What's New in Aesthetics With Heidi Prather, MD

Heidi Prather, MD, FAAD

“One new treatment I love is SkinVive, which is a first-of-its-kind injectable that acts as a skin hydrator to improve skin smoothness and glow,” said Heidi Prather, MD, FAAD, while discussing the top aesthetic advancements from 2023. In an interview with Dermatology Times, Prather, a board-certified dermatologist and fellowship-trained cosmetic and procedural dermatologist at Westlake Dermatology, gave an overview of her favorite recent advancements in aesthetics, including Galderma’s Restylane Eyelight and Sculptra.

Prather also discussed her favorite highlights from this year’s American Society for Dermatologic (ASDS) annual meeting. “One session that is always near and dear to me is about liposuction. I believe this treatment is truly an art and skill, and it was pioneered by a dermatologist that still practices in California named Dr. Jeffery Klein. As a medical student, he invented tumescent lidocaine anesthesia, which is a hyper-diluted numbing solution that helps create a pain-free treatment and is now the worldwide standard of care for liposuction and many other plastic surgical procedures,” said Prather.

Dermatology Times: In your opinion, what are some of the most exciting/new updates in aesthetics?

Prather: Hyaluronic acid fillers have made notable strides in the aesthetic space as of late, particularly undereye filler. Restylane Eyelight was FDA-approved earlier this year for the correction of undereye hollows and can last up to 18 months with optimal treatment. It’s an exciting step because it is the first and only undereye filler in the US formulated with NASHA® Technology, which has a firm gel texture resistant to water absorption and is close to the naturally occurring HA found in our skin. The innovative technology is ideal for undereyes because it’s precise and has minimal swelling effects to treat tired-looking eyes.

Additionally, biostimulators are a fascinating and rapidly growing part of the aesthetic market. As injectables continue to grow in popularity, the appetite for a treatment that stimulates your natural collagen growth and promotes natural-looking results is higher than ever, with new indications becoming available. Sculptra is a great example of this. As the first and original PLLA injectable biostimulator with over 14 years of clinical aesthetic use, Sculptra received its newest indication for use in the full cheek area this year, helping restore skin volume to increase firmness, correct fine lines and wrinkles and help boost your natural glow when injected into the cheek.

Dermatology Times: What are a few current trends that you are currently seeing in your practice and among patients?

Prather: Many of my patients come in and share the common sentiment that "less is more" when asking for specific treatments. Compared to years past, patients are desiring natural aesthetic looks that focus on global skin health and favor improvement rather than modification.

Dermatology Times: What new dermatology research or innovation are you looking forward to in 2024?

Prather: One new treatment I love is SkinVive, which is a first-of-its-kind injectable that acts as a skin hydrator to improve skin smoothness and glow. The science behind this treatment demonstrates increased hydration in the skin, and the end results include improved radiance, skin glow, and even decreased pore count. The ideal candidate for this treatment would be someone who is looking for an enhancement to their skin quality rather than volumizing results that traditional dermal fillers provide. 

Another treatment that I’m excited about is ellacor, which is a minimally invasive device that uses small, hollow needles to remove micro-sized portions of excess skin without scarring. I like to think of ellacor as a step beyond microneedling, acting as a multifactorial nano face lift that removes skin and also improves collagen remodeling of the skin through mechanical stimulation. As ellacor does not fully replace a traditional face lift, the ideal candidate for ellacor is a patient entering their late 30s or 40s that are starting to see early signs of jowling of the face, laxity around the jawline and mouth, and shadowing near the mouth and chin. This novel approach to skin rejuvenation is the first of its kind to physically remove skin volume to address skin laxity.

Dermatology Times: What topics or sessions did you find the most compelling at ASDS and why?

Prather: I absolutely loved the leadership session at ASDS led by Dr. Mona Sadeghpour and appreciate that a medical/surgical society is investing in improving the leadership skills of its members. During the session, Dr. Katie Rodan shared her personal experience of being a mom, a woman in medicine, and a business leader/entrepreneur, and even spoke about the scaling of her business. As a mother and woman in medicine, I can attest that we are faced with many challenges managing our time and resources to take care of our families, our patients, and ourselves, and having sessions like these create incredible opportunities for us to learn from and lean on each other.

I also appreciated the new perspectives within the neurotoxin space. I believe it’s so important for us to use our knowledge of a treatment’s function and the body’s anatomy to improve upon how we are teaching and delivering these technologies. For neurotoxins like Dysport/Botox/Xeomin/Jeaveau & now Daxxify (& many more emerging in the market space!), we assume we know everything – especially in regard to the first indication for treating frown lines between the brows – but that is still an area where we can look to place the neurotoxin a bit differently (i.e., closer to the brows) to leverage the body’s anatomy to minimize unwanted results like brow drop. Sessions like these help to spread awareness, change the way we treat our patients, and train new physicians how to use the product, and elevate our specialty

One session that is always near and dear to me is about liposuction. I believe this treatment is truly an art and skill, and it was pioneered by a dermatologist that still practices in California named Dr. Jeffery Klein. As a medical student, he invented tumescent lidocaine anesthesia (TLA), which is a hyper-diluted numbing solution that helps create a pain-free treatment and is now the worldwide standard of care for liposuction and many other plastic surgical procedures. Since liposuction was developed within dermatology, I believe it’s important to have sessions where physicians who are starting to offer it or other body tightening treatments in their practice can learn from each other, elevating outcomes of body fat removal.

Dermatology Times: Including ASDS, what other surgical or aesthetics meetings do you enjoy?

Prather: In my opinion, the American Society for Dermatologic Surgery (ASDS), American Academy of Dermatology (AAD), American Society for Laser Medicine and Surgery (ASLMS), and the Women’s Dermatologic Society (WDS) are core meetings that help propel science forward in dermatology. Personally, I’m very passionate about chemical peels, so I also make sure to attend International Peeling Society (IPS) each year, and I will also be attending SCALE for the first time in Nashville to be a part of a multidisciplinary approach to a conference. Masters of Aesthetics Symposium in San Diego is a newer meeting, but I have found that it also helps to elevate our field. Additionally, there are many private meetings that have their own strengths and benefits to give more access points for dermatologists to learn and share knowledge.