Dieter Manstein MD, PhD: Innovative Procedures Get Under Your Skin

A profile of Dieter Manstein, MD, PhD, and his great achievements in Dermatology: fractional photothermolysis and selective Cryolipolysis®.

Dieter Manstein, MD, PhD turned a two-year research project into a career of developing major dermatology innovations to treat scars, skin aging, and noninvasively remove fat. In November of 1998, he immigrated to Boston, from Germany, where he had earned a PhD in biomedical physics and completed medical school at the University of Muenster as well as his residency in dermatology. Pursuing his interest in medical research, he accepted a position as a fellow in laser research at the Wellman Center for Photomedicine at MGH. He is on the faculty of the Cutaneous Biology Research Center, part of MGH's Dermatology department. Throughout this time, Dr. Manstein teamed with fellow innovator Rox Anderson, MD, who directs the Wellman Center, and the creative duo co-invented two major advances in dermatological treatments. The first procedure, fractional photothermolysis, employs a laser to destroy tiny amounts of tissue to treat skin photoaging or the affects of skin exposure to the ultraviolet rays in sunlight. Prior to their innovation, laser resurfacing was used to peel off an entire skin surface, but it resulted in significant side effects. Drs. Manstein and Anderson's procedure made a pattern of microscopic lesions into the skin, capitalizing on their discovery that each lesion heals quickly when surrounded by healthy tissue. “It was a reasonably simple modification of the previous procedures, but nobody had done this before,” Dr. Manstein explains. “By applying thousands of small spots of laser injury to the skin tissue, you could get a substantial regeneration and treatment of photoaging with no or very limited recovery time.” Since the fractional photothermolysis technology was launched to treat photoaging, it has become extremely popular in dermatology as a treatment for many other conditions including varying pigmented lesions, and has proven to be a highly effective treatment for scars, including severe burn scars. “What we are doing now is trying to further improve this concept,” Dr. Manstein says of the research being conducted in his new lab. “We are studying the mechanism behind how these many small spots can cause tissue regeneration and how it might potentially be applied to nondermatological organs.” Drs. Manstein and Anderson's second major clinical success is selective Cryolipolysis®, a process of applying cold therapy to injured subcutaneous fatty tissue. In fact, subcutaneous fat is more susceptible to injury from cold than all of the other tissues that surround it. Under controlled conditions, their procedure cools the subcutaneous fatty tissue with an external applicator, allowing doctors to remove the tissue gradually and noninvasively. After three to six weeks, the treatment results in visible fat loss. Selective Cryolipolysis is used for removal of fat bulges in localized areas, not as a treatment for obesity or weight loss. Known as the CoolSculpting® procedure, it works as a noninvasive alternative to liposuction. Cleared by the FDA in September of 2010, the medical device is now manufactured by ZELTIQ®, and according to Dr. Manstein, more than 850,000 procedures have been performed all over the world in more than 55 countries to date. Today, Dr. Manstein leverages the licensing fee income reinvested to his lab to his advantage. “I continue to expand my research so that we can create new ideas and invent medical devices in the dermatology domain that have the potential to generate further revenues,” he concludes. “We also use it to investigate and advance our understanding of laser procedures and medical devices in dermatology, so it's a win-win situation for me right now.”