few other countries that are not always associated with plastic surgery:
1.    United States
2.    China
3.    Brazil
4.    India
5.    Mexico
6.    Japan
7.    South Korea
8.    Germany
9.    Turkey
10.    Spain

The Survey also revealed that, contrary to popular belief, breast augmentation is not the most popular invasive procedure performed internationally. The top 5 invasive aesthetic procedures are as follows:
1.    Liposuction-18.8%
2.    Breast Augmentation-17%
3.    Blepharoplasty-13.5%
4.    Rhinoplasty-9.4%
5.    Abdominoplasty or Tummy Tuck-7.3%

As for as non-surgical procedures go, neuromodulators like Botox® top the list in popularity. Not only that, the overall number of non-surgical cosmetic treatments performed surpassed the number of surgical procedures. The top 5 non-invasive aesthetic treatments for 2009 were:
1.    Neuromodulators such as Botox® and Dysport®-32.7%
2.    Hyaluronic acid injections such as Juvederm and Radiesse-20.1%
3.    Laser hair removal-13.1%
4.    Fat grafting-5.9%
5.    IPL treatments-4.4%

Amongst other things, the Survey established that there are approximately 30,817 board certified (or national equivalent) plastic surgeons currently practicing. The number of surgical procedures performed globally in 2009 was 8,536,379, while the number of non-invasive treatments was 8,759,187.

The ISAPS Biennial Global Survey™ was created and proctored by Industry Insights, Inc., an independent research firm from Columbus, OH.  Scott Hackworth, a CPA who, along with the firm, has 15 years of experience in researching trends in aesthetic plastic surgery, led the Survey. The two-page, English-based questionnaire was administered to different international plastic surgery societies and focused on the aesthetic procedures performed in 2009.

Study: Less Frequent Botox Injections Achieve Same Results

A study recently found that patients require less frequent Botox® injections after two years of treatment to maintain the same wrinkle-reducing effect.

“After two years of treatment at recommended intervals, patients can potentially cut the frequency, and thus, the cost of their Botox® treatments by half,” says Roger A. Daily, leader of the study and professor of oculofacial plastic surgery at the Oregon Health & Science University (OHSU). The research also showed that Botox® injections are capable of preventing wrinkles in patients who begin treatment during their 30s.

During the study, 50 females aged 30 to 50-years-old were analyzed over two years while they underwent regular Botox® injections. Dailey and his colleagues found that, after undergoing injections every four months for two years, patients can slow the frequency to once every six months and still see desired results.

Physicians previously advised patients—based on earlier research—that they should undergo Botox® injections every three months to see maximum wrinkle-smoothing benefits. According to Dailey, the cost and frequency of Botox® deterred some patients from starting or even continuing their treatment.

Botox® was approved by the FDA for cosmetic purposed eight years ago. In 2009 alone, more than 2.5 million Americans underwent the popular injection (source: ASPAS). Botox® in Delaware should be injected by, or under the supervision of, a board certified plastic surgeon.

Japan Makes Sizable Advances in the Use of Stem Cells During Fat Grafting

Fat grafting is an alternative used during soft tissue augmentation that has grown in popularity over the past few years. Although this technique has been around for over a decade, recent international advancements and the use of stem cells have dramatically increased the presence of fat grafting in the plastic surgery industry.

Fat grafting is beneficial in that it only leaves incisional scars and often has less complication then injecting dermal fillers and other foreign substances into the body. Although doctors around the world have been working hard to improve the final result of fat grafting, physicians in Japan have recently made the most important headway

Kotaro Yoshimura, M.D., associate professor of plastic surgery at the University of Tokyo, is leading the investigation into the use of stem cells of aesthetic applications. The doctor and his team recently developed a strategy called cell-assisted lipotransfer (CAL) to overcome some common issues with traditional fat grafting such as unpredictable results and low fat cell survival rates due to necrosis.

How CAL Works:
Stem cells found within adipose (fat) tissue are combined with traditionally lipoinjection. The fat removed after liposuction is split in half and stem cells from one half of the fat are removed and added to the other part of the fat. This process creates stem cell-enriched fat. Dr. Yoshimura and his colleagues found that after grafting fat, some of the cells die off and are replaced by new fat generated by the stem cells. The amount of stem cells contained in the graft is crucial in determining the final results following lipoinjection.

Dr. Yoshimura has tested the CAL process on more than 450 breast augmentation and restoration patients since 2003. The results demonstrated CAL as a safe and effective alternative for soft tissue augmentation.

How Stem Cells Are Isolated:
There are three basic steps executed during CAL: fat and stem cells are extracted from a donor site, the soft tissue is purified, and then the tissue is injected elsewhere into the body. The most difficult step in the process is isolating the stem cells from the rest of the fat cells. This can be done manually using a cell-processing room or automatically using Tissue Genesis technology.

According to Dr. Yoshimura, using stem cell-enriched fat during grafting may boost the safety and effectiveness of the traditional methods. The fat stem cells may even have a therapeutic effect, similar to bone marrow-derived stem cells, which can aid in the healing process following lipoinjection.

These advances in stem cell technology are certainly promising, however, Dr. Yoshimura stresses that the long term safety and efficacy of CAL still needs to be studied. Patients with a low BMI may also be poor candidates for fat grafting as issues may arise in harvesting enough fat and stem cells to make the procedure successful.

C-Tucks: Unsafe For Regaining a Post-Baby Body

While celebrities like Jessica Alba and Gisele Bundchen may be able to bounce back to their pre-baby bodies quite easily, not all women can slim down with ease just weeks after childbirth. Skinny celeb mommas—who have the luxury of hiring personal trainers, chefs, and nutritionists—have sparked rumors about a controversial new cosmetic procedure: the ‘C-Tuck’.

The C-Tuck is a cesarean section for childbirth, immediately followed by a tummy tuck (abdominoplasty).  If the idea of having a little nip and tuck during childbirth sounds too good to be true, it probably is. It is hard to find a doctor offering the procedure, however, this is not a surprise as the C-Tuck is considered to be relatively unsafe. While OB/GYNs or other unlicensed individuals may be performing C-Tuck’s under the radar, you won’t catch a board-certified plastic surgeon cashing in this trend.

The average abdominoplasty can take up to five hours, which would require an unsafe amount of anesthesia for both the mother and child. Combining an abdominoplasty with a cesarean section could be potentially deadly for both parties.  In addition, a woman’s hormone levels are spiked during childbirth and therefore the skin and soft tissue of the abdomen may not heal the same with a C-Tuck as it would with a standard tummy tuck.

C-Tucks can also run a high risk of infection as there are numerous cavities exposed to a combination of fluids during a cesarean section. By adding another in another procedure, there is more tissue exposed to pathogens. Combining a hysterectomy with a tummy tuck is a more controlled procedure that is more commonly practiced.

If you are a mom who is considering a tummy tuck, I recommend waiting at least nine months after childbirth before undergoing the procedure. Patients will see optimum results if they allow their body to heal and the abdominal skin to shrink as much as possible.  Also, you should not undergo an abdominoplasty unless you do not plan on having any more children. Giving birth after a tummy tuck can reverse the results of the procedure completely.

While C-Tucks would certainly make life easier on moms, they are neither realistic nor safe. Tummy tucks in Delaware should only be performed by a board-certified plastic surgeon, not an OB/GYN or otherwise.