s MODERN AESTHETICS® NEWS + TRENDS

SPECIAL REPORT ACTRESS DREW BARRYMORE GETS REAL WITH MODERN AESTHETICS® Emsculpt’s first celebrity ambassador shares her experience. BY DENISE MANN, MS

rew Barrymore is the first ever celebrity ambassador for BTL’s Emsculpt, a non-invasive high- intensity focused electromag- netic technology that induces Dsupramaximal muscle contractions to tone the core, buttocks, thighs, arms, and calves. She took some time to discuss her reasons for undergoing the procedure to tighten her core and shared how Emsculpt has changed her life and lifestyle for the better.

MODERN AESTHETICS: WHAT MADE YOU DECIDE TO TRY EMSCULPT? Drew Barrymore: I wanted to try Emsculpt because I was tired of get- ting injured from working out, which and I have certain genetics. I don’t affected what I wear. I always try to is something that is really important feel like battling them my entire life dress in a way that suits my body. I’d to me, not because I want to look a to be thin. I love food. I love exercise rather wear a pair of sweatpants with certain way, but because I want to because it helps me equally mentally a vintage T-shirt and a kimono and feel a certain way. as it does physically—sometimes make it look chic with accessories for My core was not available to me so maybe more. For me, it is about never a drapey bohemian vibe than wear I needed to find a way to work out being able to work out this consis- [something] because it is fancier, better and smarter. Between physi- tently without injury in my entire life. cooler, or more fashionable. cal therapy and pilates to develop It’s not invasive. It’s not surgery. It’s We are all built differently and all my pelvic floor and Emsculpt to not vanity. It’s a way for me to be stron- have different genetics. Growing up strengthen my mid-section, I now ger and better. You can feel it and you in Hollywood I learned to sort of have a foundation that is better and can see it, and something that is results- embrace what I am and what I was stronger than it was before kids. oriented brings people back for more. rather than feeling bad that I wasn’t something or someone else. There are MODERN AESTHETICS: HAVE YOU BEEN MODERN AESTHETICS: HOW HAS IT plenty of industries that can tend to TEMPTED BY OTHER BODY CONTOURING CHANGED YOUR LIFE AND LIFESTYLE? make you feel like you are supposed to TREATMENTS? Ms. Barrymore: I have been able to be something you are not and that’s Ms. Barrymore: Nope, not even a work out consistently without injury, the perfect recipe for a toxic lifestyle. little, because so many are about the making my whole core stronger. Even I have plenty of other problems aesthetics and that is not my personal before kids, I was not in tune with and I am not putting that one on my motivation. I have a certain body type my core. Having treatment hasn’t plate electively.

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MODERN AESTHETICS: DOES EMSCULPT doing it, which is strengthening and I go into meditative state. I do a face HURT? tightening in tandem, so I am really sheet mask and just really tune every- Ms. Barrymore: I do a lot of my leaning into it and embracing it and thing out for a full integrative holistic pelvic floor breathing when I am giving it my all. experience. And no, it doesn’t hurt.

ALLERGAN WITHDRAWS TEXTURED This global recall does not affect positive changes in society’s percep- BREAST IMPLANTS DUE TO SAFETY Allergan’s Natrelle smooth or tion of their persona,” he says. CONCERNS Microcell breast implants and tissue In recent years, men in America Just days after surgeons from the expanders. have changed their social attitudes British Association of Aesthetic Plastic about “appearance maintenance” Surgeons (BAAPS) and elsewhere from one bordering on narcissism called for warnings on silicone-filled FACIAL PLASTIC SURGERY IN to somewhere on a continuum of breast implants due to risk of “breast MEN ENHANCES PERCEPTION OF well-being, Dr. Reilly adds. Men are implant illness,” Allergan announced ATTRACTIVENESS, TRUSTWORTHINESS now 15-20 percent of the cosmetic a voluntary worldwide recall of Biocell When a man has facial plastic sur- surgery market, but many preferred textured breast implants and tissue gery, others see him as more attrac- male facial features are the opposite expanders due to concerns of another tive, likable, socially skilled, and trust- of what is prized on a female face. For health issue—breast implant-associ- worthy, new research shows. example, it is believed that attrac- ated anaplastic large cell lymphoma The study, published in JAMA Facial tive male features include prominent (BIA-ALCL). Plastic Surgery, shows that men ben- cheekbones, a square jaw, and promi- Breast Implant Illness is an umbrella efit from facial cosmetic surgery in nent chin, while attractive female term for a constellation of symptoms much the same way as women: other features are round cheeks, softer con- including tiredness, “brain fog,” joint people find more to like in that new tours, wide smile and large, wide eyes. aches, immune-related symptoms, visage. However, the study did not “Our studies are designed to see if and sleep disturbance that some show a significant impact on percep- this is indeed true,” Dr. Reilly says. women report experiencing and attri- tions of masculinity, whereas a similar In the study, 24 men underwent bute to silicone implants. study performed with women in 2015 facial cosmetic surgery by one of two Allergan is taking its recall action as showed a significant increase in rat- Georgetown surgeons—Dr. Reilly or a precaution, because the rare ALCL ings of femininity for those subjects. Steven P. Davison, MD, who is also form of cancer has been linked to “The tendency to judge facial a co-author. The men had one or textured implants. Surgeons and their appearance is likely rooted in evolu- more of the following surgeries: upper patients should note that the FDA tion, as studies suggest evaluating a blepharoplasty, lower blepharoplasty, and other health authorities have not person based on appearance is linked face-lift, brow-lift, neck-lift, rhinoplas- recommended removal or replace- to survival—our animal instinct tells ty, and/or a chin implant. ment of textured breast implants or us to avoid those who are ill-willed, These men, who paid for their own tissue expanders in asymptomatic and we know from previous research surgery, agreed to the use of their patients. that personality traits are drawn before and after photographs for Biocell saline-filled and silicone- from an individual’s neutral expres- research purposes. Six surveys were filled textured breast implants and sions,” explains the study’s senior designed, each of which included tissue expanders will no longer be investigator, Michael J. Reilly, MD, eight photographs (four before sur- distributed or sold in any market an associate professor of otolaryn- gery, four after surgery. No survey where they are currently available. gology at Georgetown’s School of contained both of a single individual). Effective immediately, healthcare pro- Medicine. Dr. Reilly is board certified More than 150 participants (mostly viders should no longer implant new in Facial Plastic and Reconstructive white, between the ages of 25-34, Biocell textured breast implants and Surgery and sees patients at MedStar and with a college degree) reviewed tissue expanders and unused prod- Georgetown University Hospital in the photos and were not told of the ucts should be returned to Allergan. Washington, DC. study’s intent. They were asked to Allergan will provide additional infor- “Taken together, our findings sug- rate their perception of each patient’s mation to customers about how to gest that both men and women personality traits (aggressiveness, return unused products. Textured undergoing facial cosmetic surgery extroversion, likeability, risk-seeking, breast implants have not been com- can experience not only an improved sociability, trustworthiness), attrac- monly used in the US market. perception of attractiveness but other tiveness, and masculinity.

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The research team built a complex tiveness, likeability, social skills, and to 55 on their social media use, their multivariate linear mixed model in order trustworthiness. self-worth, and their interest in plastic to be able to assess participants’ reaction “Cicero described the face as the surgery. People who used social media to a specific surgical procedure—rhino- ‘mirror of the soul,’ meaning that a platforms that are more visual, like plasty, for example—while controlling person’s physical appearance is the per- YouTube, Tinder, and Snapchat, were for changes from additional procedures sonal characteristic most obvious and more likely to consider plastic surgery done on other areas of the face. accessible to others in social interac- to be a positive option. Additionally, Researchers found that chin aug- tion—so it’s not surprising that subtle people who regularly use filters when mentation was the only procedure changes in neutral facial appearances posting selfies, have removed self- that did not have an effect on per- are powerful enough to alter judg- ies because they weren’t edited or ceived attractiveness, masculinity, or ments of personality,“ Dr. Reilly says. enhanced to their liking, or based their personality. The authors believe this Dr. Reilly says more study is needed self-worth more on their appearance was due to the low number of study in order for cosmetic surgery to reach were more likely to see plastic surgery patients undergoing this procedure. its full potential. “Optimizing patient in a positive light, the study showed. The other procedures showed the fol- outcomes will require a broader None of the survey respondents had lowing changes, among others: understanding of the potential chang- undergone any cosmetic surgeries. • Upper eyelid: increased likeability es in social perception that can occur Overall, YouTube and WhatsApp and trustworthiness with surgery.” social media users had lower self- • Lower eyelid: decreased risk-taking esteem scores than nonusers, as did • Brow-lift: improved perception of photo editing platform users of VSCO extroversion and risk-taking “SELFIE-ESTEEM” MAY INFLUENCE and Photoshop. Researchers say their • Face-lift: increased likeability and PERCEPTIONS OF PLASTIC SURGERY findings could help to inform discus- trustworthiness Low “selfie-esteem” may be a gate- sions between patients and physicians • Neck-lift: increased perceived extro- way to cosmetic surgery acceptance, regarding expectations and outcomes version and masculinity a new study in JAMA Facial Plastic of cosmetic surgery but caution that • Nose: improved attractiveness Surgery suggests. results aren’t representative of most The statistically significant findings Researchers from Johns Hopkins in patients seeking cosmetic surgery due overall reflected increases in attrac- Baltimore surveyed 252 adults aged 18 to the young age of survey participants. TAKE 5

As many as pany’s injectable cellulite product and subdermal anatomy, specifically the 98 percent of their go-to-market plans, if the drug fibrous septae that tether the skin to women have gets the FDA nod. “We are preparing the underlying fascia, is a key determi- cellulite, and for FDA submission in the second half nant. Targeting and dissolving these there is little of 2019, and anticipate the launch of septae could reduce the appearance they wouldn’t CCH for cellulite, if approved, in the sec- of cellulite dimples. In November, we do to get rid of ond half of 2020,” he shares. announced the results of RELEASE 1&2, their dimpled cottage cheese thighs the largest cellulite study ever conduct- and butts. They’ve tried creams and KEY MILESTONE ed with 845 participants. Results from specialty massages, lasers, and subcision, Patrick Barry: In our Phase 3 trials, these two identical Phase 3 RELEASE and many still feel frustrated by the lack collagenase clostridium histolyticum trials showed statistically significant of aesthetically pleasing results. Now, (CCH) was investigated for the treat- levels of improvement in the severity of Endo Pharmaceuticals’ collagenase ment of cellulite in women. When cellulite after treatment with CCH, as clostridium histolytic (CCH) cosmetic injected into an area identified for measured by the primary endpoint. is set to shake up the cellulite market. treatment, CCH is thought to lyse the The Phase 3 studies of CCH cosmetic Patrick Barry, Executive Vice President fibrous septae. We recognize that the for cellulite are an important milestone and Chief Commercial Officer of Endo appearance of cellulite is a result of sev- for our branded business as we com- Pharmaceuticals, talked to Modern eral factors, including age, skin elasticity, plete the transformation into a specialty Aesthetics® magazine about the com- and body mass index (BMI). However, focused branded organization. They

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create a clear regulatory pathway for cellulite and the role CCH may play quartered in Malvern, PA. Endo has seeking approval of what could be the in its treatment. We plan to invest an established presence in men’s first approved injectable for the treat- heavily in consumer engagement health, orthopedics, and endocrinol- ment of cellulite. The results give us rea- and marketing efforts to motivate ogy, and in 2017, the company made son to broaden our footprint by enter- demand and to ensure that appro- a strategic shift toward investing our ing into the medical aesthetics space. priate promotional efforts do not resources into highly focused spe- fall solely to practices. We believe cialty treatments, sterile injectables, DISRUPTIVE TECHNOLOGY we have the opportunity to create a and high-value generics. Our specialty Mr. Barry: There is currently no category and our aim would be to do portfolio is a growth driver for the FDA-approved injectable treatment just that because today there isn’t an organization with Xiaflex as our cor- for cellulite. We recognize that cellulite FDA-approved injectable solution to nerstone asset. The active ingredient occurs as a result of various factors, treat one of the underlying causes of in Xiaflex is CCH. Xiaflex, a different including age, BMI, and skin elasticity, cellulite, the fibrous septae. preparation of CCH, is indicated for and, as such, may require a multi- the treatment of Peyronie’s disease modal approach for some patients, LARGE, UNMET NEED and Dupuytren’s contracture. As but we believe that CCH has the Mr. Barry: If approved, CCH for cel- result of our current footprint, we potential to become the cornerstone lulite will be the first FDA-approved have a growing medical therapeutics for the treatment of cellulite. These are injectable treatment for cellulite. portfolio and we are thrilled to be in truly exciting times and we believe if In spite of multiple therapeutic a position to potentially launch an approved CCH for cellulite could truly approaches for the attempted treat- additional growth driver, by expand- be a potentially disruptive technology ment of cellulite, physicians and ing the branded strategy into medical for the medical aesthetics space. patients continue to struggle to find aesthetics. additional appropriate treatment Our primary goal is to direct all of LAUNCHING INTO AESTHETICS options. This remains a large, unmet our efforts toward the successful launch Mr. Barry: On the physician side, need in aesthetics. In a growing, well- of CCH for cellulite before we consider we will do this by increasing our pres- accepted injectable space, an inject- other products and treatments. With ence at aesthetic meetings leading able cellulite treatment could repre- the potential for an upcoming launch, up to the anticipated launch date. sent considerable opportunities for we are excited to keep the momentum If approved, the goal would be to patients, physicians and practices. going with first-to-market products provide support services for physi- that will revolutionize the industry. Of cians and clinics to help our partners THE BIGGER PICTURE course we will continue to look at CCH increase patient engagement. On Mr. Barry: Endo Aesthetics is part as a part of our ongoing life cycle man- the consumer side, we will be filling of Endo Pharmaceuticals Inc., a com- agement process and we will continue the gap by engaging consumers and pany with more than two decades to assess opportunities for additional educating them in the pathology of of pharmaceutical experience, head- indications.

NEW FLORIDA LAW TIGHTENS Department of Health. (HB 933) was filed by Rep. Anthony RESTRICTIONS ON COSMETIC SURGERY The Florida Board of Medicine Rodriguez. Florida is cracking down on the recently approved an emergency mea- “Tonight, victims and families of state’s cosmetic surgery industry. Gov. sure prohibiting Brazilian butt lifts, those affected by surgical center mal- Ron DeSantis signed into law a major USA Today reports. practices can breathe easier. Safety reform that gives the state the power to Florida now has one of the toughest should be of utmost concern to all suspend a clinic’s operations or revoke laws regulating cosmetic procedures physicians, but unfortunately, many its registration if the facility poses an in the nation. At least 13 women innocent lives were lost at the hands imminent threat to the public. died after surgeries at Florida facili- of bad actors,” Mr. Flores said of the The new law will also block doctors ties opened by felons over the past bill’s passage. from opening a new facility for up to 10 years, the USA Today Network five years if their previous clinic has reported in April as part of its ongo- been shut down due to malpractice. ing investigation. ALASTIN ISSUED SECOND PATENT Doctors operating these offices would The legislation was filed by Sen. Alastin Skincare, Inc. was issued a also be required to register with the Anitere Flores. A companion bill second US Patent (No. 10,286,030)

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from the United States Patent and Proof of Concept Study Supports Dermata’s Hologic’s Cynosure Division Expands Body Trademark Office covering Alastin’s Topical Delivery Mechanism for Toxin Contouring Line platform TriHex Technology. The “This study provides convincing Hologic is rolling out the patent also covers a variety of topical evidence that DMT310, our Spongilla TempSure Firm handpiece and a compositions based on Alastin’s TriHex lacustris powder with millions of petite mask for WarmSculpting with Technology. microscopic needle-like spicules, is SculpSure Profile treatments. And The comapny says its products with effective in creating channels through SculpSure submental treatments are TriHex Technology have created a new the stratum corneum for biolog- now FDA cleared for patients with and growing category within the aes- ics to enter the dermis, resulting in a BMI up to 49—the highest BMI thetic market to address a previously effects similar to injections,” says clearance on the market for submen- unmet need for topical products that Gerry Proehl, President and CEO of tal treatments. provide complementary benefits for Dermata Therapeutics. patients undergoing rejuvenating pro- Adelle Walker is New CMO at SENTÉ cedures. These products are designed Clint Carnell and Clement Gingras Join As Chief Marketing Officer, Adelle to help patients prepare the skin prior SENTE Board Walker will take a leadership role in to a procedure, speed recovery, and “We are thrilled to have both Clint defining pipeline strategy and inter- enhance outcomes post-procedure. and Clement join the SENTÉ team,” nal and external portfolio planning. says Faheem Hasnain, Chairman of the Her commercialization leadership Board of Directors of SENTÉ. “They will span across all facets of com- MORE HEADLINES FROM bring tremendous expertise and valida- munications from marketing to AESTHETICSWIRE tion to our company during this excit- professional relations, education, and BTL Partners with Dress for Success ing next phase of growth.” promotion. Through the partnership, participat- ing practices will collect accessories at Sciton Inc. Launches Clear Suite Products Cutera Introduces truSculpt flex their practice and host in-office “acces- The Clear Suite offerings make “We are very excited to introduce sory drives” that support their local the JOULE platform customizable. truSculpt flex, and proud to be Dress for Success chapter. BTL will also Utilizing the 1064 Nd:YAG wave- the first aesthetics laser company be supporting the organization via a length, the Clear Suite family of to offer a muscle toning system monetary donation. This partnership products, including ClearV, ClearSilk, that treats up to 8 muscle groups kicks-off BTL Cares, which provides a and ClearHair, combined with simultaneously, covering the largest platform to engage physician partners BroadBand Light (BBL), allows physi- treatment area in the body sculpting by creating an opportunity for them to cians to treat veins, skin, and hair industry,” says Jason Richey, COO give back to their local communities. from a single platform. and Interim CEO of Cutera.

MY NEW FAVORITE THING: BUILDMYBOD

“BuildMyBod is ested in a treatment versus those who ing almost 200 new leads a month! the best thing are merely browsing. Many practices pour tons of money I’ve done for I’ve been using BuildMyBod for into SEO or Google and Facebook ads, my practice to the past five years since relocating but with BuildMyBod, we get organic date. The simple my practice from Houston, TX to leads by simply driving them to our technology Knoxville, TN. It has streamlined my site. We use deep links for specific allows me to office processes and made my con- procedures to share on Instagram add an easy line of code and embed sults infinitely more productive. The too. For example, when we’re sharing a ‘Get a Quote’ button at the top of days of the ‘price shopper’ consults Mommy Makeover testimonials and my site. The great part is that patients in my office have been eliminated. results, we include the deep link on enter in their information for fully Also, it has helped me build both my our profile and add a call to action to transparent pricing, and it allows me patient and email database—2,991 click the link to learn more. to segment those who are truly inter- leads since June 2015. We’re now see- The beauty behind BuildMyBod is

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that by using price transparency, you can reminds them (and the doctor’s office) then and there, they can!” easily attract more leads, but also drive via email that they have to finish their —Jason J Hall, MD, FACS conversions with their checkout process. selections to get a quote. And last but Plastic and Craniofacial Surgeon If a potential patient starts entering in not least, BuildMyBod is even set up for Knoxville Plastic & Craniofacial their information and stops, the system payment. If someone wants to pay right Surgery | Knoxville, TN WHAT’S ONLINE #REALDEALAESTHETICS RECAP ON HEALING AND RECOVERY… Modern Aesthetics® magazine’s Tweet chat series—#realdealaesthetics— #cO2 laser has a 7-14 day recovery time and a month of pink which is featuring New York City dermatologist Gary Goldenberg, MD covered by makeup. Results improve over time up to a year (@Goldenberg_Derm) and Charleston, SC dermatologist Todd E. @SkindocDLCC Schlesinger, MD (@SkindocDLCC)— recently took on questions about the role of nonsurgical eyelid rejuvenation in practice including whether it can ON EXPECTATION MANAGEMENT prevent or delay the need for blepharoplasty. It is important to explain to patients what they can expect. Faster results can be achieved with downtime. Combination treatments over time can Here’s what you missed: rebuild and maintain a youthful look. If they are unable to do downtime, I suggest #microneedling with #PRP as well as #nonablative fractional or ON GO-TO NONINVASIVE EYELID REJUVENATION PROCEDURES… #radiofrequency. @SkindocDLCC Our protocol includes CO2 followed after healing by #radiofrequency then #fillers #prp combination periorbital upper and lower. We use ON DELAYING THE NEED FOR SURGICAL BLEPHAROPLASTY… #btlaesthetics #radiofrequency. Safe delivery and proper tissue Many of these procedures will prevent or delay need for need for #surgery. targeting helps build new #collagen. @SkindocDLCC #Ulthera is a perfect example - it’s a deposit into your #collagen bank that pays off #dividends later on. @Goldenberg_Derm Fractionated lasers are a favorite of mine also. One can see the tightening as the energy is applied in layers. @SkindocDLCC Minimally invasive procedures aren’t a replacement for #eyejob #surgery. So realistic expectations are a must. But these procedures may prevent or Adding #prp drawn and spun during procedure enhances healing and delay need for surgery. @Goldenberg_Derm results when applied post-op. @SkindocDLCC Follow @ModAesthetics for information on the next Twitter chat. ON THE ROLE OF SKINCARE… #skincare with #antioxidants vitamin C, #growthfactors and #retinoid combinations help a lot. Optical diffusers help the immediate appearance while #hyaluronic acids draw moisture. #Sente with HSA is a pre-growth factor that seems to work well. #Eltamd has an eye product we use as well @SkindocDLC

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