Episode Transcript
[00:00:20] Speaker A: Hey, this is Lacey with SmartCast, and we're here in Arizona with the owner sermon of A and and we're joined today with Dr. Peter Hilton. Peter, it's so nice to meet you. And we're going to be talking to you a little bit about their brand new Selenus dermaprp. So I know you did a class yesterday doing a training with some of the injectors here in Arizona. Tell me how that went. What is the buz about this new product and what are the doctors and the injectors thinking about this so far?
[00:00:50] Speaker B: Well, it's a really exciting product because it's in a different niche than the typical things that we inject into people's faces.
Most people have familiarity with hydronic acid fillers, which is a great filler in the right hands, but it has a tendency to sometimes give you a puffy type result. So this is a whole new class of volumizer that essentially harnesses the power of platelet rich plasma and puts it into a gel matrix that time releases it over several months. So what that means is we're essentially putting to work the body's healing mechanisms and creating new collagen using an autologous source. Meaning we take the filler out of the person's blood, we mix it up, treat it in a certain way, and then we inject it back into their face. And the results have been very impressive, quite honestly, and quite different than what we've experienced before with the other hyaluronic acid fillers.
[00:01:58] Speaker A: Right, and so what would the safety profile on this type of filler be in comparison to a traditional ha filler?
[00:02:06] Speaker B: Well, Ha fillers are nice because they're made out of hyaluronic acid, but then they're not nice because to make them last longer, we have to bind them with a chemical called BDDE, and some people get an allergic reaction to that. And then in some people, the hyaluronic acid fillers don't go away, which can be a problem in some situations. But what's nice about this particular volumizer is that it's composed of all natural components that are within your body. So it's the very first autologous volumizer that I've come in contact with.
[00:02:49] Speaker A: So would there be a way to erase this, if you will, if someone didn't like it or they felt like it just wasn't the look they were going for, or would that even be necessary at all?
[00:03:02] Speaker B: Yeah, well, luckily it's not necessary because as a volumizer, it's very forgiving. And even if you overdo it at the time of treatment, the swelling goes down considerably quickly. I haven't had a situation where I've had to try to figure out how to decrease it. But as physicians and injectors, we like to use a little forethought in where we put things so that that doesn't happen. Now, again, the hyaluronic acid fillers, that's where all that fear comes from because they're very easy to overdo.
They absorb many times their weight in water, and then they can get an augmented result that you weren't expecting once the person walks out. But if you have an artistic injector, they typically don't try to overdo things. So we haven't had a need to try to melt this and then there isn't a reversing compound, but I don't feel that there's a need to in this situation.
[00:04:02] Speaker A: So then would it fill in the same way that a traditional ha filler would? Or would you get a little bit softer result? Would it be something that would be a little more in line with say, like a belatera or something that's a little bit softer like that?
[00:04:18] Speaker B: So what happens with other fillers? And then I'll compare it with fillers, but it's almost in its own category outside of fillers. So again, it's a volumizer more than a filler. When you're talking fillers, the hyaluronic acids are a big family. They're all a bunch of brothers and sisters. And one of them is better at math, the other one's better at absorbing fluid, the other one's more solid and needs to be on bone.
So there's different viscosity and thicknesses that you have with hyaluronic acid fillers. And what happens with this volumizer is you can adjust the thickness based on the preparation of the filler. So you can make it thinner, you can make it thicker, and you can basically bake it to whatever you would like it to be. So that's what's nice. So it's not so much you have to worry about belatero being too thin or voluma being too tight.
You can adjust it to where it is. But let's go back to what it is compared.
It's almost in a different category to hyaluronic acid fillers. And in my hands, it's not going to displace hyaluronic acid fillers, but it fills a certain niche that didn't exist before. You can get large volumes of fillers, so you can get large volume of volumizer, you can get up to twelve MLS of this volumizer. And you could do things that you couldn't do before. Because the problem with ha's is they're expensive and they grow and all the problems that you see that ha's could have. But what we do with this is we can treat large surface areas like the preuricular area of the face below the cheeks. You can do large surface areas like the neck, you can do the back of the hands.
And there's a certain amount of augmentation that happens with that. But the interesting thing that happens is you're taking advantage of the platelets. And what the platelets do is nourish the skin and actually create a luminosity or a glow that's in the skin. And that luminosity in that glow is really what the filler does. It's kind of a cross volumizer does. It's really kind of a cross between doing a laser treatment and getting a facial augmentation in the traditional sense.
[00:06:38] Speaker A: That sounds really great. I would love that.
So typically with an Ha filler or even like say, radius hyperdilute, you can almost fill it in the skin. How would this fill in comparison to that?
[00:06:53] Speaker B: To the patient can almost fill in the skin.
[00:06:56] Speaker A: Like when you can fill the ha filler where it's placed until it kind of softens up in the skin. Can you fill this product, you're saying.
[00:07:06] Speaker B: Like, it's getting lumpy type thing?
[00:07:08] Speaker A: Sometimes lumpy, or sometimes you can just feel that there is a foreign body inside your skin, like, especially if you get your lips or your cheekbones or anything like that, you can feel the filler in your skin. Would this have a similar or would this be like more natural feeling in the skin?
[00:07:29] Speaker B: Definitely is a more natural feeling in the skin.
Day one, there's always swelling because you have the associated trauma of whatever needle or cannula used to place the product. But most of that is soft tissue swelling. It's very forgiving as far as swelling goes. Most people's swelling is down within 24 hours.
The longest I've seen is within seven days, it's Massageable. So if you really don't like the way it looks, you can sort of massage it to be less full.
And then again, what happens is the platelets will kick in with their healing powers and actually create more volume in the skin that was there previously.
[00:08:18] Speaker A: So for us, part of our protocol is immediately post injectables. We'll apply the xoe exosomes to significantly reduce any inflammation in the skin. Would that be something good to do after this as well, or would it not be necessary?
[00:08:32] Speaker B: Well, I love xoe, and I think xoe really shines after a dermal penetration energy device, and it certainly helps anything that's inflammatory. But since we're actually injecting under the skin, xoe wouldn't be as great of a benefit because there's not a whole lot of redness or irritation on top of the skin.
[00:08:55] Speaker A: Okay, so as far as vascular occlusions go with this product, would this be a safer product as far as that's concerned?
[00:09:05] Speaker B: Well, yeah, we hate to have vascular, vascular occlusions, and that's always a practitioner's greatest fear.
Whenever you're injecting something that's outside of a liquid, there's a possibility of a vascular occlusion. And the key to avoid vascular occlusions is to know your anatomy, use appropriate implements, use a cannula when possible. A larger bore cannula try to avoid sharp needles, especially in high risk areas like the nose and the glabella.
And any viscous material injected into a vessel can give you a vascular occlusion. So luckily, we have not seen this with salinas PRP. It's been in the market for six years, but we're going to knock on wood on that because it's a possibility with anything that has a greater viscosity than water.
[00:10:06] Speaker A: Okay, so tell me where all you are injecting the cilinus PRP yourself, and where's your favorite place to see it.
[00:10:14] Speaker B: So I started out very conservatively. I was doing the broad areas of the face, underneath the cheeks, and then I was doing necks to try to rejuvenate necks. And it is probably one of the few products that you can inject into a neck that actually makes the skin look better. Just because of the radiance that you get out of the product or the luminescence of the skin, that happens. It increases the trans epidermal water that is present in the skin. So it actually physically thickens the skin, use it in the back of the hands. And again, back of the hands are often aged as well. And again, where this product shines is it changes the way the skin looks as well as changing the volume underneath the skin. So that's why I started playing with it initially.
And then you can also use it as a traditional filler and inject it onto bony prominences. And I'm getting some pretty good results, too, going placing it superperiostically and placing it deeply. Certainly not the same longevity that we get out of a hyaluronic acid.
Hyaluronic acids could virtually last forever, whereas this product metabolizes and again, sort of secretes its healing material over time. You got to think of it as a time released stem cell program. So what we're doing is we're taking the platelets and we're mixing it inside of a gel. And then that gel is like a big cloud. And as the cloud starts to deteriorate, the platelets will come to the surface and exert their influence over a longer period of time. So we've all seen vampire facials and seen the benefits of PRP, where someone's got totally raw red skin on day one and day two, they're going to the prom.
So that's the benefits we can get with this gel, except we're doing it sub Q as opposed to pouring it on top of the skin like you would an Xoe.
[00:12:14] Speaker A: Yeah. So you said that you're probably one of the more conservative docs on the team as far as where you're placing this. Where are some of your colleagues placing it that you haven't tried out yet?
[00:12:25] Speaker B: Well, some of my colleagues, when they introduced this product to amp, they gave it to a dermatologist, they gave it to an aesthetic practitioner, a body aesthetic practitioner, and then a plastic surgeon. So I again started with more traditional dermatological. I'm trying to enhance the beauty and the vibrance of the skin. But then after talking to my colleagues, they're placing it underneath the eyes and they're using it as a traditional filler. Interesting place is lips. Not only does this augment the lips in a non puffy hyaluronic acid way, it looks very natural as it augments the lips, but it also increases the redness of the lips. So when you get someone who's over age 50 who's totally fearful of getting anything in their lips, this is a great alternative because not only can it be injected into the lips, you could inject it intradermally to help with the vertical skin lines above the lips. So it's a double edged product for perioral rejuvenation. And again, my colleagues are using it. Anywhere else that you would use filler.
So mostly under the eyes is probably the most advanced location, and they're getting good results with it.
[00:13:42] Speaker A: I could see under eyes being a really popular area. And for lips, too, we have a lot of patients, a lot of younger patients getting their lips done, and they're a little bit nervous about doing a full syringe of filler, and they're always asking for baby lips, which is a half a syringe of filler. But one thing I have noticed, too, is that sometimes with ha filler in the lips, it does somewhat block the blood flow, and it takes away the natural pinkness in your lips. So I think that would be really a nice thing to be able to say, that this is bringing back the pink, the natural plump pink color in the lips, almost like a natural lip gloss. So I like that idea. I'm excited to bring that back to our practice. So you guys have cosmetic treatments at your office. Tell me about some of the treatments that you have. And what of those treatments are you cross promoting into the Salinis PRP?
[00:14:33] Speaker B: Well, we've only started playing with the Salinas PRP for over the last three months. And so initially I was looking at it from a filler point of view, and I was saying, okay, I really need another filler. There's so many out there. There's two more there hitting the market.
[00:14:47] Speaker A: So many.
[00:14:48] Speaker B: So do I really need another filler? But I wanted to try it and I wanted to play with it, and it's gotten to the point now where I'd be sad if I didn't have it. So there is a place for a new volumizer, and the reason I say volumizer is we're not trying to displace the filler market. It's just something that's that's totally different, that hasn't been seen before, because we're integratively generating a person's own collagen, using their own body products. So in 20 years, I got to think that this is the way it's going to be. Ha's will go away, and we're going to figure out some way to generate our own dermis, and this is actually a step in that direction.
[00:15:33] Speaker A: I think our patients are looking for that too. I mean, they're becoming more aware of what they're putting in their bodies, and they are more self educated on the things that we're offering today too. And so I agree with you 100%. I believe that this is definitely the direction that we'll be going into in.
[00:15:49] Speaker B: The future as far as stacking the treatments, I think it's going to go really well with Scarlett.
I'm sure it'll go well with Agnes as well.
Any skin beautifying treatment, it's got to be a synergistic result.
[00:16:03] Speaker A: Yeah.
So what do you have currently at your practice?
[00:16:08] Speaker B: I have an Agnes that's used for facial shaping. I have a scarlet, which is used for skin rejuvenation and thickening the dermis.
I use the Xoe products because I like the fact that it's a natural plant product.
In the exosome realm, you avoid the pathogen problem you have with other exosomes.
[00:16:35] Speaker A: Derive. Do you have derive?
[00:16:37] Speaker B: Yes. And then the hair products are derived from Xoe. And I like those results.
[00:16:43] Speaker A: Are you getting good result trace of your derive?
[00:16:45] Speaker B: I've only started playing with derive over the last month, so I can't tell you that yet. But I'm pretty excited about it because.
[00:16:53] Speaker A: It'S a big demand.
[00:16:54] Speaker B: It is, yeah, definitely.
[00:16:56] Speaker A: So we have derive and then we're using it with ultrasound, and then we're also using it with our 1550 laser and pairing it also with our salt facial Led light. So we've been seeing some pretty remarkable results. A lot of our staff have struggled with thinning hair, and so I sent in some self assessment photos from one of my staff members. And the difference was in like, Mary Margaret was at four weeks, I think.
[00:17:21] Speaker C: It was like two months. And then she just two treatments, last treatment, but her head is full of baby hairs. We were just like, shocked.
[00:17:30] Speaker A: She cried.
[00:17:31] Speaker C: Yeah, she was in tears. She's been through a lot. And as a woman, that's pretty hard to lose your hair at such a young age. So it's life changing for a lot of people.
[00:17:39] Speaker B: Well, they're saying one out of four people after COVID are having problems with hair loss. And I could see that with the uptick of hair loss. That's in my practice. And you said something interesting with the Led. So if you don't have access to these powerful devices that also have powerful price tags to them, an Led is also another way that you can increase the delivery of the Xoe and derived products.
[00:18:02] Speaker A: Yeah, we pair our salt facial Led light even if we're not doing the other components of that device. We use the Led light on there a lot. And then we also have the light stem with our hydrofacial, Cindyas. So we've got lots of Led lights. Led is a very universal treatment modality to help with redness inflammation. Anytime anyone has any sort of redness or a breakout or anything, we're putting them under the light for sure.
[00:18:31] Speaker B: I've got one in every room.
[00:18:32] Speaker A: Yes, we need a bed.
We have three Saluma lights and three light stem lights, and then the salt facial Led light as well. We're big with that.
[00:18:45] Speaker C: I think the salt facial light is the best.
[00:18:47] Speaker A: It is.
[00:18:48] Speaker C: They have collagen rejuvenation, skin rejuvenation, or collagen restoration skin rejuvenation. And then they have the acne Led. But I feel a difference whenever I use it compared to the other lights we have.
So I like that one.
[00:19:04] Speaker B: I'm a big fan of the light.
[00:19:05] Speaker A: Stem, so I've noticed that these guys amp is going to be launching some skincare treatment lines. What are your thoughts on that?
[00:19:14] Speaker B: Well, that's really exciting because they're all basing it on the success of Xoe.
And again, the exosomes sounds like a buzword in medicine right now. What is an exosome? So think of a stem cell. What a stem cell is is something that is pluripotent, meaning it can create itself and it can create other cells. So basically, it's like a 3D printer of whatever the body may need.
The problem with stem cells is where do you get them from? You can get them from embryonic, which is controversial. You can get it from the bloodstream, you can get it from bone marrow.
But let's get away from exactly. The stem cells are a great thing, but hard to acquire.
But what exosomes are are the soup that stem cells live in. So all the signals that stem cells send out go through exosomes. So think of it as a chicken noodle soup. The stem cell is the chicken and the soup is the exosomes. So you're getting 90% of the benefits of the stem cell without actually having the stem cell.
And other products on the market are not plant derived. So to me, that bothersome from a pathogen point of view, and they've all got their quality control to make sure there is no pathogen problem. But I feel much more comfortable using a plant product. Why a plant product? Okay, I'm a human. Why am I using a plant? Well, if you look at the chlorophyll molecule, the only difference between the chlorophyll molecule and the hemoglobin molecule is the hemoglobin molecule uses an iron molecule within the center of it. Other than that, they're exactly the same. So there's a lot of homology, there's a lot of similarity between the evolution of plants and the evolution of animals.
And if you think about all the products that we use on our face, they're all plant based. So it's a comfortable way to go.
And Dr. Newman, who developed the plant based exosomes, has had a lot of experience with creating products, and he's assisting in the creation of the product line that amp is mean. You can orient them towards growing hair, you can orient them towards growing skin, you can orient them towards repair.
It's really an exciting new branch that it's probably one of the most exciting pharmaceutical like drugs that we've drug that's not really a drug, pharmaceutical like products that we've had access to in the past few years.
[00:21:57] Speaker A: Well, I think it's really exciting where they're going with this technology, for sure, because the possibilities are endless, right? Like, they're treating hair and they're treating inflammation. Like, what else are they going to be able to target treat with the exosomes? So I'm really looking forward to looking down the pipeline to see what's coming up next and just like the different things that they're able to utilize this for now, too. And we partner with amp for our PRP as well, and we do a good bit of that but I'm seeing that more and more of our patients are moving over to the exosomes, and they are excited that it's a plant based exosome therapy as well, and they are asking about that. And so as soon as we tell them that it's plant based, then they're on board, and they love not having to get their blood drawn and all that stuff, as far as just adding it onto scarlet or adding it onto our skin pin or any of our other services.
And we use the exosomes a good bit for lots of different things.
[00:22:58] Speaker B: So the exosomes just another caveat to that that's been being under development for the last ten years. Dr. Newman has been working on it for the last ten years, so we're seeing the fruits of his labor, whereas most of the other exosomes that are out on the market haven't been under development for that long.
[00:23:18] Speaker A: And I appreciate that it comes with a take home skincare for them to follow up as well too, so for them to do the detox beforehand and the repair afterwards. My daughter's 16. She has perioral dermatitis, and so we've been using ultrasound with exosomes, and then she's been using the repair at home, and it's one of the only thing that has helped her to get that under control. Right.
[00:23:40] Speaker B: It looks anti inflammatory, so it's not surprising.
[00:23:42] Speaker A: Yes. I mean, she's tried lots of different things. She's been on antibiotics. She's done all kinds of different treatment modalities, and she asks me all the time, mom, can you bring me home some more of the repair? It's the only thing that helps my face. And as a 16 year old, that's important to her, her appearance and feeling confident when she goes to school and not having red inflamed around her mouth and around her eyes too. So she loves, um, so Mary Margaret is an esthetician, and she's in the treatment room every single day. Do you have any questions for Dr. Hilton about the exosomes or PRP or.
[00:24:23] Speaker C: Are we ever going to be able to inject exosomes in the future? Do you think do you think you'll be able to inject it at all?
[00:24:32] Speaker B: I think we'll get there, but you got to have lots of studies to get that direction, to get through the FDA to do things like that. I think there's a big scientific leap and investment that needs to be made to go that direction.
But I can see that happening in the future, not in its present form. It'll have to be refined a little bit more, but I can see that.
Like I said, I think in ten years we'll all be doing that. We'll be injecting ourselves with our own stem cells. We'll be injecting ourselves with exactly exosomes, or preferably having somebody else inject us with them, I guess.
[00:25:09] Speaker A: So what are you looking forward to with exosomes? As far as specialized treatments?
[00:25:17] Speaker B: What I like most about exosomes is the acceleration and amplification of healing that happens.
So if you have done a laser treatment and the person is bright red because some people react with different vascular reactions, you can put the exosomes on there, and within an hour, they've almost got a normal skin tone. The next day, they're usually good to go.
So not only is a good rescue treatment to help alleviate some of the trauma that's happened to them, but it's also beneficial in increasing someone's collagen and increasing the healing process the same way a stem well cell would. So, again, the stem cell makes whatever it needs. So if I just injured the skin, I need some more collagen production, so it's going to assist in collagen production.
[00:26:09] Speaker A: Do you use this on your psoriasis patients?
[00:26:15] Speaker B: I've had some success with rosacea.
I haven't tried it on psoriasis yet. I've had some success with acne.
As a dermatologist, I try to rely on the existing armamentarium, but there are a couple of people who are resistant that I have tried that on, but not enough to really say that this is what I'm going to do to everybody.
[00:26:40] Speaker A: Well, and now, you know, it works on perioral dermatitis.
[00:26:43] Speaker C: Exactly.
[00:26:47] Speaker A: Well, thank you so much for joining us today. We really appreciate your time and being here, and we look forward to seeing how your practice grows in the future.
[00:26:56] Speaker B: Thank you very much.
[00:26:57] Speaker A: Thank you for joining us on today's episode of SmartCast in our weekend in Arizona with our partners at Amp, Sam.
