Inside Aesthetics Ep 268 Part 1 What's Trending in Aesthetics (Chapter 5) | Dr Steven Weiner
Episode 268 hosts Dr Steven Weiner (Facial Plastic Surgeon based in Florida, USA)
Back on July 11th, Steve and another previous IA guest April Harrison did an Instagram Live together where they discussed their thoughts and aproach to botulinum toxin resistance in their own patients - including a very novel (and controversial!) approach to using hyaluronidase to 'cure' it.
In our 'What's trending in Aesthetics?' episodes we cover topics that have got injectors talking on social media or been in the news. We'll cover controversies, big stories and themes that affect our speciality.
In Chapter 5 Part 1 (free for listeners on any podcast app), we explore:
- Botulinum toxin resistance
- Theories around what happens with the immune system to cause toxin resistance
- The issue of 'pseudo-resistance'
- How to approach suspected toxin resistance in patients
00:00 Introduction 00:31 Catching Up and Weekly Updates 01:22 Clinic Busyness and Market Trends 02:16 Biostimulators and Sculptra Talk 03:56 Patreon Split Episodes Update 05:21 Meet Dr Steven Weiner 09:24 Origins of Toxin Resistance Live 10:03 What Is Toxin Resistance 13:43 Antibodies and Protein Load Debate 15:45 Vaccines Illness and Injecting 18:27 Does Xeomin Reduce Resistance 20:39 Brand Hopping Myth 21:22 Pseudo Resistance Explained 22:12 Testing Limits and Hype 24:16 Toxin B Option 25:20 Injector Error Deep Dive 27:15 Frontalis Depth Nuances 30:31 Frequency Drives Resistance 31:31 Dilution and Longevity Debate 36:24 Ultrasound Guided Toxin 41:56 Saline Reconstitution Myths 43:42 How Rare Is Resistance 44:53 COVID Vaccine and Fibrosis Theories 47:33 Part Two Preview and Patreon
In Chapter 5 Part 2 (Now available inside our new app, IA Community, ahead of our official launch this May. Click here to join our waitlist), we discuss:
- The background to why they looked at using hyaluronidase for toxin resistance
- April's toxin resistance case
- Steve's theories about how hyaluronidase might work
00:00 Introduction 01:08 Immune System Damping Ideas 04:21 Practical Limits and Ethics 07:51 Hyaluronidase Paper Insight 11:51 Hyaluronidase Products Explained 13:23 Fraxel Surprise and Efficiency 16:18 Mechanism and Diffusion Risks 19:13 April Case Breakthrough 22:55 Protocol and Dilution Strategy 27:04 Is Resistance Actually Rare 28:05 When Tox Stops Working 28:47 Washout Period Reality 29:37 Antibody Data Surprises 31:43 User Error And Referrals 32:50 Dose Variability In Vials 34:58 Stock Theft Business Risk 37:36 Touchups And Timing Rules 41:14 Dose Adjustment Language 43:38 Zinc Supplement Myth 44:59 Off Label And Insurance 50:15 Wrap Up And Outro