Louisville one of America's 'vainest' cities; local plastic surgeon shares the treatment patients want most

Louisville, Kentucky is overflowing with plastic surgery and aesthetic treatments.

Kentucky locals may be surprised to learn that Louisville was ranked one of America's vainest cities by Forbes magazine at one point, due at least in part to the high plastic surgeon-to-residents ratio. It's no secret that plastic surgeons don't tend to crop up where their services aren't wanted or needed, indicating that Louisville is a sort of coast-free mini Los Angeles, Miami, or New York that nobody expected.

"The aesthetic scene in Louisville is surprisingly competitive as there are a lot of plastic surgeons per capita," explains Michael Keyes, M.D., a plastic surgery fellow at the University of Louisville and founder of @CelebrityPlastics on Instagram. "Louisville actually ranked sixth in a Forbes article titled Vainest American Cities due to the number of cosmetic procedures and products its residents purchase per year. The average household income is lower compared to some of the bigger cities, so prices for procedures are much more affordable."

Michael Keyes, M.D.

The procedures people are coming in for are of course the typical face lifts, liposuction, and boob jobs -- but Dr. Keyes says neuomodulators like Botox, Dysport, and Xeomin are actually the local favorite.

"Neuromodulators are extremely popular in Louisville, especially as they have gotten more accessible to patients. Patients are realizing that neuromodulators can be used to prevent wrinkles if used early enough. Academic institutions like the University of Louisville are a popular place to get neuromodulators, as drug companies often provide free products to resident clinics for teaching purposes. Those savings are then passed onto patients," adding that the most common complaint about these wrinkle-busting injections is simply that they don't last long enough.

Sam Moqadam on Unsplash

"Patients will see more and more wrinkles in their second and third months after treatment," which is why Keyes is particularly excited about a new type injectable that works much the same way Botox and Dysport might, but with a six-months lifespan. "Daxibotulinumtoxin A, also known as DAXI by Revance Therapeutics, Inc., is a new long-lasting neuromodulator currently in the final stages of FDA approval. DAXI has the same active ingredient as the other neuromodulators on the market (Botulinum Toxin Type A)"

What sets this six-months Botox competitor apart is a modern take on peptides that help stabilize the product resulting in a longer duration.

"A double-blinded, randomized control study published in Plastic and Reconstructive Surgery Journal, showed DAXI had a median duration of action of 24 weeks (six months) when used to treat moderate-to-severe glabellar lines. This is a very promising result, as it means DAXI potentially doubles the duration of action of the current neuromodulators on the market. This is a game changer because it means less office visits for existing patients, thereby freeing up providers to treat more patients! It’s a win-win for both patients and providers."

Keyes expects this to be a game-changer in the national medical aesthetics market, but of particular popularity in Louisville where appearance is apparently everything, and keeping up with the most beautiful Jones on the street is a college-level sport.

"This product is exciting because it could potentially make treating wrinkles a twice a year endeavor instead of every quarter," he explains. "It also means providers' schedules will open up significantly, allowing them to focus on other procedures/treatments that their patients may be interested in."

For now, pricing information hasn't been shared because DAXI is still awaiting full FDA approvals that were delayed thanks to COVID-19, but Keyes expects the price to be higher than Botox and its competitors.

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"I would anticipate the cost of DAXI to be significantly higher than Botox due to the increased longevity of the product. Current pricing for Botox to the forehead, glabella and crow’s feet can range anywhere from $400 to $700 in Louisville, so I anticipate DAXI will be roughly double that. It’ll be interesting to see how the rest of the neuromodulator market responds whenever DAXI enters the market."

Are you in the Louisville area and a fan of injections that fight wrinkles? We'd love to hear your feedback in the comments section below.