Aesthetic medicine is a branch of modern medicine that focuses on altering natural or acquired unwanted appearance through the treatment of conditions including

scar A scar (or scar tissue) is an area of fibrosis, fibrous tissue that replaces normal skin after an injury. Scars result from the biological process of wound repair in the skin, as well as in other Organ (anatomy), organs, and biological tissue, t ...

s, skin laxity, wrinkles, moles,

liver spot Liver spots (also known as age spot, solar lentigo, "lentigo senilis", "old age spot", "senile freckle") are wikt:blemish, blemishes on the skin associated with aging and exposure to ultraviolet, ultraviolet radiation from the sun. They range in c ...

s, excess fat,

cellulite Cellulite () or gynoid lipodystrophy (GLD) is the herniation of subcutaneous fat within fibrous connective tissue that manifests as skin dimpling and nodularity, often on the pelvic region (specifically the buttocks), lower limbs, and abdomen. C ...

, unwanted hair, skin discoloration,

spider veins Telangiectasias (), also known as spider veins, are small dilated blood vessels that can occur near the surface of the skin or mucous membranes, measuring between 0.5 and 1 millimeter in diameter. These dilated blood vessels can develop anywhere ...

and or any unwanted externally visible appearance. Traditionally, it includes

dermatology Dermatology is the branch of medicine dealing with the Human skin, skin.''Random House Webster's Unabridged Dictionary.'' Random House, Inc. 2001. Page 537. . It is a speciality with both medical and surgical aspects. A List of dermatologists, ...

oral and maxillofacial surgery Oral and maxillofacial surgery (OMFS) is a surgical specialty focusing on reconstructive surgery of the face, facial trauma surgery, the Human mouth, mouth, Human head, head and neck, and jaws, as well as facial plastic surgery including clef ...

reconstructive surgery Reconstructive surgery is surgery performed to restore normal appearance and function to body parts malformed by a disease or medical condition. Description Reconstructive surgery is a term with training, clinical, and reimbursement implicat ...

and plastic surgery, surgical procedures (

liposuction Liposuction, or simply lipo, is a type of fat-removal procedure used in plastic surgery. Evidence does not support an effect on weight beyond a couple of months and does not appear to affect obesity-related problems. In the United States, lip ...

, facelifts,

breast implant A breast implant is a prosthesis used to change the size, shape, and contour of a person's breast. In reconstructive plastic surgery, breast implants can be placed to restore a natural looking breast following a mastectomy, to correct congenita ...

radio frequency ablation Radiofrequency ablation (RFA), also called fulguration, is a medical procedure in which part of the electrical conduction system of the heart, tumor, sensory nerves or a dysfunctional tissue is ablated using the heat generated from medium fre ...

), non-surgical procedures ( radio frequency skin tightening, non-surgical liposuction,

chemical peel A chemical peel is a treatment used to improve and smooth the texture of the skin. The skin on the face is most commonly treated, but peels can also be performed on the body. Chemical peels are intended to remove the outermost layers of the skin ...

, high-intensity focused electromagnetic field, radio frequency fat removal), and a combination of both. Aesthetic medicine procedures are usually elective. There is a long history of aesthetic medicine procedures, dating back to many notable cases in the 19th century, though techniques have developed much since then.

History

Physical beauty has been a consistently coveted notion. Efforts to improve and enhance beauty through aesthetic medical practices can be seen as early as 2000 years ago, in India, where the 'forehead flap' was used to reconstruct the noses and faces of soldiers injured in war and criminal punishments. This technique, though thoroughly developed and modified, is still used today as a common method to repair nasal defects. Although Greek and Roman medical practices have been considered the foundation for European and modern-day medicine for a long time, ancient Egyptian texts have revealed that Egyptian medicine produced many key medical discoveries and the basis for many modern practices. The Egyptians recorded their use of oils, waxes,

Cyperus ''Cyperus'' is a large genus of about 700 species of sedges, distributed throughout all continents in both tropical and temperate regions. Description They are annual or perennial plants, mostly aquatic and growing in still or slow-moving ...

, and other plant materials to reduce the signs of aging, like wrinkles and spots, and to restore youthful skin. They studied bodily functions, like inflammatory processes, and were able to make discoveries that allowed them to treat cosmetic wounds and burns using therapies and medicines. This included the initial application of fresh meat to the wound, followed by the use of oil/lipids, honey, and fibers, generally woven linen, until the wound had healed. As physicians have discovered more about medicine throughout history, these practices have been developed to be more efficient and sanitary and can be seen today in common skin reparation remedies. In more recent history, within the past 30 years, the industry of aesthetic medicine has been developing rapidly with the addition of and growing demand for "injectables," a form of transcutaneous treatment used to rejuvenate and restore the skin of a patient. These medical injectables have become well established due to their associated low risk, especially compared to other aesthetic surgical practices, as well as the practically non-existent recovery time needed after the procedures are performed. Within the past ten years, the

U.S. Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...

has reviewed and approved over 20 injectable products used for medical aesthetics, in response to the growing demand. The most commonly used injectables in the industry today are

botulinum neurotoxin Botulinum toxin, or botulinum neurotoxin (commonly called botox), is a neurotoxic protein produced by the bacterium ''Clostridium botulinum'' and related species. It prevents the release of the neurotransmitter acetylcholine from axon endi ...

, commonly referred to as botox, and hyaluronic acid fillers. According to statistics from an annual survey conducted by the

American Society for Aesthetic Plastic Surgery The American Society for Aesthetic Plastic Surgery (ASAPS) is an organization of approximately 2,600 plastic surgeons worldwide devoted to the advancement of cosmetic surgery. Founded in 1967, their mission includes medical education, public educ ...

, from 1997 to 2011 the number of nonsurgical procedures performed by aesthetic physicians increased by 356%.

Statistics

*Worldwide, there were 20 million aesthetic procedures performed from 2014-2015. Cosmetic surgery is a major driver of

medical tourism Medical tourism is the practice of traveling abroad to obtain medical treatment. In the past, this usually referred to those who traveled from less-developed countries to major medical centers in highly developed countries for treatment unavaila ...

. In February 2018 the president of the

British Association of Aesthetic Plastic Surgeons The British Association of Aesthetic Plastic Surgeons is a British surgical organisation based at the Royal College of Surgeons of England The Royal College of Surgeons of England (RCS England) is an independent professional body and regist ...

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 The National Health Service (NHS) is the term for the publicly funded health care, publicly funded healthcare systems of the United Kingdom: the National Health Service (England), NHS Scotland, NHS Wales, and Health and Social Care (Northern ...

. *Countries that performed the most aesthetic procedures in 2014 were ;United States *There were more than 11 million aesthetic procedures performed from 2012-2013, and 83.5% of the procedures were nonsurgical. *The top five surgical aesthetic procedures were 1)

Liposuction Liposuction, or simply lipo, is a type of fat-removal procedure used in plastic surgery. Evidence does not support an effect on weight beyond a couple of months and does not appear to affect obesity-related problems. In the United States, lip ...

Breast augmentation In medicine, breast augmentation and augmentation mammoplasty are terms that describe a cosmetic surgery procedure that uses either a Breast implant, breast implant or a fat-graft to realise a mammoplasty to increase the size, change the shape ...

Blepharoplasty Blepharoplasty (Greek: ''blepharon'', "eyelid" + ''plassein'' "to form") is the plastic surgery operation for correcting defects, deformities, and disfigurations of the eyelids; and for aesthetically modifying the eye region of the face. With ...

Abdominoplasty Abdominoplasty or "tummy tuck" is a cosmetic surgery procedure used to make the abdomen thinner and more firm. The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia ...

Rhinoplasty Rhinoplasty (, nose + , to shape), commonly called nose job, medically called nasal reconstruction, is a plastic surgery procedure for altering and reconstructing the human nose, nose. There are two types of plastic surgery used – plastic sur ...

*The top five nonsurgical aesthetic procedures were 1)

Botulinum Toxin Botulinum toxin, or botulinum neurotoxin (commonly called botox), is a neurotoxic protein produced by the bacterium ''Clostridium botulinum'' and related species. It prevents the release of the neurotransmitter acetylcholine from axon en ...

Hyaluronic acid Hyaluronic acid (; abbreviated HA; conjugate base hyaluronate), also called hyaluronan, is an anionic, nonsulfated glycosaminoglycan distributed widely throughout connective, epithelial, and neural tissues. It is unique among glycosaminog ...

Laser hair removal Laser hair removal is the process of hair removal by means of exposure to pulses of laser light that destroy the hair follicle. It had been performed experimentally for about twenty years before becoming commercially available in 1995–1996. One ...

Microdermabrasion Dermabrasion is a type of surgical skin planing, generally with the goal of removing acne, scarring and other skin or tissue irregularities, typically performed in a professional medical setting by a dermatologist or plastic surgeon trained spec ...

Photorejuvenation Photorejuvenation is a skin treatment that uses lasers, intense pulsed light, or photodynamic therapy to treat skin conditions and remove effects of photoaging such as wrinkles, spots, and textures. The process induces controlled wounds to the ski ...

;United Kingdom *There were 50,000 cosmetic surgery procedures performed in 2013-2014. *Surgical aesthetic procedures account for 10% of the cosmetic procedures, and non-surgical techniques constitute the remaining 90%. ;South Korea *More than 980,000 aesthetic procedures were performed from 2014–2015. *The top five surgical aesthetic procedures were 1)

3) Fat Grafting 4)

Rhytidectomy A facelift, technically known as a rhytidectomy (from the Ancient Greek () 'wrinkle', and () 'excision', the surgical removal of wrinkles), is a type of cosmetic surgery procedure intended to give a more youthful facial appearance. There are ...

Hair Transplantation Hair transplantation is a surgery, surgical technique that removes hair follicles from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'. The technique is primarily used to treat ...

Indications

Aesthetic medicine specializes in altering the 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

s. Aesthetic medicine also plays a role in the treatment of excess fat,

, and obesity. Laser based therapies can be indicated for the treatment of

s, unwanted hair, skin discoloration, and

. 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

* Injections of

Botulinum toxin Botulinum toxin, or botulinum neurotoxin (commonly called botox), is a neurotoxic protein produced by the bacterium ''Clostridium botulinum'' and related species. It prevents the release of the neurotransmitter acetylcholine from axon en ...

(Botox) * Injection of

dermal fillers Injectable filler is a special type of substance made for injections into connective tissues, such as skin, cartilage or even bone, for cosmetic or medical purposes. The most common application of injectable fillers is to change one's facial appear ...

Cryolipolysis Cryolipolysis (commonly referred to as "fat freezing") is a non-invasive procedure for fat removal that uses extreme cold to freeze subcutaneous adipose tissue in specific areas of the body. This process aims to reduce localized fat deposits. ...

Chemical Peels A chemical peel is a treatment used to improve and smooth the texture of the skin. The skin on the face is most commonly treated, but peels can also be performed on the body. Chemical peels are intended to remove the outermost layers of the skin ...

Mesotherapy Mesotherapy (from Greek ''mesos'', "middle", and therapy from Greek ''therapeia'') is a form of alternative medicine which involves intradermal or subcutaneous injections of pharmaceutical preparations, enzymes, hormones, plant extracts, vitamins ...

injection *

Cellulite Cellulite () or gynoid lipodystrophy (GLD) is the herniation of subcutaneous fat within fibrous connective tissue that manifests as skin dimpling and nodularity, often on the pelvic region (specifically the buttocks), lower limbs, and abdomen. C ...

treatment *

Nutrition Nutrition is the biochemistry, biochemical and physiology, physiological process by which an organism uses food and water to support its life. The intake of these substances provides organisms with nutrients (divided into Macronutrient, macro- ...

Permanent makeup Permanent makeup, also known as permanent cosmetics, derma-pigmentation, micro-pigmentation, semi-permanent makeup and cosmetic tattooing, is a cosmetic technique which employs tattooing techniques to replicate the appearance of traditional ma ...

Hair transplantation Hair transplantation is a surgery, surgical technique that removes hair follicles from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'. The technique is primarily used to treat ...

Laser Therapy Laser medicine is the use of lasers in medical diagnosis, treatments, or therapies, such as laser photodynamic therapy, photorejuvenation, and laser surgery. The word ''laser'' stands for "light amplification by stimulated emission of radiatio ...

for scars and stretch marks * Nd:YAG laser for

* Contour threads * Non-surgical liposuction *

Lipotomy Bariatric surgery (also known as metabolic surgery or weight loss surgery) is a surgical procedure used to manage obesity and obesity-related conditions. Long term weight loss with bariatric surgery may be achieved through alteration of gut ho ...

* Carboxytherapy * Radio Frequency skin tightening * laser tattoo removal * facelifts *

or reduction *

Brachioplasty A brachioplasty, commonly called an arm lift, is a surgical procedure to reshape and provide improved contour to the upper arms and connecting area of chest wall. Although "brachioplasty" is commonly used to describe a specific procedure for the up ...

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 In medicine, a surgeon is a medical doctor who performs surgery. Even though there are different traditions in different times and places, a modern surgeon is a licensed physician and received the same medical training as physicians before spec ...

medical doctor A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the study, diagnosis, prognosis ...

(Dermatologist/plastic surgeon/ENT surgeon/Oculoplastic surgeon) or maxillofacial surgeon /Cosmetic Dentist. Medical Aesthetics requires specialized training and certification beyond a nurse license / aesthetic license. Counselors,

psychologist A psychologist is a professional who practices psychology and studies mental states, perceptual, cognitive, emotional, and social processes and behavior. Their work often involves the experimentation, observation, and explanation, interpretatio ...

s or

psychiatrist A psychiatrist is a physician who specializes in psychiatry. Psychiatrists are physicians who evaluate patients to determine whether their symptoms are the result of a physical illness, a combination of physical and mental ailments or strictly ...

s can help people determine if their reasons for pursuing aesthetic procedures are healthy and help to identify psychiatric disorders such as

compulsive eating Disordered eating describes a variety of abnormal eating behaviors that, by themselves, do not warrant diagnosis of an eating disorder. Disordered eating includes behaviors that are common features of eating disorders, such as: * Chronic restra ...

anorexia Anorexia nervosa (AN), often referred to simply as anorexia, is an eating disorder characterized by Calorie restriction, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. Individuals wit ...

, and

body dysmorphic disorder Body dysmorphic disorder (BDD), also known in some contexts as dysmorphophobia, is a mental disorder defined by an overwhelming preoccupation with a perceived flaw in one's physical appearance. In BDD's delusional variant, the flaw is imagined ...

. Reconstructive surgeons can help correct appearance after accidents, burns, surgery for

cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...

(such as

breast reconstruction Breast reconstruction is the surgical process of rebuilding the shape and look of a breast, most commonly in women who have had surgery to treat breast cancer. It involves using autologous tissue, prosthetic implants, or a combination of both wi ...

after

mastectomy Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. A mastectomy is usually carried out to treat breast cancer. In some cases, women believed to be at high risk of breast cancer choose to have ...

for cancer), or for congenital deformities like correction of

cleft lip A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may be on one side, both sides, or in the middle. A cleft palate occurs when the palate (the roof of the mouth) contains an opening into the nasal cavi ...

Orthodontists Orthodontics (also referred to as orthodontia) is a dentistry specialty that addresses the diagnosis, prevention, management, and correction of mal-positioned teeth and jaws, as well as misaligned bite patterns. It may also address the modificati ...

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