JUL-AUG 2019

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 14 JULY/AUGUST 2019 | Med Esthetics © GETTY IMAGES ANTIBIOTIC MESH MAY REDUCE RISK OF CAPSULAR CONTRACTURE A retrospective analysis of fi ve patients with capsular contracture (CC) who were treated with an antibiotic-impregnated absorbable mesh during implant replacement revealed no recurrence of CC two years after surgery. For "Evaluation of Antibiot- ic-Impregnated Mesh in Preventing the Recurrence of Capsular Contracture," published in the May issue of the Aesthetic Surgery Journal, Eric S. Ruff, MD, et al, analyzed the outcomes of patients who were treated with a TYRX absorbable minocycline and rifampin-eluting antibacterial envelope—cur- rently indicated for stabilization of cardiovascular implantable electronic devices (CIED), such as pacemakers or defi brillators—at the time of capsu- lectomy and implant replacement. A total of nine mammary augmentations utiliz- ing the TYRX mesh were performed on the fi ve patients. All patients underwent capsulectomy through an inframammary incision with implant replacement into the submuscular plane with simultaneous insertion of the mesh. The mesh, which was not stabilized to any surrounding tissue, was placed anterior to the implant, adjacent to the breast parenchyma. The surgeon followed a standard protocol for infection prevention. Patient follow-up was 29 months for two patients, 25 months for two pa- tients and 10 months for one patient (median, 25 months). At follow-up, there were no suture site infections and no recurrence of CC. One of the best ways to get your practice in front of your most likely prospective patients is to rank high in local online searches. At The Aesthetic Meeting in May, Peter Houtz of Plastic Surgery Studios, a practice marketing fi rm, shared strategies to help practices achieve high local rankings on Google. It starts by claiming and completing your "Google My Business" listing. This is a free product that allows you to fi ll out a form describing your business, and post photos, practice hours and contact information. From there, you want to strive for consistency in the following areas across all social media and web listings, following the acronym NAPWCHD: Name, Address, Phone: You must use exactly the same name, address and phone number wherever your practice is listed online, including your own website, social media pages and your Google My Business listing. Website: Maintain and regularly update your practice website, and make sure your website is included on all social media pages and online practice listing pages. Categories: On Google My Business, choose one primary category (e.g., plastic surgery, dermatology, medspa) and additional categories relating to the top proce- dures (e.g., Botox, laser hair removal) for which you would like to be known. Hours: Make sure your hours of operation listed on Google My Business are correct, including any special holiday hours. Description: Create a consistent practice description that includes your key categories on your website and across all online listings. BOOST YOUR LOCAL RANKING Effect of Energy-Based Devices on HA Filler A study using abdominoplasty skin samples revealed that the heat of fractional microneedle radiofrequency (RF) devices can cause thermal damage to hyaluronic acid (HA) fi llers. For "Histologic Effects of Fractional Laser and Radiofrequency Devices on Hyaluronic Acid Filler," published in the April issue of Dermatologic Surgery, Sarah Ham Hsu, MD, Hye Jin Chung, MD, MMS, and Robert Weiss, MD, divided abdominoplasty skin samples into eight zones. They injected HA fi ller intradermally into seven zones with one zone left untreated to act as control. Following injection, six of the zones were treated with a 1,540nm, 1,550nm, 1,927nm or 10,600nm fractional laser, or fractional bipolar RF delivered through insulated microneedles or fractional bipolar RF delivered through noninsulated microneedles. After treatment, biopsies were collected for Haemotoxylin and Eosin (H&E) staining. There were no morphologic changes to the fi ller following treatment with 1,540nm, 1,550nm, 1,927nm and 10,600nm lasers. However, the researchers did observe thermal changes from the 1,540nm and 1,550nm lasers in very close proximity to the fi ller. Both RF devices caused thermal damage of the fi ller along the microneedle tracks. The authors concluded that the deeper dermal penetration of the RF energy will cause damage to fi llers in the mid- to deep dermis, and advised caution in using these devices over recently injected HA fi llers.

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