Revolutionizing Plastic Surgery with AI: Unveiling the Future of Beauty

Join Dr. Roy Kim and Dr. Kristy Hamilton in this eye-opening episode of 'The Beauty Scientists' as they delve into the fascinating realm of AI and plastic surgery. Exploring the groundbreaking capabilities of ChatGPT and other AI technologies, they discuss its impact on diagnosis, treatment planning, and even aesthetic ideals. From the efficiency of AI in administrative tasks to the potential for AI-generated videos and deepfake technology, this episode uncovers both the positive advancements and raises thought-provoking questions about the future of plastic surgery in the age of artificial intelligence. Don't miss out on this intriguing discussion that explores the intersection of technology and beauty!

#BeautyTech #PlasticSurgeryAI #TheBeautyScientists #AestheticsInAI #ChatGPT #FutureOfPlasticSurgery #BeautyandTech #MedicalAI #PlasticSurgeryPodcast #AIAdvancements #DeepfakeTech #TechandBeauty #AIApplied #MedicalInnovation #BeautyReimagined

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Transcript

Kristy Hamilton, MD (00:01.484)

Hello everyone. I'm Dr. Kristy Hamilton, board certified plastic surgeon here with.

Roy Kim (00:07.616)

Hi, I'm Dr. Roy Kim, another board certified plastic surgeon with another episode of The Beauty Scientist.

Kristy Hamilton, MD (00:14.132)

And we are very excited to be here and talking about great things today, which is the future. What's coming in 2024. Happy new year.

Roy Kim (00:25.53)

Oh yeah, Happy New Year, Kristy. I have not seen you since the New Year started, so I trust you're doing great.

Kristy Hamilton, MD (00:31.752)

I am and always excited for new beginnings, January, what's on the horizon. And, you know, everyone's always talking about the gym and exercise and good habits. And that's important. But you and I love discussing beauty and aesthetic and everything else we can do to augment those gym results. So here we go.

Roy Kim (00:54.098)

Yes, absolutely. So first off, one of the new topics that you and I know about is Skinvive, which is an HA filler made by Allergan that actually is injected mainly into the cheek, although outside of the US is actually injected all over the face and even the neck.

Kristy Hamilton, MD (01:12.712)

Yes. And have you tried it?

Roy Kim (01:13.982)

So I have tried it once, it does work. It does not seem to be like game, as game-changing as I thought. I think it's because it's only HA filler and it's not Botox or neurotoxin with HA filler.

Kristy Hamilton, MD (01:30.188)

So in my practice, I do a cocktail to micro-infuse the skin. I believe you do as well. And we incorporate neuromodulators like Botox or Dysport, injectable-grade hyaluronic acid. And then we can customize it to the patient's skin, growth factors, pigment correctors, vitamin C, anti-freatment.

free radical agents and antioxidants. And I find by infusing with the micro channels as opposed to needles, we go over the entire surface of the skin and we get it into the skin itself as opposed to injecting with the needle on the grid pattern with Skinvive.

Roy Kim (02:09.618)

surface of the skin and we get into the skin itself as opposed to injecting with the needle on the grid pattern.

Roy Kim (02:21.194)

You know, I have, I forgot to tell you, the needles that come with the packaging are okay, but they tend to get dull. There's a couple products from overseas. I have some needles from Korea. I should send you some. They are super sharp. So specifically they're made to Japanese, Korean, German stainless steel standards. They stay sharp. So they're not as painful and they're actually the correct depth. They come actually in different lengths, different depths.

to deliver it to the skin.

Kristy Hamilton, MD (02:51.988)

That I think makes a lot of sense. It's something when I was talking with the company I mentioned, maybe they need to consider how the product's being delivered just as much as the product itself.

Roy Kim (03:06.086)

Right. So the product, you know, has to be fresh, of course, but the product has to be delivered to the proper depth, which I think sometimes is hard to do with regular needles and regular syringes. To be honest, I don't think it's the syringe. I think it's the needle and the consistent needle depth and how deep it is.

Kristy Hamilton, MD (03:23.124)

That makes sense. So for the viewers, what are the benefits of Skinvive and products like it around the world?

Roy Kim (03:34.27)

Um, around the world, the big thing is what's happening in the U.S. It's the combination of neurotoxins and A.J. fillers, as well as the growth factors. Um, in the U.S. it's very difficult to get two prescription medications into one actual pill. That's just what the FDA has deemed impossible for the most part. And so that's why it's been hard aesthetically. But I do think that

we can do it or we can certainly do it in the office just like you're doing.

Kristy Hamilton, MD (04:07.38)

Yeah, so the off label mixing, I think I agree with you. I think it's a superior product. And one of the reasons that they rebranded or repackaged this product, which is hyaluronic acid, so it is like a filler, but they rebranded it as a skin booster because it's not for sculpting the face, it's not for changing.

Roy Kim (04:10.399)

Yeah.

Roy Kim (04:22.006)

which is hyaluronic acid, so it is like a-

Roy Kim (04:31.662)

It's not for changing the bone structure.

Kristy Hamilton, MD (04:33.172)

the bone structure or folds or hollows, it's really for direct infusion into the skin because we all know, you know, you do beautiful filler work. I like to think I do too. So for our patients, fillers are a good thing, but there's a lot of patients that have had bad experiences with fillers, pillow face, et cetera. And so by repositioning it as a skin booster, it's an interesting way to reintroduce.

Roy Kim (04:50.03)

that have had bad experiences with fillers, pillow face, et cetera. And so by repositioning it as a skin booster, it's an interesting way to reintroduce hyaluronic acid to patients. Totally agree with you. And it's, I mean, multiple papers have shown, like, it increases your skin quality, the skin texture, makes your pores smaller. So...

Kristy Hamilton, MD (05:03.008)

hyaluronic acid to patients.

Roy Kim (05:17.43)

That's what's cool about this combination treatment. And I'm glad that you're doing it, although it sounds like you're doing what I'm doing, we're like combining it with other things. We're not just using it on itself.

Kristy Hamilton, MD (05:27.004)

Yes, and I use the concept of glass skin, Korean glass skin as the model for it, just having just that beautifully hydrated, so smooth, pore so small, it just reflects light. And I think the combination of a couple of those ingredients together leads that result.

Roy Kim (05:48.298)

Yeah, that's my goal. That's my goal this year to get glass skin, no matter what.

Kristy Hamilton, MD (05:52.657)

Okay, me too. I'm having this baby and then I'm going to be lasered and botoxed and hydrated from within. It's going to be a beautiful thing.

Roy Kim (05:53.783)

Haha

Roy Kim (05:59.538)

Yeah. Good. Well, you're glowing anyway, so I'm sure the baby helps. So next up is talking about Ozempic, semaglutide, and the long-term ramifications because I know that you prescribe it and I know that you follow patients with it and I'm sure that the patients are very happy. In theory...

Kristy Hamilton, MD (06:05.664)

Thank you, so they say.

Kristy Hamilton, MD (06:18.119)

Mm-hmm.

Roy Kim (06:25.554)

and this is according to the FDA, once you're on it, like you're off of it, like you're on it for a short period of time and you maintain your body and your lifestyle and your exercise treatment program. Knowing human behavior, I tend to think that these patients are gonna need it like once every three or six months forever.

Kristy Hamilton, MD (06:43.756)

And some of the studies have pointed to that, and it's part of my counseling for patients, I'm sure it is with yours, is that you can't expect the medication to do all the work. I mean, it's as close to a silver bullet as we have right now, but the reality is that you can't go back to poor lifestyle habits, poor eating, no exercise, and then expect your BMI or your weight to stay the same.

So I tell patients this needs to be a tool. You still need to be doing lifting, resistance exercise is maintaining your muscle mass and then using the medication really more to encourage smaller portions, portion control. And that's when patients are more effective. But if you are just eating chips for your small meal a day, then you're not gonna see the same results.

Roy Kim (07:16.142)

We'll be doing lifting.

Roy Kim (07:27.746)

smaller portions, portion neutral, and that's when patients are more effective. But if you are just eating chips for your small meal a day, then you're not gonna see the same results. I think you can have a 4,000 a day, I'm sorry, 4,000 calorie a day diet and then just stay on this forever, right?

Kristy Hamilton, MD (07:47.588)

Yeah, that's not my intention with my patients. I'm definitely prescribing for the short term. But I think we'll see people that are just on this medication for years, like you said, maybe forever. In the meantime, though, it's definitely impacting our surgical practices. What have you seen?

Roy Kim (08:11.218)

You know, interestingly, I haven't seen that much. I think it's because in California, maybe people are already started to be, they're not that overweight maybe, and so this definitely helps. I have not seen that many patients who are, who have lost, I don't know, 50, 75 pounds and have morbid obesity, loose skin, yet. I have seen some patients with like, moderate to minor loose skin.

Kristy Hamilton, MD (08:34.309)

It's coming.

Kristy Hamilton, MD (08:38.172)

It's coming and then in my practice, it's not even necessarily massive weight loss on that scale. For some patients, they wanted to lose that final 15, 20 pounds and they finally did it and they hit their BMI goal to be ideal for surgery and now they're ready.

Roy Kim (08:55.662)

Uh-huh. For surgery and now they're ready. Well, that's good. I mean, we could talk about this more with another episode because it's so huge. It's just, it depends on your face, your skin laxity, your age. It depends on your body. It depends on a lot of factors, but 15 to 20 pounds in some people may not be noticeable and 15 to 20 pounds in other people may be very noticeable.

Kristy Hamilton, MD (09:19.624)

Very noticeable. So I'm predicting for 2024 for the face, more fat transfer, more facelifts, in patients that have lost a lot of weight, they may be on the younger side to tighten everything up over the weight loss. And then...

Roy Kim (09:29.294)

Mm.

Kristy Hamilton, MD (09:38.728)

I also expect more body contouring in the form of surgical body contouring in the form of tummy tucks, arm lifts, thigh lifts as patients do continue to lose more significant amount of weight.

Roy Kim (09:53.022)

Yeah, I mean, I agree with you. I definitely think that facelift will increase because patients will notice a lot of loose skin and the less invasive, non-invasive things that we know slightly tighten skin is plastic surgeons, but they don't tighten it that much. So, hey, if patients can live with that, that's great. But if patients can't live with that, they'll be.

may be concerned about their appearance. And specifically, one topic I wanted to talk about is RF micro-needling. There are a lot of not great studies or not great technologies that claim to tighten skin a lot. And honestly, it can improve skin quality, it can improve skin texture and thickness, but to tighten skin a lot, like if you have jowling or loose neck skin, I'm not aware of anything non-surgical that's actually going to correct that.

And I'm not going to name any products because I think all the laser companies, the micro-needling companies, other companies, it will tighten skin a little, but not certain if it's going to reverse losing 15, 25 pounds on Ozempic or, you know, God forbid you lose 50 to 75 pounds, something of that nature.

Kristy Hamilton, MD (11:04.144)

Absolutely, I agree with that. I think fractionated CO2 laser yields the most non-surgical tightening, but again, it's conservative. I'm always telling patients, this is not a surgical equivalent at all, but it definitely improves your skin quality. We may even use it in conjunction with your surgery.

so that we have healthier, more glowing skin, less crepiness, thinness that we get with time. But some of these more lunchtime procedures, I think they are wildly oversold to patients in terms of how much tightening they'll get with no pain, no downtime, minimal recovery. If it sounds too good to be true, it is.

Roy Kim (11:45.143)

in terms of how much tightening they'll get with no...

Roy Kim (11:53.687)

sounds too good to be true. And I noticed on social media, congratulations on getting a new laser. Thank you. And it's diffractionated CO2? It is. Uh-huh.

Kristy Hamilton, MD (11:59.06)

Thank you. I love it.

It is, and that's a workhorse laser in my practice because it works so well. I use it in conjunction with facelift surgery. And then I think it's really great for the so-called gap patients, patients that they're starting to notice some looseness, they notice some dullness to their skin, enlarged pores, some pigment. They wanna address all of these things, but they're clearly not a surgical candidate.

Roy Kim (12:31.922)

Right.

Kristy Hamilton, MD (12:32.012)

So this is a great way to maintain that. And that degree of tightening can be just right for someone that's just showing the earliest signs of aging.

Roy Kim (12:43.574)

Totally makes sense. And then that leads us into our next segment. I read an article in Wall Street Journal on Daxxify. It actually had a, I created a YouTube reaction video about it and Daxxify as a company is not doing that great despite having a pretty good product. It doesn't seem to consistently last six months in all areas of face. And I use it, but...

their original pricing plan doesn't seem to be working out so they've reduced the price. What are your thoughts on it?

Kristy Hamilton, MD (13:19.168)

So rewinding, because it was funny watching our little clips of our original podcast on Daxxify and seeing what we thought then and then comparing it to what we think now. So Daxxify for the listeners who don't know, it is in the same class as Botox and Disport, but it was presented to us as an intermodulator that would last closer to six months, whereas Botox and Disport are more three to four months.

Roy Kim (13:41.543)

as a modulator that would last for six months. Whereas, we've got to.

Kristy Hamilton, MD (13:48.688)

And the thing is it took us five or six months to find out. So I, this time last year, injected myself. And I will say it did not last six months for me. I think it lasted longer than Botox, but I don't think it justified the 70% premium in price. What do you think?

Roy Kim (13:51.726)

to find out.

This time last year, I injected myself.

I think it lasted longer than Botox, but I don't think it justified the 70% premium in price. What do you think? I mean, for me, it only lasted four and a half to five months, not six. And again, I'm getting it at probably just kind of price compared to a regular consumer. And I just wasn't ecstatic.

DacRain Vance has definitely lowered the price of this product in the past couple of months, nationally I think. And we'll see if it can have a bigger stronghold.

Kristy Hamilton, MD (14:40.156)

it'll be interesting to come back from the initial marketing. Because I think with any product launch, if anything, you want it to perform better than you're telling us. And I think that was an interesting strategy. I'm sure they thought it did last that long, but I think it's really hard to resurrect something and say, oh, this is something that works a little bit better than Botox and maybe price it the same,

Roy Kim (14:56.63)

I'm sure they thought it did last that long, but I think...

Roy Kim (15:07.01)

the same versus charging the premium that they did. And for me, what it came down to is of the patients that I tried it with me, and they knew this was a new.

Kristy Hamilton, MD (15:09.252)

um, charging the premium that they did. And for me, when it came down to is of the patients that I, that tried it with me. And they knew this was a new product. I've only had one wanted again.

Roy Kim (15:24.641)

Wow.

Kristy Hamilton, MD (15:25.088)

So I'm bearish on Daxxify.

Roy Kim (15:30.922)

Good to know because I have not injected that many patients and no one really wants it now that they've lowered the price. I have a couple trickling in who want it, but it's just, how do you say it? I don't really blame Revance. I think this is what happened with Jeuveau and what happens is to the people watching this, the FDA studies are real. It really does last 24 weeks or six months.

in the FDA-specified areas right here between the eyebrows. I think the problem is that even though they had a good study and it's statistically significant, they didn't inject 10,000 people or 100,000 people or hundreds of thousands of injections, and they can't. That's literally impossible. They're just checking for safety. So when you inject it that much, that often, in all types of patients, you can't predict what's gonna happen, and what happens is, in all types of patients, maybe it doesn't last six months, maybe it lasts five.

Kristy Hamilton, MD (16:25.undefined)

Yeah. And then patients were disappointed because they were truly expecting to get a six month duration. And when you think about how Botox or Dysport works, when you hit the three or four month mark, it's not as strong as it was the first month. So I think by extension it's probably unfair to expect the six month result. You know, there's probably still something on board, but.

maybe it's not significant enough to the patient.

Roy Kim (16:55.982)

I agree and maybe it looks okay-ish at five months but if you're paying that much money when it first came out and it's supposed to last six months and they can't see you as often I mean they're thinking great I don't have to see the injector the plastic surgeons often that's awesome it's like great you still have to see them so you know they're disappointed

Kristy Hamilton, MD (17:17.212)

Yes, I agree. And that's what we don't, none of us, like as physicians, we want happy patients. We want them to be pleasantly surprised at how much longer it will work than expected.

Roy Kim (17:28.466)

Yeah. So switching topics to breast implants, Motiva implants are probably going to be coming out in early 2024. So if you look at their last clinical submission and like approximately 10 months later, most things get approved by the FDA. And of course, nobody really knows, but we're talking like for probably the first six months, Q1, Q2 of this year. Establishment labs.

company that's publicly traded based in Costa Rica. Their main product is Motiva breast implants, already in Europe and South America and Asia. They're coming to the US. So are you excited? You're holding off? You're just thinking about it?

Kristy Hamilton, MD (18:12.264)

I like to keep my finger on the pulse of things and then hear what you think. Ha ha ha.

Roy Kim (18:18.222)

Oh, so for the consumers out there, you know, we have today smooth shell implants. So it's an envelope and it's smooth. And what happens is that it's very good technology is very old. It's very known. There are a couple of problems with smooth shell implants. There's still some tissue reaction. They could rotate. And

the way the biophysics is of the envelope, sometimes it's not quite as soft as it could be. Sometimes there's some debate, but they think certain manufacturers have thinner implants that have a higher problem rate, whereas other manufacturers have a thicker implant, they have a lesser problem rate, but it doesn't feel as nice. It doesn't feel as natural. With Motiva, it's very interesting physics because technically it's a smooth implant, but if you look at it, it's like, come on, dude, this is not smooth.

This has like some slightly pebbly surface on it. It feels like velvet when you touch it. Technically though, according to biophysics, that's a smooth textured implant. And because of the way that it works in the human body, there's not much tissue reaction to it. So specifically there's not much capsule.

Kristy Hamilton, MD (19:19.196)

Mm.

Kristy Hamilton, MD (19:34.972)

So this is interesting, right? Because it's a very popular implant outside of the United States. Why, and why do you think that is? Is it surgeon driven or is it patient driven or both?

Roy Kim (19:41.375)

Huge.

Roy Kim (19:49.598)

It's everything. So in terms of pure science, I know some of my friends overseas really love it. They have warned me or told me, look, when you use it, you have to have a smaller pocket, a more precise pocket. You're not gonna have as much capsule, which is great for the patient. You're not gonna have as much tissue reaction, but you're not, like if the pocket's normal size or a little too big, the implant may drop. It's just not gonna form as much scar tissue around it. So you have to be very precise in terms of...

the pocket creation as well as closing it. The other thing is that I think they do fantastic marketing. I mean, they even have an Instagram account here and it's extremely business to consumer friendly. And it's my friends in Korea, my friends in South America have told me it's the only implant that patients ask for by name. They don't know Allergan, they don't know Mentor, they don't know Cientro, they don't know PIP, they don't know anything.

They don't know Sabin, they don't know these other big companies. They know Motiva.

Kristy Hamilton, MD (21:00.8)

Well, that is huge. Had a little wifi moment there, but I heard what you said. And that, I mean, that to have patients ask for anything by name, whether it's a breast implant, whether it's neuromodulator, a filler, that is really significant. Because I think in most of those cases, the patients are coming in for the procedure or the result, but don't necessarily have an opinion on.

Roy Kim (21:03.198)

Yeah. Oh.

Kristy Hamilton, MD (21:29.929)

the material being used.

Roy Kim (21:32.077)

on the material being used? Yeah, you know, we don't ask for facial tissue paper, we ask for Kleenex. Patients don't ask for a neuromodulator, they ask for Botox. And Allergan's done a fantastic job in terms of marketing of making sure everybody asks for Botox, because it's their name. Well, Motiva has done a fantastic job overseas where patients ask for Motiva. They don't ask for breast implants, so.

Kristy Hamilton, MD (21:45.896)

Yep. Yeah.

Kristy Hamilton, MD (21:54.981)

So are you going to be an early adopter?

Roy Kim (21:56.85)

I think so. As soon as it comes out, I am eager to try it because the other thing is that it's a publicly traded company. I mean, so technically they have a lot of money, specifically a lot of reserves. The warranty means something. They are already currently under US, at least, like accounting regulation because it's publicly traded. So they have also a lot of sales overseas. So this is their final frontier.

Kristy Hamilton, MD (22:26.344)

I know where you're going with that last comment. Are you drawing a comparison?

Roy Kim (22:29.774)

Are you drawing a comparison? Possibly, because, you know, Mentor implants are owned by Johnson & Johnson, the world's largest healthcare company. Allergan implants, Naturale, are made by Allergan, part of AbbVie. AbbVie is a massive, massive company. Cientra is a tiny company. They have FDA-approved implants. Their implants are fine, but I just question, you know, how long they're going to be around if...

they go under or go into receivership or whatever, what's the lifetime or 20 year or 10 year warranty mean in a C-entery implant? I don't know.

Kristy Hamilton, MD (23:06.46)

And I think that's a concern for a lot of people because they have the best warranty on the market as of right now with 20 years, but it is a concern. What does the 20 year warranty mean if the company is not around in 20 years? And I agree with you. I think most people feel, most surgeons feel like it's a great product and a great device. And I've done some.

consulting for them. And so I've seen a number of patients across the United States who've had their implants in for 10 years. And the overwhelming majority of them is all different surgeons. So it's kind of controlled in that sense. They're really happy, and the patients look great. But it's one reason I don't use Sandra in my own practice, because I don't know that they're going to have the level of service with them in.

Roy Kim (23:33.387)

across the United States who had their implants in for 10 years. And the overwhelming majority of them was all different surgeons.

Roy Kim (23:48.442)

Sandra at my own practice because...

Kristy Hamilton, MD (23:58.496)

five, 10, 20 years. So we'll see.

Roy Kim (24:02.85)

Yeah, we'll see. And on our final topic, I think, I don't know how you feel, I don't know what you're seeing in Texas, but BBL is a trend that's sort of, I wouldn't say dying out, but definitely tapering. And I do think that if you're going to do BBL, it's more for buttock sag as opposed to getting the largest buttock hip ratio in the universe.

Kristy Hamilton, MD (24:28.364)

I agree. It is still a popular procedure in Texas, but my patients are not coming in for the very exaggerated, not made in nature, extra hourglass. They are looking to go from a boxy shape to a nice S shaped silhouette.

to accentuate their waist and have a beautiful curve to the hips and buttock. So I think it's still a very powerful operation for creating shape. And it's more a skinny BBL or just a lower volume fat transfer BBL for most of my patients. What do you see in California?

Roy Kim (24:53.518)

to accentuate their waist and have a beautiful curve to the hips and buttock. So I think it's still a very powerful operation.

Roy Kim (25:07.118)

It's more a skinny bb-all. Yes.

Roy Kim (25:19.998)

I totally agree. I mean, it's the same thing here where people care about the shape, people care about rejuvenation, but at least for my patients, they're not asking for the most sort of like pushing the envelope, larger size or anything like that. I really don't have that many patients before but I'm basically seeing virtually none now.

Kristy Hamilton, MD (25:39.336)

Yeah, that was my experience as well. It was very, very few patients, even during the pandemic, that were asking for a really exaggerated shape. And I think we're seeing the power of the Kardashians again with this. They've really, whether it's ozempic or diet and exercise, they've really slimmed down the curves. The curves are present, but they're not as accentuated.

Roy Kim (26:08.718)

Correct. Yeah. So, well, I don't know about the Kardashians, but I'm sure you will be starting some trends soon, hopefully, and we'll see if the social media influencers, other celebrities will also continue with various facial trends and body trends.

Kristy Hamilton, MD (26:09.041)

as they used to be.

Kristy Hamilton, MD (26:29.32)

Yes, and I love that I think for 2024 again, I think we are maintaining a trend towards shapes, faces and bodies. Ultimately that could be found in nature and to not have things be so obvious. We want very subtle plastic surgery, subtle non-surgical work, ensuring the health of our skin and tissues and just

Roy Kim (26:41.366)

we found in nature.

Roy Kim (26:56.639)

tissues and just overall community aesthetic very natural. I agree. Well as always it's so great talking to you and catching up and we will see in 2025 what our predictions and trends show. Like you know what we predicted or what we said will they actually come true I don't know.

Kristy Hamilton, MD (26:57.872)

overall keeping the aesthetic very natural.

Kristy Hamilton, MD (27:16.66)

We'll be doing a recap video then too and see if we had our crystal ball was well tuned in.

Roy Kim (27:18.507)

Ha ha!

Roy Kim (27:23.602)

Well, thanks so much for talking to me, Dr. Hamilton, and thanks for another episode of The Beauty Scientist. To all of our viewers out there, thanks so much for watching and or listening out there. And as always, you know what our tagline is.

Kristy Hamilton, MD (27:36.964)

Remind me again, it's so good. Stay beautiful. We'll catch you next time.

Roy Kim (27:38.897)

Stay beautiful.

Roy Kim (27:42.506)

Take care.