Shocking Truth Behind the World of Cosmetic Medicine | Truth behind the industry - Dr Davin Lim

The cosmetic industry is filled with sale driven ethos, and the dignity of medicine has suffered. New lasers are flooding the market, together with lax laser licence laws means poor training. 15 years ago to obtain a laser licence for procedures like hair removal and laser tattoo removal one had to go though a vigorous examination. Nowadays, open book online courses are available, additionally there is no structured learning both for doctors and for dermal therapist or laser nurses. 



In Queensland, Australia any doctor, including dentists and vets can purchase high powered CO2 and erbium lasers without training. In my opinion, this is similar to buying a fully automatic shotgun. Used incorrectly lasers have the potential to cause life long serious scarring, even in ‘safe’ fractional laser resurfacing mode. I love working with laser technology however for many cases of acne scarring, lasers are NOT the answer. Lasers such as CO2, erbium, Fraxel, and energy devices such as RF microneedling Infini, Intensif, Secret RF and many more are merely tools to treat a certain scar type. The majority of effective scar revision relies on manual manipulation of the scar type, this means treating under the skin where scars lie, not on the skin. More on this topic in a separate video. Laser settings are essential to obtain a good result. Backtracking, one has to assess – Is this patient suitable for laser? If so, what is the BEST laser for this condition. The most common conditions cosmetically are hair removal, skin pigmentation, wrinkles, sun damage, skin laxity, age warts and broke blood vessels or veins. The most common medical conditions include acne scarring, birthmarks and rosacea. After one has obtained a diagnosis, the second step in the algorithm is finding the best settings for the energy devices for that patient. Every patient is different, you can not optimise results pressing the default button on the laser. Play of words is a very common marketing ploy, IPL, laser resurfacing, fractional resurfacing, CIT or collagen induction therapy, microneedling, Max RF subablation, subablative , Ultherapy, Ultratransformer, HIFU, and many more brands, and acronyms are used for the purpose of marketing. In reality most patients are so confused, and rightfully so! Every week I get a glossy catalogue or a phone call, followed by emails introducing a new laser- device that will ‘revolutionise acne scars’ or promise a zero downtime wrinkle erasing procedure. Working out what works and what is utter lies is what I love doing, however it can be frustrating at times dealing with the ethical issues of laser companies. Their goal is very different to mine. They want to sell, I want clinical outcomes. If we are aligned I work with them, if they are not I hand the device back and don't usually talk about it on Social Media unless they really poke me in the back. Several companies are about to have some interesting news shortly. Kle#$*ca is on my list. Botox, Xeomin and Dysport are popular anti- wrinkle injections. Cost price varies by a factor of 3-4 to ensure you are getting what you pay for. Same goes for fillers – top line fillers include Juvederm, Restylane, and Boletero as well as Sculptra and Radiaesse. Always ask your injector what you are getting. This one YouTube video will have zero impact on the industry, but if you did watch it you will be wiser if you elect to have aesthetic work done.

If you are a layperson and wish to understand more about the world of medical aesthetics, check out our Aesthetics 101 mini-series:

Part 1: Aesthetic Medicine Course for Layman, Beauticians, Aestheticians and Nurses
Part 2: Basic Science for Aesthetics: Human Physiology, Pathology, Biochemistry, Microbiology & Pathology
Part 3: The 6R's of Aesthetics
Part 4: Introduction to LASER, Laser Types and Indications
Part 5: Introduction to HIFU (High Intensity Focused Ultrasound
Part 6: Introduction to Body Contouring

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