Cosmetic Surgery in a Bottle? Cosmetic Surgeon Dr. Richard Buckley Comments on Creams in Development that Could Live Up to the Claim of Cosmetic Surgery in a Bottle

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Creating topical solutions to address cosmetic concerns typically treated by injectables, surgery or other cosmetic procedures isn’t easy. But there are two products being studied that could someday eliminate the need for cosmetic surgery or injectables for some patients.

Cosmetic surgery in a bottle.

Cosmetic surgery in a bottle? There are products that are on the path for FDA approval to address cosmetic concerns that now can only be treated with an injection, laser treatment or surgery.

Cosmetic procedures are becoming less and less invasive and requiring less in the way of downtime and recovery. I wouldn’t be surprised if we see big changes in what we can achieve for cosmetic patients with creams, ointments and gels before 2020.

Buyer beware of any cosmeceutical or topical cream or gel that claims to be as good as injectable Botox or cosmetic surgery. “It’s one thing to add an ingredient to a cream; it’s another to make that ingredient safely and effectively penetrate the skin’s surface to have a positive effect on skin aging,” says Dr. Richard Buckley, who is medical director at MilfordMD Cosmetic Dermatology Surgery & Laser Center, in Milford, Penn. Prescription topical preparations and cosmeceuticals that actually penetrate and impact skin aging concerns, like wrinkles and lines, continue to challenge scientists and researchers. But there are a few topicals in the research pipeline (meaning, they’re not yet approved for sale in the U.S.) that could someday live up to the description: cosmetic surgery in a bottle.

To illustrate how difficult it is to create a topical good enough to gain FDA approval for a cosmetic indication, just look at recent news from Revance Therapeutics. The company announced this year that a phase 3 trial of its topical botulinum toxin product, DaxibotulinumtoxinA Topical Gel (RT001), fell short of meeting the endpoints necessary to treat patients with moderate to severe crow's feet. The company announced it would not continue development of RT001 topical for crow's feet, nor would it pursue the topical botulinum toxin’s development plan for the treatment of underarm sweating. Instead, Revance would focus on efforts to develop DaxibotulinumtoxinA for Injection (RT002).

But, take heart, there are products that remain on the path to approval in the U.S. for cosmetic concerns that now can only be treated with an injection, procedure or surgery. One such product in development is XAF5 ointment, for treatment of under-the-eyelid fat; another is TAT4 Gel, for reduction of nasolabial folds. The DailyMail.com called XAF5 “eye lift in a bottle,” in an article, which reported on early research indicating the ointment had been shown in 90 patients to notably reduce under-eye bags. There was even speculation that the cream might dissolve double chins and reduce body fat.

Yahoo! reported that Allergan, which owns Botox and Juvéderm, has since purchased XAF5 Ointment from its developer Topokine Therapeutics. And there’s speculation that the topical cream used under the eyes could become available in 2018. “XAF5 is a promising medical aesthetic treatment that could be the first topical approved to address bulging lower eyelid fat, which is now treated with blepharoplasty, or eyelid surgery,” Dr. Buckley says. “The cream includes an active ingredient shown to penetrate the skin and go into the fat, where it shrinks fat cells.”

The biotechnology company Topokine Therapeutics is developing TAT4 Gel and announced in January of this year that it started a phase 2 study of TAT4 Gel for reduction of nasolabial folds, or laugh lines. TAT4 is a topical that increases fat under the skin, therefore diminishing the often deep lines that run from the nose to the edges of the mouth. Patients in the study are applying TAT4 Gel to their nasolabial folds once a day for three months. “We typically treat these lines by softening them with injectable fillers,” Dr. Buckley says. “We’ll be watching for results of this early research from Topokine on TAT4 Gel, which, if it pans out in studies, could be a future filler in a bottle.”

The field of cosmetic medicine is always evolving, as researchers look for new and better ways to address people’s cosmetic concerns. “Cosmetic procedures are becoming less and less invasive and requiring less in the way of downtime and recovery,” Dr. Buckley says. “I wouldn’t be surprised if we see big changes in what we can achieve for cosmetic patients with creams, ointments and gels before 2020.”

About MilfordMD Cosmetic Dermatology Surgery & Laser Center:

The MilfordMD Cosmetic Dermatology Surgery & Laser Center offers state-of-the-art highly specialized procedures in laser and cosmetic surgery and aesthetic skin care. In addition to its AAAHC accredited surgical center and extensive laser surgery capabilities, MilfordMD offers physician designed skin care products for home use. Milford Pennsylvania’s MilfordMD Cosmetic Dermatology Surgery & Laser Center is sought out by patients from around the world for expertise and innovation in cosmetic treatments performed by Richard E. Buckley, M.D. and Marina Buckley, M.D.

MilfordMD Cosmetic Dermatology Surgery & Laser Center is located at 303 W. Harford Street, Milford, PA 18337. Tel: (800) 664-1528. For real patient video testimonials, visit our MilfordMD YouTube channel.

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Richard E. Buckley
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