Pre‐/postprocedure measures for minimally invasive, nonenergy aesthetic treatments: A survey

Abstract

Background Non‐energy based devices used in aesthetic medicine include treatments such as microdermabrasion, microneedling, threads, and chemical peels. Practitioners may use these devices to address signs of facial photo‐ and chronological aging (fine lines, wrinkles, pigmentary, and skin textural changes). Currently, consensus papers or guidelines are lacking in peri‐procedural measures or their potential role in the prevention or treatment of adverse events in non‐energy based aesthetic procedures. Aims To explore current practices using non‐energy devices, a survey was developed to identify trends in peri‐procedure treatment measures. Patients/Methods The survey was sent electronically to 2000 dermatologists and 388 plastic surgeons. Randomly selected sites included those practicing medical aesthetics using non‐energy devices for facial rejuvenation. The survey gathered information related to practitioner demographics, types of devices used, and peri‐procedural measures for non‐energy device‐based treatments. Results The survey was active from February to May 2019. Nine hundred and twenty clinicians opened the survey, and 109 surveys were completed, providing a total response rate of 11.8%. The results revealed inconsistencies with regards to skin preparation strategies and post‐procedure care. While the majority of clinicians indicated a need for topical treatments to reduce inflammation, prevent scarring, and shorten time to healing, a standard of care was not observed. Conclusions The results of this survey confirm a lack of standardized measures for peri‐procedural care when using non‐energy based devices for aesthetic medicine treatments. These findings emphasize the need for evidence‐based recommendations for optimizing patient outcomes, reducing and managing adverse events, and shortening time to healing.

INDIVIDUAL ARTICLE: Algorithm for Nonenergy and Injectable Treatment Pre-/Post-Procedure Measures

“…[4][5][6][7][8][12][13][14][15][16][17][18][19][20][21][22][23] Two previously published surveys reported that no guidelines or algorithms are currently available concerning pre-and post-procedure measures and agents for nonenergy-based and injectable facial treatments and their use in preventing or treating post-procedural side effects or complications. 24,25 The current algorithm aims to provide clinicians with guidelines when treating patients with nonenergy-based and injectable treatments for facial rejuvenation to improve treatment outcomes.…”

“…The two previously published surveys showed that almost 95% of clinicians advised patients to avoid excessive sun exposure before, during, and after facial nonenergy-based and injectable treatments as sun exposure can contribute to postinflammatory pigment alterations or limit the effectiveness of the procedure. 24,25 To protect the face from sun exposure, broad-spectrum sunscreen with an SPF 30, or higher, is to be used and can be combined with protective measures such as wearing a wide-brimmed hat and sunglasses. 24,25 Before nonenergy-based and injectable treatments, the avoidance of alcohol, retinol peels, and agents such as acetylsalicylic acid and non-steroidal anti-inflammatory drugs (NSAIDs) amongst other agents is recommended (Table 1).…”

“…24,25 To protect the face from sun exposure, broad-spectrum sunscreen with an SPF 30, or higher, is to be used and can be combined with protective measures such as wearing a wide-brimmed hat and sunglasses. 24,25 Before nonenergy-based and injectable treatments, the avoidance of alcohol, retinol peels, and agents such as acetylsalicylic acid and non-steroidal anti-inflammatory drugs (NSAIDs) amongst other agents is recommended (Table 1). 24,25 Most clinicians who responded to a survey indicated not to use antiviral prophylaxis for nonenergy-based and injectable treatments.…”

“…a panel of dermatologists and plastic surgeons convened a virtual meeting to develop an algorithm on measures before and after facial nonenergy-based and injectable treatments. The panel members previously published two surveys 24,25 on before and after measures for nonenergy-based and injectable facial treatments to prevent or treat post-procedural side effects or complications.…”

“…26,27 Based on literature searches, including two surveys, the panel discussed the proposed design of the algorithm. 24,25 After presentations of the summaries of the literature searches and the proposed algorithm, the panel worked in small groups, advising their algorithm, editing, and revising it. They then reconvened into a plenary group to reach consensus through blinded reiterations and votes to determine the final algorithm.…”