Positive Energy

Energy-based devices have revolutionized cosmetic dermatology, and the already hot category is experiencing a growth spurt.

This market was valued at $5.1 billion in 2021 and is expected to reach $15.9 billion by 2030, according to Grand View Research. The main drivers of growth in this market are body contouring and skin-tightening devices.

Todd Schlesinger, MD, founder and medical director of the Dermatology & Laser Center of Charleston as well as the Clinical Research Center of the Carolinas sat down with Practical Dermatology® magazine to discuss his go-to devices and the growing role they play in his practice.

Favorite microneedling pen and why?

“My favorite pen is the SkinPen. I like it because it has good, surgical-quality needles that last a long time. The pen is ergonomic and battery-operated, and the design of the tips ensures no contamination from patient to patient. Their platelet-rich plasma (PRP) system uses a horizontal centrifuge design that allows for better PRP extraction from the tubes after spinning. SkinPen also has been studied to achieve the depth of penetration that it is set for, which not all devices can do.”

Is microneedling more effective with radiofrequency or topicals?

“Radiofrequency, properly applied, can enhance the effectiveness of microneedling by utilizing controlled thermal injury to stimulate collagen production and skin rejuvenation. There has been a lot of advancement in the devices and energy delivery patterns, which have improved outcomes and safety. Topicals are an enhancement and are designed to mainly be a glide although there is a lot of interest out there about the transcutaneous delivery of topicals and whether that improves their effect. Unfortunately, with transcutaneous delivery, some regulatory issues and safety issues arise as topicals that are not designed for implantation are being used.” (For more on this topic, click here.)

What is your go-to minimally invasive body contouring protocol?

“Our go-tos are EMSCULPT Neo combined with Coolsculpting. EMSCULPT Neo can treat a wider range of body types, but it is limited to those without implants or devices either near the treatment area or in the body. It is good to be at or close to a person’s ideal body weight for their height. We use these kinds of devices to treat problem areas/build muscle and reduce fat. Coolsculpting has come a long way with new software and applicators that allow safer, faster, and more effective treatments. It is still a treatment for those who have “pinchable” subcutaneous fat and a healthy body mass index.

Today, with the best devices, we are able to achieve highly noticeable results in body shaping, an improvement of how clothes fit, and reduction in body measurements. These changes produce a difference you can see and feel, which is our practice tagline.”

Are we approaching what could be achieved only with surgery?

“There is still a role for surgery in the removal of excess skin in those who have lost weight. Liposuction is an option for patients who desire a more permanent result or those who may have a larger volume of fat to be removed. I think combination treatment is where it is at. Many more patients do not want surgery than do, which is why we have seen such an explosion in the non-invasive body sculpting market. Even though some may need surgery, they do not want to interrupt their lives for it, so they chose other methods.”

What is your most requested device?

“EMSCULPT Neo for body sculpting, IPL for rejuvenation followed by RF microneedling, other lasers, and then ablative fractional resurfacing.”