The 73rd Annual meeting of the American Academy of Dermatology met in San Francisco. The City by the Bay is always a favorite location due to the sheer size of the Moscone Center, and the fact that we need this amount of space to house over 6000 exhibitors and several thousand dermatologists and healthcare professionals under…well, not just one roof but three.

I arrived late Thursday evening in time to get to bed so that I could rise and shine bright and early on Friday for my first session—the cadaver prosection and live patient demonstration of filler (soft tissue augmentation) and toxin injections. Throughout the three hours, we were able to dissect the face into thirds — upper, mid and bottom portions in order to both evaluate and inject, while reminding ourselves of the boundaries, danger zone and important facial structures of which we need to be respectful. Physicians like Drs. Butterworth, Matarasso, Narins, Monheit and Yee were able to explain their preferences for various toxins based on location and treatment targets while simultaneously injecting. Fortunately, we had a surgeon who had pre-dissected the face so that we could easily reference various structures of the face and neck.

On to the afternoon session to hear Dr. Braverman (the cutest octogenarian!) discuss how to improved observational skills in medicine. This was my favorite presentation for the entire weekend. Instead of using patients to analyze our observational skills, we used three different paintings by European artists to see how observant we actually were. I loved listening to his experiences with teaching observational skills (yes – teaching!!) to the Yale medical students.

Dinner that evening was provided by Allergan at the Palace Hotel and focused on Dr. Mauricio Demaio from Brazil discuss three pairs of mothers and daughters. To see one generation to the next on one platform, and to see how we can better arrest sag (wrinkles are easy! But sag is definitely harder to deal with!!) in the lower third of the face and the neck region by injection of products such Voluma in the mid face and Juvederm in the perioral region accompanied by Botox in certain necessary areas to affect muscle movement. When each woman was asked, “do you want to prevent sag?” it was always met with a resounding “yes please!”

I collapsed into bed in order to rise and shine on Saturday to another round of lectures. On this day, the EXHIBITS OPEN!! I remember my very first Academy ever. That one was in Washington, D.C. By the time I left for home in San Antonio, I had more than doubled my return baggage weight. This time, I was more discerning with my selections and attended certain booths for a designated period of time only. Of course, I had to get to the lectures of which included the fun Resident Jeopardy (just like the real Jeopardy including music!) and the live esthetic demonstrations. The buzz this year is all about plasma – topical, injectable, and every other way. Microneedling was the buzz as well. I truly believe we are on the right track in regards to use of one’s own platelet rich growth factors in order to achieve natural facial rejuvenation and correction. By seeing the “greats” in the field on stage peppering injector Dr. Ewer from Beverly Hills, CA with questions we have learned over the past four years in our own Dallas-based Dermatology Office, I am firmly convinced this is the next revolutionary procedure in facial esthetics. Our office began with harvested PRP but has advanced on to Selphyl and now the newest Eclipse product. Combine microneedling with plasma injections using cannulas such as the Magic Needle and you have a winning combination in natural-appearing facial rejuvenation.

As I left on the last bus heading back to my hotel for a much-needed rest (why did I wear those cute slingback heels again??), I was brought back to the place I began. I met, quite by accident, Dr. Keller from San Antonio. Turns out that right after I graduated from my dermatology residency, Dr. Keller went in as Dermatology Chair to the VA and the program exploded. He listed off all the lasers, medial and cosmetic procedures they are now doing there. The number of dermatologists employed there is multiplied and allows for continued dermatology resident training. I asked about one of my old professors —Dr. Eric Kraus. (I don’t mean he is “old” but rather he is a former professor and mentor to me!) Per Dr. Keller, Dr. Kraus is doing quite well – still teaches the dermatology residents and loves what he does each and every day. It was bittersweet to remember three years of training compiled into my memory, but it brought me back home – to my dermatology home—if just for a bit.

Photo by everythingpossible/