"How have new technologies revolutionised the field of aesthetic dermatology (not just diagnostics) and opened up new frontiers in treatments for facial and body rejuvenation?"
I can tell you, says Dr. Luigi Coricciati, that today the scenario has completely changed: until recently it was the doctor who – after careful evaluation – proposed solutions and treatments; today thanks to the ease of access to information offered by Internet and digital platforms, patients arrive with proposals and solutions that are already structured, but not always adequate and correct.
However, whoever wears a gown has nevertheless learned that a DIAGNOSIS must first be made, and that this must be as correct and precise as possible. This is why today technological innovation has expanded and strengthened the possibility for the professional to make the most accurate and scrupulous diagnosis possible. I cite just some examples, continues Dr. Luigi Coricciati, to explain what I mean: significantly advanced technologies for aesthetic and medical analysis of skin, or 3D skin analysis, which is an innovative skin analysis device based on an advanced optical analysis method that allows analysis of the skin in 2 and 3 dimensions, and multi-spectrum analysis of epidermal and dermal pigmentation, or think of the progress made thanks to videodermatoscopy in the mapping of moles, and the importance of all dermatological screenings that make it possible to identify the moles at risk and to control any change over time, permitting an early diagnosis of the melanoma.
"From latest generation lasers to microfocused ultrasound: how have the new devices enhanced and extended methods of treatment to rejuvenation of the face and body?"
Currently, explains Dr. Luigi Coricciati, the solution is rarely given by a single treatment; the best results are obtained with a combination of methods, because it is one thing to treat the skin on a superficial level and another to have to intervene more deeply on laxity.
When the dermatologist has to act on the surface, fractional lasers are a valid solution to the treatment of the classic imperfections of the face, such as spots, wrinkles, some acne scars, and other signs of aging, allowing a quick return to work or to social life.
When the request is to act in depth for a non-surgical lifting, notes Dr. Coricciati, echo-guided microfocused ultrasound represents the revolution in dermatology and aesthetic medicine, because of reduced down time and people can return to social and professional activities in a very short time, with excellent satisfaction over time and without side effects.
Today, investing in the quality of technology represents an added value, as it ensures maximum patient satisfaction and safety for the professional. There are many devices that look alike, but the microfocused ultrasound associated with ultrasound control represents a "plus". Furthermore, it has 4 FDA approvals which are a guarantee and people are asking for safety and effectiveness.
"Treatment with microfocused ultrasound: why is ultrasound support for the doctor so important for patient safety?"
It is fundamental, explains Dr. Luigi Coricciati, because it is only with the ultrasound support of microfocused ultrasound that we can know where we are going to act, if we are operating in a muscle area, above a blood vessel or in fat tissue. In addition, having to correct loss of tone and laxity, it is important to act in a targeted manner, saving the surrounding structures.
"How has the doctor changed the way of working in recent years? How have patients and requests changed?"
I have been in this profession for over 17 years, answers Dr. Coricciati, and I can tell you that at the beginning my clientele was characterised by women over 55 in 98% of cases. Women currently account for 60% of customers and men 40%. Even the male clientele today pays greater attention to aesthetics, to health and prevention. Men are also asking for botulinum toxin and non-surgical lifting using microfocused ultrasound. Women are turning to medicine and dermatology long before the age of 50. For example, the younger women who turn to our structure do not seek perfection, but ask for minor corrections, for interventions on imperfections and signs such as the glabellar wrinkle, barcode line or marionette line. We intervene on a case by case basis, proposing all possible treatments and the different alternatives, always agreeing the project with the patient.
"What challenges will the dermatologist face in the aesthetic field in the next future, doctor?"
We have all gone through a period in which we looked at what was happening abroad as a benchmark for models or trends to be pursued. I, on the other hand, comments Dr. Coricciati, believe that affirmation of Italian taste and style should remain the benchmark.
When aesthetics produce improvements that do not distort or alienate expressiveness, features and proportions, it means that the professional has worked to the best of their ability in terms of aesthetic taste and technology, and from the deontological point of view.
I refer to the concept with which I opened this interview: diagnosis first of all, and to make an accurate diagnosis we need to listen to the patient, understand why he/she wants to intervene on their face or body in that particular way, in that particular moment of their life.
Today, working in dermatology and aesthetic medicine means "educating" and "accompanying" the patient, giving the pros and cons of treatments and interventions. The "Barbie Face", excessive turgidity, rubber-dinghy lips, and over-planed and stretched cheekbones are aberrations to be discouraged.
Today, the aesthetic intervention should reshape, restore freshness and naturalness and be gentle, elegant; it should be able to make you pleasing, never coarse or excessive. Otherwise the effect is that of a row of inexpressive and unnatural doll faces.
"Doctor Coricciati, do you mean that the dermatologist and the aesthetic doctor must also work a lot on the psychology of the patient?"
Certainly yes, concludes Dr. Coricciati. For example, in America, before cosmetic surgery patients have to undergo a psychological examination that highlights the vision of the patient. There exist forms of dimorphism that have very deep and complex origins and that the scalpel does not solve; in fact, people end up in mechanisms that are not healthy and lead to increasingly inadequate and excessive demands.
The real "challenge" that every professional will have to face in the future is to help patients intervene in a thoughtful and just way. We should not go too far, because otherwise we are talking of overkill. Knowing how to say no to excesses is a deontological duty. Not all wrinkles should be removed, some characterise the expressiveness of a person.
So to sum up: first listening, then an accurate diagnosis and only after that the therapeutic proposal. Where the professional evaluates, advises, ponders, asks questions – a bit how a life coach proceeds – and only then proposes the different treatments that can be performed, but attention to the psychology of the person is certainly the first pillar.