Clinical Research by Dr Darren McKeown

Clinical Research

Why It Matters

As a speciality, minimally invasive cosmetic medicine remains in its infancy.

Although the first dermal filler treatments, using bovine collagen, were carried out in the 1980s, it has only been in the last decade or so that the practice of the minimally invasive cosmetic medicine has exploded, becoming a mainstream part of life for many normal men and women. As a result of the rapid and recent expansion in cosmetic practice, there are still many unknowns and gaps in our collective knowledge that it seems highly unlikely we are yet achieving the best possible long term outcomes for our patients. Where there are gaps in the scientific literature, there are only too many clinics willing to fill the gaps with what ever marketing speech suits their own commercial objectives, with patient interests remaining a secondary endpoint. My goal is to help change all of that through a simple commitment to clinical research.

I published my first paper in a medical journal, the British Journal of Cancer, in 2004 whilst I was still in my final year of medical school.

Since then I have continued to work on clinical research, initially coursing through plastic and reconstructive surgery to latterly focus on aesthetic medical research. When I founded my Glasgow clinic it was deliberately named the Aesthetic Medicine Institute to reflect the research ambitions of the practice to not only offer our patient the ‘latest technology’, but to be actively involved advancing new technology and shaping the future of the speciality.

Dr Darren McKeown has published widely in the academic literature including chapters in medical textbooks, papers in scientific journals and his work has also been presented at national and international conferences. Here are some of his research contributions.

Dr Darren Mckeown’s Clinical Research

Textbook Publications

Dermal Fillers. In ‘Evidence Based Plastic and Aesthetic Surgery’. Pending publication (New York). Expected date of publication: Summer 2013.

Medical Journal Publications.

McKeown DJ. The risk of blindness following ‘non-surgical rhinoplasty’ J Plast Reconstr Aesthet Surg. 2013 Apr 27. doi:pii: S1748-6815(13)00247-7. 10.1016/j.bjps.2013.03.045. [Epub ahead of print]

Mackey SP, Diba R, McKeown D, Ward K, Wallace C, Booth S, Gilbert PM, Dheansa BS. Return to work after burns – a qualitative study. Burns. May 2009;35(3):338-42.

McKeown DJ, Hogg FJ, Brown IM, Walker MJ, Scott JR, Weiler-Mithoff EM. The timing of autologous latissimus dorsi breast reconstruction and effect of radiotherapy on outcome. J Plast Reconstr Aesthet Surg. 2009 Apr;62(4):488-93.

Robertson AG, McKeown DJ, Bello-Rojas G, Chang YJ, Rogers A, Beal BJ, Blake M, Jackson IT. The buccal myomucosal flap in secondary cleft palate repair. Plast Reconstr Surg. 2008 Sep;122(3):910-7.

McKeown DJ, Mackey SM, Dheansa BS. Gathering follow-up information on people with burns–not as easy as it seems. Burns. 2008 Sep;34(6):898.

Grimsley SJS, Khan MH, McKeown DJ, Paterson PJ, Jones GE. Day Case Flexible Ureteroscopy at a Tertiary Referral Centre: An Observational Study. J One Day Surgery. 2007 17(3):79-83

McKeown DJ, Brown DJ, Kelly A, Wallace AM, McMillan DC. The relationship between circulating concentrations of C-reactive protein, inflammatory cytokines and cytokine receptors in patients with non-small-cell lung cancer. Br J Cancer. 2004 Dec 13;91(12):1993-5.

McKeown DJ and Weiler-Mithoff E. Immediate breast reconstruction have important benefits. BMJ rapid response. 22nd April 2009

Reference link

McKeown DJ, Walker MJ, Scott JR, MacKay IR, Ray AK, Weiler-Mithoff EM. Does radiotherapy really affect the cosmetic outcome of immediate DIEP breast reconstruction? In-press. Short communication. Journal of Plastic Reconstructive and Aesthetic Surgery.

Brown IM, Hogg FJ, McKeown DJ, Scott JR, Weiler-Mithoff EM. Long-term aesthetic outcome of immediate breast reconstruction with the autologous latissimus dorsi flap. Accepted. Journal of Plastic Reconstructive and Aesthetic Surgery.

Presentations at Medical Conferences.

McKeown DJ. Silhouette Soft Sutures for the temporary improvement of the ageing face and neck. British association of aesthetic plastic surgeons. 27th September 2013.

McKeown DJ and Elliot DE. Management of scar tethered nerves in the upper limb by nerve division and proximal relocation. British association of plastic, reconstructive and aesthetic surgeons. 3rd July 2010.

McKeown DJ and Jones ME. Complications of breast reconstruction. Plastic Surgery Update, Val d’Lesere, France. Presented by ME Jones, 4th February 2008.

McKeown DJ, Brown IM, Hogg FJ, Walker MJ, Scott JR, Weiler-Mithoff EM. The timing of autologous latissimus dorsi breast reconstruction and affect of radiotherapy on outcome. Presented at British Association of Plastic Surgeons Summer Meeting, 14th July 2006.

McKeown DJ, Walker MJ, Scott JR, MacKay IR, Ray AK, Weiler-Mithoff EM. Does radiotherapy really affect the cosmetic outcome of immediate DIEP breast reconstruction? Presented at British Association of Plastic Surgeons Summer Meeting, 14th July 2006.

McKeown DJ, Brown DJF, Kelly A, Forrest LM, Wallace AM and McMillan DC. The basis of the systemic inflammatory response in patients with inoperable Non-Small Cell Lung Cancer (NSCLC). Edinburgh Royal College of Surgeons, Edinburgh. 13 April 2005.

MH Khan*, SJS Grimsley, DJ McKeown, PJ Paterson, GE Jones. Flexible Ureteroscopy as a Day Case Procedure: a Retrospective Study. Scottish Urological Society 28th April 2006 (poster). *Presented by MH Khan.

Robertson AGN, McKeown DJ, Blake M *, Bello-Rojas G, Rogers A, Beale B, Jackson IT. Secondary Repair of Cleft Palates using the Buccal Myomucosal Flap. Midwestern Association of Plastic Surgeons 43rd Annual Meeting, 23-24th April 2005, Chicago, Illinois, USA.

Brown IM *, Hogg FJ, McKeown DJ, Scott JR, Weiler-Mithoff EM.Long-term aesthetic outcome of immediate breast reconstruction with the autologous latissimus dorsi flap. British Association of Plastic Surgeons Summer Meeting, Dublin 7th July 2004.

Research Projects Underway

Cold Induced Lipolysis For Spot Fat Reduction

(‘Fat Freezing’).

At present the gold standard treatment for spot fat reduction is liposuction. Liposuction is a surgical technique that often requires admission to hospital, administration of anaesthetic, substantial bruising and swelling, prolonged recovery and a risk of side effects and complications including lumpiness, unevenness and skin indentations. As a result, there has been a strong drive to find less invasive ways of spot fat reduction

In the past, ‘non-invasive liposuction’ techniques have attempted to use heat generated from laser or ultrasound – delivered through the skin – to destroy fat cells. This technology however has been met with limited success and has never been widely accepted as an effective treatment. In more recent years technology has begum to shift to look at the other end of the thermal energy scale to remove fat, using very cold conditions. Preliminary work in this area is yielding very promising results.

We are currently undertaking a clinical trial of a new ‘fat freezing’ machine. Although the technology is already on the market and widely used, we are undertaking the first formal clinical trial of the machine.

In the first phase of the trial, currently underway, we attempting to accurately quantify how much fat can be removed with a single treatment with current manufacturer recommended settings. In the next phase of the trial we are going to be looking at optimising treatment parameters to maximise the amount of fat that can be treated. This is an exciting clinical trial because it will enable us to more accurately advise patients in the future exactly how much fat they can expect to lose as well as help us to optimise treatments to ensure that each and every patient gets the best possible result.

The Use Of Topical Anti-Glycation Agents And Sirtuin Stimulators To Prevent Ageing In The 25-35 Year Age Group.

There is a growing interest from young people, typically only in their 20s or early 30s, in preventing the ageing process. Many clinics are currently advocating that people start having cosmetic treatments as early as their late teens or early 20s to stop wrinkles before they have a chance to appear. I do not believe this to be a wise strategy and believe this will result in a propensity towards long term complications, particularly muscle atrophy and unnatural results.

We are currently trialling various topical agents in combination with lifestyle advice in an effort to delay the ageing process for younger patients as opposed to having cosmetic procedures carried out unnecessarily.

Optimising Doses Of Anti-Ageing Treatments.

Anti-ageing treatements are the most commonly performed cosmetic procedures worldwide. Despite its widespread use however there is currently a great deal of uncertainty and confusion over what is the optimal dose at which to use these drugs, something which is not greatly supported by the medical literature. Although each brand of toxin comes with its own recommended dosing regime, in clinical practice these are often varied. In general, drug companies encourage doctors and practitioners to use higher doses than recommended so that more of their product is used. Clinics and practitioners however will often advocate lower doses to lure in apprehensive patients and keep product costs down.

We are currently undertaking a randomised, double blinded controlled clinical trial to compare standard dose with high dose facial filler injections to see if there are any differences in efficacy at reducing wrinkles or duration of results. This trial will help us to optimise treatment strategies in the future, so that future patients can be treated – with certainty – at the optimal dose.

Dr. Darren Mckeown, Glasgow Cosmetic Surgeon

“Although extremely apprehensive and never having had any filler treatments before because of a fear of needles and on ethical grounds, I have to say, I was elated to discover that after going ahead, it was as promised, the feeling of a tiny scratch or like a little pin prick. I don’t do pain very well, so it was more than a big deal for me. I was made to feel very welcome and at ease. Darren answered every question honestly and most importantly, I never felt rushed or pressured into anything. I’ll definitely be back! Thanks again.”

S. Cuerden / A Dr. Darren Mckeown Client

Clinical Research