Tips for Better Outcomes in Aesthetic Dermatology, With Mark S. Nestor, MD, PhD

The 2025 Fall Clinical Dermatology Conference in Las Vegas, Nevada, featured a variety of sessions, including 1 titled ‘60 Tips for Better Outcomes: Aesthetic, Regenerative, Hair.’1

This session was presented by a variety of experts, including Mark S. Nestor, MD, PhD, the director of the Center for Cosmetic Enhancement and Director of the Center for Clinical and Cosmetic Research in Aventura, Florida. In an on-site interview at Fall Clinical, Nestor touched on some of his portion of the session’s biggest takeaways.

“I talked about the issue of how to avoid cosmetic complications of things like fillers, knowing the anatomy, knowing what to look for if you have a vascular event, is very important,” Nestor explained. “[This is] because you need to treat it very quickly with hyaluronidase, with nitroglycerin paste, and other things as well. So I touched on that as one of my tips.”

In another tip highlighted in this session, Nestor talked about ways to expand one’s cosmetic procedures as a dermatologist.

“I think the beauty is that being a dermatologist, we have a lot of patients coming through our office, which is different than plastic surgeons, and the idea is to educate those patients as to what you can do,” Nestor said. “I can do toxins, I can do fillers, I can do these procedures. Patients are looking for this. They're looking towards our expertise, and that's the best way to really expand this in your practice.”

Nestor was also asked about his session on the science of botulinum toxin use in dermatology practices, also known as Botox.2

“There are now a total a number of different toxins,” Nestor explained. “Letybo is the most recent one that's been approved…And the question is, you have reps coming into your office. How do you choose? What I discussed is the issue that, number one, all type A toxins are identical. They work the same way. The difference is what we call molecular potency.”

Molecular potency, Nestor noted, has to do with the number of 150-kilodalton proteins. These are specifically the heavy chains that bind to what is known as the SV2 receptor.

“The more binding that is, the more heavy chains get in, the more light chains get in,” Nestor said. “That's what cleaves the SNAP-25 protein of the trans-SNARE complex; therefore, the acetylcholine vesicles can’t bind, and nothing happens to the muscle. The issue then becomes, how do you get a more robust response?”

What needs to occur, Nestor noted, is a clinician must figure out the ‘molecular potency quotient,’ or what type of effect is desired. If the desired effect is occurring with different toxins, then a lower-cost option may be chosen.

For any further information on Nestor’s sessions at Fall Clinical, view his full interview segment posted above.

In this summary of Nestor's interview, quotes were edited for the purposes of clarity.

Nestor has reported serving as a consultant for Revian.

References

1. Nestor M, Ablon G, Weinkle S, et al. 60 Tips for Better Outcomes: Aesthetic, Regenerative, Hair. Session presentation at the 2025 Fall Clinical Dermatology Conference, Las Vegas, Nevada, Oct 23-26, 2025.

2. Nestor M. The Science of Botulinum Toxin. Session presentation at the 2025 Fall Clinical Dermatology Conference, Las Vegas, Nevada, Oct 23-26, 2025.