The Global Future of Aesthetic Medicine with AMWC Americas Leaders Ft. Dr. Steven Dayan, Dr. Sabrina Fabi, & Dr. Nathan LeBrasseur

0:00hey guys welcome back to skin anarchy today we're going to be talking about an amazing amazing Aesthetics Conference. It is the world's best conference in aesthetic medicine. And so without further ado, I would like to welcome back Dr. Dayan and Dr. Fabi, who are coordinators of the conference. And they're on the advisory committee. So welcome. I'm so excited to host both of you. Thank you so much for having us. Well, it's great to be back with you. It's so great to have this opportunity to talk to both of you about the scope of this conference, because there's so much that is covered and there's so much amazing insights and people get to learn so much.

0:33So I would love, Dr. Allen, if you could kind of start us off, like, tell us a little bit about what you think, you know, AMWC really stands for in the space and like the aesthetic space and overall, I guess, in general. Well, AMWC is a big brand of meetings and they're all around the world. And we've been going to AMWC meetings. The big one, which is in Monaco every year, is the real exciting one where tens of thousands of people show up and it's the latest and greatest in aesthetic treatments, mostly non-surgical treatments. And it's one of the Best conference of the year for Sabrina and I love going there.

1:04About four years ago, right before COVID, they started a version of it in America, in Miami. And I helped originate that first conference. We called it Miami Cosmetic Search at the time. It's now, the name has been changed to AMWC Americas. So it's nothing that's brand new, but it's still early on in its evolution. And every year it gets better and better. It's at the Turnberry Hotel in Miami. and it draws doctors from all across the U.S., but a lot from South America who love coming to Miami. And we get a lot of insights. It also draws doctors from Europe because AMWC is such a big branded name for meetings that people know the name and they want to come to the U.S.

1:43to participate. And every time I go to one of these meetings, I get an opportunity to learn so much from my colleagues about what's new in many parts of the world that we're not at or we don't have first sight on some of their procedures and some of their products. Yeah, I mean, that's amazing though that it covers such a wide scope, you know, especially for anyone who's like new to aesthetics. If you're like a new professional in the space, it's, you know, invaluable research. Dr. Fabian, I'd love to hear from you as well about, you know, what is like your favorite part of the Miami conference, especially?

2:11I think that one of my favorite parts of AMWC in general is that you do get to mingle with colleagues from all over the world, where many of them generally have access to injectables, procedures, devices that we may not necessarily have in the United States because it's launched elsewhere first. And so we get that firsthand knowledge from them, their experiences, either investigators or now users of these products and procedures that you really wouldn't be able to get at a U.S. conference where you mainly have U.S. doctors because it hasn't become available yet here. And so that way we can kind of learn what we need to watch out for, maybe shortcomings of some of the procedures that might be out there, and then also things to be really excited about.

3:00Along those lines, we learn about science and of different perhaps topicals or potentials for topicals, as well as maybe the direction that aesthetics might be going globally that we may not necessarily have full scope of when we just attend a US-based conference. So that's probably, you know, some of the things that I really appreciate when I go to AMWC. Am I going to add on? I think I echo what Dr. Favie said, but also one of the benefits of this meeting is that it's available to all levels of providers. So you'll see those who really want to nerd out on the science, as well as some of the novices who are coming to kind of just test their feet in the water, so to speak.

3:41And one of the best sessions, I think one of the most popular sessions always is the anatomy section, where we have a live cadaver dissection. and you get to see that being done. And we talked through it. It's about a three-hour course. And throughout that, the room's packed and you really get to understand like what you're doing when you're treating these patients. That's really interesting. I feel like they've gotten rid of cadaver dissections now in medical school. So that's really a great opportunity for someone to, you know, see it. If you haven't seen it in medical school, I know my brother is 10 years younger than me.

4:10He's like, we never even got to do it. You know, we didn't have the exposure. That's really great. And it's one of the best parts of medical school. It is. I know that was my favorite part. That's really cool. I, you know, I'm very interested, though, because I'd love to get both of your perspectives on your specific specialties and what you love the most about the conference from that angle. Because I know, Dr. Diane, from a surgical perspective, what are some of the things that you really look forward to every year, you know, in terms of like just, you know, the groundbreaking stuff that we see at the conference from surgical perspective?

4:39So as far as surgical, this conference in Miami is not, surgery is not primary. There's one we do in Vegas in end of May, which is more surgical focused. Having said that, there are quite a few surgeons here who are really trying to figure out how they add non-surgical procedures to their armamentarium. And it's one of the ways in which I learn when is it time to do surgery, when is it time to do non-surgical procedures, and how do I fit those two together? And also, I find a lot of things that I can add on to my surgical procedures, whether it's a laser adjunct afterwards or topical skincare, which, you know, Serena and I are particularly really invested in right now is how to add on topicals to really make our results even better.

5:18That's fascinating. Dr. Fabio, I would love for you to kind of go off of that because I know in dermatology, there's just so much happening. The scope is broadening so much, I feel like, you know, for the whole field. And so a conference like this, I think it's such a great place, you know, for someone to learn, obviously, but then also discover. I mean, what are your thoughts on that in terms of from the dermatology perspective? Like, What can people really expect and gain from attending this kind of event? I love that, you know, in the word inherently, it's an anti-aging medicine World Congress, right?

5:47And so there's a focus on anti-aging. What we do in our practice every single day as aesthetic dermatologists or facial plastic surgeons is, of course, the aesthetic element of it, making someone look and feel more beautiful. But a part of that is also youth that is lost. And so to a degree, you're trying to restore some of that youth, which is not just in the ability that our procedures are able to perhaps stimulate stem cells or decrease cellular senescence, but also in a more holistic approach that sometimes hormones can provide, whether topically or systemically, or in the way that perhaps other modalities, now peptides and And even macronutrients and micronutrients, whether in an injectable form or whether systemically taken, can also help aid and support our patients' longevity journey.

6:40And so I do like to have a more holistic approach when I deal with my patients because I do recognize that what I do is limited. You can have beautiful results, but there is no doubt that someone who is more hormonally supported, optimized nutritionally, is always going to look better in the end. And patients want to look and feel better after 15 years of doing aesthetic procedures. So I feel that this conference does have sessions and lectures that sometimes provide that information where I may not necessarily see that in just dermatologic conferences or facial plastic surgery conferences alone.

7:17That's really fascinating that you brought this up because I feel like right now we're in a time where everything's online. You know, there's so many courses, so many certifications that are online based. And I think it's important to talk about, and I'd love to get both of your insights on this, is why is a conference like this so important to attend versus just relying on these like online certifications or online continued education platforms? Dr. Dion, maybe you could start us off there. Sure. You know, the online platforms, while they're awfully attractive, they're not comprehensive enough.

7:46And you can't just dabble. You have to really invest into this process. If you want to be an aesthetic physician at the highest level or an aesthetic provider, you've got to spend the time, energy, and effort. And it doesn't just come with an online course. I think hands-on is super helpful. And going to conferences like this where you can see the way that experts are doing it. You keep in mind that lots of times these courses that are online, they may be presenting just one way to do it. You're not getting multiple opinions. You're also maybe getting it just unlabeled, whereas you want to hear from experts who are doing it multiple different ways.

8:16Also, doctors in different parts of the world are doing differently. Also, some of these products are launched in different parts of the world first. So there's more experience in those parts of the world. And here you get a chance to work closely with a lot of physicians and providers who are heavily experienced. So I think you just can't beat that. And then you get to see the cadaver anatomy at the same time. So not just one conference is going to make you proficient. It's something that you really have to take a lot of time. You have to learn it didactically, but you also need to spend time going to these conferences.

8:43So if you're really committed to it, I would suggest going to a conference like this. Dr. Fabi, I'd love for you to also tell us here because you had brought up longevity, which was really very fascinating to me. From that perspective, I'd love to hear more. Right, because many procedures generally just focus on stimulating one cell or in stimulating some, you know, constituents of a particular tissue in dermatology. Let's say it could be collagen and elastin, but we don't know how long that stimulation takes place for. And we also know that the environment that that stimulation takes place in influences how long the stimulation effect may continue for, right?

9:25And so it's kind of like putting flowers on soil. If the soil is not optimized, if the environment is not optimized, those flowers may not flourish to their full potential. And so longevity, I think, is heavenly driven on, at least from the procedures that we do and the results that we're getting from our procedures, the longevity of our procedures even, is really optimizing the person and optimizing their health. And so there's more and more, of course, it's beyond just diet and exercise. It's also hormonal status. Perhaps we'll find out, you know, in the long term, the influence of GLPs and decreasing overall inflammatory status, because this ultimately that inflammation, inflammation directly links to aging.

10:08And GLPs have an effect on about four different pathways of cellular aging that we're aware of. If we use the paper and cell to guide us, there's about 16 different pathways. There's very few things that we can do injectable-wise or topical-wise that can really influence many of those pathways, unless you're dealing with hormones or you're potentially dealing with GLPs. And so that's why optimizing the environment can get greater longevity from our results. Yeah, that's really fascinating. I need to read that paper that you're talking about. I don't think I caught it. Yeah, they just did an update 2025.

10:47Wow. Thank you so much, Dr. Fabi. days. Yeah. I mean, GLPs is definitely, I mean, I think that's a great example that you brought up because there's so much happening right now in the longevity space that I don't think in aesthetic medicine, we're even like looking at it. Like I know like for people who are interested, right? You guys are immersed in the field. And so you see this, I think more than maybe like a medical student or a resident or a fellow, but like, if you're just now getting into it, such a vast ocean, you know, in terms of like what's out there and what are the potentials so that I could see that be so helpful for someone, you know, to go to a conference like this, get a footing in that kind of science and that knowledge.

11:22That's huge. We're all seeing a merging of like sexual health and wellness, holistic health and aesthetics. They're all kind of coming together right now. Yeah. And we're all kind of leading to the same point. So it's really interesting to be part of that world as that happens. Yeah. No, this is really interesting because, you know, also you brought up international. I love that you both brought up the international component of medicine. I think this is something that's never really discussed in actual continued medical education. And I'd love for you to expand on this a little bit, because I feel like when I was in my training, I learned so much from like Nigerian doctors, for example.

11:53I had one amazing physician that taught me so much. And I was like, I feel like you summed a year worth of training up, you know, in a month when I trained with him. And so something like that, like the international component, like what are your thoughts on that for especially young doctors and attending an event like this and what that means for their overall training? You know, about three years ago, Sabine and I did a whole world tour. We went to six different countries and we studied aesthetic medicine in those countries and we compared it to the U.S. So we went to Africa. We treated an African patient in Africa with an African doctor and an African-American patient in America with an American doctor.

12:27So we compared and contrast how we treat those patients in those different parts of the world. It was absolutely fascinating. We went to India. We went to Asia. We went to Europe. We went to South America, the Middle East. And then we wrote it all up. We published it. It's called Diversity in Aesthetics. and you can get those articles if you want to see it. But I'll tell you that Sabrina and I came back, I think we came back as different doctors, just because you see how things are done differently in different parts of the world. And you recognize that we all have an aesthetic bias because we're all trained one way.

12:53But when you go to other parts of the world that have Eastern influences or native influences, you start to see that they look at things a little bit differently and a little bit more holistically. And the way they look at the anatomy might be different than how we look at the areas of the body they treat. And the products that they use are also a little bit different, which means that maybe they use the products differently. I remember the first time I went to China and they were using Botox and they're like, they're putting it in the masseter. So I'm like, wait, why are you putting it there?

13:19Don't you put it up here in the glabella area and between the eyebrows? They're like, no, we put it here. And then we're talking about fillers. And I'm like, okay, you put fillers in the nasal labial fold. They go, no, we put it in the nose. And it was like, we were completely on different planes, the way they treat faces in Asia versus the way we treat faces in the US. So anyways, you come back a better doctor because you expand your reference range. And anytime you expand your reference range, it changes where you fall because you like the average of all that big expanded reference range and you become a better physician and a better aesthetic physician, in my opinion.

13:49Dr. Dan, just to wrap it up, I just want to, you know, get a few more thoughts from you about, you know, in terms of just continued medical knowledge, you know, like I feel like that is the key. And I think this conference and everything that I've learned about AMWC, it stands for this idea of like, never stop learning. So I'd love for you to offer us some words of wisdom on this topic, especially for all the young physicians out there that are just starting their careers off. Anything you can tell us that we should know? Well, there's no better way to defeat prejudices, whether against your past feelings in science or any type of prejudice, than education.

14:24It breaks down all barriers. And I think that's important. Education is the cornerstone to medicine. It's part of our Hippocratic Oath. When we decide to become doctors, we pledge ourselves to always teach and we have to always learn. And medicine is constantly changing. Whatever I learned in medical school is completely irrelevant now for the most part. Some of those foundation, those basics are still there, but the actual practice of medicine completely changes. And that's one of the reasons why we have to continue to educate ourselves. And CME, our continual medical education, is something that's part of our licensing.

14:55So for physicians and nurses and PAs, continuing medical education is a very critical component to not only staying within regulations because you have to do it, but also becoming a better physician. So I think we should learn. And likewise, I think we have a responsibility to teach those after us as well. And I think you see that flourishing at a conference like AMWC where you have people just coming there to learn and it's for the betterment of the field and the betterment of our patients. I love that. Well, I'm really excited about the conference. And for all of our listeners, you guys can find all the information in the show notes to check it out.

15:29But Dr. Dunn, thank you so much. This has been so great. And I'm really excited to see how many people show up and just all the wonderful things at the conference. I look forward to seeing you and all the others who are going to be there. It's always a great, it's a fun time. I'm excited. Take care. Today we have Dr. Labrasser with us, who is going to be the keynote speaker at the Miami AMWC conference. And he will be really teaching about longevity. And so welcome, Dr. Labrasser. I'm so excited to kind of pick your brain a little bit and learn about this conference and your work. I mean, I'd love to if you could tell us about, you know, your focus in longevity medicine.

16:04Yeah, it's great to be here. And I'm really looking forward to the conference. It's not the typical audience that I speak to. So it's good to kind of spread our news and share what we're learning with a larger group and a more diverse group. And I have an incredible job. So I have the privilege of directing the Robert and Arlene Kogod Center on Aging at Mayo Clinic. And we're really a highly translational group, as you might expect, meaning that we do kind of very fundamental basic discovery science in cells and then model organisms and then really try to understand what is aging? What is this process that we all experience?

16:39And then bring that information into models where we can test new ideas and interventions and ultimately translate those into the clinic, which I would argue we do better than anybody else in the world at Mayo Clinic. So we're learning a lot. And, you know, I think we all fully appreciate that aging is by far the greatest risk factor for the overwhelming majority of chronic diseases. And if we can understand that process better, we can ultimately envision interventions to delay age-related diseases as a group, right? And I can't think of a better way to fundamentally transform human health. I'm glad you opened with that because, you know, I noticed that your work does focus on like cellular senescence and this is, it's become so buzzworthy, you know, in the last, like, I think even one year or two years, I've noticed people are now making it a mainstream term, which is very exciting, I think, for any scientist out there to hear that.

17:28But, you know, I would love to get your take on like, where do you think us like just normal people, you know, what should we know about cellular senescence in terms of its actual understanding we should have about, you know, how it plays into overall health and just every day? Yeah, I can't blame you for asking the question that way, because even as scientists who know this incredibly well, we still kind of struggle with really understanding the cell fate. And, you know, we should really think of aging as our cells in our body undergoing different forms of wear and tear. Aging is a law of physics.

18:02It's entropy, right? And that wear and tear leads to different forms of damage. And sometimes our cells are really good at repairing that damage and they function perfectly and there's no harm. Other times they undergo really extreme damage and they die, right? So those cells are lost. But there's this interesting kind of middle ground that cells persist and they're not labile or inactive, but they're actually just the opposite. They're incredibly active influencers over their surrounding environment and the body at large. So these cells have been referred to as zombie cells. And I think part of that is because they're damaged and they look different, they behave different, they spread.

18:39But it's really they're these active players in health and function because factors that they elicit or release into our bodies can really wreak havoc. And before I get too far ahead of myself, I should note that I think senescence is always a good thing. You have senescent cells. I have senescent cells. Individuals much younger than us have senescent cells. And that's to protect us from the growth and spread of cancers. But as we get older, we're less effective at clearing those cells from our system. They start to accumulate. And that's when we really see them causing harm and damage. Yeah, that's really fascinating because, you know, I think I always worry about longevity becoming a buzzword, you know, and that's why I asked you about that, because I think that, you know, with cellular senescence, one of my biggest question marks has always been like, you know, well, how do we define a senescent cell, you know, and are we there yet?

19:21You know, have we really found all of the markers that we would say this is a quantitative representation of senescence? And so what are your thoughts on that in terms of the progress of the field at large? Yeah, I think we made just remarkable progress over the past decade. So I will tell you, and we started in this space, you know, our landmark paper on showing that these cells really do cause damage to multiple organ systems was 2011. And since that time, we've developed really a rich way of characterizing what truly is a senescent cell. And we now sometimes refer to those as core properties of senescence or major hallmarks of a senescent cell where we see that they have features of growth arrest.

20:00So they're no longer dividing or replicating. They have upregulation of this what we call senescence associated secretory phenotype, which is the fact that these cells produce so many different factors that can influence inflammation and tissue remodeling and degeneration and compromised regeneration. And then they turn on these pro-survival factors. Again, they're damaged and you think they would just go away, but they don't. They survive. And then they have these different histological features and hallmarks. So it does take a rich understanding of the biology and kind of a very good toolkit to identify a senescent cell.

20:32And that's what's caused a little bit of confusion, I think, is that the senescent cells that might occur in my liver or my kidney or my lungs could be very different than the senescent cells in my skin. And I think that's created a little bit of confusion and back and forth in our field. But it's a recognition that why would a hepatocyte in your liver or renal epithelial cell in your kidney or a fibroblast or melanocyte in your skin look just like these other cell types? So they all have their kind of unique characteristics, which is not surprising to me. Right. Yeah, that's very fascinating.

20:59I'm glad you said that, you know, because I think that is I have noticed that people are trying to I think because we're trying to wrap our head around it, that differentiation between cell types and then how organs kind of perform individually. I mean, that is getting kind of pushed aside right now, you know? And I think that's just the nature of, right, like just academia, you want to focus so hard on one area and then kind of bring in. But that translational component to me is incredibly fascinating. Speaking of translational medicine, I would love to get your take on where you feel that a conference like AMWC really fits into kind of bridging this gap between physicians and the super clinical side of medicine and obviously you know, research and academia and translational understandings, you know, how do you feel that this kind of conference benefits that?

21:43Yeah, so I think I say this phrase probably far too often, but it's really learning together. And what we study in a dish or in a preclinical model, or even in patient-derived biospecimens, we really need to kind of compare across these different formats to show that there's consistency, to show that there's meaningfulness about what we're discovering and that there's a link to human health and function, right? And that can be physical function, cognitive function, metabolic function, and skin health and function, right? So it's really a matter of connecting the pieces and connecting the dots and making the clinical audience really aware of what's happening behind the scenes.

22:20And, you know, I'm a huge advocate for healthy aging, right? And I'm less concerned about living longer, but I very much want to add life to our years versus years to our life. And it's what are the proactive things that we can do? And there's no more influential voice than the clinicians at kind of reinforcing the behaviors and the pillars of healthy aging. So it's really important to have this dialogue and also to kind of say, hey, this is what might be coming down the pike and keep an eye on this because this is really exciting. Well, I mean, that's really fascinating because, you know, I think that is kind of the gap right now that I've noticed, you know, just from talking to people that are more on the clinical side and they're wanting to bring longevity into their daily practice, you know, and bring it in front of patients, you know, and really talk about it openly.

23:03Where do you think the most promise is right now in the field when it comes to that translational component, like where physicians can openly discuss this without fear mongering or, you know what I mean? Like, because, you know, patients get so worried so easily. So where do you think, what are some of the topics that I think are worth discussing in aesthetic medicine when it comes to longevity? Yeah, you guys may be ahead of the curve in a way, because I think part of this is really getting people to think about aging as a life course event. You know, it's not that, hey, I celebrated my 65th or my 70th birthday, so I should start thinking about aging.