When she was in nursing school, Leslie Fletcher dabbled in interior decorating and clothing design. She now uses those talents on her patients’ faces.

“I happen to be a very artistic person,” said Fletcher, now a registered nurse. “And I have been able to put those skills into tailoring a face instead of tailoring an outfit.”

In fact, she recently received a patent on her technique, known as ArqueDerma. The technique, which she developed at the InjectAbility Institute, an international training company in Torrance that is part of the clinic where she works, has been performed on more than 1,000 patients since 2007. Fletcher provides training for licensed practitioners.

ArqueDerma is a cosmetic procedure that restores facial volume loss caused by aging. Fletcher uses a needle to inject filler products in facial hollows, such as those that form in the mid-cheek. She also pulls up patients’ excess tissue, which has sagged down into their jowls, redirecting it to their cheeks or chins to fill in facial folds.

“Conventional methods put product next to the fold to prop it up; we move the tissue into place in the folds to put the cheek back where it was,” Fletcher said.

By moving a patient’s own tissue, she can cut down on the amount of dermal filler she uses to restore volume. The technique destroys some unhealthy, fragmented collagen that is then reabsorbed into the body and stimulates production of new collagen, which stabilizes the results and maintains the change in appearance.

She claims that ArqueDerma is less invasive than a facelift, which is performed under anesthesia, and lasts longer than Botox, an injection of toxin that temporarily improves the appearance of lines and wrinkles.

She developed the method after hearing from patients who had injections of collagen and other soft-tissue dermal fillers that left their faces looking swollen or fat.

“Patients wanted more of a lift, they did not want to look puffy or have overstuffed cheeks and lips,” she said.

Cost has been a big driver of non-surgical cosmetic procedures in the recent years, with more patients requesting cheaper, non-surgical alternatives during the recession. The American Society of Plastic Surgeons reported that of 13.8 million procedures performed in 2011, non-surgical, minimally invasive procedures accounted for 12 million. Injections of soft-tissue fillers, “experienced some of the largest growth in the minimally invasive market during 2011,” with 1.9 million procedures performed in 2011, up 7 percent from 2010.

“Economically, there’s been a big shift with people going the non-surgical route because of the money,” Fletcher said. “A lot of my patients are surgery candidates, but this is less invasive and less costly.”

An ArqueDerma treatment runs $500 to $2,000 and lasts up to two and a half years, compared with an average cost of $6,400 for plastic surgery and results lasting five to eight years, she said.

Immediate results

The other benefit to the non-surgical route is immediate results: “You see it when you walk out the door,” Fletcher said. There is some swelling and bruising, but it typically resolves within a couple of days, compared to much longer recovery times for facelifts.

Fletcher licenses her technique to practitioners who take a $1,500, eight-hour course. She has not been charging for the license, but now that she has a patent, she said, she’ll begin charging $100 every two years. The fee will cover all procedures done during that time.

She and her staff train the majority of U.S. practitioners and she has trainers who work in Canada and the United Kingdom as well. She does the training at industry conferences and for pharmaceutical companies and at the Torrance office.

She estimates revenue from the training totals $475,000 since its launch in 2007.

Fletcher is one of a growing number of nurses performing procedures in the $10 billion U.S. cosmetic surgery and aesthetic procedures market. In the past, most procedures were traditionally performed by plastic surgeons and dermatologists. Fletcher has worked under the supervision of plastic surgeon Michael Newman since 2005.

Fletcher is the main injector at the clinic and is also the main trainer, but other trainers help her keep up with demand.

“The demand for injectable procedures required physicians to find a way to handle overflow and many, as I did, looked to our skilled and trusted nurses rather than outside the practice,” Newman said. In 2011, for the first time ever, the American Society for Aesthetic Plastic Surgery’s annual survey counted non-surgical procedures being performed by nurses and physician assistants as well as by physicians. The association found that $1.7 billion was spent on injectable procedures last year, including Botox and fillers.

“Before ArqueDerma, many of my patients thought their only option for lifting sagging skin was a facelift,” Fletcher said. “They’d come in, lift parts of their face up in the mirror and say, ‘This is what I want, I think I need fillers.’ The truth was that many of them had enough facial volume, it was just in the wrong place.”

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