Transcript File - Bible based Medicine

Evidenced based Aesthetic
Primary Care Forum
3 Oct 2015
Aesthetic Medicine
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Aesthetic Medicine
Science and evidence of Aesthetic Medicine
Aesthetic Medicine in Singapore
The future of Aesthetic Medicine
Definition of Aesthetic Medicine
There is currently no internationally accepted definition of aesthetic
medicine
Definition of Aesthetic Medicine
• UK – “Operations and other procedures that revise or change the
appearance, color, texture, structure or position of badly features,
which most would consider otherwise to be within the broad range of
‘normal’ for that person”
• USA –”a subspecialty of medicine and surgery that restricts itself to
the enhancement of appearance through surgical and medical
techniques. It is specifically concerned with maintaining normal
appearance, restoring it, or enhancing it beyond the average level
toward some aesthetic ideal”
American Academy of Aesthetic Medicine
• First coined by Dr JJ Legrand, a French Endocrinologist in the early 70s
• A new medical discipline that involves multidisciplinary collaboration
to provide answer to the total aesthetic needs of the community
• Aesthetic medicine exalts the association between health and beauty
because beauty means to “feel good under one’s own skin and to
have a perfect psychophysical balance”
Growth of Aesthetic Medicine
• Prevailing culture to prolong youthfulness and self image
• Increase disposable income
• Technological and medical advances with minimal downtime and
complications
• Social acceptance, taboo no more
• Media driven demand and promotion
Aesthetic Medicine
Cosmetic Surgery
• Breast augmentation
• Rhinoplasty
• Blepharoplasty
• Liposuction
• Abdomnioplasty
Cosmetic Dermatology
• Topical Creams
• Chemical Peels
• Laser / Light Rejuvenation
• Botulinum Toxin injection
• Soft Tissue Fillers
• Laser / Light Hair removal
American Society of Aesthetic Plastic surgery
• 2014 US figures
• $12 billion on surgical and non surgical procedures / year
• 10 million cosmetics procedures/ year
• 91.4% women
• More men are turning to aesthetic procedures, surgical and non
surgical
Most Popular Procedures – Men & Women
Top 5 Surgical Procedures
• Liposuctions 342,494
• Breast Augmentation 286,694
• Eyelid surgery 165,714
• Tummy Tuck 164,021
• Nose surgery 145,909
Top 5 Non Surgical Procedures
• Botox 3,588,218
• Hyaluronic Acid 1,696,621
• Hair removal 828,480
• Chemical Peel 484,053
• Mircodermabrasion 417,034
Aesthetic Medicine
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2.
3.
4.
Aesthetic Medicine
Science and evidence of Aesthetic Medicine
Aesthetic Medicine in Singapore
The future of Aesthetic Medicine
Evidence based Aesthetics Medicine
• Many aesthetic treatments claim are supported by good scientific
evidence
• Skin treatments – Acne / scars, pigmentation, chemical peeling,
wrinkles
• Device based – Laser / IPL, face lifting / firming ( RF, HIFU ) ,
cryolipolysis
• Injectable – Toxin, fillers injection
Papers written
• Wrinkles and Retinoids
• Botox and Crow’s feet in combination with Glabellar lines
• Botox and forehead lines
Laser
• Dr Leon Goldman – “Father of lasers in Medicine in United States”
• Dr Rox Anderson – Theory of Selective photothermolysis
• 1963 Ruby Laser
• 1964 Photoexcision with Continous wave CO2
• 1983 Selective photothermolysis
• 1996 (Er); YAG
• 2004 Fractional photothermolysis
Aesthetic Medicine
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2.
3.
4.
Aesthetic Medicine
Science and evidence of Aesthetic Medicine
Aesthetic Medicine in Singapore
The future of Aesthetic Medicine
Practice of Aesthetic Medicine
• Consumer driven medicine
• Industry driven medicine
- Laser / device industry, cosmeceutical industry
-Minimize risk / side effects, exaggerating benefits
• Media driven medicine
-Media benefits as vehicle of advertising
• Current trending
-Increased interest among medical / dental
practitioners offering aesthetic procedures for which they were
were never trained during their medical training
SMC guidelines on Aesthetic practice for
doctors
• Aesthetic Practice Oversight Committee ( APOC)
SMC Classification of aesthetic procedures
Based on currently available scientific evidence, aesthetic treatments
and procedures are classified into
• List A
- Moderate to high level of evidence; and / or Local medical
expert consensus that procedure is well established and
acceptable
• List B
-Low or very low level of evidence; and / or Local medical expert
consensus that procedure is neither well established nor
acceptable
List A aesthetic practices
Non invasive
Minimally invasive
• Chemical peels
• Microdermabrasion
• Intense pulsed light
• RF, IR skin tightening procedures
• Photodynamic therapy
• External Lipolysis
(heat/ultrasound)
• Botox
• Filler injection
• Phlebectomy
• Sclerotherapy
• Threat lifts
• Lasers (vascular lesions, skin
pigmentation and skin
rejuvenation)
List B aesthetic practices
List B contains aesthetic treatments and procedures that re currently
regarded as having low / very low of evidence and / or being neither well
established nor acceptable.
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Mesotherapy
Carboxytherapy
Microneedling dermaroller
Skin whitening injections
Stem call activator protein for skin rejuvenation
Mechanized massage ( eg “endermologie” for cellulite treatment)
The future of Aesthetic Medicine
• Patient safety concern and diagnostic skills
• Maintaining professional standard and excellence with adequate
training
• Misrepresentation
- Dermatologist / Plastic surgeons
- Other specialist /GP
• Upholding credibility of doctors, avoid the lost of confidence and trust
in the medical profession