As we say goodbye to 2020and all its drama, there have been some exciting advancements in the aesthetics realm, that despite some pandemic related delays, have either very recently won FDA approval or are on the cusp of earning that distinction. Over the past several months, in between monitoring case counts and watching poll numbers, I’ve been tracking the status of hotly anticipated injectables and devices—from game-changing cellulite busters to the neurotoxin we’ve all been waiting for, here are bright spots on the beauty horizon.
A Neuromodulator that lasts 6 months
I have been closely following the evolution of this new version of Botox (or Dysport), called Daxi (aka DaxibotulinumtoxinA), for several years. I participated in the “industry leader” discussion groups along with many thought leaders in the world of aesthetic medicine to discuss the potential and future of this new neurotoxin, and let me tell you, it’s pretty awesome!
Daxi’s biggest selling point is its longevity. While all currently FDA-approved neurotoxins work for about three to four months, phase three studies of Daxi show clinical improvement for up to 28 weeks—that’s seven months! That could mean only twice-a-year visits to your injector. I particularly like this not only because of time and potentially cost savings, but also for the convenience of twice a year visit, as most dermal fillers’ maintenance injections are best done twice a year. Same goes with many laser and radiofrequency skin treatments and chemical peels. Moreover, potential toxin complications, like ptosis (an uncommon drooping of the lid or brow post-treatment), did not seem to last any longer than Botox or Dysport.
Daxi derives its power from a proprietary peptide, which acts as an endurance booster. Typically dosage is the primary determinant efficacy and durability, the higher the dose, the longer the duration. However, there’s a limit to how high we can dose without getting side effects, like ptosis or an unnatural, frozen appearance, so efficacy must be balanced with safety. The intriguing possibility with Daxi is that we might be able to achieve greater efficacy without increasing side effects.
Another potential Daxi advantage: it’s considered “cleaner” than its rivals, because it lacks human serum albumin, a foreign stabilizing agent. Due to the peptide, Daxi is the first injectable botulinum toxin type A to not require human- or animal-derived additives.
We are looking at a winter 2021 debut. While this toxin will be approved for frown lines, it’s also being studied for the treatment of forehead furrows and crow’s-feet. Most of us will use it off label like many other toxins, all over the face and body.
Restylane Volyme: a flexible volumizer for cheeks
I have loved and used Restylane family of products for many years, and the latest has me most excited! Just like the partner you desire in life, this product is strong, soft, and supportive. Volyme, is a forthcoming hyaluronic acid with specific crosslinking that makes it flexible enough to move freely and not look awkward or obvious when our cheeks rise and fall when smiling. This will be particularly great for older or thin folks, because most cheek fillers are meant to be placed bone deep, creating a severe or angular look in a volume depleted faces with thinner skin. Volyme can be layered in the more superficial subcutaneous tissue, enabling the skin and underlying tissues to move as they should and look natural, and blending well with the tissue. Better yet, product is purported to last up to 18 months, one of the longest lasting on the market!
RHA I: A precise filler for lip lines
RHA fillers have very recently been approved in the US with limited availability. They have longer HA chains with reversible, mobile bonds which give a soft look and feel and really perform well in highly mobile parts of the face, such as around the mouth and eyes.
RHA I is one of these products- it kicked off a bit later than those for its siblings, and will likely get approved in 2021, for the correction of fine lines around the mouth, which are notoriously tricky to treat. The perioral region is so dynamic; it can be challenging to get a natural result both at rest and in motion. Plus the shearing forces of our always-moving mouths tend to break down fillers rather quickly, creating yet another hurdle. RHA I overcomes both obstacles, remaining undetectable and having a reasonable longevity when injected into lip lines. In the FDA trial, 66% of subjects had significant improvement in lip lines at 52 weeks, when the study ended, with the majority having had touch-ups in the weeks following initial treatment. Since the gel doesn’t pull in much water, it gives predictable results without a lot of swelling—also making it an optimal filler for the under-eyes, an area where most other fillers can cause swelling.
Qwo: a first-of-its-kind shot for cellulite
This treatment is one of a kind and one of the most anticipated in industry for decades! After winning FDA approval in July for the treatment of moderate to severe cellulite in the buttocks, this first-ever cellulite injectable will be available nationwide this spring. The shot uses collagen-degrading enzymes to break the fibrous bands tethering skin to muscle; relieving their pull, allowing the overlying skin to smooth out. In recent months, the makers of the drug, Endo Aesthetics, have announced new findings, further boosting it’s appeal: Qwo not only erodes dimpling but also ramps up collagen synthesis, to thicken skin over time. Moreover, studies have shown improvements lasting up to four years following a series of treatments. While the current FDA indication is for buttocks treatment only, wonderful results are seen on the thighs as well. Who doesn’t want to get rid of what Covid isolation did to our bodies?
A smart needle for safer filler injections
By the end of 2021, we hope to have in hand the industry’s first smartneedle, S3Inject. With a proprietary guidance technology, the needle works by measuring the change in electrical properties as it passes through subcutaneous tissue, distinguishing blood vessels from other structures. It can then alert injectors when they’re inside a vessel, with the goal of heading off a vascular occlusion—a filler-clogged artery, which can lead to skin death, blindness, or stroke. As a physician with enormous respect for patient safety and “First do no harm rule” who performs daily filler injections in high risk vascular territories, despite extensive training and experience, this is perhaps what I look forward to the most this year… It will help me keep my patients healthy and safe!
Cytrellis microcoring: skin tightening sans scalpel
Here is a face lift without scars, downtime or anesthesia! Expected to get FDA clearance in early 2021, this device painlessly removes up to 8% of treated skin, drilling out tiny columns and allowing them to cinch closed, for a tighter, smoother surface. The device can treat the full face and neck and has the potential to improve select areas of sagging on the body as well. Skin is prepped with either prepped with topical numbing cream versus local lidocaine shots for this half-hour procedure, and recovery is fairly minimal. Patients are red for a day or so, with maybe some minor bleeding. Bear in mind that, unlike a facelift, the machine does not reposition muscles or address their connective-tissue covering, so microcoring results will be less dramatic than with surgery. Sign me up!
Renuva: a fat-building injectable
Liposuction has always been a prerequisite for fat transfer—but a new injectable is supposed to disrupt that paradigm come January. Renuva is made from donated human tissue that’s been screened, processed, and purified; it contains the same collagens, growth factors, and proteins as human fat. When injected, it acts as a scaffold, allowing the body to recruit fat cells to attach to it, and over the course of 12 to 16 weeks, the material is gradually replaced by your own fat. It can be injected anywhere fat lives naturally—including the cheeks, temples, chin, nasolabial folds, marionette lines, and backs of the hands. The technology offers the potential for predictable and durable volumizing results and expands the options for patients for many patients. Renuva will cost more than traditional fillers but expect its volumizing effects to last years longer!
Keep an eye out for these exciting launches, personally the one I am most anticipating is Daxi with it’s 6 month duration! I love following the latest the industry has to offer and as these roll out I will be particularly interested to see the science and papers behind each.
To learn more about what I do and some of the proven, scientifically based treatments we perform at V Boutique follow us on our social media profiles or visit us for a one-on-one consult.
Meet Dr. Vanden Bosch!
Dr. V - Neda Vanden Bosch is an highly-trained physician and sought after injector of dermal fillers and neurotoxins. With over 10 years of experience in aesthetic medicine, she is a faculty member of the prestigious Galderma Injection Training Network (GAIN) and trains physicians how to perform cosmetic procedures. Dr. V was recently named to Galderma's Top 100 Injectors. She has had extensive training and experience with collagen stimulators, laser and radiofrequency treatment, as well as skin care. Dr. V is licensed in 10 states. She is board certified by the American Board of Radiology. Dr. V has treated thousands of patients with injectables and has numerous of hours of experience perfecting specialized injection placement to correct facial volume loss and facial asymmetries. Preciseness with a woman's deft touch means the best and longest lasting results from volume replacement treatments. Dr. V was named a "Top Doctor" by online, aesthetic and cosmetic treatment community Realself.com. This recognition is awarded to less than 10% of doctors site wide. Most recently, she was named as one of the 2020 TOP Aesthetic doctors by Aesthetic Everything.