The Consulting Room™ Industry Magazine Edition 118, March 2013

[COVER]

From The Editor's Desk Welcome to The Consulting Room™ Industry Magazine For March 2013 And so we prepare for the shake-up...if you’ve not already bitten your finger nails down to the quick then you will be soon as we all wait on tenterhooks for Sir Bruce Keogh to deliver his findings and recommendations following the review in UK cosmetic interventions. Due to be published in March, we will keep you updated on results via our blog and social media with a full round-up in April’s edition of the magazine.

In this March issue of our Member Magazine our Feature Article delves into the basics of laser hair removal, courtesy of our guest author Dr. Pablo Naranjo, who also touches on some of the contrasting technologies available for this indication.

Our Latest News includes a round-up of recent published procedure statistics for the cosmetic industry from three of the main US based organisations, ASPS, AAFPRS and ASDS. The Legislation section includes updates on the CEN aesthetic standard, medical indemnity insurance policy changes from the MDU for dermal filler providers and cosmetic injectable lobbying from beauty therapy organisations to the Keogh panel.

Lorna Jackson

As always the magazine is packed with our Business Corner, New Product Reviews, Clinical Information, and Interesting News Articles and Blogs That You May Have Missed. Also, don’t miss 7 pages of classified adverts featuring a host of different aesthetic devices for sale in our Equipment Sales at the rear of the magazine.

Consulting Room Team Asked to Speak at BACN Business Workshop Director, Ron Myers and Editor, Lorna Jackson from The Consulting Room™ are honoured to have been asked to present a talk each at the forthcoming British Association of Cosmetic Nurses (BACN) Business Workshop to be held in London on Monday 11th March 2013.

The event which aims to help nurses to improve their aesthetic practice, will cover new ideas and concepts, business planning and implementation, misconceptions and how to understand the bottom line to achieve better results and increased profits.

Ten speakers in all will present on the day with topics ranging from selling techniques and retaining customer loyalty to business models that work and cloud based clinic management.

Ron will be discussing web marketing strategies and discounting decisions while Lorna covers the dos and don’ts of advertising within the aesthetic industry when marketing treatments to the public.

Some Recent Blogs You May Have Missed Fly-In-Fly-Out Cosmetic Surgeons: What Are The Risks?

By Edward Roberts-Beardsell The term ‘fly-in-fly-out’ surgeons or 'seagull surgeons' has been coined to refer to practitioners who carry out work on a short term basis but are not permanently resident in the UK. Due to the increasing popularity in cosmetic surgery procedures, many British cosmetic clinics have taken to using foreign surgeons on a fly-in-fly-out (FIFO) basis in order to meet the ever growing customer demand. Currently, all surgeons practicing in Britain have to be registered with the General Medical Council (GMC). However, unlike British surgeons, foreign surgeons are not legally required to have UK medical indemnity insurance in order to carry out procedures in Britain. Consequently, many foreign FIFO surgeons who provide surgery at British cosmetic clinics are not insured in the UK, making it exceptionally difficult for patients who experience complications from their surgery to later claim compensation. www.consultingroom.com/blog/359

Home Remedies / DIY mole removal

By Dr. Ross Perry As a doctor who specialises in mole removal for aesthetic reasons I see many patients who have been tempted by home remedies and do it yourself mole removal solutions. The temptation is quite obvious as the so called ‘treatments’ are not only portrayed as quick, simple and easy but are also invariably free or cheap. Some patients of mine are often embarrassed to mention they have tried home treatments and other DIY cures with results ranging from ineffective to those that are extremely dangerous and in some cases left with severe scarring. I can understand why patients are keen to get rid of their bothersome moles; whether it is for cosmetic reasons (not liking the look of them), practical reasons (e.g. where they catch on clothes) or simply peace of mind where the mole is causing any concern.

The great benefit of the internet is the vast amount of information available, enabling people to research any topic under the sun. Unfortunately, that information is not always correct… A quick Google search on DIY mole removal reveals some staggering suggestions. www.consultingroom.com/blog/355

Podcasts Sublative Rejuvenation From Syneron Candela - What is it all about?

In this first Consulting Room Podcast, Consulting Room Editor Lorna Jackson talks to James Bartholomeusz, Global Vice President of Product Development at Syneron Candela about the concepts behind their Sublative Rejuvenation approach to ageing skin.

Topics discussed include:      

The theory behind the technology What a patient can expect from treatment with sublative rejuvenation The technology available on the eTwo and elosPlus platforms The unique feature of intelligent feedback which aids delivery of the energy for optimum treatment 'doses' A comparison with radiofrequency (RF) needling devices The future for Syneron Candela

www.consultingroom.com/blog/360

Looking For Best Prices on Toxins & Fillers? This Month’s Deals The Consulting Room™ Product & Price Comparison Charts for Dermal Fillers and Botulinum Toxins are available in the Product Comparisons section (login required) within our Members Area where you can compare the prices and bulk deals available through direct purchase from manufacturers/distributors or through the major third party wholesalers and pharmacies such as Wigmore Medical Ltd, Health XChange Pharmacy and Med-fx.

Offers this month: Prices ex.VAT Botox 100U / 50U Azzalure 2 x 125U (Twin pack)

Wigmore Medical

Health XChange

Med-fx

N/A £100.00 4+ Packs @£91.00 each

£140.00 / £76.01 N/A

£118.00 / £53.95 10+ Packs @ £107.00 each / 20+ Packs @ £51.00 each £89.50

N/A

£145.00 £95.00 Buy 5 @£84.00 each* £64.50 Buy 5 @ £54.50 each* £119.90 / £53.00

£83.24

N/A

£95.50

Azzalure 1 x 125U (Single) Xeomin 100U / Bocouture 50U

Restylane 1ml Juvéderm Ultra 2 (2 x0.55ml)

£85.00 *Buy any 2 Fillers & get 2 Recovery Creams FREE £93.35 st

th

* offers valid 1 Mar - 30 Apr 2013

Nip & Tuck - Facts & Stats

€4.4 (US$6) Billion

US$30.5 Billion

Estimated value of the global cosmetic procedures market (surg & non-surg) in 2012.

Estimated value of the global cosmeceutical market in 2011.

Source: Reportlinker.com

Source: IMCAS

‘Back Fulge’ Term coined to describe the ‘bulge of back fat’ which often appears below the bra strap line on many women.

Source: Optifit Bras

£150

6.6%

The price of the latest ‘must-have’ skin cream, Rodial’s Bee Venom Moisturiser containing toxin melittin from bees.

The forecasted growth in the European market for cosmetic procedures (surg & non-surg) in 2013.

Source: Daily Mail

Source: IMCAS

Latest News It’s ‘Stat’ Time of Year Again!

The start of a new year always brings with it a flurry of reports and member audits from around the globe offering an insight into the number of cosmetic surgical and non-surgical procedures being performed by practicing medical professionals in a given year. Already in 2013 we have seen UK figures for 2012 published by BAAPS, the British Association of Aesthetic Plastic Surgeons, as well as indicators of global trends from ISAPS, the International Society of Aesthetic Plastic Surgery for 2011. During February further reports arrived from ASPS, the American Society of Plastic Surgeons, AAFPRS, the American Academy of Facial Plastic and Reconstructive Surgery and the ASDS, American Society of Dermatologic Surgery.

American Society of Plastic Surgeons (ASPS) The American Society of Plastic Surgeons (ASPS) is the world's largest organisation of board-certified plastic surgeons, representing more than 7,000 members, and comprising more than 94% of all boardcertified plastic surgeons in the United States.

According to statistics released by the ASPS, 14.6 million cosmetic plastic surgery procedures, including both minimally-invasive and surgical, were performed in the United States in 2012, up 5% since 2011. In addition, 5.6 million reconstructive plastic surgery procedures were performed last year, up 1%.

"Our annual statistics serve as a snapshot regarding the plastic surgery industry," said ASPS President Gregory Evans, MD. "For the third consecutive year, the overall growth in cosmetic surgery continues to be driven by a significant rise in minimallyinvasive procedures, while surgical procedures remain relatively stable. We are aware, however, that patients who begin with less invasive treatments with a plastic surgeon may opt for more invasive, surgical procedures once required."

Cosmetic minimally-invasive procedures increased 6%, with more than 13 million procedures in 2012. The top five minimally-invasive procedures were:     

Botulinum toxin type A (6.1 million procedures, up 8%) Soft tissue fillers (2 million procedures, up 5%) Chemical peel (1.1 million procedures, up 2%) Laser hair removal (1.1 million procedures, up 4%) Microdermabrasion (974,000 procedures, up 8%)

Cosmetic surgical procedures decreased 2%, with nearly 1.6 million procedures in 2012. The top five surgical procedures were:     

Breast augmentation (286,000 procedures, down 7%) Nose reshaping (243,000 procedures, no change) Liposuction (202,000 procedures, down 1%) Eyelid surgery (204,000 procedures, up 4%) Facelift (126,000 procedures, up 6%)

Interestingly, facial rejuvenation procedures, both surgical and minimally-invasive, experienced the most growth in 2012. Facelifts and eyelid surgeries were up, while 2012 marked the highest number of botulinum toxin type A (Botox®, Dysport®) injections performed to date. Other facial rejuvenation procedures like soft tissue fillers, laser skin resurfacing (509,000 procedures, up 9%) and microdermabrasion also saw sizable increases.

Female cosmetic breast surgeries such as breast augmentation and breast lifts (89,000 procedures, down 2%) dropped last year, while male breast reduction (gynecomastia) shot up. Nearly 21,000 male breast reductions were performed, up 5%.

"Female cosmetic breast surgeries such as breast augmentation, as well as body contouring procedures like tummy tucks, were some of the most popular procedures performed in 2012, although they saw declines," said Dr. Evans. "Facial rejuvenation procedures to eradicate wrinkles, refresh, or tighten sagging skin experienced growth, as more consumers chose to maintain or restore a youthful appearance with these procedures."

View the 2012 National Clearinghouse of Plastic Surgery Statistics report from ASPS. Source: www.plasticsurgery.org

American Society of Dermatologic Surgery (ASDS) The American Society for Dermatologic Surgery (ASDS) is the largest specialty organisation exclusively representing dermatologic surgeons who have unique training and experience to treat the health, function and beauty of your skin.

A member survey was conducted for data experienced in 2012 on 3,705 practicing ASDS members. Survey results are reported based on 630 physicians or a 17% response rate and generalised to represent all ASDS members.

According to their statistics dermatologic surgeons continue to be the physicians of choice for patients seeking treatment for skin cancer as well as cosmetic procedures with dermatologic surgeons performing nearly 8 million medically necessary and cosmetic procedures in the United States in 2012 (a nearly 7% increase over 2011).

Among the top procedures performed were:    

Skin cancer treatments: 2.69 million procedures – a 3.5% increase over 2011.

Laser/light procedures: 1.68 million procedures – a 5.3% increase over 2011.

Neuromodulators (wrinkle-relaxing injections such as Botox®): 1.49 million procedures – a 24.4% increase over 2011.

Soft-tissue fillers (such as Juvéderm®): nearly 917,000 procedures – a 10.4% increase over 2011.

“Once again, these survey results illustrate how dermatologic surgeons continue to be chosen by patients for their unique training and wide-ranging experience to treat not only the health of the skin but also its function and beauty through medically necessary as well as cosmetic procedures,” said ASDS President Timothy C. Flynn, M.D. “No other physician has the level of training and experience with the focus on the skin as a dermatologic surgeon.”

Of the 1.49 million wrinkle-relaxing procedures performed in 2012, 1.09 million were Botox® procedures – a 9% increase over 2011; and nearly 379,000 were Dysport® procedures – a 37.8% increase over 2011.

Photorejuventation, a low-cost skin treatment utilising intense pulsed light (IPL) or other thermal or chemical methods to treat some skin conditions and remove wrinkles, was the most common laser/light procedure, with ASDS members performing more than 438,000 in 2012 – a 76.5% increase over 2011, representing the largest single jump among procedures performed.

“As our population continues to age and people still continue to enjoy the sun without wearing appropriate sunscreen, sun damage will occur that will require treatment,” said ASDS President-Elect Mitchel P. Goldman, M.D. Other top laser/light procedures include: facial redness with nearly 322,000 procedures and age spots with nearly 265,000 procedures. ASDS members also performed more than 86,000 acne scar procedures and nearly 63,000 tattoo removals.

Other popular cosmetic procedures performed by ASDS members include softtissue fillers, the most common of which was Restylane® (352,261), followed by Juvéderm® (335,151).

Of the nearly 144,000 body sculpting procedures performed by ASDS members in 2012, cryolipoysis (otherwise known as “fat-freezing”) was the most common, representing 57.2% of all body sculpting procedures and a 49% increase over 2011.

As the incidence of skin cancer continues to rise, dermatologic surgeons have been able to demonstrate their commitment to skin cancer awareness and prevention as well as their expertise in diagnosis and treatment. Of the skin cancer treatments performed by ASDS members in 2012, nearly 130,000 were for melanoma – an 18% increase over 2011. In 2012, ASDS members also performed more than 205,000 phototherapy procedures – up 26.8% over 2011 – to treat pre-cancerous cells (actinic keratosis) as well as sun damage, acne and rosacea.

Source: www.asds.net

American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) is the world's largest specialty association for facial plastic surgery. It represents more than 2,700 facial plastic and reconstructive surgeons throughout the world.

According to a new survey by the AAFPRS, social media is leading consumers to have a more self-critical eye.

Their annual member poll, which showed results from 752 of the organisation's board-certified facial plastic surgeons, found that there was a 31% increase in requests for surgery as a result of social media photo sharing.

The study shows that a growing number of procedures are cosmetic versus reconstructive in nature, accounting for 73% of all procedures in 2012, up from 62% in 2011. Of the procedures requested as a result of social media influence, rhinoplasty, Botox®, and facelifts topped the list.

While social media continues to play an increasingly large role in how consumers view themselves, its influence as a trusted informational resource for plastic surgery is diminishing. Last year just 7% of prospective patients used social media to research doctors and procedures, down from 35% in 2011. Instead, 57% got their information about plastic surgery online, with 33% relying on referrals.

“Patients are becoming increasingly more sophisticated in their knowledge of plastic surgery due to the obvious increases in online research and validations,” said Ed Williams, MD, Group Vice President for Public and Regulatory Affairs for the American Academy of Facial Plastic and Reconstructive Surgery. “Our members are seeing a much more educated consumer base than ever before, thanks to the increased availability of information.”

Non-surgical treatments made up two-thirds of all cosmetic procedures requested in 2012. While they are still popular for their ability to delay signs of ageing with minimally invasive measures, the number of non-surgical procedures performed was down last year. The most common cosmetic non-surgical procedures remain Botox® and hyaluronic acid fillers, with the top three areas of the face most treated by injectables being the forehead (42%), cheeks (35%) and the lips (18%).

Conversely, requests for surgical procedures are on the rise, with rhinoplasty, blepharoplasty and facelifts being the most requested in 2012. Among all procedures, the largest increase was among requests for facelifts and blepharoplasty (eyelid surgery), while lip augmentation and calcium hydroxyapatite injections showed the greatest declines.

The number of men undergoing facial plastic surgery continues to rise, and the AAFPRS survey suggests there's no sign of slowing down. With more patients citing the need to remain competitive in the workforce as a determining factor in the decision to have surgery, men are turning to non-invasive procedures to retain their professional edge.

Notably, the number of men having Botox® was up 27% from 2011, with hyaluronic acid fillers and microdermabrasion also among the most popular maintenance treatments.

The AAFPRS study also shows that men are more likely to request plastic surgery as a result of their significant other also undergoing cosmetic surgery, with 20% of all male patients being influenced by a partner’s decision.

Rhinoplasty remains the most requested surgical procedure overall among men.

Women continue to be the most likely candidates for facial plastic surgery, accounting for 80% of all surgical as well as non-surgical procedures last year. Of this group, two-thirds of women having procedures are mothers, primarily in their 40’s and 50’s. AAFPRS members have seen an uptick in female family procedures as a bonding experience, with a 16% increase in mother-daughter procedures and a 12% increase in sister-sister procedures.

In 2012 the most common cosmetic surgical procedure for women was facelifts, followed by blepharoplasty, and rhinoplasty. The most common non-surgical cosmetic procedures among women were Botox®, hyaluronic acid injections and microdermabrasion, respectively.

The face of plastic surgery is getting younger thanks to the availability of more minimally invasive procedures and growing social acceptance. In 2012, 28% of AAFPRS members saw an increase in cosmetic surgery and facial injectables in those under the age of 25. For children and teens, the survey found that they are more likely to have plastic surgery as a result of being bullied (76%) versus a way to prevent bullying (24%).

For both female and male patients under the age of 35, the most common procedure performed was rhinoplasty (53% females; 70% males), followed by Botox® (30% women; 13% men). For all procedures, except rhinoplasty, the majority were performed on patients between the ages of 35 and 60.

Plastic surgery continues to advance due to new technology and improved techniques, attracting more consumers than ever before. The top trend AAFPRS members have identified is that consumers are more educated about plastic surgery. A more educated consumer base is leading to the further decline in requests for celebrity procedures (down to only 7%), with 53% of patients instead asking for a procedure by area of concern and 28% asking for it by name. When considering surgery, most patients were primarily concerned with the results (40%), followed by cost (33%) and recovery time (21%), with pain/invasiveness and social perception playing a very small role in their decision.

Source: www.aafprs.org

Galderma Issue Urgent Field Safety Notice For Restylane Sub Q Lidocaine th

On 26 February 2013, on the advice given by the manufacturer Q-MED AB, Galderma (UK) Ltd decided to withdraw batches (Lot No.s) 11907 and 11516 of Restylane SubQ Lidocaine from the market. This decision has been taken due to defects affecting the blister pack which means that the external sterility of each syringe can no longer be guaranteed.

Restylane SubQ Lidocaine syringes are first packed in blister packs and then sealed prior to sterilisation in an autoclave. The sealed blister pack containing the syringe is then placed in a cardboard carton which is then sealed before transportation.

At internal quality control they have discovered two defects in some of the blister packs; there has been incomplete sealing of the paper covering the plastic blister pack and small holes have been created in the paper during transfer of the blisters to the packaging line. Whilst sterility of the content inside the syringe in unaffected, these defects in some of the blister packs mean that the external sterility of the syringe can no longer be guaranteed.

Corrective actions have already been identified and implemented.

Galderma (UK) Ltd ask that practitioners be assured that the sterility of the content in the syringe is not affected.

Neither technical complaints nor an increase in adverse events related to these two batches have been reported.

The risk or potential risk to the safety or health of patients is assessed to be unlikely due to the intact syringe barrier maintaining the sterility of the gel content.

If you are concerned about a potential side effect following the use of Lot 11907 or 11516 of Restylane SubQ Lidocaine, please report this to them so that they can investigate further.

Galderma (UK) Ltd ask that practitioners please identify any syringes they have corresponding to these two batches of Restylane SubQ Lidocaine (Lot No 11907 and 11516) and return them to Galderma (UK) Ltd using a freepost address. Any returned stock from either of the two affected batches will be replaced free of charge.

This Field Safety Notice has been sent to all customers who have purchased Restylane SubQ Lido Lot No 11907 and 11516.

Galderma (UK) Ltd ask that practitioners be assured that no safety concerns have been identified with Restylane SubQ Lido.

If you need any further information regarding this withdrawal please contact Galderma (UK) Ltd either via telephone on 01923 216000 or email sales.uk@galderma.com.

Image courtesy of AESTHETiKA

Round-Up of ASA Health & Beauty Adjudications The Advertising Standards Authority polices the content of Health & Beauty advertising through all mediums in accordance with rules set out in the CAP (Committee of Advertising Practice) code. This month we did a quick round-up of the naughty advertisers in our industry, in the hope that we can all learn a thing or two:

Getting it right! Clinic proves before and after images are ‘pukka’ A website offering Vaser Liposuction for men, www.efmedispa.com, stated, "You may want to get rid of a stubborn pocket of fat. Or perhaps you wish to have your body re-sculpted, have a six pack or have more defined pectoral muscles. But what are your options? There are thousands of men in the UK who are looking to re-sculpt their appearance but do not wish to have major surgery or conventional liposuction".

Under the text, "Vaser Lipo and Vaser High Def for men" the website featured a number of before and after photographs.

The complainant challenged whether the before and after images were misleading.

EF Medispa (EFM) confirmed that the before and after images used in the advert featured models who had undergone the Vaser hi-def procedure. The photographs were unedited and the clients provided full consent to their photographs being used and shown to the public as an example of the results that could be achieved by having the procedure. EFM provided documentation in support of this.

EFM explained the mechanisms involved in the Vaser procedure and provided journal articles, online editorial content from specialist websites and national press articles, which outlined the same. EFM also explained that they always encouraged their clients to maintain their results through diet and exercise.

The ASA did not uphold the complaint and noted that the complainant had challenged whether the before and after photographs used in the advert featured real clients who had undergone the Vaser procedure.

In light of the consent forms and other documentation provided they considered that EFM had demonstrated that the models had undergone the Vaser procedure. They understood that the procedure alone would not tone muscles or increase muscle size; instead it would increase the appearance of muscle definition through a process known as 'liposculpting'. The results were shown in the before and after images. This was reflected in the main body of text on the web page, which stated, "(Vaser hi def) can precisely sculpt and define areas of the body creating greater contour and definition".

Because EFM had demonstrated with suitable evidence that the models in the photographs had undergone the Vaser procedure the ASA concluded that the advert had not breached the Code. No further action necessary.

Full Adjudication

Avoid claims that you’re ‘the best’ unless you can prove it!

Claims on www.cadoganclinic.com a private healthcare clinic, stated "the best consultants the best care". Claims under the heading "The Very Best Consultants" stated "The Medical and Surgical consultants at The Cadogan Clinic are the best in Europe, hand picked for their skills. They are supported by an exceptional team of nursing staff and management".

The Whiteley Clinic challenged whether the claims that the advertiser's consultants were "the best" and "the best in Europe" were misleading and could be substantiated.

Cadogan Clinic said they had sought guidance from CAP's Copy Advice team and been advised that "best consultants" was a subjective term and they would not be required to substantiate it in the event of a complaint. Cadogan Clinic said, as a private clinic, they hand-picked their consultants and strove to have the best staff and to offer the best treatments and procedures.

The ASA upheld the complaint and considered that the claim that the advertiser had the "best consultants" was likely to be interpreted by readers as an objective claim that their consultants had been objectively

shown to be better than their peers, for example in terms of surgical success rates. They considered that impression was enhanced by the claims that the consultants were "the best in Europe, hand picked for their skills", which, by referring to a limited geographical territory, added to the impression that a specific group of consultants had been compared.

They welcomed Cadogan Clinic's efforts to comply with the Code by seeking advice from CAP. However, because they understood that they were not able to objectively substantiate the claims to have the best consultants, they concluded that the claims were misleading and must not appear again in their current form.

Full adjudication

Don’t make health or medical claims about sun beds!

A website promoting the use of sun beds and spray tans included the text "At Sunseekers we take your health and well-being very seriously. We whole heartedly believe that exposure to UV light (sunlight) is not only good for us but is in fact a vital ingredient for good health and well being".

Further text included "complete abstinence from exposure to sunlight is more harmful than the very small risk associated from exposing ourselves to UV".

The advert made a number of claims about potential health benefits of tanning, based on increased vitamin D intake from UV light, including: improved bone structure, reduced risk of heart disease, increased wellbeing, weight loss, reduced cancer risk, stronger immune system, cure of skin disorders and reduced risk of burning.

The complainant challenged whether the implied claims that tanning using a sunbed was beneficial for health were misleading.

SunSeekers Sunbeds stated that the controlled use of sunbeds was beneficial to health and well-being and provided published research documents about the benefits of vitamin D from sunlight and the detriment to health associated with complete abstinence. They also provided published articles which linked vitamin D to disease prevention.

The ASA upheld the complaint and noted the definition of a medical claim under CAP code rule 12.1 included claims that a product could be used to prevent an ailment or adverse condition in human beings.

They understood it was generally accepted that vitamin D intake from UV sources could be beneficial for bone density. However, they considered the implied claims that vitamin D intake from tanning could reduce the risk of heart disease, reduce the risk of cancer, give a stronger immune system and cure skin disorders, amounted to medical claims. They noted evidence was not presented to demonstrate that the sunbeds used by SunSeekers were CE-marked medical devices and they therefore concluded that the medical claims made in the advert were in breach of the CAP Code.

The ASA concluded that the advert should not appear again in its current form. They told SunSeekers not to make claims about disease prevention linked with vitamin D from using a sunbed without holding robust evidence.

Full adjudication

Voucher deals, how to make them a ‘responsible’ option for consumers A daily deals website seen on 20 September was headlined "Hair Loss Treatment Voucher". A sub-heading stated "£99 for a £1000 voucher towards any hair loss treatment at Foley Court … save 90%".

A bullet point under the headline stated "Highlights" and further text stated "Use your voucher towards treatments such as laser hair therapy, FUE hair transplant or hair loss hair extensions". Another bullet point stated "Get your confidence back!". Text in the main body of the advert, under the heading "Full details" stated "You'll start by having a consultation with a professional hair consultant to discuss your suitability and needs … offering procedures such as laser hair therapy, FUE hair transplant and hair loss hair extensions, there's bound to be something to help you get your confidence back!".

The complainant challenged whether advertising a hair transplant procedure on a time limited deal was irresponsible.

Wowcher Ltd (Wowcher) said the voucher was available to purchase for a period of four days and that upon purchase, the voucher provided a period of three months for an initial consultation to take place, with a further three-month period in which to make and attend an appointment for treatment. An individual had up to six months to use their credit and to decide whether they wished to then proceed with a treatment. They said that on this particular promotion, individuals were not committed to receiving treatment and the cancellation policy allowed the individual to cancel up to 24 hours before the consultation or appointment, and a refund would be available, if requested, if they decided not to proceed. They said if an individual decided, post consultation, that they did not wish to proceed with treatment, they would be able to receive a full refund of the price paid for the voucher.

The ASA did not uphold the complaint and noted the voucher related to a variety of hair loss procedures, most of which were non-surgical and therefore participation was unlikely to require such careful consideration. However, the FUE treatment towards which the vouchers could be used was surgical in nature and therefore something that was likely to need careful consideration on behalf of the participant. They noted the voucher could be used towards the FUE treatment but because of the price of the procedure could not be used to buy it outright and that individuals who were considering the surgical procedure would need to also invest a significant amount of their own money. They therefore considered that the offer was unlikely to incentivise individuals who had not already given significant thought to investing in such a procedure.

Individuals who purchased the voucher were not financially committed to the procedure from the outset and a consultation was available immediately after purchase and, if customers then considered that none of the procedures were suitable, they could obtain a full refund. A consultation was also available to individuals prior to purchase of the voucher. Whilst the adverts did require a speedy response to take advantage of the vouchers, they did not consider that they would encourage consumers to commit to a cosmetic procedure without the appropriate personal, financial and medical consideration. They therefore concluded that the advert was not irresponsible and no further action was necessary.

Full Adjudication

The Consulting Room™ 3rd Annual Golf Challenge Day Whether you're an amateur or experienced golfer join us to eat, drink, play, relax, network and play a round of golf. After the success of the last two Consulting Room Golf Days in 2011 and 2012 we are pleased to announce the th date for our 2013 tournament: 18 May 2013 at Old Thorns, Surrey.

We will be looking for clinics to enter a team of two and to compete for the Consulting Room Challenge Cup. If you can't find a partner, we'll aim to find one for you on the day, which will be a great opportunity to enjoy a round of golf - with a competitive edge, whilst networking with industry colleagues and friends. Spa options are available for non-golfing partners!

Consulting Room Members Get 5% Discount on all Bookings!

For more information and to reserve your place, please visit www.consultingroomgolf.co.uk

New Product Reviews Alma Lasers Unveils 'ICE' Cold Laser Hair Removal Alma Lasers (distributed in the UK by ABC Lasers Ltd) has unveiled the next generation of its award winning Soprano laser hair removal system. Called Soprano ICE the new laser is the most effective and most comfortable method of permanent hair reduction and removal according to the company.

The device was launched in the UK by Guy Goudsmit, MD of ABC Lasers at the recent Cosmetic News Expo in London, see photo.

Soprano is Alma Lasers' flagship laser hair removal system based on the Company’s patented SHR technology – a clinically proven method of effective and virtually pain free hair removal. In multiple clinical studies conducted by leading dermatologists, Soprano has been proven as safer, equally or more effective, and resulting in considerably less pain than other laser hair removal technologies. It is the only technology that can be used all year round on all hair and skin types.

Soprano Ice cools the skin with an encircled sapphire tip, preventing burns on the skin surface while maintaining heat within the dermis. This high fluency delivery system provides an even more comfortable and faster treatment with improved results for light coloured & thin hair. A lighter and improved ergonomic design also means Soprano Ice is now even easier to use and can be used to treat smaller and difficult to target areas like the eyebrows, nose and ears.

Mr. Lior Dayan, Alma Lasers VP of Sales & Marketing applauded the new system, "Since 2006 when Alma Lasers unveiled its clinically proven SHR hair removal technology, the Soprano has become the industry's gold standard in laser hair removal. The new Soprano ICE further raises the bar in laser hair removal, and places Alma Lasers firmly in the position of industry leader."

Watch Their Promotional Video

http://www.youtube.com/watch?v=ZWQE-panaIo

MD Lash Factor Launches Offering Naturally Long Lashes MD Lash Factor (3ml RRP £79.95 and 6ml RRP £109.95) is a drug free, prescription free, physician formulated eyelash conditioner with unique patented technology that improves the appearance of natural lash length, thickness and fullness.

Developed by Dr. Susan F. Lin, a practicing physician in women’s health, anti-ageing and aesthetic medicine for over 21 years, the Prostaglandin Free formula combines the latest skin care science with safe, results oriented ingredients.

In a one month study 95% of users reported an improvement in the overall appearance of lashes with an average increase of 53% increase in length.

The active ingredients include Cytokine Complex that delivers the nutrients necessary to develop fuller, thicker, longer looking lashes and Thiotaine, a powerful mushroom derived peptide, that condition and helps protect and nourish lashes and allows them to develop to their fullest potential without irritation.

BENEFITS INCLUDE:     

Physician formulated Ophthalmologist Tested Safe for Contact Lens Wearers Prostaglandin Free Results in 30 days

Apply to a clean, dry lash line once a day. Maximum results will be achieved between 2-4 months.

For more information please contact Baron Health and Beauty - www.baronhb.com. The product is also available direct from Medical Aesthetic Group - www.magroup.co.uk

At a loose end this weekend? Need something to do?....

Why not visit our sister site www.cosmeticvideos.co.uk and check out all the great videos, including Member’s Only content!

The Member’s Only section of our specialist video website contains videos that are more instructive and aimed at purely at medical professionals, relating to detailed explanations of concepts, techniques, procedures, protocols and dealing with problems.

If you haven’t accessed this section already, it’s quick and easy to do so...

Simply Register using your Consulting Room membership information (username or email address and password) and if everything matches you will be authorised automatically and you can then log in to the Cosmetic Videos Members Only Area whenever you like; all free of charge to Consulting Room members.

www.cosmeticvideos.co.uk

Feature Article Guide to Using Laser Technology for Hair Removal There are many different systems on the market for hair removal. It is possible to divide them in two different groups: absorption and transmission lasers. The absorption devices (ruby, alexandrite and 810nm diode lasers) have high absorption by melanin and lower by haemoglobin and water. The transmission lasers (neodymium-YAG and 915nm diodes) have high penetration in the tissue and coagulate directly the bulge and the surrounding vessels. Lastly, there are IPL devices which can help us with hair removal.

Our target is to destroy the stem cells that are on the hair shaft and dermal papilla. They are colourless which makes them difficult to be targeted by light devices, so we need to coagulate and thermally destroy the keratinocytes surrounding the stem cells at the bottom of the hair shaft and dermal papilla to be able to hit them. To achieve this you need to use a minimum temperature of 65 degrees Celsius at a depth of one to four millimetres in order to achieve good coagulation and thermal destruction of the stem cells. By doing this, the lower part of the hair shaft and dermal papilla are destroyed permanently. We say permanently but not definitively, because after all the hormonal changes in the body during puberty, 15–20% of hair follicles will not have created hair shafts in the body and more than 30% on the face and neck. Therefore it is impossible to destroy all the hair we have, we can only destroy the hair that has been not in a “sleeping” situation, as they cannot be destroyed until they receive vascularisation to create a new hair shaft.

It is important to know the different phases of hair growth – anagen, catagen and telogen. Interaction in the anagen phase is likely to give better results in fewer treatment sessions.

When carrying out hair removal treatments, we will be exposed to certain challenges, treating patients with a high phototype and tanned skin, treating sensitive areas, treating complex anatomical areas and getting unexpected poor results. When treating a patient with a high phototype or tanned skin, the absorption lasers – alexandrite, ruby and 810 nm diode lasers – have a high absorption by melanin on the hair shaft and epidermis. Those devices may be the gold standard to treat dark, thick hair on white skin but should not be used on phototype IV, V, VI and phototypes I, II, III with very thin, light hair because it's too risky. The light doesn't know where to deposit the energy and it is likely to cause burns or postinflammatory hyperpigmentation.

It is vital to thoroughly evaluate patients to avoid complications. Never treat a patient who has had sun exposure in the last few days. You need to wait a minimum of four weeks before treating with an alexandrite ruby or 810 diode laser and a minimum of seven days when using a Neodymium-YAG laser or 915nm diode laser. Talk with the patient, take a good clinical history and ask about sun exposure – not just on the beach but daily exposure in the last two to four weeks.

Alternatively we can use devices that give us information about the quantity of melanin and quantity of redness on the body. Those devices are very low cost and give realistic information about melanin in the skin. You need to obtain measurements of melanin in a patient’s skin by evaluating the “real” phototype from the wrist of the hand, an area which does not get much sun exposure. Then

measure the phototype in the area you want to treat and if the quantity of melanin is multiplied by two or more, treatment is too risky. Even if you reduce the energy with an alexandrite laser to 12 joules per centimetre square, if a patient is recently tanned and doesn’t tell you or you don’t take measurements, you can burn the patient. Another way to prevent secondary effects is to cool the skin. By cooling the skin you reduce the risk of burning when applying high energy. You may apply high energy if you feel the hair shaft does not have enough colour compared to the epidermis to receive the energy selectively. So when you treat thin, light hair it is important to cool the skin because you will need to use higher energies.

To treat a patient with a high phototype or recently tanned skin, you can select a wavelength with less absorption by melanin – a transmission laser, 915nm or 1064nm. If you only have a regular diode or alexandrite laser, you would have to increase the pulse duration of the laser, but doing this you sacrifice the effectiveness of the treatment. Pulse duration is not related to the phototype of the patient – pulse duration is related with the thickness of the hair. Thinner hair needs shorter pulse duration, larger hair needs larger pulse duration. If you enlarge your pulse duration on thin hair, you are sacrificing the effectiveness.

During recent years we have been considering other ways of treating patients with high phototypes or tanned skin.

Apogee Elite from Cynosure is a device combining two wavelengths, Neodymium-YAG and Alexandrite on a blend mode. One after the other, milliseconds apart, you can shoot with Neodymium-YAG and then Alexandrite.

This protocol reduces the energy needed for each one of the wavelengths and decreases the risk of superficial burns by a half. A study which took place in the IML Clinic in Madrid demonstrated that 54% of Neodymium-YAG plus 46% of Alexandrite, one just before the other, was the best combination, but the efficacy obtained was exactly the same as one shot of Alexandrite.

Another device that can be used on patients with high phototypes is the 810nm diode laser with high repetition rates and low energy, the first such device was the Soprano from Alma Lasers. This is not a regular diode laser, it has the regular mode with the high energy pulse and different pulse durations but also has the ability to work with dynamic epilation using low fluence and eight repetition rates, ten shots per second. Soprano hair removal efficacy cannot be explained by photothermal theory like other devices, but by the fact that the accumulation of heat on the dermis after each pass of the laser would destroy the stem cells on the hair shaft and dermal papilla. This dynamic epilation is less painful, although when you increase the number of passes on the same area you increase the heat and this increases pain sensation. The last pulses are going to be much more painful than the first ones, but it can be considered as a less risky and less painful technique.

The gradual increase in heat within the dermis explain the lower risk of superficial burns of this technique and the ability to treat higher phototypes and long lasting tanned skin. It's an interesting device but very technically dependent. You need to move the handpiece correctly: if you move too quickly, you don't increase the energy enough and if you move too slowly, you can burn the skin. A problem with this device is that you cannot set the pulse duration you want. You have pre-fixed pulse durations and pre-fixed energies. You have limitations as you cannot adjust the duration and energy separately, and you cannot use very short pulse durations which is needed for very thin hairs.

Another similar device on the market which uses this same theory of accumulated heat is the eLase from Syneron-Candela. It works in exactly the same way with pre-fixed pulse durations and pre-fixed energy. The difference is that the eLase needs less power as it uses ELOS technology, a combination of radio frequency (RF) and light. Radio frequency is not selective to any chromophore, it doesn't look to the melanin and is only influenced by resistance, the electrical impedance of the tissue. If the device delivers RF before the light of the 810nm diode laser, the dermis will be pre-heated and the fluence needed to achieve a coagulation threshold will be less. The temperature delivered by RF will specifically increase in the part surrounding the hair shaft and dermal papilla as this is the most resistant structure we have in the dermis. You will increase the vasodilation and the extravasation of the plasma. If you apply RF and light simultaneously, light will be selective and RF will be deposited in the area with highest resistance. You can decrease the energy of the light because we have the synergy of the electrical current and light both creating heat.

The electrical current and light together increase the temperature to 55–65 degrees. This is why RF is used, as it is less risky than the light especially for patients with tanned skin and high phototypes.

Areas such as the ears, nose, and the upper lip are complicated to treat using a diode laser. It is very difficult to place the sapphire or quartz crystal of a diode laser in a perpendicular and covered position, so it is easier to use an Alexandrite, or Neodymium-YAG laser. It is important not to angle the handpiece to prevent bad results on hair

removal caused by partial coagulation of the hair shaft and dermal papilla. Also take care with excess refrigeration.

It can reduce the effectiveness of the Neodymium-YAG laser, which has absorption by haemoglobin because it decreases the diameter of the vessels feeding the dermal papilla if skin is cooled too much.

We can have problems on hair re-growth when trying to treat a delimitated area or just one hair. While you may see one hair, the patient can have many “sleeping” hairs in the area and if you treat with a laser, you create a scattering effect, heat not just in the area being treated, but in the surrounding areas. This heat has been proven to create neovascularisation, vasodilation and increase the blood flow to the bulge area of “sleeping” hair. This situation can cause re-growth of those follicles. Don’t treat outside of the pre-treated areas, don’t treat individual hairs and don’t treat with low energy in large spots because you increase the scattering effect. Make sure you always refrigerate the surrounding areas to prevent this unwanted effect.

Bad results on areas like the naso-labial area can also be explained by a bad stretch of the skin. Sometimes we have patients who don't get good results: patients who have undergone up to ten sessions in an area which is easy to treat, without any apparent problems, no hormonal problems. We have recently started a study at the King Juan Carlos University in Madrid (Spain) to try to clarify those situations and problems related to oestrogen receptors of the dermal papilla can be part of the explanation of those bad results.

Dr. Pablo Naranjo Elite Laser Clinic, Madrid (Spain) Dr. Pablo Naranjo has more than 10 years experience in the field of medical aesthetics and is the Medical Director of Elite Laser in Madrid, Spain. Following his medical degree, he undertook a Masters in Administration and Management of Health Services (with distinction), a Masters in Aesthetic Medicine (with distinction), where his dissertation looked at aesthetic treatments with Q-switched laser and then a Doctorate in Medicine (Summa Cum Laude). He is a member of the Aesthetic Medicine and Cosmetic Registry in the Medical Association of Madrid. He is also a Coordinator, Lecturer and Honorary Associate of the Master’s degree in Aesthetic Medicine of the Rey Juan Carlos University of Madrid, covering modules in Laser and IPL. Pablo has been the European Clinical Director for Candela Corporation, a leading manufacturer of devices for aesthetic laser treatments, since 2008.

Eye Spy With My Industry Eye Cosmetic News Expo 2013 The Consulting Room™ team attended the third annual Cosmetic News Expo at the Business Design Centre in Islington, London th th held earlier this year on Saturday 16 and Sunday 17 February.

With an estimated 1,000 delegates over the two days, enjoying a combined event of an Aesthetic Conference agenda, business and practical workshops, as well as a trade exhibition floor, the event goes from strength to strength.

The team was pleased to see and catch up with many well known faces over the weekend, including many of our members, along with a myriad of new practitioners who are now entering the UK marketplace to offer aesthetic treatments.

Some novel devices and new treatment options were on display at the event, which again highlights the growth and demand of this industry; these included Dermapen, Soprano Ice, Juvéderm Volbella and the FLABélos to name but a few. The highlight of the Expo though has to go to the team at Rosmetics who brought along a giant inflatable Dracula to promote their Platelet Rich Plasma (PRP) Therapy solution from Selphyl!

More images from the event are available on the Cometic News Facebook Page.

AAD 2013 – Celebrating 75 years of Excellence in Dermatology st

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Impressions from the 71 American Academy of Dermatology (AAD) Meeting at Miami Convention Centre, South Beach. By Ron Myers, Director of The Consulting Room When my business partner, Martyn Roe, suggested that I go to the AAD instead of him this year, (as his wife is due to give birth to their first child this month), understandably, I didn’t take a lot of persuading!

Neither did my 18 year old daughter, who is embarking on a career in the beauty industry, when I suggested that she might like to accompany me for 5 days, staying in a hotel on Miami Beach!

As we drove from the airport, through Miami harbour containing three vast cruise ships and past multi-million dollar yachts, and real estate, there certainly seemed to be no sign of the recession that America has been living through, on and off, since the economy nose-dived in 2008.

This was my first visit to the largest dermatology conference in the USA, with over 10,000 people attending and hundreds of exhibitors selling a wide range of prescription products, skincare, lasers and other equipment.

My main reason for going to the AAD was to represent Martyn, (who helps to sell the Hydrafacial™ System with UK distributor Skin Brands Ltd) at an annual exhibitors meeting hosted by Edge Systems, the US based manufacturer of the Hydrafacial devices. This two day event had distributors attending from all over the world, and it was fascinating to hear the differences between the aesthetic markets in places such as Finland, Russia and Japan, (where they cannot legally buy and sell equipment, but instead have to “facilitate” direct sales of the device from the USA to a clinic owner in Japan). The other interesting feature related to the marketing approach and uptake of the Hydrafacial system in America, with over 200 sold to medically led clinics in Miami alone in the last 4 years showing how popular this brand now is in the USA. Over the few days that I was there, I met many more UK distributors who were involved in similar processes with their brands, including David Hicks from Wigmore Medical Ltd who was at a ZO distributors meeting with Dr. Zein Obagi at the launch of their new 3-Step Simulation Peel, Lee Boulderstone from BTL, Roger Bloxham from Aestheticare, Tracy Parkin from Cosmeceuticals and many others. It certainly seemed that this was a mecca for distributors learning the latest about their individual brands rather than Doctors from the UK attending the meeting, although I did bump into Dr. Nick Lowe and Dr. Tapan Patel, who both run London based cosmetic clinics.

I spent a whole day scouring the vast exhibition hall for anything new and potentially different that might be wending its way across the Atlantic, and was a little disappointed!

As the AAD’s main focus as a meeting is disease dermatology, there were many drug companies selling topical solutions for skin diseases such as acne and psoriasis; however, these were more than matched by the vast array of cosmetic skincare brands, many of which will never reach our shores. In addition, there were a number of compounding companies offering to formulate and manufacture “self brand” skincare lines.

Because of stricter FDA approval before licensing, the UK tends to have far more choice of new aesthetic innovations, and many brands that we see in Europe are not promoted in the USA. A few new things that I noted were: Cynosure’s new world’s first picosecond laser for tattoo removal; MiraDry – a new electromagnetic energy system for long lasting treatment of axillary hyperhidrosis, (European launch due this year) and Fibrocell Technologies with Azficel-T, brand name Laviv® (autologous fibroblasts), it seems that this revival of Isolagen® has no immediate plans for a European launch – once bitten twice shy perhaps!

Talking to American Dermatologists, price pressures (similar to the UK) are a cause for concern, especially in the laser hair removal and cosmetic injectables marketplaces, where they are finding more dentists, (which has been a feature of the UK market) starting to compete against them for new facial rejuvenation clients. However, the savvy Derms who understand how to market and differentiate themselves in their locality are still, (as I am), very upbeat about the future of the non-surgical section of the aesthetic market and potential for future growth.

Although the quote of the trip has to be from the device manufacturer who told me that the largest seller of Lasers and IPL in the USA is now eBay!

”

Medicis - distribute Dysport, Sculptra and Restylane in the USA

California based Hydrafacial manufacturers Edge Systems at ADD

ZO launching new peel system

Syneron Candela at AAD

Allergan promoting their newly acquired Skinmedica brand

Dr’s Toy Store – the Hamley’s of second hand equipment

Merz preparing to launch Xeomin when embargo finishes this year

Business Corner Medical Professionals Have Wrong Diagnosis When it Comes to Average Claims Value Says Insurer Hamilton Fraser They may know their dermatology from their dermal fillers but medical professionals are lost when asked to guess the average claims value (paid between 2007 and 2011) under their medical liability insurance says the company.

Hamilton Fraser Cosmetic Insurance recently polled medical professionals at the Cosmetic News Expo and Professional Beauty Show to find out if they could guess what the average claim value was for a range of aesthetic treatments, including laser hair removal, dermal fillers, botulinum toxin, chemical peels and body contouring.

Without exception all of the practitioners who entered got the answers wrong - showing that medical professionals do not realise how much claims can cost.

The impact of this could be that if the worst was to happen and the insurance cover was inadequate, the cost to the practitioner could be huge. For example, Hamilton Fraser Cosmetic Insurance’s average cost of a dermal filler claim between 2007 and 2011 was £12,398.35.

Potentially a large claim over a body contouring procedure which goes wrong could put a small clinic out of business. The average claim for this procedure was an eye watering £36,111. Even a common procedure such as a wrinkle relaxing injection commands an average claim value of £2,054.51.

Eddie Hooker, CEO from Hamilton Fraser Cosmetic Insurance, said: “It is of concern that medical professionals were seriously misinformed of the potential cost of claims. Seriously underestimating what a claim can cost you could have a major impact on your business. Ensure you are adequately insured for the procedures that you provide – and always speak to an insurance expert when you launch a new treatment into your clinic.”

Advertorial

New & Expectant Mothers in the Workplace When a female worker becomes pregnant it is often a very happy time and a cause for celebration, however, many women worry that they cannot say anything for fear that it may cause problems at work especially in small businesses where staffing levels are low.

In today’s society women constitute a large percentage of the workforce in many industrialised countries, and as a result, addressing pregnancy-related health issues in the workplace is an important factor in order to protect the expectant mother and the unborn baby. Pregnancy should not be equated with ill health and should be regarded as a part of everyday life.

Ideally workers should advise their employer as soon as they are able to when they know that they are pregnant.

Legally a female employee must give her employer three pieces of information.

Firstly, she must tell her employer that she is pregnant prior to or during the 15th week before the expected week of childbirth (EWC). She must then notify her employer of the EWC date, and she must give the date on which she intends to start her maternity leave. This must be given in writing if the employer requests it. Where necessary the company can also ask to see the form MAT B1.

The employee can only change the date on which she intends to start her maternity leave by giving 28 days notice before the new intended start date. Again this must be in writing, if requested.

Once the employee has advised her employer of the pregnancy they must acknowledge the notification of maternity leave within 28 days. Employers are under a duty to protect the health and safety of their employees and there are special duties that apply in respect of new or expectant mothers in the workplace, therefore it is important that the employer and the employee work together to deal with any issues, with a full and open communication.

Being pregnant does not prevent anyone from working or developing their career and every year around 350,000 women continue to work during their pregnancy and over 69% of them return to work after giving birth. In many workplaces there are conditions that are deemed safe under normal circumstances, but may not be so during pregnancy.

For example:Lifting and carrying of heavy loads.

Standing or sitting for long periods of time.

Exposure to infectious diseases.

Work related stress.

Workstation and posture.

Excessively noisy workplaces.

Therefore the Management of Health and Safety at Work Regulations places a legal duty on all employers to assess the health and safety risks that their employees are exposed to. Once the risks have been assessed, as an employer it is your responsibility to implement any necessary control measures to either control, eliminate or reduce the identified risks.

When compiling the assessment it will be important to take into account any medical advice that has been provided by the individual’s GP or midwife.

As the risk assessment is being conducted it is crucial to pay particular attention to the health and safety risks that may affect the new or expectant mother and the baby. If any risks are identified then the new and expectant mother is entitled to a change in working conditions in order that the risk be significantly reduced.

However if the risks cannot be removed then you have to ensure that the new or expectant mother is not exposed by offering suitable alternative work if there is any.

(The term 'new and expectant mothers' covers women who are pregnant, have given birth in the last six months or are breastfeeding.)

Unfortunately, if there is no other suitable alternative work you must place the new or expectant mother on "maternity suspension" and pay her normal wage or salary throughout the suspension.

The only exception is where you have offered suitable alternative work and it has been unreasonably refused. For expectant mothers, maternity suspension can last, if necessary, up to the fourth week before the expected week of childbirth, at which time the ordinary maternity leave period begins.

When compiling the risk assessment, consideration should be given to additional rest breaks, as a new or expectant mother is more likely to need to go to the toilet more frequently, also it will be important for the pregnant worker to drink plenty of fluids both while they are pregnant and when breastfeeding.

As the pregnancy progresses you should constantly monitor and review the assessment to take into account possible risks at various stages of the pregnancy. If as a result of your specific risk assessment, stress has been identified as a possible risk then you should, where possible, remove the risk, or alternatively change the individuals working conditions or hours. As an example, this can extend to hours of work being adjusted in order to reduce the likelihood of having to travel during rush hour.

It is important to remember that an employee can return to work even though she is still breastfeeding. However, it is important that the individual gives written notification ideally prior to the return date in order for a suitable assessment to be completed.

As an employer you are required to provide a place for pregnant or breastfeeding mothers to rest. The Health and Safety Executive ‘recommends’ (but it is not a legal requirement) that a private healthy and safe environment be provided for nursing mothers to express and store milk. (Please note: the toilet is not deemed suitable.)

Further advice and guidance on employees requirements in relation to New and Expectant Mothers can be obtained from Citation Plc. We offer a fixed price health and safety and employment law consultancy service in order to help our clients comply with legislation.

Citation plc is one of the UK’s largest Health & Safety and Employment Law firms, with over 6,500 UK businesses as clients. For further details call 0845 844 1111 or visit www.citation.co.uk/affinity/abs.

Legislation Update on New European Draft Standard: Aesthetic Surgery and Aesthetic Non-Surgical Medical Services The public consultation process held last year for the European standard for Aesthetics Surgery Services, EN 16372, received a large number of comments from European countries, including the UK. The comments have now been reviewed by the European committee and as a result the draft has undergone significant changes.

The revised draft is now going out for a second public consultation before moving on to the final stage in its development process.

As a result of feedback received during the first consultation, the title of the standard has been changed from ‘Aesthetic surgery services’ to ‘Aesthetic surgery and aesthetic non-surgical medical services’ to reflect its wide scope.

EN 16372 is a proposed European standard and has to take in to account the nature and country variances across the European market place with regards to aesthetic surgery. To accommodate the UK’s country requirements with regards to cosmetic surgery, BSI has requested for a number of exceptions to be included in the draft for review.

These exceptions can be found in Annex C of the draft.

The British Standards Institution (BSI) is leading the consultation process in the UK and interested parties from the aesthetics sector can register their comments online at http://drafts.bsigroup.com from 16th March 2013.

The final version of the standard is expected to be published in 2014.

Mike Regan Chair to the Aesthetic Surgery Services Committee (CH403) of the British Standards Institution Mike has been actively involved in the national and international standardisation sector since 2001. This experience ideally positions him to advise and manage the BSI CH403 Committee from a process point of view - how Standards are developed, managed, voted on and implemented.

His specific technical area of interest is laser safety. With a background in physics and engineering, he has since 2005 actively represented the UK on the Aesthetic / Medical Working Group (WG4) of the IEC TC/76 Laser Safety Committee. IEC is the International Electrotechnical Commission.

He works full time as a Laser Protection Adviser in the aesthetics sector, carrying out clinic risk assessments, delivering Core of Knowledge Training, and liaising with laser and IPL product manufacturers. Mike is a Chartered Engineer with the Institution of Engineering and Technology, and also holds the position of Chair to the Association of Laser Safety Professionals.

Update on Cosmetic Surgery (Minimum Standards) Bill 2012-13 The bill was due to have its second reading in the Houses of Parliament on Friday 1st March 2013, but at 23rd place on the agenda for the day it was no surprise to see it get missed for a second time in as many months. The sponsoring MP, Ann Clwyd has nominated 3rd May 2013 for the postponed second reading to be scheduled again, however as the House is not expected to sit on this day it is unlikely to be debated on this date either and another date will likely be chosen. With the report from Keogh around the corner, it is not surprising that the points raised in this bill are being side lined somewhat. You can keep up to date with the progress of the bill by subscribing here http://services.parliament.uk/bills/2012-13/cosmeticsurgeryminimumstandards.html

HABIA, AAIC & cdBAFI Join Forces to Lobby Keogh on Injectables HABIA, the Hair and Beauty Industry Authority, has asked that the views of its sector are taken into account as the government prepares to decide on the future of injectable treatments through the review into the quality and safety of cosmetic interventions being undertaken by Sir Bruce Keogh and due to report this month. The widespread review will be looking at regulation of medical devices, including dermal fillers and the issues of who should and shouldn’t be providing this service to the public, something which as we know is routinely available in salons and spas up and down the country and not always delivered by a medical professional.

Currently there are no national regulatory requirements for those delivering cosmetic injectable treatments to be trained or qualified in non-surgical cosmetic interventions, (aside from the prescription requirements for toxins).

However, both medical and beauty professionals are equally able to gain insurance to carry out such procedures following a short training course with no licensing to monitor them.

Habia was invited to present to the Keogh review committee in January 2013 and has proposed a 'training and recognition' model which would allow their sector professionals to continue delivering some treatments. The proposed model includes:    

A minimum qualification that is recognised by government for all those offering injectable treatments, regardless of whether they are from the medical or beauty sector National Occupational Standards (NOS) for injectable treatments to be developed A not-for-profit Professional Register to be established and maintained, with the backing of the Keogh Review committee, sitting within a regulatory framework (i.e., not voluntary) and with Industry Authority oversight A compulsory commitment to Continuing Professional Development (CPD) for those on the Professional Register.

Habia MD Rob Young said, "We see no reason why adequately trained and responsible sector professionals cannot deliver treatments they have been delivering safely for years. As an Industry Authority, we fully understand the concerns of the public and the medical profession. However, it is not in the interests of our sector to scare away its own clients with shoddy practice. Professionals want professional training and professional recognition; I have every faith they will actively seek it out by supporting a recognised qualification and embracing a Professional Register."

Following this the Association of Aesthetics, Injectables and Cosmetic Laser (AAIC) and cdBAFI (Cosmetic, Dermal, Aesthetics, Botulinum and Fillers Inspectorate) stated that they had united with Habia to issue a joint call to government to take the views of the sector into account as the Keogh Review prepares to publish its recommendations.

AAIC MD Chris Wade said, "We have presented to the Keogh Review and outlined our proposal of a 'training and recognition' model which would enhance the delivery of high quality, professional non-surgical treatments as well as public confidence in the sector. " Una Riley, MD of cdBAFI, said, "We fully understand the concerns of the public which is why we have endeavoured to introduce best practice for all. We want the consumer to be able to make an informed choice and be confident of receiving high quality treatment from qualified professionals. We would be happy to transfer our Register to be maintained by either a joint group or single industry authority, sitting preferably within a professional regulatory framework."

However, John French, Chief Executive of the Federation of Holistic Therapists (FHT), said, "FHT does not recognise beauty therapists carrying out injectable treatments; this is corroborated by the absence of regulated qualifications for the beauty therapist in this area. FHT is supportive of the development of a medically lead national core curriculum authorised by an independent overarching group comprising medical and nonmedical stakeholders, and would endorse relevant beauty therapy sector organisations to be representative within its membership. FHT would not be against any beauty therapist wanting to access and gaining this qualification. FHT supports the need for regulation, but this should be provided by an independent organisation. Indeed we welcome and lobby for regulation for the whole of the beauty therapy sector."

Habia MD Rob Young concluded by said, "It's time for a more collaborative and supportive stance within our sector and I am encouraged that there are so many organisations that are willing and able to work together for the good of the sector. A potential professional registration model includes a minimum qualification that is recognised by Government for all those offering injectable treatments."

MDU Won`t Cover Non-FDA Approved Dermal Fillers in its Indemnity Policy The MDU, Medical Defence Union, the UK's leading medical defence organisation has announced some important changes to the provision of medical indemnity for those involved in facial aesthetics and the service provision of dermal fillers. From 1st April 2013, the MDU membership benefits for members performing treatments with dermal fillers will change and they won’t be covered for dermal filler brands which don’t have an American FDA approval, despite dermal fillers in the UK being regulated by European CE Mark regulation.

The MDU underwriters stated in a letter to members; “While we carefully consider requests for help, it is unlikely that the MDU will provide support or representation for any claim arising in respect of a treatment or procedure carried out on or after 1st April 2013 which involves any dermal filler, unless the product is one which has been approved, prior to your use of it, by the Food and Drug Administration (FDA) in the United States of America.”

They went on to say; “Insured cover for claim notifications arising from non-FDA approved filler use after April 2013 will extend only up until the end of the current policy year. There will be an exclusion in respect of claims arising from the use of non FDA approved dermal fillers in subsequent membership periods.”

A list of US FDA approved dermal fillers can be found on the FDA website. However, as many who view the list will note, it includes some now discontinued brands such as Evolence, Hylaform, Cosmoderm/Cosmoplast and Zyderm/Zyplast which simply confuse the issue. The main brands used in the UK marketplace who have FDA approval include Restylane (with and without lidocaine), Radiesse, Sculptra and Belotero (Balance in America known as Basic in Europe). The list detailed on the above FDA link is however also incomplete, as it doesn’t mention the approvals for Juvéderm Ultra and Juvéderm Ultra Plus, as well as the lidocaine versions which include the notation XC after the product name, which are also FDA approved and branded slightly differently in the UK. There are those who wish the MDU had published a comprehensive list of their own, even if it is said to rely on the FDA list, as many confusions are possible due to differing branding.

The MDU is advising members who administer dermal filler products as part of their practice, and use products/brands which have not been approved by the FDA to urgently review their indemnity arrangements for this work.

Many we have spoken to within the aesthetic industry find this to be an unusual stance for the indemnity provider to take, yet welcome a nod towards those products with a wealth of clinical data to back up their safety, compared to the now saturated levels of CE marked products available with little to substantiate their safety and efficacy. With both the European Parliament and the Keogh Review both looking at the current regulation of medical devices, including dermal fillers, this MDU announcement perhaps is a pre-emptive move towards the likelihood of tighter European and UK regulation of these products in the future. It will be interesting to see if other insurers choose to follow suit or simply pick up extra business as a result of this decision from the MDU.

Martyn Roe, Consulting Room Director

Eddie Hooker, Hamilton Fraser www.cosmetic-insurance.com

Neil Revill, Cosmetic Insure www.cosmeticinsure.com

"Clearly demonstrating that insurers do not really understand the market. What happens with a product that has the same name as an FDA cleared product but is not actually the same product?

"Following the recent MDU announcement on the use of FDA approved dermal fillers Hamilton Fraser Cosmetic Insurance would like to reassure aesthetic practitioners that our current insurance acceptance criteria has not changed. We will continue to provide indemnity for CE marked fillers for registered medical professionals only, namely doctors, nurses and dentists, until we understand more about the MDU's reasons for their statement and further medical information."

"Following the recent announcement by the MDU concerning the provision of Medical Indemnity Insurance for their members involved in facial aesthetics and the provision of dermal fillers, Cosmetic Insure would be delighted to be of assistance to any member who seeks clarity about their continued insurance obligations.

Cosmetic Insure continues to provide such cover for its policyholders so long as they are professionally qualified as a Surgeon, Doctor, Dentist or Nurse."

Incidentally the FDA do not actually approve any products they only clear them!

Potentially another half baked attempt at back door regulation with limited knowledge and understanding!"

Advertorial

Filling the gaps in aesthetic skincare training Traditionally, training in aesthetic skincare techniques has focused on general level skills, with little available to therapists and medical practitioners who want to build their business with advanced practical skills alongside knowledge and understanding of advanced skin health and treatment.

Sally Durant Training and Consultancy is bridging the gap, with fully accredited courses up to level 4 for skin health professionals, clinical nurses, doctors and dentists in this fast-growing and progressive sector of the skincare industry.

A name for quality With a 30-year career in the skincare industry, Sally Durant is a specialist in the field of cosmetic dermatology, skin health and advanced skin care education.

She has worked as a training consultant to a number of high profile companies including L’Oreal UK and Paris, SAKS, Renew Medica, the sk:n Clinic Group and various higher education institutions.

She founded Sally Durant Training and Consultancy in 2009, with the aim of raising the standard and availability of advanced clinical skincare training for both the beauty therapy and medical aesthetic sectors.

Train the way you want Businesses need to be flexible to grow and survive – and therapists and medical practitioners are no different from any other in this regard.

That’s why Sally Durant Training and Consultancy offers a number of ways to train, with online knowledge-based courses, on-site practical skills training or bespoke corporate training packages tailored to your company’s needs.

Advertorial Online training (www.sallydurant.com/onlinecourses.html) can be accessed wherever and whenever you want and is delivered in modular, bite-sized chunks for flexibility.

Courses currently available include:      

Advanced skin science Investigative consultation and advanced skin assessment The skin ageing process and regenerative treatments Photoageing and pigmentation irregularities of the skin The causes, development and treatment of acne vulgaris Understanding and treating hypersensitive skin and rosacea

Courses coming soon include:  An introduction to medical aesthetics for the non-practitioner  Nutrition and the skin  Modern cosmetic science for the skin care clinician  Treating skins of colour  Dermatology for the aesthetic practitioner  The art of skin resurfacing Practical skills training courses (www.sallydurant.com/practicalskills.html) are accredited by IQ Industry Qualifications. The underpinning knowledge-based elements are accessible online with the practical elements delivered over two days at one of our nationwide training venues.

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Non-surgical blemish removal The physiology and practice of micro-needling The physiology and practice of chemical skin peeling

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Bespoke resource development and delivery In-house practical skills development Formal education programmes Online knowledge based courses Organisation of training schedules Assessment of competency Training your trainers - ensuring standardisation and quality assurance

The quality assurances you can rely on Our commitment to quality has led us to found the International Institute for Skin Health and Clinical Aesthetics (IISHCA) (www.sallydurant.com/iishca.html), a formal education body committed to the highest standard of professional post-graduate training. All IISHCAcertified courses offered by Sally Durant Training and Consultancy are accredited by IQ Industry Qualifications.

To find out more, contact Sally Durant Training & Consultancy on 01527 919880; email us (enquiries@sallydurant.com) visit our website (www.sallydurant.com) or see us on YouTube.

Educational Opportunities

Training, Events, Mentoring etc...

Ensure that you are kept up to date with all educational opportunities, including webinars, seminars and conferences. www.cosmetictraining.co.uk is a focused directory that brings together key training opportunities and events. The dedicated and unique reference site will provide information about all areas of the Aesthetic business:

Cosmetic Training Features:      

Conferences & Meetings Bespoke Training and Mentoring Cosmetic Industry Qualifications Training Venues for Hire Training Courses & Webinars Business Related Seminars

With over 40,000 Procedures performed in Britain in 2010 we are constantly seeing emerging trends, new innovations, new products and new procedures. Therefore it’s important for you and your staff to keep constantly updated on all the changes in this fast paced business.

Receive a FREE monthly email update on the upcoming and latest events and opportunities.

For those members who offer training/mentoring or rooms for hire we also offer a range of competitively priced advertising options - including listing of training courses in our directory, targeted banner advertising in our training search results pages and opportunities to sponsor our monthly training update e-newsletter. Click on the image to learn more.

www.cosmetictraining.co.uk

Conferences Dates For Your Diary SMART IDEAS Seminar: Proven Business Strategies and New Product Ideas to Increase Your Profits in 2013 This unique seminar, organised by The Consulting Room , includes a full day business agenda, featuring the very latest practical business and marketing tactics related to running an aesthetic clinic, alongside a parallel agenda devoted to the latest devices, injectable aesthetic techniques and other concepts that you can incorporate to increase your clinic's profits during 2013. CPD points applied for. For more information on the two agendas and to register, please visit: www.smartseminar.co.uk Saturday 27th April 2013 (London)

FACE Conference 2013 FACE 2013, the UK’s premier medical aesthetic conference and exhibition is moving to a larger venue in 2013 to help accommodate the growing lecture programmes. For more information as the agendas unfold, please visit: www.faceconference.com 21st – 23rd June 2013 at the QEII Conference Centre, Westminster, London

Clinical Cosmetic & Reconstructive (CCR) Expo A business-to-business event that will bring the international surgical and non-surgical community together under one roof. The expo will showcase over 120 international exhibitors: from cutting edge surgical equipment and supplies through to non-invasive products, business services, training and consultancy. There will be 14 days of Continuing Professional Development (CPD) content, including workshops, conferences and live demonstration theatre. For more details, please visit: www.ccr-expo.com 11th – 12th October 2013 at the Olympia, London

IAAFA 2013 The International Academy of Advanced Facial Aesthetics (IAAFA) annual meeting will be later this year, being held in November. The event also includes a charity ball. For more details, please visit: www.iaafa.net th

th

29 & 30 November 2013 at the Royal College of Physicians, London.

Aesthetic Awards 2013-14 in Association With Cosmetic News The date has been set for another glamorous industry awards this Autumn. More details when available. (Date may be subject to change). th

30 November 2013, London.

For details of all upcoming UK and Non-UK conferences and exhibitions please visit our Cosmetic Training website.

Give Your Aesthetic Business a Competitive Edge & Attend

Following the success of our Manchester meeting; register Today for the next one!

Practical Business Strategies & Product Ideas to Increase Your Profits in 2013 The Consulting Room™ are again hosting several special SMART Ideas events during 2013, in conjunction with the world’s largest laser and radiofrequency device manufacturer - Syneron Candela, and cosmetic injectables manufacturer – Merz Aesthetics.

Saturday 27th April 2013 in London This unique seminar includes a full day business agenda, featuring the very latest practical business and marketing tactics related to running an aesthetic clinic, alongside a parallel agenda devoted to the latest devices, injectable aesthetic techniques and other concepts that you can incorporate to increase your clinic's profits during 2013. CPD Points applied for and Registration from just £15 inc. lunch.

See details of the two agendas here: www.smartseminar.co.uk/agenda The SMART Ideas format provides an opportunity for you to explore the very latest product innovations, alongside reviewing core business principles related to running an aesthetic clinic.

SMART ideas provides an informal and friendly opportunity for you to explore unique new products, have personal demonstrations, discuss your business model and network with industry colleagues all in one day! A range of industry exhibitors will also be attending the events.

Delegates attending these unique seminars will learn the very latest information related to practical use of cosmetic injectables for total facial contouring; lasers and RF devices for hair removal and skin rejuvenation; topical skin lightening treatments; and web marketing and business development techniques.

To register your interest please call Danny Large on 01788 577 254 or visit www.smartseminar.co.uk/Register/

Still Undecided About Attending?

Watch this short video of comments from delegates who have attended past SMART IDEAS Seminars to hear what they gained from the day. www.youtube.com/watch?v=qA67ncb4a3I

Clinical Information

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Safety and Efficacy of Intradermal Injection of Botulinum Toxin for the Treatment of Oily Skin.

Rose AE, Goldberg DJ. Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

Dermatol Surg. 2013 Jan 7.

OBJECTIVE: To evaluate the safety and efficacy of intradermal injection of abobotulinumtoxinA for the treatment of oily skin.

METHODS AND MATERIALS: Twenty-five patients with oily skin were treated in the forehead region with intradermal injections of botulinum toxin. Baseline and post-treatment sebum production was measured using a sebometer. Photographs were taken. Patients were also asked to rate their satisfaction with the treatment in terms of improvement in their oily skin.

RESULTS: Treatment with botulinum toxin resulted in significantly lower sebum production at 1 week and 1, 2, and 3 months after injection (p < .001, t-test). Twenty-one patients (91%) reported that they were satisfied (50-75% improvement) with intradermal botulinum toxin as a treatment for oily skin. [Correction added after online publication 7-Jan-2013: the number of satisfied patients has been updated] CONCLUSION: Intradermal injection of botulinum toxin significantly reduced sebum production in the forehead region, with a high degree of patient satisfaction. Intradermal botulinum toxin may be an effective treatment to reduce sebum production in patients with oily skin. Larger, randomized, blinded, placebo-controlled studies are warranted.

Muscle Atrophy Beyond the Clinical Effect After a Single Dose of OnabotulinumtoxinA Injected in the Procerus Muscle: A Study with Magnetic Resonance Imaging.

K Koerte I, Schroeder AS, Fietzek UM, Borggraefe I, Kerscher M, Berweck S, Reiser M, Ertl-Wagner B, Heinen F. Institute for Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany.

Dermatol Surg. 2013 Feb 4.

BACKGROUND: Botulinum toxin is a powerful and often used agent to treat dynamic rhytides. Focal and reversible neurogenic atrophy is considered to be the relevant mechanism of action.

OBJECTIVE: To investigate the loss and regain of muscular volume in relation to clinical wrinkle severity as assessed using standardized scales.

METHODS: The facial procerus and corrugator supercilii muscles were injected in two drug-na誰ve men with 20 U of onabotulinumtoxinA at five injection points (onA). Two men served as controls (one with the same volume of placebo injection using saline solution, one without any intervention). All subjects underwent 3 Tesla magnetic resonance imaging before and after the injection and 1, 4, 6, 10, and 12 months after the injection. Standardized photographs were taken at each test point.

RESULTS: Volumetric muscle analysis revealed a 46% to 48% reduction in procerus muscle volume lasting for 12 months after a single dose of onA; glabellar line severity returned to the drug-na誰ve status after 6 to 10 months.

CONCLUSION: The gap between long-term focal muscular atrophy and regained function remains to be elucidated. Future studies will be needed to investigate the complex interaction between focal neurogenic atrophy and potential compensatory functional muscle changes.

A longitudinal evaluation of the impact of a polylactic acid injection therapy on health related quality of life amongst HIV patients treated with anti-retroviral agents under real conditions of use.

Duracinsky M, Leclercq P, Armstrong AR, Dolivo M, Mouly F, Chassany O. BMC Infect Dis. 2013 Feb 20;13(1):92.

BACKGROUND: Many HIV patients receiving antiretroviral treatment develop lipodystrophy. NEW-FILL(R) is a polylactic acid injected to treat facial lipoatrophy. The objectives of this study were to describe (1) change in quality of life (QoL) of HIV patients treated with NEW-FILL(R) in the management of facial lipoatrophy; (2) efficacy of NEW-FILL(R) using facial photographs and (3) a patient-reported "Overall Treatment Effect" (OTE) scale; and (4) safety of NEW-FILL(R).

METHODS: Doctors from 13 treatment centres recruited 230 HIV patients to receive up to 5 sessions of NEWFILL(R) injections. Patients self-reported QoL with the ABCD questionnaire before the first set of injections, at 2 months and at 12 to 18 months after the last session of injections. Efficacy was evaluated at each interval through photographs and OTE scale. Safety was evaluated via Case Report Form (CRF) data.

RESULTS: 64.4% of patients reported QoL improvements of >10% at 2 months, and 58.8% at 12--18 months.

Lipoatrophy grades improved at each visit ("no lipoatrophy" or "limited lipoatrophy": 20.3% at inclusion, 77.4% at 2 months, 58.4% at 12--18 months). Average OTE scores of 5.3 and 5.0 at 2 and 12--18 months indicated "moderate improvement". Minimum Important Difference (MID) in QoL score was 7.1 points at 2 months; 7.4 points at 12--18 months. For 911 injection sessions performed, 3.4% resulted in "immediate" adverse events, 7% in "nonimmediate" events, and 1.7% in "other" events.

CONCLUSIONS: Improvements to quality of life and diminished lipoatrophy visibility were observed in the months immediately following NEW-FILL(R) treatment and were maintained 12--18 months post-treatment. Most adverse events were mild and transient. ABCD MID thresholds provide clinicians with means to assess the impact of lipoatrophy therapies on QoL. For full text article visit: www.biomedcentral.com/1471-2334/13/92

Extracorporeal shock wave treatment of capsular fibrosis after mammary augmentation - Preliminary results.

Heine N, Prantl L, Eisenmann-Klein M. Caritas-Krankenhaus St. Josef, Klinik fĂźr Plastische und Ă&#x201E;sthetische, Handund Wiederherstellungs-Chirurgie, Regensburg, Germany.

J Cosmet Laser Ther. 2013 Feb 5.

Extracorporeal shock wave therapy has undergone continuous development and has become a well-established therapy option both in urology and in orthopaedics/trauma surgery. Experimental and clinical studies have proved the effectiveness of extracorporeal shock wave therapy in the treatment of connective tissue diseases such as fibromatosis. The pathomechanism of capsular fibrosis after augmentation of the female breast with silicone implants presents a series of analogies with mechanisms that are generally recognised to be associated with fibroproliferative diseases. The starting point of the disease is the inflammatory reaction caused by the silicone and/or by the sub-clinical bacterial contamination of the implant surface and can create an inflammatory reaction and fibrosis. A total of 19 cases of capsular fibrosis in 12 patients following insertion of mammary implants were treated with extracorporeal shock wave therapy. The therapy was performed with the Duolith SD1 system manufactured by Storz Medical. Shock waves were applied with the C-Actor handpiece designed for planar shock waves. Extracorporeal shock wave therapy appears to be a non-invasive, well-tolerated and easy-to-use procedure for pain reduction and fibrotic tissue softening, especially after aesthetic breast implant augmentation.

Laser-assisted in-situ keratomileusis (LASIK) versus photorefractive keratectomy (PRK) for myopia.

Shortt AJ, Allan BD, Evans JR. The Moorfields Eye Hospital/UCL Institute of Ophthalmology National Institute for Health Research Biomedical Research Centre,London, UK. Cochrane Database Syst Rev. 2013 Jan 31;1:CD005135.

BACKGROUND: Myopia (also known as short-sightedness or near-sightedness) is an ocular condition in which the refractive power of the eye is greater than is required, resulting in light from distant objects being focused in front of the retina instead of directly on it. The two most commonly used surgical techniques to permanently correct myopia are photorefractive keratectomy (PRK) and laser-assisted in-situ keratomileusis (LASIK).

OBJECTIVES: To compare the effectiveness and safety of LASIK and PRK for correction of myopia by examining post-treatment uncorrected visual acuity, refractive outcome, loss of best spectacle-corrected visual acuity, pain scores, flap complications in LASIK, subepithelial haze, adverse events, quality of life indices and higher order aberrations.

SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 11), Ovid MEDLINE, Ovid MEDLINE In-Process and Other NonIndexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2012), EMBASE (January 1980 to November 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to November 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials.

We last searched the electronic databases on 15 November 2012. We also searched the reference lists of the studies and the Science Citation Index.

SELECTION CRITERIA: We included randomised controlled trials comparing LASIK and PRK for the correction of any degree of myopia.

DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. We summarised data using the odds ratio and mean difference. We combined odds ratios using a random-effects model after testing for heterogeneity.

MAIN RESULTS: We included 13 trials (1135 participants, 1923 eyes) in this review. Nine of these trials randomised eyes to treatment, two trials randomised people to treatment and treated both eyes, and two trials randomised people to treatment and treated one eye. None of the paired trials reported an appropriate paired analysis. We considered the overall quality of evidence to be low for most outcomes because of the risk of bias in the included trials. There was evidence that LASIK gives a faster visual recovery than PRK and is a less painful technique. Results at one year after surgery were comparable: most analyses favoured LASIK but they were not statistically significant.

AUTHORS' CONCLUSIONS: LASIK gives a faster visual recovery and is a less painful technique than PRK. The two techniques appear to give similar outcomes one year after surgery. Further trials using contemporary techniques are required to determine whether LASIK and PRK as currently practised are equally safe.

Randomising eyes to treatment is an efficient design, but only if analysed properly. In future trials, more efforts could be made to mask the assessment of outcome.

Common causes of injury and legal action in laser surgery.

Jalian HR, Jalian CA, Avram MM. JAMA Dermatol. 2013 Feb 1;149(2):188-93.

OBJECTIVE To identify common causes of legal action, injuries, claims, and decisions related to medical professional liability claims stemming from cutaneous laser surgery. DESIGN Search of online public legal documents using a national database.

MAIN OUTCOME MEASURES Frequency and nature of cases, including year of litigation, location and certification of provider, injury sustained, cause of legal action, verdict, and indemnity payment.

RESULTS From 1985 to 2012, the authors identified 174 cases related to injury stemming from cutaneous laser surgery. The incidence of litigation related to laser surgery shows an increasing trend, with peak occurrence in 2010. Laser hair removal was the most common litigated procedure. Nonphysician operators accounted for a substantial subset of these cases, with their physician supervisors named as defendants, despite not performing the procedure. Plastic surgery was the specialty most frequently litigated against. Of the preventable causes of action, the most common was failure to obtain an informed consent. Of the 120 cases with public decisions, 61 (50.8%) resulted in decisions in favor of the plaintiff. The mean indemnity payment was $380 719.

CONCLUSIONS Claims related to cutaneous laser surgery are increasing and result in indemnity payments that exceed the previously reported average across all medical specialties. Nonphysicians performing these procedures will be held to a standard of care corresponding to an individual with appropriate training; thus, physicians are ultimately responsible for the actions of their nonphysician agents.

Striae Distensae after Breast Augmentation: Treatment Using the Nonablative Fractionated 1550-nm Erbium Glass Laser.

Pacheco Guimar達es PA, Haddad A, Sabino Neto M, Lage FC, Ferreira LM. S達o Paulo, Brazil From the Division of Plastic Surgery, Department of Surgery, Universidade Federal de S達o Paulo.

Plast Reconstr Surg. 2013 Mar;131(3):636-42.

BACKGROUND: Stretch marks, or striae distensae, are dermal scars and result in considerable aesthetic concern.

The responsible factors for their development are poorly understood. Development of striae distensae is a rare complication after breast augmentation. Successfully treating striae distensae has always been challenging. Lasers and light devices have recently become a good therapeutic option. The fractional laser has shown encouraging results with less risk of pigmentation in the treatment of recent stretch marks.

METHODS: Forty-seven patients underwent breast augmentation over a period of 2 months; of these, 10 patients developed new striae distensae. They were submitted to nonablative fractionated 1550-nm erbium glass laser treatment. Response was assessed from photographs obtained before and 4 weeks after the end of treatment.

Two plastic surgeons analyzed improvements clinically and photographically, and a patient satisfaction score was recorded as well.

RESULTS: There was a significant relationship between age and development of striae, (p = 0.003), but there was no significant relationship between striae distensae and nulliparity (p = 0.147), volume of the silicone implant (p = 0.892), or use of oral contraceptive (p = 1.00). The scores achieved by both the evaluators and the patients were high, with 50 percent of them between 9 and 10 (maximum scores), and with a high index of satisfaction with the treatment.

CONCLUSIONS: Age is statistically significant in the development of striae distensae after breast augmentation.

This report demonstrates excellent patient and plastic surgeon satisfaction after treatment. The use of fractional photothermolysis is a good treatment modality for striae rubrae.

Metabolic and Structural Effects of Phosphatidylcholine and Deoxycholate Injections on Subcutaneous Fat: A Randomized, Controlled Trial.

Reeds DN, Mohammed BS, Klein S, Boswell CB, Young VL. Dr Reeds is an Assistant Professor of Medicine at Washington University School of Medicine, St Louis, Missouri.

Aesthet Surg J. 2013 Feb 25.

Background: Phosphatidylcholine and deoxycholate (PC-DC) injections are a popular nonsurgical method to eliminate unwanted fat. The safety and efficacy of this approach is uncertain.

Objective: The authors evaluate the effects of PC-DC treatments on body composition, adipocyte function, and mechanisms responsible for fat loss.

Methods: This randomized, open-label study enrolled 13 women with a body mass index (BMI) ≤30 kg/m(2) and lower abdominal subcutaneous fat suitable for small-volume liposuction. Patients were randomized by the final digit of their Social Security numbers and received between 2 and 4 PC-DC treatments, spaced 8 weeks apart. One side below the umbilicus was injected with PC-DC. The contralateral, control side received no treatment. Adipose tissue biopsies were performed on the treated side at baseline, 1 week after the first treatment, and 8 weeks after the final treatment. The primary outcome was change in adipose tissue thickness at baseline and 8 weeks after the final treatment.

Results: Seven women completed the study. Treatment with PC-DC significantly reduced the thickness of the anterior subcutaneous abdominal fat (P = .004). Adipose tissue showed rapid increases in crown-like structures, macrophage infiltration, and reduced expression of leptin, hormone-sensitive lipase, adipose tissue triglyceride lipase, and CD36. Plasma C-reactive protein, lipid profile, and plasma glucose concentrations were unchanged.

Conclusions: PC-DC injections can effectively reduce abdominal fat volume and thickness by inducing adipocyte necrosis. These treatments do not appear to increase circulating markers of inflammation or affect glucose and lipid metabolism.

TRASER - Total Reflection Amplification of Spontaneous Emission of Radiation.

Christopher B. Zachary, Morgan Gustavsson, Department of Dermatology, University of California Irvine, Irvine, California, United States of America.

PLoS One. 2012;7(4):e35899.

Background and Objective Light and lasers in medical therapy have made dramatic strides since their invention five decades ago. However, the manufacture of lasers can be complex and expensive which often makes treatments limited and costly. Further, no single laser will provide the correct parameters to treat all things. Hence, laser specialists often need multiple devices to practice their specialty. A new concept is described herein that has the potential to replace many lasers and light sources with a single ‘tunable’ device.

Study Design/Material and Methods This device amplifies spontaneous emission of radiation by capturing and retaining photons through total internal reflection, hence the acronym Total Reflection Amplification of Spontaneous Emission of Radiation, or TRASER. Results Specific peaks of light can be produced in a reproducible manner with high peak powers of variable pulse durations, a large spot size, and high repetition rate.

Conclusion Considering the characteristics and parameters of Traser technology, it is possible that this one device would likely be able to replace the pulsed dye laser and many other light based systems.

For full text article visit: www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0035899

SOURCE: PubMed

Interesting News Articles You May Have Missed Due to global copyright laws the Consulting Room™ is unable to reproduce entire news articles; therefore we provide an abstract and a link to the original news article. Although every effort is made to ensure that these links continue to function, there are occasions when third party websites will remove or archive the news article, leading to a broken link. We apologise if you find such a problem, and would appreciate it if you would inform us by emailing admin@consultingroom.com so we can make every attempt to remedy it.

PIP Implants: There Are Still Unanswered Questions The British Association of Aesthetic Plastic Surgeons, today welcomes the Department of Health's toxicology report into faulty PIP implants but warns that many questions remain unanswered. The BAAPS, the only organisation based at the Royal College of Surgeons exclusively dedicated to aesthetic (‘cosmetic’) surgery, says that what studies show, and what surgeons and patients are experiencing, still differs.

SOURCE: BAAPS

G-spot jab G-shot: Cosmetic treatment created by Beverly Hills Dr David Matlock to boost sex life It's the latest cosmetic treatment that promises to pep up your sex life. But, warn doctors, it could do exactly the opposite.

Dr David Matlock, a controversial Beverly Hills cosmetic gynaecologist, invented 'The G-shot'. He describes himself as 'the pioneer of female genital plastic surgery'. Glancey Medical Associates in Essex has attracted a lot of attention for offering such injections. Owner Dr Lucy Glancey, a highly qualified cosmetic doctor, introduced the injections three years ago.

SOURCE: Daily Mail

The Secret About Cosmetic Surgery That Doctors Are Hiding A secret about cosmetic surgery exists that several physicians are hiding from their patients. The truth is many doctors performing cosmetic surgery in the USA are not actually cosmetic surgeons, a claim made by a growing number of board certified cosmetic surgeons around the country.

SOURCE: Medical News Today

Research group unearths new info on photo-ageing damage Scientists have provided an objective index for evaluating the degree of progress of dermal tissue changes caused by photo-ageing and revealed for the first time that elastin abnormality develops in the lower dermis during the early stages.

SOURCE: Cosmetic Design News

Self-Image and Sexual Well-Being Increase after Breast Augmentation A recent study suggests that women who have breast augmentation procedures report higher satisfaction not only with the overall appearance of their breasts, but in their physical, sexual and psychosocial well-being as well. The researchers also found that overall satisfaction with breast augmentation was most strongly correlated with breast appearance satisfaction.

SOURCE: ASAPS

FDA Approves Natrelle® 410 Highly Cohesive Anatomically Shaped Silicone-Filled Breast Implants Allergan, Inc. today announced that the company has received approval from the U.S. Food and Drug Administration (FDA) to market the the Natrelle®410 Highly Cohesive Anatomically Shaped Silicone-Filled Breast Implants for use in breast reconstruction, augmentation and revision surgery.

SOURCE: Businesswire

Syneron Settles U.S. Patent Infringement Lawsuit with EndyMed and Eclipse Aesthetics Syneron Medical Ltd. announced today, jointly with EndyMed Medical Ltd. and Eclipse Aesthetics, that Syneron has dismissed its United States patent infringement lawsuit against EndyMed and Eclipse Aesthetics relating to EndyMed`s Fractional Skin Resurfacing Products. EndyMed and its United States distributor, Eclipse Aesthetics, agreed to immediately stop selling EndyMed`s Fractional Skin Resurfacing Products in the United States but may continue to service and support previously purchased products and supply replacement electrodes for them.

SOURCE: PRNewswire

Buyers Of Beauty Products Should Not Trust The Claims That Liposomes Can Carry Active Ingredients Into The Skin According to the beauty industry liposomes are capable of transporting active ingredients deep into the skin where they release the active ingredients so that they can alter the skin´s structure by rejuvenating and smoothing the skin. Research from University of Southern Denmark now shows that liposomes are not capable of transporting themselves deep into the skin, and thus they are not capable of transporting active ingredients deep into the skin.

SOURCE: Medical News Today

Renowned Miami Plastic Surgeon Condemns Botox and Dysport use for Wrinkle Treatments Dr. Rian A. Maercks, known for his uniquely insightful and unconventional teachings and techniques in plastic surgery, has released a blog explaining why he often refuses to use Botox or Dysport to treat wrinkles. The doctor explains "It is always best to treat the causative agent of any problem. Neuromodulators only poorly disguise the problem. They do not treat the cause of wrinkles and commonly they cause additional aesthetic problems."

SOURCE: PRWeb

Acne Linked To High Glycemic Index Foods And Dairy Products A study published in the Journal of the Academy of Nutrition and Dietetics has determined that there is increasing evidence of a connection between diet and acne, particularly from high glycemic load diets and dairy products, and that medical nutrition therapy (MNT) can play an important role in acne treatment.

SOURCE: Medical News Today

Stitch Me, Lift Me, Tuck Me: Inside the secret world of celebrity cosmetic surgery Famous TV faces are queuing up to get their wrinkles smoothed, wobbly bits sucked and sweaty armpits injected in front of prying cameras. Stitch Me, Lift Me, Tuck Me, on the Sky Living channel, goes inside the secret world of the cosmetic surgery industry. It follows the stars and some of the other patients at Harley Street Skin, a clinic in the exclusive medical district of London, run by husband and wife team Dr Aamer Khan and Lesley Reynolds.

SOURCE: The Mirror

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Great Member Special Offer Receive a Free Pair of NoIR LaserShields® IPL Shade 3 Style 35 Goggles when you buy Yamamoto Patient Eye Safety Guards. *** OFFER EXTENDED! *** This great offer is only available to Consulting Room members.

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Purchase these superb Yamamoto patient eye safety guards for only £105.75 (inc. VAT) – that’s a saving of £17.63 on non-member prices already - and receive the NoIR IPL Shade 3, Style 35 goggles (worth up to £52.88) absolutely free!

Take advantage of this great offer!

For more information on the products and to discuss this and other great laser/IPL eye protection deals, call us on 01788 577254.

Equipment Sales SaveOnKit pride themselves on excellent customer service. They stock a large inventory of high quality medical, dental and beauty equipment at vastly reduced prices. They are very pleased to offer a high quality service for all your equipment needs. All orders are processed quickly and sent to UK addresses free of charge; they will ship worldwide.

Below are the various devices that they currently have for sale.

Lutronic Mosaic non-ablative Fractional Laser Er:Glass skin-resurfacing System In good condition and full working order For Sale at £14,000 + VAT *PRICE REDUCED £13,300 + VAT* More info - www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=506 Chromogenex NLite V Pulsed Dye Laser Hair removal Rejuvenation System In good condition and full working order For Sale at £3,800 + VAT More info - www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=458 Lynton Lumina IPL Laser Hair Removal + YAG Skin Rejuvenation Acne Beauty System In very good condition and full working order For Sale at £9,500 + VAT More info - www.consultingroom.com/services/equipment-display.asp?equipment_id=651 Depilex Dermapeel Professional Microdermabrasion System In good condition, full working order For Sale at £912 *PRICE REDUCED AGAIN £570 + VAT* More info – www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=537 RVB active 7 touch beauty machine facial toning professional System This unit has had very minimal use and the condition reflects this some items are new in original packaging For Sale at £475 More info - www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=599 Yperion L900 SR PSR002012 beauty treatment head Brand new, in original box. For use with L900 Hair removal and photolifting beauty machine.

For Sale at £912 *PRICE REDUCED £760* More info – www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=539 Eporex K69 Mesotherapy Cellulite Fat Reduction and Skin Rejuvenation System In good condition and full working order, costs £20,000 brand new For Sale at £8,400 + VAT *PRICE REDUCED AGAIN £3,166 + VAT* More Info - http://www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=446 E Light IPL Laser Hair removal Rejuvenation Wrinkle Vascular salon beauty System For Sale at £3,800 + VAT More info - www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=496 Cosmopro Eye-O-Matic facial restore & skin rejuvenation Full working order. Helps restore and rejuvenate the face and delicate eye contour maximising product absorbency.

For Sale at £285 + VAT More info – www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=598 Nemectron Noblesse for Face and Body Facelift Wrinkles In good condition and full working order For Sale at £1,500 + VAT *PRICE REDUCED AGAIN £950 + VAT* More info - http://www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=437 Beauty Scope BS-888 Skin and Hair Analyser Intelligent skin/sebum/moisture/pigment diagnosis system For Sale at £300 + VAT *PRICE REDUCED £237.50 + VAT* More info - http://www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=438

Over line Xilia Stim 8 Face + Body Skin tightening System In good working order complete with attachments, cables, user manual and stand.

For Sale at £1,400 + VAT *PRICE REDUCED AGAIN £1187 + VAT* More info - www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=434 Nemectron Nembrasion Professional Microdermabrasion System In good condition and full working order For Sale at £1,425 + VAT More Info - http://www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=439 Smart Peel Microdermabrasion with LED Light Therapy professional system In good working order complete with attachments For Sale at £2, 280 *PRICE REDUCED £1,425 + VAT* More info - www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=535 Caci Future-Tec Skin Rejuvenation Beauty Machine In good working order complete with attachments - Vaculase, Microlase, Actuator attachments & foot pedal For Sale at £1,700 + VAT More info - www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=367 Bio –Therapeutic L.A. Smile Teeth whitening system Cost £12,600 new in 2006. Current model, in good condition, had very little use.

For Sale at £3,000 + VAT *PRICE REDUCED £1,900 + VAT* More info - www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=325 Biotec Bioskin LAS Skin Resurfacing Microdermabrasion System Bioskin Las Technology utilises a unique two-element approach to activate skin regeneration.

For Sale at £1,425 + VAT More info - www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=344 Nora Bode OxyJet Star Oxyaroma Oxyspray facial and body treatment salon machine In very good condition, had had low usage and in full working order For Sale at £7,500 +VAT *PRICE REDUCED £6,175 + VAT* More info - www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=516 Pollogen ReGen Tripollar Radio Frequency skin body facial beauty machine salon Very good condition, full working order. Unit was removed from a small clinic which closed shortly after it opened For Sale at £8,000 +VAT *PRICE REDUCED AGAIN £7,125 + VAT* More info - www.consultingroom.com/Services/Equipment-Display.asp?Equipment_ID=515 No+Vello IPL Laser Hair Removal & Skin Rejuvenation Treatments Beauty System In very good condition and full working order. Supplied new in 2010 For Sale at £6,650 + VAT More info - www.consultingroom.com/services/equipment-display.asp?equipment_id=638 Beau Visage Facial Skin Imaging Diagnosis Treatment Beauty Therapy System In very good condition and full working order For Sale at £3,800 + VAT *PRICE REDUCED £3,325 + VAT* More info - www.consultingroom.com/services/equipment-display.asp?equipment_id=640 CACI Flash 1 IPL Hair Removal & Skin Rejuvenation Acne Treatments Beauty System In good condition and in full working order For Sale at £4,000 + VAT More info - www.consultingroom.com/services/equipment-display.asp?equipment_id=649 New Meridian Lapex BCS Pro 2000P Liposuction Cellulite Fat Laser Beauty Machine New in original packaging. Supplied to a clinic which closed shortly after opening in Late 2011. Unit never used.

For Sale at £9,500 + VAT More info - www.consultingroom.com/services/equipment-display.asp?equipment_id=677 Biorem Skin Master Plus Multi-functional Ultrasonic Beauty Treatment Machine In good condition and full working order For Sale at £1,330 + VAT More info - www.consultingroom.com/services/equipment-display.asp?equipment_id=678

Clinical Lasers are a team of dedicated professionals with a single vision, to change the face of the Clinical Laser supply industry by leveraging value from all aspects of the supply chain using cutting edge proprietary technologies, unmatched knowledge assets and a repository of thought leadership techniques that will deliver considerable advantages to your business. Our team consists of Technology Evangelists, Medical Professionals and Product Specialists who provide pre and post sales support. We are in the business of "Care Pathways". What this means to you is additional value by way of total quality outcomes instead of buying a box with "theoretical" treatment protocols. When you procure from us you own a part of what we do, which is to research, develop and create meaningful ways of helping people to do get new and empowering results, or "get better" faster, more comfortably. We are constantly developing new proprietary Low Level Laser (LLLT) systems to treat a whole number of conditions. Below are the various devices (new and ex demo) that they currently have for sale.

Contact: Steve Shawsh and the Online Sales Team, 0844 589 6378, sales@clinicallasers.com

Ex Demo Sigma Lumislim 48 Retails at £3,490. Save £2,290 !! Only ever used as a demo machine.

Sigma LumislimPro 48 comes with 4 paddles with 8 Laser Diodes plus 2 small Lymph paddles. That's 6 in total - Available now, best value on the market.

This is the model everyone has been waiting for. Maximise treatments and results.

With more options and a choice of configurations to suit your needs, Lumislim continues to evolve whilst gaining a larger slice of the market daily.

Lumislim will augment your business and keep you at the forefront of your market, Priced sensibly, LumiSlim gives you the opportunity to offer treatments at a price that your clients are comfortable with, Non invasive laser liposuction has taken the world of cosmetic surgery by storm.

This method offers painless fat reduction and body sculpting . Two of the most important benefits here include the quick visible results, as well as the fact that non invasive laser lipo is completely safe, with no down time.

Price: £1,400 plus VAT (inc. training)

Sigma LumiVeress F-Light + RF + Laser Combi Introducing the latest combi package F-Light + RF + Laser tattoo removal machine all accessed for one easy to use touch screen interface.

Main product features:  Treat More conditions and offer more services  Keylock protection  Long lamp life 150000 pulses  Dual Colour touch screen  Intuitive easy to use menu  High quality impact resistant plastic case Applications: Hair removal, Removing Freckles, Treating skin pigmentation, Acne repair, Sun damage, Vein removal, Skin rejuvenation, Wrinkles, Liver spots, Stretch Mark reduction and Soft Peel

Price: £5,4000

New Sigma Nexus 2 with RF and F-light technology IPL with the new faster F-light technology, RF for non surgical face lifts.

Touch screen colour user interface, 1 touch treatment buttons Large spot size, German lamp Multiple income streams

Price: £3,799.00

Sigma Hanya IPL with the new F-Light technology The very latest in IPL technology comes built into the brand new Sigma Hanya 2.

Based on our top selling Hanya model, this pro series machine is a full 2kw machine with 2 hand pieces, meaning more treatments and more revenue.

Price: £4,8000 (VAT Included)

Sigma LumiSpa 1 Laser Lipo The first low cost professional Laser Lipo system. Now you can offer this revenue busting machine with total peace of mind and a money back guarantee, if it does not pay for itself in its 1st year. Add Laser Lipo to your treatment menu and watch the bookings flood in. What’s more, this machine comes with training from a Harley Street Practitioner and Registered Nurse who has treated hundreds of patients.

Price: All this and free delivery for just £1,350.00

Sigma Sapphire Body Contouring System Question ......which is best Laser Lipo?

Cryo lipo?

RF Contouring?

Ultrasound Cavitation?

Answer .....All of the above!

All of the beneifts of Laser Lipo with the combined advantage of RF for targeted fat loss, offering fast results.

6 large Diodes per paddle plus RF, Cavitation and Cryolipo, means that Sapphire is simply fantastic value. A simple easy to user touch screen user interface allows the user to quickly provide a quality service and maximise income potential. No other vendor offers such a complete and powerful solution in one package.

Sigma Sapphire comes with 4 paddles, each with 6 large diodes, offering more in terms of value than any other fat loss system on the market.. This is our new mid range solution that offers those with a lower budget the opportunity to compete with high end Lumislims, Ilipos or Strawberry.

Sigma Sapphire is simple to use but more powerful at delivering results as any other machine on the market. It's simple touch screen operation makes it the perfect choice for those who want a machine that is as sophisticated as high end machines, but at a sensible price.

Price: £5,200.00 plus VAT (Including delivery & training)

For more information, please see www.clinicallasers.com

Visit www.consultingroom.com/services/equipment.asp for a full list of classified sales.

Classifieds FOR SALE OXYjet Basic (Oxygen generator and OXYjet in one unit) Rated as the A List Facial and producing a beautiful soft radiance to the skin, the Oxyjet facial has a great reputation and is a favourite facial treatment to offer to clients. Refurbished machine, in excellent working order.

OXYjet Basic allows clients to experience a more advanced range of anti-ageing treatments targeting muscle tone, eye bags and fine wrinkles to tired, dull and lifeless skin with great results for deep cleansing, acne, pigmentation, body treatments and lymphatic drainage. Medical experience shows that vaccines, anaesthetics for children and insulin could be delivered into the skin by applying a high degree of pressure. The same techniques have been applied to advanced cosmetic care and are used in the Oxyjet treatment.

The Nora Bode OXYjet Basic is an oxygen therapy system created by NORA BODE company in GERMANY. Oxyjet is a laboratory tested and scientific proven treatment that rejuvenates skin affected by fine lines, frown lines, crows feet, loss of skin tone and elasticity, dehydration and general sun damage. It is one of the most advanced methods of restoring lost moisture and stimulating collagen renewal at a cellular level.

Operating Voltage: 230/115 V 50/60 Hz Operating Temperature: 10º to 40º C Power Consumption: 350/400 W Weight: 31 kg Measurements: 900 x 350 x 520 mm Warranty: 2 years Flow Setting: 0,5 to 6 litre/min Treatment Pressure: max. 2 bar Oxygen Performance: to 3 litre/min. 95% O2 ± 3%, to 4 litre/min. 95% O2 ± 3%, to 5 litre/min. 90% O2 ± 3%, to 6 litre/min. 85% O2 ± 3% Safety Certification: CE This item would need to be collected in person or I am willing to drive up to 50 miles to either deliver or meet you at no charge. Courier would be about £60.

Prices: Offers over £999 (£3,599 new) Contact: Alison Taylor, 01242 234707, info@skindetox.co.uk

UltraShape Version 3 Pulsed, focussed Ultrasound and bi-polar RF for fat cell destruction/body contouring. Exdemonstration model of the very latest UltraShape Version 3 from Carleton Medical Ltd, the former distributor before UltraShape was sold to Syneron. Low usage, with the latest VDF technology and 33,000 shots remaining on the transducer (36,000 max).

UltraShape utilizes patented focussed, pulsed ultrasound to selectively destroy fat cells with an average circumference reduction of between of 4 and up to 10cm cm after three treatments of the stomach, thighs or flanks. Non invasive, no downtime procedure. Clinically proven as the most effective body contouring technology.

Full training, installation and support available. Warranty is negotiable.

Price: Negotiable Contact: Nick Fitrzyk, 07827 298399, info@carletonmedical.co.uk

Lynton’s Skin Abrasive Medical Microdermabrasion Machine Lynton’s Skin Abrasive System is an easy to use and incredibly reliable microdermabrasion system offering two grades of crystals. It is a light weight desktop base and ergonomically designed treatment handpiece. Includes crystals and tips. Excellent condition and full working order

Price: £500

Lynton Lumina MF (Medical Flashlamp), IPL System LOW USE AND EXCELLENT CONDITION FULL WORKING ORDER The Lumina Medical Flashlamp system is a platform onto which a whole range high intense pulsed light or laser handpieces can be attached. The Lumina System is designed to be versatile and up-gradable, allowing multiple applications now and in the future. The software control automatically detects the handpiece attached and sets suitable parameters to work to.

This particular Lumina is in excellent condition has had low use and a full service history by Lynton Lasers. The Lumina platform for sale includes the following handpieces: 650 advance handpiece for treating skin types 1-3 hair removal, latest technology offers enhanced performance and greater flexibility in the selection of treatment parameters. Great for fine, fair and resistant hair.

650 handpiece for skin types 1-5 hair removal.

650 handpiece also for skin rejuvenation treatments.

585 handpiece for treating acne, pigmentation, vein/ roscea treatments and port wine stains.

Protective eye wear x 4 for clients and practitioners.

Quartz blocks x 4 for all body areas.

Canon IXUS digital camera – for before and after photos.

IPL policies and protocols.

Treatment information leaflets.

Consultation and consent form and after care sheets.

Lynton's comprehensive service history for IPL.

Price: £18,000 Now reduced to £15,000

Zimmer Cryo 5 cooling system An indispensible cooling system for use with IPL and Laser treatments.

Excellent condition and full working order

Price: £2,000

Clinic for sale in South East Kent Sadly due to personal reasons. To include equipment as described above, PLUS: Database of 280+ clients.

Currently working out of GP premises.

Recent CQC inspection available on their website and excellent local reputation.

Lucrative buisiness, even as part time venture.

Price: £25,000 Contact: Julie Kenyon Vaughan, 07505 635 226, enquiries@pureskinclinic.co.uk

Pedicure, threading, barber chair Features: 1. Big pump, high-quality chromed base, durable vinyl; 2. Reclinable, adjustable height; 3. Classical style; 4. PU, chromed armrest, heavy steel metal frame construction with full welds on chair base.

5. Removable headrest; 6. Packaging: seven-layered strong carton, size 78x76x110 cm, weight 46 kg

Price: £350

Electric massage couch Electric massage couch, white leather, two motors, remote control.

Back reclines. 2 meters long, 75cm wide, goes down as low as 40cm, goes up as high as 90cm. Packed in a strong cartons enforced with wooden bars around it.

Price: £1050 The prices exclude delivery. Can be collected from SE13.

Contact: Anna Saprykina, 07748325895, anna.saprykina@bodysilk.co.uk

Room to Rent in Knightsbridge Large room in Knightsbridge would suit doctor, beauty therapist, alternative therapist, consultations. Would also be suitable as a training venue for up to 6 students. Available for daily let or full term contract also available.

The clinic is situated just 2 minutes from Harrods on the corner of Brompton Road and Beauchamp Place between Armani and Mulberry.

There is a waiting area for your clients, computer, desk, lots of storage, natural window light.

Prices for a daily rate are £150 per day Monday-Saturday and £100 per day on Sundays. Hours are from 9am until nd 8pm Monday to Saturday and 10am until 6pm on Sundays. Available from 2 Jan 2013.

Please contact me if you would like any further details.

Price: Starting from £100 per day Contact: Jemma Upton, 07789792353, jemma_upton@yahoo.co.uk

WANTED Gemini Laser by Laserscope If you are looking to sell your Gemini Laser by Laserscope please contact me on the details below

Contact: Michelle Gilvarry, 01491 873 989, info@chilternmedical.co.uk

Advertisement S.A.F.E.â&#x201E;˘ System Surgical Smoke Evacuation The Smoke Evacuator vacuums the plume created by laser and electrocautery treatments such as hair removal, tattoo removal and erbium procedures and protects physicians and staff performing these operations.

The U.S. FDA approved and European CE marked SAFE System smoke evacuator is built to handle any type of surgical smoke. Costs are low to purchase and operate.

Application:

The removal and filtration of laser and surgical smoke

Used by:

Hospitals, Plastic Surgeons, Cosmetic Surgeons, and more

Economical:

Due to the real time filter life pressure gauge

Compact:

9" x 9" footprint, 14" high

Quiet:

Less than 52dBA, quieter than the competition

Filtration:

ULPA: 99.999+%@ 0.12 micron

Weight:

24 lbs.

Electrical:

100-120 VAC, 50/60 HZ 220-240 VAC, 50/60 HZ

Regulatory:

UL, CSA, CE

Tubing:

Vacuum Tubing 7/8" x 8'

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For more information, please contact Martyn Roe on martyn@abs4u.co.uk or telephone 07734 101275

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