SEP 2018

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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BEST PR ACTICES 16 SEPTEMBER 2018 | Med Esthetics © GETTY IMAGES FINDING PATIENTS WHERE THEY FIND YOU Aesthetic practices often spend their marketing dollars based on current trends or feelings about where they gain the greatest number of prospects. A better strategy is to review recent patients and determine how they heard about your practice. Then, spend your marketing dollars proportionately based on their answers, says Catherine Maley, founder of Cosmetic Image Marketing. She asked her clients, which include cosmetic surgery practices across the United States, to look at their schedules and determine how their last 40 surgical patients found their practice. They discovered that: • 25 percent came to the practice through Internet marketing • 30 percent were returning patients • 45 percent came through patient or physician referrals "These practices were surprised because they thought the Internet leads would have been greater," says Maley. "When you ask the new patient how they heard about you, they oftentimes say the internet but neglect to mention it was their friend, family or colleague who mentioned you fi rst and then they went to the internet to learn more about you." Physicians can speed clearance of unwanted tattoos by adding acoustic shock wave therapy to their picosecond laser and perfl uorodecalin (PFD) patch treatments, according to the results of a split-tattoo study published in Lasers in Surgery and Medicine (June 25, 2018). For the study, a 28-year-old female with Fitzpatrick Skin Type V and a 6-year-old professional black tattoo on her left wrist underwent three treatment sessions at six to eight week intervals with a 1,064nm picosecond Nd:YAG laser (PicoWay, Can- dela) and a PFD patch (Describe Patch, Merz). At each session, she received two passes with the laser (4mm spot size, 2.8 to 3.2J/cm 2 and laser repetition rate of 2Hz). Between laser passes and following the fi nal laser pass, the medial portion of the tattoo was treated with acoustic shock wave therapy (ASWT) using the Zwave device (Zimmer MedizinSystems) with settings of 90mJ, 22Hz and 1,200 pulses. After three treatment sessions, there was 80 percent clearance of the medial portion of the tattoo that received the ASWT compared with 60 percent clear- ance of the lateral portion treated with picosecond laser and PFD patch alone. In addition, the area treated with ASWT had less edema, erythema and epidermal crusting in the days following treatment. Patients with facial telangiectasia who receive topical brimonidine following IPL treatment experience less postprocedure erythema with no reduction in ef- fi cacy. Anne-Cathrine E. Vissing, Christine Dierickx, Katrine E. Karmisholt and Merete Haedersdal of Denmark performed a randomized, two-center, single-blinded, split-face trial on 19 patients with facial telangiectasia. The patients were treated with adju- vant brimonidine and air cooling on one side of the face and air cooling alone (control) on the other. The brimonidine was applied at the end of each of three IPL treatments, performed at three-week intervals. Blinded evaluators measured erythema and edema (using fi ve-point scales) and IPL effi cacy using photo evaluation. Red fi lter analysis provided objective erythema scores. The researchers found that IPL treatment induced moderate-to-severe erythema after each treatment. Application of brimonidine reduced post-treatment erythema to baseline values compared to air cool- ing alone, and the effects lasted for 24 hours after treatment. Application of brimonidine and air cooling reduced erythema 50 to 95 percent compared to a 9 to 28 percent reduction after air cooling alone. At one-month follow-up, patients had 75 to 100 percent clearance in telangiectasia on both sides of the face. Seventy-nine percent of patients preferred treatment with brimonidine. The study was published in Lasers in Surgery and Medicine (online June 17, 2018). TOPICAL BRIMONIDINE FOR POST-IPL ERYTHEMA Acoustic Shock Wave Therapy Enhances Laser Tattoo Outcomes

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