>> Facial plastic surgeons doing nonsurgical treatments to tighten the skin in the office.
Dr. Bloom, what's your solution?
>> So we have a couple different ways to, like, tighten skin in the lower face and neck.
I talk about basically radio frequency.
You can either go in, under, or through.
You can use transcutaneous radio frequency, on top of the skin.
You can actually use microneedles to push the energy through the skin and epidermis.
And then, finally, you can just go right underneath it.
So in some of the younger patients -- and what I call them is my tweener patients.
So these are patients, maybe some of the topic radio frequency treatments haven't really
worked for them.
They want something a little bit more, you know, improved in their lower face and neck,
but they're sure not ready for surgery.
Those tweener patients, kind of the late 40 year old to your early 50-, mid 50-year-old
patient, this percutaneous radio frequency techniques are totally great for that.
>> So percutaneous, making a tiny, little incision and slipping a probe in?
>> So incision is, that's a far stretch.
Actually, I tell them there's no scalpels, there's no sutures, and there's no surgery.
So I am making a needle poke opening.
It's about a 16-gauge needle, and I put 1 underneath the chin and 1 under each ear,
and I'm able to insert this catheter or probe to kind of lay down this radiofrequency energy.
>> And it's done in the office.
I'm assuming just local anesthetic?
>> Yeah, I use a local anesthetic, a tumescent solution.
It's done in the office.
The patients are completely awake.
Once you get the tumescent anesthesia in, they're, like, completely comfortable for
the entire procedure, and it takes about an hour and a half.
>> An hour and a half?
That's quite some time.
>> You know, you have to spend enough time to actually get the energy, the heat energy,
into the tissue to kind of cause neocollagenesis over time to tighten down the tissues.
>> Okay, you're a surgeon and you do face-lifts, so the question we're all going to ask is,
does it last?
Are the patients satisfied?
>> So patient satisfaction, absolutely.
I haven't had a patient who's seen nothing, which is, for me, that is one of the things
I look at when I'm evaluating new technologies is I want to make sure there's a difference
there.
And the patient satisfaction is high.
And in the patients who, you know, don't need a face-lift type of result because they're
this younger group, it does work well for them.
>> Thin skinned, thick skinned?
Which patients are better for it?
>> You know, if they have a little bit thicker skin, you can, you have to spend a little
bit more time to, you know, to heat up the, you know, the skin and the soft tissues underneath
in order to produce the same result.
The one thing we say is that time is not the end point of these cases.
We use a FLIR thermal camera, which is, you know, they use this in the Army.
It's a thermal camera, and you need to get the surface of the skin up to around or above
42 degrees, but we keep that temperature below 48 degrees so that we're not producing a burn.
You can see the skin, once it reaches 42 across the entire treatment area, then you know you
can move on to the next section.
>> So you break it up into 3 different sections.
Each section takes you about 30 minutes to do?
>> Yeah.
Well, I actually treat the lateral neck.
I will treat the jowl area on each side, lateral neck on each side, and then the submental
area.
>> Nerve damage?
Any risk for that?
>> There certainly is a risk.
I've never seen a permanent nerve paresis.
There is a small risk when you're treating the jowl area.
It's important that you stay immediately subcutaneous at that point.
This is all preplatysmal that we're, you know, just in the same kind of dissection plane
that you would use for neck liposuction.
So you're above the muscle, but if you start diving deeply into the jowl, then you can,
there's a risk for nerve paresis.
>> Is there downtime with this procedure?
>> The great thing is there is way less downtime than like an ablative laser or something like
that.
I tell patients, if you have this done on a Wednesday or Thursday in my office, you
may have a little bit of bruising in the neck, but usually those patients are back to work
by Monday.
>> And the demand for this procedure?
>> It's becoming increasingly popular.
And the interesting thing is the idea of injectable radio frequency or percutaneous radio frequency,
that resonates with a lot of patients because, listen, we're using neuromodulators to, you
know, through an injection to, you know, weaken the muscles of their face.
We're giving them fillers with an injection.
And I tell them, now, we can tighten the soft tissues in your neck with an injection.
>> It's clearly the holy grail is to be able to tighten the skin non-surgically.
Patients are demanding it and wanting it, and we've been falling short a little bit
in the neck area.
And now, you're saying you may have a solution for treating the neck.
>> Yeah.
I mean, I have been blown away by these kind of treatments, which I certainly have never
thought 5 years ago that this was possible.
I can, I tell patients I can reliably get you a 30 to 40% improvement in the lower face
and neck tightening with 1 of these procedures.
>> All right.
The question I have for you, and I think we all want to know, is, is surgery going to
become obsolete one day?
>> I definitely don't think surgery will ever be obsolete.
You know, I, like you said, I'm a facial plastic surgeon.
I'm still doing face and neck lifts.
You know, the key to face-lift surgery and neck surgery I believe is release and then
resuspension.
So we're not releasing any of the tissues.
So this is kind of like a Band-Aid.
So what I do for my patients is, you know, I tell them, you're coming to me for this
treatment when you're in your late 40s to early 50s.
But in 10 years from now, you might need a face-lift surgery.
So what I do is I can even offer them some of the discounts of the money that they put
towards this device to come see me later in 10 years when they need their face-lift.
>> Yeah.
Certainly, some of those practice management issues that are helpful here with these devices.
>> Sure.
>> So the future of aesthetic medicine is certainly going nonsurgical.
There's a much great growth in the nonsurgical component.
As a facial plastic surgeon, it's imperative that we understand these nonsurgical treatments.
And Dr. Jason Bloom, you are pioneering nonsurgical treatments for all of us in facial plastic,
so thank you so much for spending time with us today.
>> Steve, thank you for having me.