Aesthetic medicine

Aesthetic medicine is a broad term for specialties that focus on altering cosmetic appearance through the treatment of conditions including scars, skin laxity, wrinkles, moles, liver spots, excess fat, cellulite, unwanted hair, skin discoloration and spider veins. ^[1] Traditionally, it includes dermatology, oral and maxillofacial surgery, reconstructive surgery and plastic surgery,^[2] surgical procedures (liposuction, facelifts, breast implants, Radio frequency ablation), non-surgical procedures (radio frequency skin tightening, non surgical liposuction, chemical peel, high-intensity focused electromagnetic field, radio frequency fat removal), and a combination of both.^[3] Aesthetic medicine procedures are usually elective.^[4]

Statistics

• Worldwide, there were 20 million aesthetic procedures performed from 2014-2015.^[5] Cosmetic surgery is a major driver of medical tourism. In February 2018 the president of the British Association of Aesthetic Plastic Surgeons said operations were performed on people who were not appropriate for surgery, and that unscrupulous practitioners have endangered their health for profit and that the cost of rectification for more than 1000 patients a year fell on the British National Health Service.^[6]
• Countries that performed the most aesthetic procedures in 2014 were^[7]
  1. United States
  2. Brazil
  3. Japan
  4. South Korea
  5. Mexico
• In the US, there were more than 11 million aesthetic procedures performed from 2012-2013, and 83.5% of the procedures were nonsurgical.^[8]
• In the UK, there were 50,000 cosmetic surgery procedures performed in 2013-2014.^[9]
• Surgical aesthetic procedures account for 10% of the cosmetic procedures in the UK, and non surgical techniques constitute the remaining 90%.^[10]
• In the US, the top 5 surgical aesthetic procedures were 1) Liposuction 2) Breast augmentation 3) Blepharoplasty 4) Abdominoplasty 5) Rhinoplasty^[11]
• In the US, the top 5 nonsurgical aesthetic procedures were 1) Botulinum Toxin 2) Hyaluronic acid 3) Laser hair removal 4) Microdermabrasion 5) Photorejuvenation^[11]
• In South Korea, there were more than 980,000 aesthetic procedures performed from 2014-2015.^[12]
• In South Korea, the top 5 surgical aesthetic procedures were 1) Blepharoplasty 2) Rhinoplasty 3) Fat Grafting 4) Rhytidectomy 5) Hair Transplantation^[13]

Indications

Aesthetic medicine specializes in altering cosmetic appearance. It has diverse applications for dermatological and surgical conditions. It includes indications related to minimizing signs of aging such as skin laxity, wrinkles, and liver spots. Aesthetic medicine also plays a role in the treatment of excess fat, cellulite and obesity. Laser based therapies can be indicated for the treatment of scars, unwanted hair, skin discoloration, and spider veins.^[14]

Overall health is assessed by a physician to ensure that the symptom being treated (for example, weight gain and excessive hair) is not a sign of an underlying medical condition (like hypothyroidism) that should be stabilized with medical therapies. It is also very important for the medical aesthetician to be inclusive in providing a team approach for minimally invasive facial aesthetic procedures.

Techniques and procedures

Careers in aesthetic medicine

A career in aesthetic medicine can be approached from a number of professions. A multidisciplinary or team based approach is often necessary to adequately address an aesthetic need. To perform certain procedures, one must be a surgeon, medical doctor (Dermatologist/plastic surgeon/ENT surgeon/Oculoplastic surgeon) or maxillofacial surgeon /Cosmetic Dentist.^[15] However, many of the procedures are routinely performed by trained Medical Aestheticians or facial aesthetic nurse-aestheticians nurses.^[16] For example, Medical Aesthetician can perform progressive chemical peels. Medical Aesthetics requires specialized training and certification beyond a nurse license / aesthetic license. Counselors, psychologists or psychiatrists can help people determine if their reasons for pursuing aesthetic procedures are healthy and help to identify psychiatric disorders such as compulsive eating, anorexia, and body dysmorphic disorder. Reconstructive surgeons can help correct appearance after accidents, burns, surgery for cancer (such as breast reconstruction after mastectomy for cancer), or for congenital deformities like correction of cleft lip. Orthodontists work to improve alignment of teeth, often partially for aesthetic reasons, and oral and maxillofacial surgeons can perform cosmetic facial surgery & correct deformities of the mouth and jaw. Both orthodontists and maxillofacial surgeons can be assisted by dental technicians.

References