Music City SCALE 2024

The 19th annual Music City SCALE (Symposium for Cosmetic Advances & Laser Education) was held May 15-19 in Nashville, Tennessee. Below are select highlights from presentations during the course of the conference, and video coverage can be seen at


Steven Dayan, MD, and Sabrina G. Fabi, MD, presented a keynote lecture, “Thriving in Diversity,” showcasing what they learned about different cultures’ aesthetic desires during recent travels to seven countries on five continents.

“The key is that we need to confront our own biases,” Dr. Dayan told Practical Dermatology®. “We may assume that an African-American patient needs their chin pushed forward, and that their lips shouldn’t be any bigger, but the reality is that they may want their lips bigger, and they may want their temples treated instead of their chin; that is what they were doing in Africa. In Asia, patients were asking to have their foreheads and eyes treated; that may not be the first place we would look in the US. Sometimes, we do not appreciate the different philosophies and different ways of looking at beauty.”

Hispanic women, Dr. Dayan and Dr. Fabi noted, tend to be bothered by sagging under the chin, the under-eye tear trough, and their lips. Asian women, they said, are generally less interested in lip filler and nasolabial fold filler. Middle Eastern women, they added, often prefer full temples, almond eyes, and arched brows. A unifying theme, they concluded, was that the desire to be beautiful dominates every culture.


Terrence Keaney, MD, FAAD, presented “New Indications: Neuromodulators for the Masseter and Platysma,” showing that botulinum toxin can be effective for nonsurgical treatment of masseter muscle prominence and platysmal bands.

The Phase 3 study for masseter muscle prominence is estimated to be completed in February 2026. With a dosage of 48 units, the primary endpoint is a composite 2-grade improvement from baseline by both investigator-rated Masseter Muscle Prominence Scale (MMPS) and subject-rated Masseter Muscle Prominence Scale – Participant (MMPS-P) at Day 90.


A potentially groundbreaking product was the focus when Steven Dayan, MD, presented “Efficacy of a Novel HA Dermal Filler for Nasolabial Fold Correction: Prospective, Controlled, Double Blind Pivotal Trial Results.”

Two investigative hyaluronic acid fillers—Evolysse Smooth and Evolysse Lift, from Evolus—use a new “cold” manufacturing process to preserve the HA molecule. The study Dr. Dayan presented was double-blind, prospective, and randomized, with an active control. It found the new fillers to be non-inferior to the control (NASHA 20mg/cc) with corresponding p-values of 0.03 and 0.02, respectively.

“Less seems to be more,” Dr. Dayan said, adding that the safety profile between the study devices and controls were similar.


James Q. Del Rosso, DO, presented “Atopic Dermatitis: The Latest and the Greatest Pearls.”

Dr. Del Rosso highlighted patient-centric selective dupilumab dosage reduction for controlled atopic dermatitis, noting a study that found disease severity scores did not significantly change over time during tapering periods from 2 weeks to 4 weeks and 6 to 8 weeks.

Another study indicated that IL-4Ra expression was undetectable regardless of the days between the last dose of dupilumab and the blook draw. Dr. Del Rosso said prolongation from Q2W to Q4W dosing should be considered in patients with well-controlled atopic dermatitis of long duration, though some patients cannot prolong beyond Q2W.

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