From facial wrinkles and skin laxity to safer dermal filler injections, Dr. Mathew Avram talks future innovative aesthetic technologies.
In the ASDS 2020 plenary session on emerging therapies, Mathew Avram, MD, JD, brought four near-future technologies to the table: A “smart” needle for dermal fillers, a non-energy skin tightening device, a noninvasive cellulite treatment, and an injectable “slurry” for targeted fat removal.
Designed by Mass General Hospital (MGH), S3 Inject (Blossom Innovations; Waltham, Mass.) is an innovative injection technology intended to make dermal filler injections safer.
Dermal fillers are frequently injected into highly vascularized areas, including the periocular, perioral, and nasolabial fold, points out Dr. Avaram. And the danger lies in the subdermal architecture of arteries and veins, which can vary by individual.
“This is a technology that can differentiate between tissues, such as fat, blood vessels, and muscle, and you get immediate response with real-time user feedback with an LED light,” says Dr. Avram.
S3 Inject helps to prevent injecting dermal filler into blood vessels, which can result in serious adverse events including blindness
Data from human clinical trials show real-time response when the needle is passed into and through a blood vessel, and the sensing tip and onboard electronics provide immediate communication to the injector.
“As the needle tip passes through different biologic tissues and fluids, it senses changes in very specific electrical properties. So, this can provide reliability [and] precision without a change in injector technique or practice,” he says.
The sensing response does not distract the injector, says Dr. Avram. “This is a proprietary process that enables for manufacturing of any size needles or cannula so you can change these in many ways.”
The sensing technology is in the needle itself; 27- and 28-gauge needles will be available first, other sizes later.
“[The technology] doesn't make them a better injector though, so the skill still needs to be there,” notes Dr. Avram. “But it does make it, hopefully, safer.”
Dr. Avram notes that this technology is still in development and is not yet available.
Also the brainchild of dermatologists and plastic surgeons at MGH, this novel dermal micro-coring device (Cytrellis; Woburn, Mass.), currently in FDA pivotal trials, is designed to improve facial wrinkles and tighten skin.
“Numerous micro-sized full thickness cores of skin are simply excised,” says Dr. Avram. “Clinical results are with minimal downtime. There is no energy used. This is not a microneedling device, and there is no scarring.”
He likens the concept to a surgical lift, explaining that skin tightening is achieved by thousands of micro punch excisions with immediate closure. Because tissue extractions are less than 500 microns, there is no scarring.
“This is mechanical only. There is no use of energy, with an immediate physical hole closure, and wrinkle improvement,” he says.
By comparison, CO2 laser creates a zone of ablation surrounded by coagulation. Microneedling punctures the skin and radiofrequency or ultrasound provide nonablative tissue coagulation.
According to Dr. Avram, clinical results show improvement in wrinkles and skin laxity 90 days after the third treatment, although patients may experience redness and swelling, 75% of patients didn’t have to take time off of work, and the treatment is well tolerated, with the average pain reported as a 3.6 on a 0-to-10 scale.
“Early clinical data shows that this device is working and is effective for facial wrinkles and tightening. It is not FDA approved, but the FDA pivotal trial has now been submitted, so stay tuned,” says Dr. Avram.