What are the treatment options in aesthetic medicine?

Treatment Options in Aesthetic Medicine

The most effective treatment options in aesthetic medicine include autologous platelet concentrates (APCs), botulinum toxin injections, hyaluronic acid fillers, microneedling, chemical peels, and laser treatments, with APCs showing particular promise for natural rejuvenation with high patient satisfaction rates. 1

Autologous Platelet Concentrates (APCs)

APCs have emerged as promising natural treatment options in aesthetic medicine, offering regenerative properties through the release of growth factors that stimulate tissue repair and skin rejuvenation.

• Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are the main types of APCs used in facial aesthetics 1
• APCs promote collagen production, improve skin texture, and reduce the appearance of fine lines and wrinkles 1
• They can be administered via microneedling, intradermal injection, or as a volumizing agent 1
• Recent advancements include the development of "albumin gel" that can last 4-6 months while building collagen over time 1

Application Methods for APCs:

1. Microneedling with APCs

   • One of the simplest and safest ways to deliver APCs in facial aesthetics 1
   • Uses microneedles (typically 12) to create microchannels in the skin at depths of 0.25-2.5mm 1
   • Advantages include short healing times (24-48h), minimal risk of hyperpigmentation, and suitability for all skin types 1
   • Can be used on patients with thin, sensitive, or ethnic skin types where lasers and deep peels may not be appropriate 1

2. Intradermal Injection of APCs

   • Delivers APCs directly into the intradermal layer, forming a papule 1
   • Particularly effective for fine lines, wrinkles, UV damage, and acne scars 1
   • Uses small gauge needles (30G, 4mm length) with injections 5mm apart 1

Botulinum Toxin

Botulinum toxin (Botox) is one of the most established treatments in aesthetic medicine.

• Primarily used for treating hyperfunctional lines and wrinkles 2
• Particularly effective for glabellar lines, crow's feet, and forehead wrinkles 2
• Treatment should be approached with caution in patients with neuromuscular disorders, pre-existing swallowing or breathing difficulties 2
• Side effects may include localized pain, infection, inflammation, tenderness, swelling, erythema, and bruising 2

Hyaluronic Acid Fillers

Hyaluronic acid (HA) fillers are widely used for volumizing and addressing age-related volume loss.

• Products include Juvederm and Restylane for facial contouring and wrinkle reduction 1, 3
• Can be combined with APCs for enhanced results - an RCT showed that combining PRP and HA (50:50 mix) provided significant improvement in facial appearance and skin elasticity compared to either treatment alone 1
• Particularly effective for tear trough hollowing and perioral rejuvenation 1

Periorbital Treatments

The periorbital area is a common target for facial aesthetics as signs of aging often appear here first.

• Dark circles (periorbital hyperpigmentation or POH) and crow's feet are common concerns 1
• Treatment options include:
  • PRP/PRF injections - shown to improve skin thickness and periocular wrinkles 1
  • Chemical peels - may be more effective than PRP for POH specifically 1
  • Carboxytherapy - comparable to PRP but slightly more effective and better tolerated 1
• Studies show that both PRP and plasma gel are effective for periorbital rejuvenation, with plasma gel showing significantly better results 1

Other Aesthetic Treatments

• Chemical Peels: Effective for exfoliation and treating hyperpigmentation, particularly for periorbital hyperpigmentation 1, 4
• Laser Treatments: Can be combined with APCs for enhanced results in skin rejuvenation 1
• Microdermabrasion: Often combined with PRP for treating striae (stretch marks) with better results than either treatment alone 1
• Nanofat Grafting: Can be combined with APCs to enhance facial rejuvenation, with studies showing significant skin quality enhancement maintained at 12 months 1

Clinical Considerations and Pitfalls

• Patient Selection: Consider facial asymmetry, ptosis, dermatochalasis, and skin thickness when selecting treatments 2
• Combination Approaches: Often yield better results than single modalities - for example, PRP combined with microdermabrasion shows better and faster results for stretch marks than either treatment alone 1
• Treatment Intervals: Most APC treatments require multiple sessions with 4-6 week intervals between treatments 1
• Safety Concerns: Aesthetic procedures should only be performed by well-educated, well-trained medical doctors with excellent medical background, never by lay persons 4
• Realistic Expectations: While treatments like liquid PRF with microneedling can improve conditions like stretch marks, complete resolution may not be achieved 1

Emerging Trends

• The global noninvasive aesthetic treatment market is expanding rapidly, valued at $61.2 billion in 2022 with projected growth of 15.4% annually through 2030 1
• There is increasing demand for minimally invasive procedures that provide natural results without surgery or extended downtime 1
• APCs represent a shift toward more natural treatment options that are safer and produce more natural-looking results compared to synthetic alternatives 1
• Recent research is focusing on extending the working properties and longevity of APCs through techniques like cross-linking agents 1

Aesthetic medicine continues to evolve with new technologies and approaches, with a growing emphasis on evidence-based treatments that prioritize both safety and efficacy while providing natural-looking results.