Outlining SCALE 2023 with Brian Biesman, MD, FACS

Brian Biesman, MD, FACS

As attendees arrive in Nashville, Tennessee, for the 18th Annual Music City Symposium for Cosmetic Advances & Laser Education (SCALE) conference from May 17th to May 21st, co-directors Brian Biesman, MD, FACS, and Michael Gold, MD, have been preparing thought-provoking sessions for the 5-day conference. Biesman, a clinical assistant professor at Vanderbilt University Medical Center, clinical associate professor at the University of Tennesse Health Sciences Center, and an expert in cosmetic and reconstructive eyelid and facial surgery, minimally invasive rejuvenation techniques, and technology-based solutions, spoke with Dermatology Times® to preview the upcoming SCALE 2023 meeting and his role as a co-director.

Dermatology Times: As a SCALE 2023 co-director, what are you looking forward to at the upcoming conference?

Biesman: My job in my co-directorr role is to develop the program. For everything except medical dermatology, the program content is what I've focused on. I've worked to put together a comprehensive and diverse program that addresses cutting-edge topics that are germane to aesthetics, with everything from surgery to topicals, to injectables and energy-based devices.

Our faculty is world-class, and we have some upcoming demonstrations which are always popular, including energy-based devices and injectables. We have a hands-on ultrasound course, which is our second year showcasing it, and the response has been extraordinarily favorable. So, I'm looking forward to that. And then, of course, we have the exciting anatomy course. When I first started co-chairing sessions with Sebastian Cotofana, learning from him completely changed the way I do injections and has taken me to a whole new level. So, we're really happy to share some of that information because I think it can be transformational for attendees. I'm also very strict about the sessions being CME sessions, and therefore, not biased. We try to be data focused as much as we can.

Dermatology Times: What do you hope attendees take away from both the medical and cosmetic components of the meeting? 

Biesman: Hopefully attendees will take away cutting-edge, up-to-date information. My goal is that if you were to attend one meeting a year, hopefully you could attend this one, and have a strong update and overview as to where things are both in the medical dermatology space as well as in the aesthetic space.

Dermatology Times: What hot topics are upcoming at SCALE 2023 that you’re excited for attendees to learn about?

Biesman: Some of the hottest topics that will be featured include up-to-date information on the newest resurfacing devices and energy-based devices for treating acne with a new acne laser. The hands-on ultrasound course is unique; that's not something that you see elsewhere. The technology demonstration is comprehensive and incredibly popular.

Dermatology Times: What makes SCALE unique compared to other conferences?

Biesman: The quality of the talks at SCALE is extremely high because the content has been carefully chosen. As I look at the program, I see high-quality content. It can be a bit overwhelming because there's so much great content and your head starts to spin a little bit. SCALE is made up of phenomenal faculty and phenomenal content.

Our meeting also continues to grow, and we are well ahead of last year in terms of registration numbers. We're growing in an environment where meetings are struggling; there are a lot of meetings that are not doing as well year after year. It is to some degree a reflection of the SCALE program, content, and quality. SCALE has something for everyone. Whether you're a surgeon or medical dermatologist, whether you are interested in energy-based devices, injectables, topicals, or exosomes, we have the latest cutting-edge data in all of these areas. 

We’ve also started including a medical ethics section. I think that ethics in aesthetics is a topic that you don't typically see at meetings, but I think that there's a great opportunity to discuss challenges that we face in the space as a whole, and also in our patient care in aesthetics. And I'm really excited about that.

Dermatology Times: What are some of the topics you will be presenting at SCALE?

Biesman: I'm speaking during the medical ethics sessions where we have a medical ethicist to set the ground rules and discuss the basics of medical ethics. I'll be talking about a resurfacing laser that I have found to be disruptive, as it has completely changed my resurfacing practice. I’ll be talking about another new energy-based device that's really unique as a microcoring device for tightening skin and reducing wrinkles, which I think is fascinating. I was able to play a role in the clinical development of this device; we did a lot of treatments in a clinical study. It is highly rewarding to see something that started as a concept with some people around a table, to a prototype, to clinical trials, and to something which is now commercially available.

For the live injections, one goal is to demonstrate the current assessment of patients: what should our goals be when a patient comes to us and says that they want an injection? And that can be a moving target that has changed over the years. At one point, it was about filling in wrinkles, and then it became about plumping volume. Now, we've evolved more into aesthetic balancing. So that when you look at someone and think they look good, but you're not sure why. It doesn't look like they've had any particular procedure done. So, we'll talk about assessment, and we'll look at demonstrating a number of different cutting-edge techniques that have two goals in mind. One of these is accomplishing the procedure objective, but the second goal also concerns safety. So, we'll focus on both the safety aspect as well as the how you get the best outcomes aspect of the live injections.

Next, ultrasound is interesting because ultrasound can play a number of different roles. One, it can be used to help treat complications of filler injections and it can be used as a diagnostic tool when people come in with a puffy face and you're trying to figure out what is happening. You can use your ultrasound to try to figure out what a patient has had injected and where it is in the past. You can also use it to do guided injections so that you can try to avoid vascular structures. Ultrasound can also help guide you to put the product in the correct layers. There's been some literature that shows if you place product in the wrong tissue plane, there's a higher risk of things not behaving the way you want. So, I'm really excited about being able to share that. 

What I'm really happy about is the fact that we have approximately triple the number of people registered for the ultrasound demonstration this year compared to last year. I'm not excited simply because there are more people in the room, but rather because I think ultrasound is a really important adjunct to the injection of soft tissue fillers from a safety perspective. And it can be a really helpful tool. So, the fact that it's catching on and more people are getting interested in learning how they can incorporate it, I think is good overall, as it can only help him improve patient safety outcomes.

[This conversation has been edited for space and clarity.]