Origins

The concept of Medical Cosmetology is no modern idea, as it already existed 2000 years ago in Ancient India with skin grafting and rhinoplasty being performed. 

What is modern Medical Cosmetology? It is a specialized medical field that combines medical science with cosmetic treatments to enhance appearance. Interestingly, some inventions such as laser, HIFU, RF, HIFES, Botox were originally invented to treat medical conditions and not aesthetic concerns.

Radio Frequency was used to heat deep tissues to improve joint conditions and induce muscle relaxation; HIFU was developed for the ablation of solid tumors in organs such as liver and prostate; Lasers were used to remove retinal tumors; HIFEM was originally designed for physical therapy; and Botox to treat migraines and hyperhidrosis. It was only until scientists expanded their applications and medical practitioners noticed their patients having much smoother and tighter skin that they realized these technologies can be used effectively for aesthetic purposes.

Common types of Medical Cosmetology

Medical cosmetology encompasses 2 main areas: aesthetic surgery and cosmetic dermatology.

Aesthetic surgery is invasive, referring to surgical procedures that change the face or body structurally involving general anesthesia, longer recovery, greater risks and usually more drastic results.

Cosmetic dermatology does not involve surgery and encompasses minimally invasive procedures to enhance the skin’s appearance by inducing controlled damages that prompts regeneration. Some popular treatments include: 

Chemical Peels - 

• Uses specific chemical solutions that are generally acidic to apply onto the skin, breaking the bonds between dead skin cells and inducing controlled damage, shedding off the stratum corneum and prompt keratinocytes to grow.

• Depending on target depth, choose from superficial, medium, or deep peels, with deeper peels usually requiring longer recovery times. 

• Common types include:

AHA: comparatively gentler for superficial lines and exfoliation.

BHA: oil-soluble BHA to unclog pores, congestion, and treatment of acne

TCA (trichloroacetic acid): medium strength that targets sun damage and shallow scars.

Phenol: intensive and targets deep wrinkles.

• Chemical Peels are gaining popularity not in professional treatments, but making their way in homecare products in low concentrations to exfoliate the skin when needed.

High Energy Treatments - 

• IPL and lasers: it employs the use of photons to target chromophores (molecules that absorb light and emit a visible color) through a theory called photothermolysis, which literally means light -> heat -> disintegration, where photo energy is absorbed and converted to thermal energy by these chromophores in which the high heat causes their damage or destruction without affecting neighbouring tissues.

• They target: vascular lesions, redness, hair removal, hyperpigmentation or simply photo-rejuvenation

• While IPL emits a range of wavelengths, laser is specific and therefore effects are more targeted

• RF: using electromagnetic waves to deliver high-frequency electrical currents heating the dermis and/or subcutaneous tissues from 40-67 degree Celsius. Less precise when compared to HIFU but has broader effect. 

• Frequency: 3-6 sessions spaced 2-4 weeks apart, then once every 6-12 months

• HIFU: delivers ultrasound waves into upper dermis, lower dermis, subcutaneous fat, and SMAS (superficial musculoaponeurotic system). 

• The energy targets precise thermal coagulation points, heating tissues to around 55 degrees Celsius and stimulates collagen and elastin growth, as well as tissue remodelling.

• Frequency: every 6-12 months, with results lasting up to 18 months

• HIFES: generates powerful electromagnetic fields that directly stimulate motor neurons, inducing muscle contractions for up to 20000 contracts in 30 minutes. The repeated contractions build muscle mass and tone while promoting fat breakdown for contouring, sculpting, and definition.

• Frequency: 4 sessions spaced every 2-7 days; then once every 1-3 months

Needles -

• Creates direct channels to deliver ingredients into the skin, BUT microneedling differs SIGNIFICANTLY from injectables even though both involve needles.

• Microneedling: creation of micro punctures in the skin using very fine needles to stimulate the skin’s own wound healing process, while delivering active ingredients into the skin. It mainly improves skin texture by prompting skin growth.

• Injectables: administration of substances into the skin or muscles via a syringe needle. There are generally 3 main types of injectables: 

• neuromodulators: such as Botox (botulinum toxin) - yes it’s a toxin - causing muscles to relax by blocking the release of acetylcholine - a neurotransmitter - such that our muscles don’t receive signals to contract. It reduces visibility of wrinkles and expression lines

• fillers: such as HA (hyaluronic acid), PLLA (poly-L-lactic acid); sculpt and restore volume in the skin using Hyaluronic Acid

• boosters:  injection of hydration and rejuvenating substances, such as peptides, vitamins, nucleotides and amino acids, to improve skin quality

While these treatments work well in theory, treatment results also depend on skin and health conditions as well as the execution of the technique, and each treatment comes with its associated risks and side effects. Be sure to do extensive research and consult multiple physicians and practitioners before making a decision!