A lot of you may ask Dr. Biesman plenty of questions when you come into the office and chances are those questions pertain to your individual visit. So this month, we decided to sit down with Dr. Biesman to ask him some questions about broader topics we feel his patients would still take an interest in: everything from industry predictions, to interesting patient stories and more. Here’s what he had to say:
Your industry is constantly evolving and improving, which means there new procedures popping up all the time. What are some of the latest procedures that are on the rise that you’re most excited about?
Dr. Biesman: “I’m really excited about some new injectable products but in particular some new applications of these injectable products. One in particular is dilute Radiesse, which is used to improve skin quality. We’ve used it successfully on the face, neck, chest, thighs, buttocks and knees (pretty much all over the body!) to produce changes that we haven’t really been able to achieve with anything else.
Another new technique we’re using with fillers is based on some anatomic principles that allow us to inject behind the hairline, yet lift the entire face somewhat, which is a pretty neat technique.
There is also some new technology that we’re using for minimally invasive skin tightening and contouring (mostly along the jawline and neck but also a bit under the eyes). It is called FaceTite and EyeTite and is an exciting combination of some newer technology and devices but provides confidence and comfort in that is based on excellent science that I have been familiar and comfortable with for many years.”
Clinical research is incredibly important to you. Tell us about some of the projects you’ve been involved in most recently.
Dr. Biesman: Since returning from the COVID-19 quarantine break our clinical research department has come back in full force! Some recent and upcoming projects we are excited about include:
- Studying several new injectable products as under eye fillers to correct hollowness or camouflage unwanted puffiness.
- Studying the safety and effectiveness of 2 new Botox-like drugs. I would like to share more but can’t let the cat out of the bag prematurely!.
- Evaluation of an injectable drug to treat cellulite.(more exciting news to come as we make progress on this!)
- Evaluation of 2 products applied to the skin’s surface:: one study tests a chemical peel and the other evaluates a new combination of existing products to achieve enhanced outcomes.
- Combination therapy is actually a very big theme we’re seeing in the clinical process these days (so instead of a patient coming in for one procedure, the idea with combination therapy is doing 2 at a time (for example a laser treatment and an injectable or 2 different laser treatments as opposed to just 1.) We have an exciting combination treatment study coming up that combines 2 energy-based treatment techniques, 1 for skin tightening and 1 for skin resurfacing,to produce a superior outcome.
Patients are often only familiar with their own stories… but you see so many different types of cases day in and day out. What is a recent patient story that has happened at the practice that you think would interest or surprise people?
Dr. Biesman: “Interesting question! (And one we have to be careful to answer, I obviously highly value patient privacy and confidentiality, so I want to ensure anonymity is maintained). Last week alone, I saw 2 different patients who were very unhappy with treatments that had been performed elsewhere and who were asking for help correcting their problems: one had undergone blepharoplasty (eyelid lift) surgery and the other had fat injection around the eyelids. Both patients were very sad with their unfortunate outcomes. The good news is that the issues are fixable and I am looking forward to helping both of these patients look better and feel better about themselves.
Another recent story was a patient we saw who had been over-injected with soft tissue fillers that her face was distorted to the point that she no longer looked like herself. This is every injection patient’s worst nightmare. The silver lining here was that the products with which she had been injected were made of hyaluronic acid and could be easily dissolved. Within a couple of days, we were able to reverse the treatments and place a modest amount of filler in the proper location to restore a natural and refreshed look. One of the takeaway messages here is to do your research carefully before you have any procedure done, even if it is offered in a spa or salon setting. When done well and for the right indications, most procedures produce excellent outcomes. However, even nonsurgical procedures have risks and can have poor or even disastrous complications. Make sure you understand the risks, potential complications of a procedure, and experience of the person performing it before having something done!
Finally, a gentleman traveled from quite a long distance (as many of our patients do) to see us. He had severe acne scarring and had undergone more procedures in an attempt to correct his scarring than any patient I have seen in over 25 years of practice. Despite having undergone all of these treatments he estimated he had only seen a 10% improvement in his scarring. We performed one combination therapy procedure on him and, after a single treatment he already feels 30-40% better, far more improvement than he has seen from any other treatment or treatment combination. That was so rewarding for me and my entire team! Helping people achieve their goals is always satisfying and is that much more so when others have failed to do so!”
You’ve been in the industry for years and have seen it evolve in many ways. What are some things you anticipate will change in the next 10 years?
Dr. Biesman: “I think we’re going to see growth in a number of areas. I think regenerative medicine is going to play a bigger and bigger role. One form of regenerative medicine that people can relate to now is known as PRP (Platelet-Rich Plasma) which is collected from the blood. We currently use PRP for a number of applications including stimulate of hair growth, helping the skin heal after treatments such as laser resurfacing, Fraxel treatment, Morpheus8 RF microneedling, and others, and to help improve skin quality in areas in which fine wrinkles have developed and patients do not have the down time to undergo a bigger laser resurfacing procedure. However, there are many other potential goals that the concept of regenerative medicine can help us achieve through the use of stem cells, growth factors, microsomes, and others. Stay tuned for a lot of new developments in those areas.
I also believe there will be ongoing improvements in technology and energy-based devices as well as injectables that will allow us to accomplish things that we can’t do now. Simply put, there are some things we can’t do with existing devices or materials that we will be able to do in the future. A few examples include improved injectables, novel treatment for acne, and many others. Some products currently exist outside the US and will likely make their way here whereas others are currently in various states of the product development process domestically. t that we’ll see some of those products in the US in the next several years.
It is my sincere hope that, as new products are developed and released, we see application of more rigorous scientific standards in the field of aesthetics. I strongly believe that the same high standards and scientific rigor applied to developing novel treatments in the rest of medicine (diabetes, heart disease, treatment of cancer, etc.) be applied to new treatments in aesthetic medicine. That is not always the case today but I am doing my best to push our industry in that direction.”
What are some of the biggest misconceptions you find yourself often setting straight with your patients?
Dr. Biesman: “I’d say one of the biggest misconceptions is that surgery is the best solution for all aesthetic concerns. Surgery is and will always remain an important tool that we use to treat some conditions. However, lasers, soft tissue fillers and other noninvasive procedures generally produce effects that complement rather than replace surgery.
Another common misconception (and one that often is associated with unfortunate outcomes) is that if a procedure does not require surgery in an operating room (for example lasers or injectables) that the skill and experience of the operator is not important. Patients who use this approach typically make their decisions based on convenience, cost, and other factors that, while important, should not be the determining principles in the decision-making process. Many patients simply are not aware of the potential risks or complications of procedures until it is too late. I recommend that anyone considering undergoing an aesthetic treatment of any type go through the same due diligence and decision-making process as they would if they were to undergo surgery. Do your homework!”
Anything else you’d like to share?
Dr. Biesman: “I do still feel like COVID is still a very pertinent topic worth speaking to. For people who are wondering if it’s safe to either come to our office or to have treatments performed during these uncommon and remarkable times, the answer is a resounding yes!. We have been extremely rigid in establishing and following safety protocols and, so far, our system has worked smoothly and effectively to keep our patients and staff safe. We screen our patients carefully, sterilize our exam rooms thoroughly in between patients, and have a long list of screening protocols that reflect best practices as recommended by the Center for Disease Control (CDC), state, and local health authorities. We update our written safety plan each week to ensure it is current and are meticulous in following it. The feedback from our patients who have visited many other offices and health department officials alike has been extremely positive with respect to our safety policies and procedures. I hope that provides some peace of mind for anyone who is wondering if our office is a safe place to visit.”
Dr. Biesman is a wealth of knowledge on all things aesthetics and is happy to answer any of your questions! Call our practice to book a consultation with him so you can chat. 615-329-1110.