Aesthetic medicine

Aesthetic medicine is an extensively broad term for specialties that focus on altering cosmetic appearance through the treatment of conditions including scars, skin laxity, wrinkles, moles, liver spots, excess fat, cellulite, unwanted hair, skin discoloration, and spider veins. Traditionally, aesthetic medicine includes dermatology, oral and maxillofacial surgery, reconstructive surgery and plastic surgery.[1] Aesthetic medicine includes both surgical procedures (liposuction, facelifts, breast implants, Radio frequency ablation) and non-surgical procedures (radio frequency skin tightening, non surgical liposuction, chemical peel, high-intensity focused electromagnetic field, radio frequency fat removal), and practitioners may utilize a combination of both.[2] Although aesthetic medicine procedures are typically elective, they can significantly improve quality of life, psychological wellbeing and social engagement.[3]

Statistics

• Worldwide, there were 20 million aesthetic procedures performed from 2014-2015.[4] Cosmetic surgery is a major driver of medical tourism. In February 2018 the president of the British Association of Aesthetic Plastic Surgeons said operations were performed on people who were not appropriate for surgery, and that unscrupulous practitioners have endangered their health for profit and that the cost of rectification for more than 1000 patients a year fell on the British National Health Service.[5]
• Countries that performed the most aesthetic procedures in 2014 were[6]
  1. United States
  2. Brazil
  3. Japan
  4. South Korea
  5. Mexico
• In the US, there were more than 11 million aesthetic procedures performed from 2012-2013, and 83.5% of the procedures were nonsurgical.[7]
• In the UK, there were 50,000 cosmetic surgery procedures performed in 2013-2014.[8]
• Surgical aesthetic procedures account for 10% of the cosmetic procedures in the UK, and non surgical techniques constitute the remaining 90%.[9]
• In the US, the top 5 surgical aesthetic procedures were 1) Liposuction 2) Breast augmentation 3) Blepharoplasty 4) Abdominoplasty 5) Rhinoplasty[10]
• In the US, the top 5 nonsurgical aesthetic procedures were 1) Botulinum Toxin 2) Hyaluronic acid 3) Laser hair removal 4) Microdermabrasion 5) Photorejuvenation[10]
• In South Korea, there were more than 980,000 aesthetic procedures performed from 2014-2015.[11]
• In South Korea, the top 5 surgical aesthetic procedures were 1) Blepharoplasty 2) Rhinoplasty 3) Fat Grafting 4) Rhytidectomy 5) Hair Transplantation[12]

Indications

Aesthetic medicine specializes in altering cosmetic appearance. It has diverse applications for dermatological and surgical conditions. It includes indications related to minimizing signs of aging such as skin laxity, wrinkles, and liver spots. Aesthetic medicine also plays a role in the treatment of excess fat, cellulite and obesity. Laser based therapies can be indicated for the treatment of scars, unwanted hair, skin discoloration, and spider veins.[13]

It is important that overall health is assessed by a physician to ensure that the symptom being treated (for example, weight gain and excessive hair) is not a sign of an underlying medical condition (like hypothyroidism) that should be stabilized with medical therapies. It is also very important for the medical aesthetician to be inclusive in providing a team approach for minimally invasive facial aesthetic procedures.

Techniques and procedures

• Photorejuvenation
• Injections of Botulinum toxin (Botox)
• Injection of dermal fillers
• Cryolipolysis
• Chemical Peels
• Mesotherapy injection
• Cellulite treatment
• Nutrition
• Permanent makeup
• Hair transplantation
• Laser hair removal
• Laser Therapy for scars and stretch marks
• Nd:YAG laser for spider veins
• Contour threads
• Non-surgical liposuction
• Lipotomy
• Carboxytherapy
• Radio Frequency skin tightening
• laser tattoo removal
• facelifts
• Rhinoplasty
• Abdominoplasty
• Breast augmentation or reduction
• Brachioplasty
• Liposuction

Careers in aesthetic medicine

A career in aesthetic medicine can be approached from a number of professions. A multidisciplinary or team based approach is often necessary to adequately address an aesthetic need. To perform certain procedures, one must be a surgeon, medical doctor (Dermatologist/plastic surgeon/ENT surgeon/Oculoplastic surgeon) or maxillofacial surgeon /Cosmetic Dentist.[14] However, many of the procedures are routinely performed by trained Medical Aestheticians or facial aesthetic nurse-aestheticians nurses.[15] For example, Medical Aesthetician can perform progressive chemical peels. Medical Aesthetics requires specialized training and certification beyond a nurse license / aesthetic license. Counselors, psychologists or psychiatrists can help people determine if their reasons for pursuing aesthetic procedures are healthy and help to identify psychiatric disorders such as compulsive eating, anorexia, and body dysmorphic disorder. Reconstructive surgeons can help correct appearance after accidents, burns, surgery for cancer (such as breast reconstruction after mastectomy for cancer), or for congenital deformities like correction of cleft lip. Orthodontists work to improve alignment of teeth, often partially for aesthetic reasons, and oral and maxillofacial surgeons can perform cosmetic facial surgery & correct deformities of the mouth and jaw. Both orthodontists and maxillofacial surgeons can be assisted by dental technicians. American Aesthetic Association (AAA) provides aesthetic diploma courses such as cosmetic gynecology, hair transplant, etc. for physicians and surgeons to enhance their medical practice. Aesthetic Medicine is often a subset of other practices of medicine, for example a family physician who is board certified by the (AAFP) American Academy of Family Physicians, may also offer aesthetic medicine treatments. Often physicians such as these will join multi-specialty associations, like the AAAM (American Academy of Aesthetic Medicine), IAPAM (International Association for Physicians in Aesthetic Medicine) or ASLMS (American Society for Laser Medicine & Surgery) to further their education.

References

1. "What is Aesthetic Medicine?", American Academy of Anti-Aging Medicine
2. International Association for Physicians in Aesthetic Medicine, IAPAM.
3. Honigman, Roberta J.; Katharine A. Phillips, David J. Castle (2004-04-01). "A review of psychosocial outcomes for patients seeking cosmetic surgery". Plastic and Reconstructive Surgery. 113 (4): 1229–1237. doi:10.1097/01.prs.0000110214.88868.ca. ISSN 0032-1052. PMC 1762095. PMID 15083026.
4. Statistics on Cosmetic Procedures Worldwide (PDF) (Report). International Society of Aesthetic Plastic Surgery. 2014. Archived from the original (PDF) on 2015-01-31. Retrieved 2015-01-14.
5. "Botched foreign cosmetic surgery leaves thousands of Brit health tourists scarred for life and NHS with £30million bill". Mirror. 11 February 2018. Retrieved 13 February 2018.
6. Statistics on Cosmetic Procedures Worldwide (PDF) (Report). International Society of Aesthetic Plastic Surgery. 2015. Archived from the original (PDF) on 2017-02-01. Retrieved 2015-12-28.
7. Cosmetic Surgery National Data Bank Statistics (Report). The American Society for Aesthetic Plastic Surgery. 2013.
8. Britain sucks (Report). London, UK: The British Association of Aesthetic Plastic Surgeons. 2014. Archived from the original on 2014-12-27. Retrieved 2015-01-14.
9. Review of the Regulation of Cosmetic Interventions (PDF) (Report). UK Department of Health. 2013.
10. Cosmetic Surgery National Data Bank Statistics (Report). The American Society for Aesthetic Plastic Surgery. 2013.
11. "Best Korean Plastic Surgery". Best Korean Plastic Surgery - Guide to Information and Facts. December 27, 2015. Archived from the original on December 10, 2019. Retrieved December 27, 2015.
12. ISAPS (July 8, 2015). "ISAPS International Survey on Aesthetic/Cosmetic" (PDF). ISAPS. Archived from the original (PDF) on February 1, 2017. Retrieved December 27, 2015.
13. Medical Aesthetics Clinical Skin Protocols 2014
14. Kaplan J., Volk A. S., Ashley J. R., Izaddoost S., Reece E., Winocour S. (2019). "A Systematic Review of Resident Aesthetic Clinic Outcomes". Aesthetic Surgery Journal. 39 (9): NP387–NP395. doi:10.1093/asj/sjz020. PMID 30715241.CS1 maint: multiple names: authors list (link)
15. Holmberg C., Carlström E., Collier H. (2019). "Registered nurses' perspectives on medically safe practices and sound ethical standards in aesthetic nursing: an interview study". Journal of Clinical Nursing. 29 (5–6): 944–954. doi:10.1111/jocn.15158. PMID 31889344.CS1 maint: multiple names: authors list (link)