Medesthetics

SEP 2014

MedEsthetics magazines offers business education and in-depth coverage of the latest noninvasive cosmetic procedures for physicians and practice managers working in the medical aesthetics industry.

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42 SEPTEMBER 2014 | Med Esthetics permanent improvement—but do not plan to undergo facelift or liposuction—is cryopreservation of fat. This technique allows the physician to harvest fat once and preserve it for future injections, which are offered over the course of several months. Dr. Stern has found that offering a one-time "mini-lipo" harvesting procedure with cryopreservation is an attrac- tive option for patients interested in replacing dermal fi llers with fat transfer. "If you look at patients who have had fat transfer versus fi llers, the patients getting autologous fat injections look better," he says. "They're not just fi lled, the appearance of the skin is improved. It looks healthier, as if they're build- ing their own collagen." Though there is an initial fee for harvesting and storage costs, Dr. Stern points to a "break even" point—patients who get a couple of syringes of fi ller, twice a year over a two-year time period or more will save money with fat transfer. In his practice, liposuction patients pay a $250 processing fee to set aside 100mL to 200mL of fat for storage. The patient pays an additional fee of about $750 to companies, like American CryoStem—used by Dr. Stern—for processing and storage for six months. "After that, the additional cost of storage is about $200 per year," says Dr. Stern. In his practice, patients who come in for fat harvest- ing and storage only pay approximately $2,000 for the mini-lipo harvesting procedure—performed using a hand syringe—and the fi rst injection, which is performed on the day of the extraction. The next injection is scheduled for three to four months later. Additional injections can be scheduled, as needed, within a similar time frame. "Injection technique is very important," says Dr. Stern. "It's a slightly higher learning curve than a facial fi ller, because you want to layer the fat and not inject large amounts at once." AUTOLOGOUS FILLERS The slow progress of autologous injections is a key con- sideration in patient selection. Some patients are happy to take their time to achieve long-lasting and more natural results using their own biological materials. But others will become discouraged with the slower progress and need for multiple injections. This has been a key deterrent for another autologous fi ller that has struggled to fi nd its place in medical aesthet- ics. "LaViv is an autologous fi broblast injection, so it works best when it's injected into the dermis," says dermatolo- gist Mary Lupo, MD, of the Lupo Center for Aesthetic & General Dermatology. "As such, it's very different from HA fi llers and even Radiesse. People need to know that it's not so much for wrinkles and folds as it is for fi ne retexturizing of the skin. It's most useful for acne scars and probably for some sort of wound-healing technology down the road." The challenge for physicians, according to Dr. Lupo, is selling the procedure to patients. "It's prohibitively ex- pensive," she says. "When you look at what they're doing © STEVE DEBENPORT/GETTY IMAGES Autologous fi llers can be a hard sell as they require multiple injections with gradual improvement. AUTOLOGOUS MEDICINE

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