Aesthetic Trends - May/June 2008 eBook by Aesthetic Trends & Technologies, Inc.

may-june 2008

www.aesthetictrends.com

volume 7, issue 3

may-june 2008

Introducing aesthetic trends & technologies™

LASER & LIGHT TECHNOLOGY

Thermage ThermaTip™ CL

legal case OF the Month

Liability Issues for Aesthetic Practices

medical spas

Meeting Medical Spa Challenges in 2008

2007

A new level of control, a new level of results.

Anti-Aging & WELLNESS

SmartSense Intelligent Handpiece

LaserBodySculptingSM energy for optimal results. SmartSense technology monitors handpiece motion to deliver

volume 7

SmartSense. The new intelligent handpiece delivery system for Smartlipo that delivers the precise amount of the appropriate laser energy for improved safety and control. Elevate your Smartlipo results with SmartSense.

issue 3

Cynosure Corporate Headquarters - 5 Carlisle Road, Westford, MA 01886 800-886-2966 www.cynosure.com

DERMATOLOGY

The Perfect BOTOX® Treatment

VASER® Lipoplasty

pRACTICE MANAGEMENT

Laser Safety in the Cosmetic Practice–Part II

Visit www.cynosure.com to learn more.

Cancer Treatment and Prevention

plastic surgery

the leading physician journal for aesthetics and wellness

These Doctors Are Among

Michael H. Gold, M.D. Gold Skin Care Center Nashville, TN

Mitchel P. Goldman, M.D. Spa MD La Jolla, CA

The Top

Physicians

George M. Martin, M.D. Dermatology Laser Center of Maui Maui, HI

In Our FielD

David J. Goldberg, M.D. Skin Laser & Surgery Specialists New York, NY Miami, FL

Michael H. Gold, M.D. Chief Medical Officer & Co-Founder

CME Training for the Medical Aesthetic Professional We’re Growing! And so can you– train in one of the offices of these leading physicians within our network. Each physician is an active Physician Network Office of the Institute for Aesthetic Medicine

With everything the VASER® Lipo System can do, you can turn your work into a work of art.

You can unleash the power of

VASER’s third-generation ultrasound technology enables the kind of accurate body sculpting that you

xanthones with just two to three

and your patients demand. Grooved probes glide effortlessly through tissue, providing you greater

daily ounces of sensational XanGo

control and predictability. The versatility of the technology makes it possible

Juice. To learn more, visit us at www.impacthealth.net/aesthetictrends/

for you to perform precision sculpting for whatever your work of art requires. For a free analysis of how the VASER Lipo System can help your practice, call 1-888-471-4777. Or visit VASER.com for more information.

www.IAMeducated.com Toll-free 800.436.9311 Waterford Business Park • 5201 Blue Lagoon Drive, Suite 800 • Miami, FL 33126 USA

THE TOOL BEHIND THE TALENT .™

or call 800.541.5842 to receive a free sample of XanGo today! All Physicians Are Board Certified

editorial advisory panel advisor y directors

featured advisor

Michael H. Gold, M.D.

Mitchel P. Goldman, M.D.

Mitchell Chasin, M.D.

Gold Skin Care Center Nashville, TN

La Jolla Spa MD, La Jolla, CA

Bridgewater, NJ

editorial advisors Diane Berson, M.D.

Arielle N.B. Kauvar, M.D.

Stacey L. Silvers, M.D.

New York, NY

Brian Biesman, M.D.

Frederick N. Lukash, M.D., F.A.C.S.

Allan E. Sosin, M.D.

Nashville, TN

New York, NY

Valéria B. Campos, M.D.

Corey S. Maas, M.D., F.A.C.S.

Institute for Progressive Medicine Irvine, CA

São Paulo, Brasil

The Maas Clinic San Francisco, CA

Anthony V. Vendetti

Stuart Maddin, M.D., F.R.C.P.C.

MAXIM Group LLC New York, NY

University of British Columbia, Vancouver, B.C.

Jeffrey Weinberg, M.D.

Antonio Cuevas, M.D.

George M. Martin, M.D.

Laserium Tijuana, Mexico

Dermatology & Laser Center Maui, HI

St. Luke’s Roosevelt Dermatology Assoc.iates New York, NY

Christine C. Dierickx, M.D.

Steven Ross Mobley, M.D.

Boom, Belgium

Salt Lake City, UT

Dermatology Associates Hunt Valley, MD

Dore J. Gilbert, M.D.

Nick Morrison, M.D., F.A.C.S.

Cheryl Whitman

Newport Dermatology & Laser Associates, Newport Beach, CA

Morrison Vein Institute Tempe and Scottsdale, AZ

Beautiful Forever New Jersey

Leslie Pollard, BSMT, CMLSO

Carlos L. Wolf, M.D., F.A.C.S.

Southwest Innovative Solutions, Richardson, TX

Miami Plastic Surgery Miami, FL

Neil Sadick, M.D., F.A.C.P., F.A.C.S.

Cecil Yeung, M.D., F.A.C.S.

Eastern Cosmetic Surgery Institute, Bala Cynwyd, PA

Sadick Aesthetic Surgery & Dermatology New York, NY

Yeung Institute Houston, TX

Ranella J. Hirsch, M.D.

Joel Schlessinger, M.D.

Skincare Doctors Cambridge, MA

Skin Specialists, P.C. Omaha, NE

Patrick Clark, CMLSO Institute for Aesthetic Medicine Highland Village, TX

David J. Goldberg, M.D., J.D. Mt. Sinai School of Medicine, New York, NY

Timothy M. Greco, M.D., F.A.C.S.

Robert A. Weiss, M.D.

Steven E. Zimmet, M.D. Zimmet Vein & Dermatology Austin, TX

Dr. Chasin is the Medical Director of Reflections, Center for Skin and Body, New Jersey’s first dedicated Laser and Aesthetic Medical Practice. Dr. Chasin received a BA in Biology and Psychology from the University of Rochester in Rochester NY in 1981. He earned his Medical Degree from the State University of New York Upstate Medical Center in Syracuse NY. His internship and residency were served at Overlook Hospital, a major teaching affiliate of Columbia University College of Physicians and Surgeons located in Summit NJ. Since the 1990s, Dr. Chasin has devoted himself fully to the field of Laser, Aesthetic, and Cosmetic Medicine. Dr. Chasin is a Diplomate of the American Board of Laser Surgery, a Fellow of the American Society for Laser Medicine and Surgery, and a member of the International Society of Cosmetic Laser Surgeons and American Society of Cosmetic Dermatology and Aesthetic Surgery. He is a Platinum Provider of BOTOX® Cosmetic and an Attending physician at Overlook Hospital and Somerset Medical Center.

We are pleased to have the above-mentioned physicians as our editorial advisors. Our thanks go out to these individuals for their time and support in providing our readership with valuable information for their practices.

may-june 2008 | www.aesthetictrends.com

—1

Letterfrom the

Editor

The Value Experience Adds to Your Practice “Wisdom stands at the turn in the road and calls upon us publicly, but we consider it false and despise its adherents. ” –Kahlil Gibran Writer | Philosopher | T heologian 1883 - 1931

As a consumer, I make an effort to understand what it is I am purchasing, whether it is a service or product. In our industry we have seen a shift in consumer awareness of the products and services physicians offer to their patients. Understanding their needs and truly defining what you are providing comes with experience. Entering the summer months aesthetic procedures are at a peak for patients wanting to look their best on the beach, as they wear less clothing during the hotter season. As seasons change, so does the shift for specific procedures. Learning the shifts and cycles of the seasons is an important part in defining where your revenue is generated and how you can best serve your demographic market. In this issue, the contributing editors of Aesthetic Trends help to hone your skills and increase your exposure to tools of your trade, defining further how to apply what you know based on your experience. Using that experience adds value to your practice and to the loyalty of your patients. A part of our industry which continues to evolve is the anti-aging segment of our market. In this issue, Dr. Sosin provides an integrative approach to the treatment and prevention of cancer in our Anti-Aging & Wellness department. Find out how you can provide your patients with the knowledge to promote a longer and healthier life. Featured in the Dermatology department this issue, Dr. Wiener authors the latest updates in the use and technique of BOTOX®. Adding this treatment to your practice is a win-win for both physician and patient as the industry continues to embrace the use of Botulinum Toxin A not only for aesthetic procedures, but also for the FDA-cleared treatments of primary axillary hyperhidrosis, adult strabismus, and torticollis. Thermage has released a new CL Tip for the treatment of cellulite and is featured in our Laser & Light department this issue. Find out how Dr. Chasin has implemented the ThermaTip into his practice as a single treatment, non-invasive option for improving cellulite. Our Editorial Advisor Megan Packard provides an in-depth look at understanding liability issues for medical spas and aesthetic practices in this issue’s Legal department. Risk management is clearly a first-step measure to ensure the success of any business. Understand how you can minimize your exposure to potential problems when opening a new practice in aesthetics. Sound Surgical is the manufacturer of the VASER ultrasonic energy device for Lipoplasty. In the Plastic Surgery department this issue, Dr. Maurice Sherman shares his experience in the use of this cutting edge device in his practice located in Del Mar, California. It is clearly evident the aesthetic market is dependent on light based devices. Ensuring that practitioners understand the safe use of these devices is key. As our market continues to grow, instilling safe practices in the use of lasers and other modalities will continue to be a concern for regulatory agencies. Contributing Editor Leslie Pollard provides further information in Part II of Laser Safety in the Cosmetic Practice in our Practice Management department. No matter what niche of the aesthetic industry your experience is from, remember to reap the benefits for your business and for your patients by providing solid experience (which includes continual training and knowledge) in the procedures and services you provide. Keep that sunscreen on, and have a safe and happy summer!

Cindy Vandruff Editor in Chief Aesthetic Trends & Technologies, Inc.

2—

may-june 2008 | www.aesthetictrends.com

may-j une

2 0 0 8

departments

7 13

anti-aging & wellness

dermatology

laser & light technology

legal case of the month

medical spas

plastic surgery

practice management

Anti-Aging & Wellness Integrative Medicine

Dermatology The Perfect BOTOX® Treatment

Product Listings Dermal Fillers & Injectables

Laser & Light Technology Cynosure Roundtable

MarketTRENDS

Laser & Light Technology Thermage – ThermaTip™ CL

Product Listings Evolving Technologies/Laser & Light Technology

Legal Case of the Month Liability Issues for Medical Spas

may-june 2008 | www.aesthetictrends.com

—3

volume 7 issue 3 | may-june 2008

in every issue 2

letter from the editor

dermal fillers & injectables product listings

laser & light technology product listings

microdermabrasion product listings

press corner

meetings & events calendar

71 60 FEATURED MEDICAL SPA–Jonathan Dental Spa, Hawthorne, New Jersey

4—

Medical Spas Meeting Medical Spa Challenges in 2008

Featured Medical Spa Jonathan Dental Spa

Product Listings Microdermabrasion

Plastic Surgery VASER® Lipoplasty

Net Visibilities

Practice Management Laser Safety in the Cosmetic Practice-Part II

Press Corner

Meetings & Events Calendar

may-june 2008 | www.aesthetictrends.com

advertiser index

edit o r in chief Cindy Vandruff cindy.vandruff@aesthetictrends.com

Beautiful Forever (www.medicalspasuccess.com). . . . . 59

t rends edit o r Dawn Larsen dawn.larsen@aesthetictrends.com

Candela (www.candelalaser.com) . . . . . . . . . . . . . . . . . 32

publis her

Canfield (www.canfieldsci.com). . . . . . . . . . . . . . . . . . . . 6

Tina Squier tina.squier@aesthetictrends.com

co nt ribut ing edit o rs Valerie J. Ablaza, M.D. Elda Argenti Jennifer Barnes Leslie S. Baumann, M.D. Charles Becker Adina Carrel, D.M.D. David Cauger Mitchell Chasin, M.D. Jacqueline Clark Patrick Clark, CMLSO Joanna Cosgrove Sam Dhatt, M.S. Richard Ellenbogen,M.D.,F.A.C.S. Mark G. Erlander, Ph.D. Stuart Frolic

Michael H. Gold, M.D. David J. Goldberg, M.D. Mark Greenberg Lou Haggerty, PUMC Nicanor G. Isse, M.D. Bruce E. Katz, M.D. Benjamin Kessler Dawn Larsen Elizabeth I. McBurney, M.D. Kathy Miller-Kramer Greg S. Morganroth, M.D. Nick Morrison, M.D., F.A.C.S. Megan K. Packard Lisa Panzica Dr. Cheryl Perlis

Cynosure (www.cynosure.com) . . . . . . . . . . . . . . . . . . . C4 Leslie Pollard, CMLSO Debra Price, M.D. Robert Prince Dr. Zakia Rahman Matthew Schulman, M.D. Asad Shahsavari, N.M.D. Steven D. Shapiro, M.D. Allan E. Sosin, M.D. Rada K.Tierney Ken Washenik, M.D., Ph.D. Greg Washington Sara Wasserbauer, M.D. Cheryl Whitman Gregory Wiener, M.D., F.A.C.S. Steven E. Zimmet, M.D.

a rt direct o r David Meyer prod u ctio n m ana g er Melissa Poliseno cre ativ e direct o r Danielle Hudson prod u ctio n direct o r Kerry Shaughnessey prod u ction co o rdina t o r B. Gunstenson marke tin g co o rdina t o r Heather Phillips s ubs cribe

Eclipsemed, Ltd. (www.eclipsemed.com). . . . . . . . . . . 39 ESBA Labs (www.esbalabs.com). . . . . . . . . . . . . . . . . . 70

IECSC (www.iecsc.com) . . . . . . . . . . . . . . . . . . . . . . . . . 12 Med-Aesthetic Solutions (www.medaestheticsolutions.com). . . . . . . . . . . . . . . . . 63 Net Visibilities (www.netvisibilities.com) . . . . . . . . . . . 76

Online: www.aesthetictrends.com.

a dv ert is ing inq uirie s For display advertising, please direct inquiries to:

Roger Feltman

Dermik Laboratories (www.sculptra.com). . . . . . . . . . . 17

IAM (www.iam-skincare.com) . . . . . . . . . . . . . . . . . . . . C3

800.277.1391 p 786.206.7278 f 8:30 am to 5 pm PT, Monday–Friday

Michael Engelhart

DermaSweep (www.dermasweep.com) . . . . . . . . . . . . 62

Susan Pearring

Director of Sales Sr. Sales Executive Sr. Sales Executive 201.925.5077 direct 201. 410.4418 direct 954.649.0642 direct michael.engelhart@aesthetictrends.com roger.feltman@aesthetictrends.com susan.pearring@aesthetictrends.com Aesthetic Trends & Technologies, Inc. 201 South Biscayne Blvd., Suite 2800, Miami, FL 33131 USA 800.277.1391 p Published by Aesthetic Trends & Technologies, Inc. Please address all correspondence to 201 South Biscayne Blvd., Suite 2800, Miami, FL 33131 USA. Aesthetic Trends & Technologies, Inc. makes all attempts to publish accurate information. However, this publication may contain technical inaccuracies or typographical errors. The reader assumes all risks concerning the suitability and accuracy of the information within this publication. Aesthetic Trends & Technologies, Inc. and its contributing editors assume no responsibility for and disclaims all liability for such inaccuracies, errors or omissions in this publication and in other documents referred to within or affiliated with this publication. Aesthetic Trends & Technologies™, the leading physcian journal for aesthetics and wellness, is a trademark of Aesthetic Trends & Technologies, Inc. Reproduction in whole or in part without permission is strictly prohibited.

Pink Glove (www.thepinkglove.com) . . . . . . . . . . . . . . 70 Professional Liability Solutions (www.professionalliabilitysolutions.net) . . . . . . . . . . . . 54 Sound Surgical (www.vaser.com). . . . . . . . . . . . . . . . . . C2 Thermage (www.thermage.com). . . . . . . . . . . . . . . . . . 33

may-june 2008 | www.aesthetictrends.com

—5

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CANCER TREATMENT AND PREVENTION

at t

Integrative Medicine

anti-aging n & wellness

anti-aging & wellness

By Allan E. Sosin, M.D., Editorial Advisor and Contributing Editor

Cancer continues to rank as the

Unfortunately the rest of the

weight would reduce the incidence of

second most common cause of

world has not followed suit, and

malignancy as well as cardiovascular

death in Western countries, behind

the incidence of cigarette-caused

disease.

cardiovascular disease. Lung cancer

mortality from cardiovascular disease

is the most common, followed by

and cancer has risen dramatically,

COLON CANCER

colonic cancer, then breast and

especially in India and China.

Colon cancer is largely

preventable, since virtually all

prostate cancer.

OBESITY-DEPENDENT CANCERS

cancers develop through progressive

LUNG CANCER

growth of premalignant polyps in

strong predisposing factor for

Cigarette smoking accounts for

Obesity has been determined a

90% of lung cancer and is a strong

a variety of cancers, except

risk factor for head and neck cancer,

for lung cancer. Obesity-

pancreatic, and bladder cancer. The

dependent cancers include

prevalence of cigarette smoking in the

breast, ovarian and uterine

United States has declined from 40%

cancer, prostate cancer,

to 20% of adults in the last few years

esophageal, kidney, colon

as a consequence of public education

cancer, lymphomas, and leukemias.

the large intestine. Surveillance

and legal restraints.

Thus, effective measures to control

is recommended at the age of fifty,

may-june 2008 | www.aesthetictrends.com

Death from all cancers is reduced by 52% in vegetarian men and 26% in vegetarian women.

â&#x20AC;&#x201D;7

anti-aging & wellness

although earlier in people with a

insurers. A C-T scanner visualizes

history of familial colon cancer.

the large intestine, utilizing instilled

Colonoscopy is the main method of

air as a contrast medium. Cleaning

detection, but fewer than 50% of

out the colon with laxatives and

people ever have one because of

enemas is still necessary; but there is

the unpleasantness of the procedure

no anesthesia, and patients can drive

and the preparation required for

home themselves after the procedure.

it. Also, the procedure requires

If a lesion is detected, routine

anesthesia with its own attendant side

colonscopy is needed to remove it.

effects, and there is additional risk of

Ninety percent of the time the study is

perforation, approaching one in every

negative, and no additional procedure

500 procedures. Therefore, screening

is needed.

colonoscopy is not recommended after

the age of 80, since risks outweigh

by 52% in vegetarian men and 26% in

benefits.

vegetarian women.

Death from all cancers is reduced

A second method, called virtual

colonoscopy, is gaining in popularity

ALCOHOL-RELATED CANCERS

as well as in acceptance by health

Alcohol is a common cause of cancer. It is a well-established cause of cancer of the mouth and throat,

The following factors protect against colon cancer: 1. Vegetarian diet- reduces the death rate by 50% in men and 25%

ingestion of more than 2 drinks per day increases breast cancer risk. The

in women. Those who eat beans at least twice a week have a 42%

carcinogenic effects of alcohol may

reduction in colon cancer risk compared with those who do not eat

relate to its antifolate effects. Thus

beans.

folic acid supplementation may be

2. Estrogen replacement therapy in women- reduces risk by 50%. 3. Calcium and folic acid supplementation- We recommend calcium citrate 1000 mg/day and folic acid 5000 mcg/day. 4. Weight reduction.

Many studies support vegetarian nutritional programs: 1. Frequent fruit consumption- more than once a day compared with less than 3 times weekly is associated with a 75% reduction of lung cancer risk, regardless of smoking status. 2. Stomach cancer is reduced in those who eat fruit frequently. 3. Raisins, dates, and other dried fruits offer protection from prostate cancer. 4. Tomatoes and dried beans also protect against prostate cancer. 5. Pancreatic cancer- people eating dried peas and beans more than twice a week have only 1/30 the risk of pancreatic cancer compared with those who rarely eat those foods.

8â&#x20AC;&#x201D;

larynx, esophagus, and liver. Alcohol

may-june 2008 | www.aesthetictrends.com

protective.

Breast cancer is related to obesity, lack of exercise, and alcohol use. It occurs less often in women who have given birth and also women who have breast-fed their children.

The following supplements protect agAinst primary and recurrent breast cancer: 1. I-3-C indole 3 carbinol and DIM-diindolylmethane- alter the metabolism of estrogen by the liver to prevent formation of

Estrogen replacement therapy is

considered a breast cancer risk by many physicians. However, breast cancer increases as women get older, suggesting that other factors besides

carcinogenic byproducts. 2. Calcium D-glucarate prevents reabsorption of estrogen metabolites from the intestine. 3. Vitamin D- 5000 units daily. Vitamin D has potent immunologic effects and also protects against colon and prostate cancer. It is of

estrogen levels are involved. In the

interest that most of the women in our practice have below normal

United States one in seven women

or low normal vitamin D levels, despite the fact that our practice is in

will develop breast cancer, and 40,000 women die of it yearly in the United States.

A recent study of hormone

replacement therapy in France followed 80,000 women over eight years. The incidence of breast cancer in women receiving estrogen plus bioidentical progesterone was

anti-aging & wellness

BREAST CANCER

California. 4. Folic acid- 5000 mcg/day. It has no toxic effects but should always be taken with supplemental vitamin B12.

When purchasing supplements, try to get the highest quality

products available. Cheaper products may contain harmful additives or contaminants. Some oil based supplements can go rancid if not preserved properly. Pharmaceutical grade supplements help guarantee that you receive the full strength and dose claimed on the label.

identical to the incidence in women receiving no hormone replacement. Women receiving estrogen alone had a 30% increased risk, and women

prostate cancer deaths. Surgical

receiving estrogen plus synthetic

removal of the prostate is not

blood levels to maintain 50-80 ng/

progesterone had a 70% increased

recommended in men over 65 years

ml concentration.

risk. Thus it appears that the type of

of age, since

progesterone used is the single most

it affords no

important hormonal factor causing

survival benefit.

breast cancer. In our practice

In many older

we always provide progesterone

men the blood

supplementation for women

PSA level can be

receiving estrogen, and we use only

used as a marker

bioidentical forms of estrogen and

for progression

progesterone.

of disease; and if

it is stable, aggressive therapy is not

4. plant sterols- 1-2 grams/day.

PROSTATE CANCER

required.

5. modified citrus pectin- 6-10 grams/

in 200,000 men yearly in the U.S.,

Preventive and protective measures:

6. EGCg- epigallocatechin gallate-

and 30,000 men die of it. Men over

1. low fat and high soy protein intake.

green tea extract, or 2-3 cups of high

75 years of age account for 2/3 of

2. selenium- 200 mcg/day.

quality, organic green tea daily.

3. vitamin D- 5000 u/day. Check

We have employed intravenous vitamin C for the support of patients undergoing cancer therapy for years. Blood levels attained through intravenous infusion are far higher than can be achieved with oral administration.

day.

Prostate cancer is diagnosed

may-june 2008 | www.aesthetictrends.com

9â&#x20AC;&#x201D;

anti-aging & wellness

INTRAVENOUS VITAMIN C AND CANCER

cells are able

to inactivate

We have employed intravenous

vitamin C for the support of patients

hydrogen peroxide

undergoing cancer therapy for

and are therefore

years. Blood levels attained through

not damaged. The

intravenous infusion are far higher

dosage of vitamin C

than can be achieved with oral

varies between 25 and

administration.

75 grams per infusion. We

often provide other nutrients

Vitamin C appears to be toxic to

cancer cells through the production

along with vitamin C, including

of hydrogen peroxide, while normal

glutathione, B vitamins, and trace

Lifestyle factors are important in the development of cancer. Diets high in fruits and vegetables, reduction of animal fat and protein, elimination of cigarette smoking and regular alcohol use, weight control, and exercise are the most important measures to implement.

minerals.

cancer

Patients receiving

patients,

these infusions

made worse by

tolerate their

toxic therapies. Intravenous nutrient

cancer therapy,

therapies, centering around vitamin

including radiation

C, have been highly effective in our

and chemotherapy,

practice for the support of patients

much better

with cancer.

than they would otherwise. Side effects are less, and we believe the infusions enhance

Allan E. Sosin,

the effect of conventional therapies.

M.D., is a board

LIFESTYLE AND DIETARY FACTORS

Lifestyle factors are important in

the development of cancer. Diets high in fruits and vegetables,

and Nephrologist with over 35 years of experience. Dr. Sosin is

reduction of animal fat and protein,

a Volunteer Faculty Member of the

elimination of cigarette smoking

University of California, Irvine, CA, and

and regular alcohol use, weight

is a Staff Physician at the Irvine Regional

control, and exercise are the most

Hospital, Irvine, CA. In addition, he

important measures to implement.

is Founder and Medical Director of

Avoidance of toxins in food and the

the Institute for Progressive Medicine,

environment is important. Diets

Irvine, CA. Dr. Sosin is a Diplomate,

should be organic and free of

American Board of Internal Medicine;

additives and preservatives as much

Diplomate, Nephrology; and Diplomate,

as possible.

A large number of nutritional

supplements are available for the prevention and treatment of cancer. Nutritional depletion is a major cause of death and disability in

10 â&#x20AC;&#x201D;

certified Internist

may-june 2008 | www.aesthetictrends.com

American Board of Chelation Therapy. For more information please contact Dr. Sosin at 949.600.5100 or visit his website on the world wide web at www.iprogressivemed.com.

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For information about current findings, ongoing clinical trials and frequently asked questions related to aesthetic procedures and products...

Anti-Aging & Wellness Dermatology Laser & Light Technology Legal Case of the Month Medical Spas Plastic Surgery

Practice Management Copyright ÂŠ 2002-2008 Aesthetic Trends & Technologies, Inc. 201 South Biscayne Blvd., Suite 2800 Miami, FL 33131 USA

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Updates in the use, technique, and FDA regulation of Botulinum Toxin Type A

By Gregory Alan Wiener, M.D., F.A.C.S.

Six years ago the Food and Drug

BOTOX® treatments which have

create lazy eye, in which the

Administration cleared Botulinum

been cleared by the FDA:

eyes do not point in the same

Toxin Type A for the treatment of

• Primary axillary hyperhidrosis

direction. This can lead to

at t

The Perfect BOTOX® Treatment

wrinkles between the eyebrows.

(excessive sweating): BOTOX®

vision problems, such as eye

Since then, BOTOX® Cosmetic (as

can be injected into the armpits

fatigue, blurry vision, overlapped

it is more commonly known) has

of individuals who suffer from

images, and difficulty reading

been used as a cure-all by people

excessive

seeking youthful, glowing skin

sweating. When

and rejuvenated appearances.

injected, the

Treatment of crow’s feet and

toxin stops

forehead is commonly done and is

the release

not approved by the FDA. If you

of chemical

want to deliver the perfect BOTOX®

messenger

to your patients, you must be aware

acetylcholine.

of these details, including approved

This temporarily prevents the

and performing other daily tasks.

uses of BOTOX®; and your

nerves from producing underarm

BOTOX® has been cleared for

application technique must be as

sweat.

treating this condition in healthy

concise and flawless as possible.

Here a list of the most popular

dermatology n

dermatology

Using BOTOX® for anything other than the treatments for which it has been approved is not only dangerous, it can also create poor aesthetic results.

• Adult strabismus (lazy eye): Overactive eye muscles can

may-june 2008 | www.aesthetictrends.com

adults who are not pregnant or nursing. BOTOX® paralyzes the

13—

dermatology

overactive eye muscle and can even permanently improve the alignment of the eyes. • torticollis (head/neck muscle spasms): Muscle spasms can be incredibly painful to endure. Spasmodic torticollis, in which the head or neck involuntarily spasms and causes a painful

Before (Left) and After (Right) BOTOX® Treatment.

jerking motion, can be eased with BOTOX®. The muscle is injected with a mixture of BOTOX®

is truly being injected right, left, and

BE REALISTIC

and saline, which will prevent

center on many patients. Many of

excessive, painful spasms.

these other treatments can be done

dream come true for most patients,

safely by trained, board-certified

but it is also a very unrealistic

cleared BOTOX® for treating

plastic surgeons and cosmetic

dream for a patient of 40+ years

moderate to severe glabellar lines

dermatologists. Unfortunately, if

old. A smooth brow looks natural on

between the eyebrows. It has

done by untrained personnel (family

a 20-year-old woman, but it looks

not yet been cleared for treating

practice, internal medicine, OB/

fake and unnatural on a woman

wrinkles on other areas of the

Gyns who have no real training, but

twice her age. Part of the art of

face. However, it is commonly

like to call themselves cosmetic/

administering the perfect BOTOX®

used by board-certified plastic

aesthetic physicians to increase

is guiding patients towards realistic

surgeons and dermatologists to

their cash flow) using BOTOX® for

and natural results, which is

treat wrinkles of the forehead

anything other than the treatments

not as simple as it might sound.

and crow’s feet.

for which it has been approved

Patients do not always realize how

Even though the FDA has not yet

• Eyebrow wrinkles: The FDA has

is not only dangerous, it can also

impractical their cosmetic surgery

cleared other uses of BOTOX®, it is

create poor aesthetic results. From

goals are. Within this profession,

still being used to treat other facial

the dreaded “frozen” face result in

doctors are likely to run into

There is no panacea when it comes to treating wrinkles and no specific injection site or BOTOX® dosage which will be effective for all patients. Depending on your patient’s age, facial structure, long-term goals, and the location and depth of wrinkles, the amount of BOTOX® you inject and the location where you inject it will differ.

14—

A wrinkle-free face would be a

which the patient

patients who demand dramatic and

is unable to smile,

life-changing results, even at their

frown, or make other

own detriment.

facial expressions

normally, to lopsided

BOTOX® appointment monthly

results and droopy

is nothing short of an addict, so

eyelids, BOTOX®

doctors have to help convince their

can be very harmful

patients to aim for subtle, realistic

if not administered

results. By resolving to administer

properly.

only minimal and age- and gender-

So what are

appropriate amounts of BOTOX®,

A patient who tries to book a

lines in many aesthetic offices across

the best methods for BOTOX®

doctors can maintain their integrity

the world. From “smoker’s lines”

administration, and how can you give

within the field; and patients will

(tiny wrinkles which form around the

your patients the wrinkle-free results

still be pleased with their smoother,

lips) to bands in the neck, BOTOX®

of their dreams?

yet natural-looking skin.

may-june 2008 | www.aesthetictrends.com

Does she have a deep wrinkle

may predispose a patient to

between her eyebrows even when

complications.

her face is virtually expressionless?

comes to treating wrinkles and no

Are the brows being pulled down

when you are treating a patient

specific injection site or BOTOX®

when the face animates? These little

with BOTOX® for off-label use,

dosage which will be effective for all

facial clues can help guide you in

your liability in this tragedy

patients. Depending on your patient’s

deciphering what the problem areas

might cost you your license and

age, facial structure, long-term

are and how best to treat

goals, and the location and depth of

them. Think of each face as

wrinkles, the amount of BOTOX®

an ever changing work of

you inject and the location where you

art—and as the artist, you

inject it will differ. It is also important

must be ever aware of the

to communicate with your patients,

individual canvases you are

understand their expectations, and

treating.

There is no panacea when it

discuss all limitations and risks. One easy way to determine your patients’ BOTOX® needs is to take pictures of their face with a digital camera.

Try many different angles, and try

If something goes wrong

Off-label uses that involve larger doses may predispose patients to complications. Always err on the side of caution, and use less dosage if there is a question.

Administer BOTOX® based on on-going clinical assessments and communication with the patient Over time, you may see that

your reputation. Although many doctors are seeing success when using BOTOX® for off-label uses,

dimming and increasing the amount

of light with each different shot.

the patient needs less BOTOX® to

label uses that involve larger

(Wrinkles will appear differently

achieve the same results, as muscles

doses may predispose patients to

when the light alternates, which will

become chronically de-enervated

complications. Always err on the

help to guide your decision-making

and wrinkles get permanently

side of caution, and use less dosage

process.) Have your patient make

smaller. The number of times a year

if there is a question.

a range of facial expressions—from

may also decrease from 3-4 to 2-3.

smiling to frowning to grimacing.

caution must still be used. Off-

The patient can always come

back for a touch-up if needed. These off-label treatments generally

you will no doubt see a trend in the

Be aware of your patient’s medical history

wrinkle formation. For instance, do

procedures like diminishing bands

the sides of her eyes crinkle when

(neuromuscular problems

in the neck (otherwise known as

she smiles and when she frowns?

in particular, such as MS)

“turkey neck”) and lines around

As you examine the pictures later,

dermatology

Treat Each Patient as an Individual Case

Certain medical conditions

include popular and successful

the mouth and nasolabial folds. Another popular procedure involves injecting BOTOX® into the gums to create a smile which reveals less gum. The so-called “gummy” smile effect can be lessened with the treatment of BOTOX®, but this treatment has not yet been cleared by the FDA. Before (Left) and After (Right) BOTOX® Treatment.

Since the long-term effects

of these uses have not been

may-june 2008 | www.aesthetictrends.com

15—

dermatology

studied comprehensively over an

Warn your patients about fauxBOTOX® and unlicensed providers

party favor. It is a toxic substance

extended period of time, these can be problematic and even lead to

carefully.

dangerous botulism toxin poisoning.

Almost all of the fatal and

which can be dangerous if not treated

near-fatal BOTOX® experiences

Always remind your patients

have been the result of patients

BOTOX® seem unappealing; but

Warnings like these might make

that symptoms such as difficulty

seeking wrinkle treatments from

as long as the proper precautions

swallowing or breathing, slurred

untrustworthy sources. BOTOX®

are taken, many people can benefit

speech, blurred vision, and muscle

which is delivered at the ever-

from its use, both aesthetically and

weakness are signs of possible

popular BOTOX® party, or at a

physically. As the FDA continues

botulism toxin poisoning.

vacation locale in Mexico, is not

to clear new and different uses for

necessarily being moderated by the

BOTOX®, the public can continue

FDA. This means that the amount of

to benefit from this wonder drug.

toxin in the BOTOX® (or whichever

As new treatments emerge, plastic

element is being used) can be

surgeons need to stay up-to-date with

deadly—and of course, the aesthetic

the latest injection techniques and

results can be disastrous as well.

safety precautions.

Since BOTOX® has become a readily Continued education is vital in this field since the world of aesthetics acceptable part of popular culture, it can be easy for people to forget

and cosmetic surgery is rarely, if ever,

that the treatment is still a medical

stagnant. By remaining dedicated to

procedure with possibly fatal side

their chosen field and continuing to

effects.

hone their craft, plastic surgeons can

deliver the perfect BOTOX® to each

This has become even more

apparent as the FDA recently

of their patients all of the time.

warned the public that BOTOX® is being linked to dangerous botulism

Gregory Alan

symptoms which have led to death in

Wiener, M.D.,

some cases. These deaths seem to have occurred most often in children who are being treated with BOTOX® for

Board Certified Cosmetic and Reconstructive

cerebral palsy (it is worth

Surgeon who

noting that most of these

has been

cases involved very high

practicing at Resurrection Hospital

doses of BOTOX® such as

for the past 9 years. He was named

400-600 units rather than

a Consumer Reports “Top Surgeon”

20-50 units such as used

and completed his residency at the

in a cosmetic treatment).

University of Illinois at Chicago. Dr.

However, these tragedies

Wiener has been featured in several

should serve as a reminder

media outlets both nationally and

that BOTOX® should never

locally. Visit Dr. Wiener online at:

be considered a fun lunchtime

www.TheArtofPlasticSurgery.com

procedure or bachelorette

16—

F.A.C.S. is a

may-june 2008 | www.aesthetictrends.com

product listings

Dermal Fillers & Injectables Sun Protection Products

Aesthetic Trends & Technologies Product Listings are shown on the following pages for your buying power. Conveniently listed, you may refer to these products. If at any time you do not see a product listed here, please contact us by e-mailing the staff at product.listings@aesthetictrends.com. We will update the listings to include the products in which you are most interested.

spotlight

Dermik Laboratories Sculptra®

The Art and Science of Sculptra®

Sculptra is an enduring treatment cleared by the FDA for

since 1999 in over 150,000 patients under the trade names

restoration and/or correction of the signs of facial fat loss, or

New-Fill™ and Sculptra.

lipoatrophy, in people with human immunodeficiency virus. It

is the first FDA-cleared product of its kind for this condition.

microparticles of poly-L-lactic acid, a biocompatible,

Sculptra has been safely used outside the United States

Sculptra is an injectable implant that contains biodegradable,

Facial fat loss, or lipoatrophy, is the loss of fat beneath the

skin, which can result in sunken cheeks, indentations, and

synthetic polymer

hollow eyes. Sculptra is a safe, synthetic, and biocompatible

from the alpha-

material that is injected below the surface of the skin in the

hydroxy-acid

area of fat loss. It provides a gradual and significant increase

family. Sculptra

in skin thickness, improving the appearance of folds and

is reconstituted

sunken areas. No skin testing is required.

prior to use by the addition of Sterile

Volume

Duration

Safety

Water for Injection, USP (SWFI) to form a sterile non-

Restores fullness of the face, creating a more natural appearance

Improvements in dermal thickness lasting up to two years

Clinically proven safe and well tolerated. No skin test required Biodegradable, biocompatible

pyrogenic suspension.

Dermik Laboratories

888.728.5787

www.sculptra.com

may-june 2008 | www.aesthetictrends.com

17—

Allergan www.allergan.com 2525 Dupont Drive Irvine, CA 92612 714.246.4500 p

18 —

Product Source

Dispensed Shelf Life Price Measurement

Botox® Cosmetic Juvéderm 24 HV Juvéderm 30 HV Juvéderm 30 Zyderm® 1 & 2 Zyplast® CosmoDerm™1 Cosmoplast™

Botulinum Toxin Type A Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Bovine Collagen Bovine Collagen Human-Based Collagen Human-Based Collagen

Artes Medical, Inc. www.artesmedical.com 5870 Pacific Center Blvd. San Diego, CA 92121 858.550.9999 p 858.875.5556 f

ArteFill

PMMA

BioForm Medical Inc. www.bioformmedica.com 1870 Grant Ave., Suite 10 San Mateo, CA 94402 650.286.4000 p

Radiesse (formerly Radience FN)

CaHa with gel carrier

1.3 & 0.3cc

Fascia Biosystems www.fascian.com 11040 Santa Monica Blvd.,Ste 340 Los Angeles, CA 90025 888.332.7242 p

Fascian

Cadaver Tissue

Yes

Medicis Aesthetics www.restylaneusa.com 8125 North Hayden Road Scottsdale, AZ 85258-2463 800.550.5115 p

Restylane® Perlane®

NASHA gel

Sanofi-Aventis (Dermik Laboratories) www.sculptra.com 55 Corporate Drive Bridgewater, NJ 08807 800.981.2491 p

Sculptra (New -Fill)

Polylactic acid (PLA) hydrogel

Yes

Yes Yes Yes Yes No No No No

100 units/freeze-dried 100 units/freeze-dried 100 units/freeze-dried 100 units/freeze-dried .5, 1.0, & 1.5cc .5 & 1.0cc 1 cc syringe 1 cc syringe

24 months from date of manufacture

Ski n Req Test uir ed

U.S. Source Product

Rec o Reh nstitu ydr ted ate / d Ref rig era tio n

DERMAL FILLERS & INJECTABLES Product Listings

Regulatory Information

$417 /vial $200-$225 $200-$225 $200-$225 List List List List

No No No No No No No No

Cleared for Cosmetic Use FDA Cleared FDA Cleared FDA Cleared FDA Cleared FDA Cleared FDA Cleared FDA Cleared

$700 - $800 per cc

Yes

FDA Cleared

$250

Cleared for Vocal Fold, Tissue Marking, Oral/Maxillofacial Defects

Multiple sizes,standard 5 years & custom.Pre-filled with 80 mg of particles; comes in six sizes from 0.01 to 2.0 ml

$85 /syringe

FDA registered

1.0 ml syringes

18 months

$275 per cc

FDA Cleared in US & Canada Pending FDA Clearance

2 vials that are reconstituted into 3 x 1 cc syringes

N/A

$480/vial

FDA cleared for restoration and/or correction of the signs of facial fat loss (lipoatrophy)

Yes Yes Yes Yes Yes Yes Yes Yes

3 years 3 years 2 years 2 years

Yes

may-june 2008 | www.aesthetictrends.com

2 years

Product Source

ABR Development www.atlean.com Parc d’activité Aftalion Rue François Perroux 34670 Baillargues France (+33) 4 67 10 94 81 p (+33) 4 99 62 05 73 f

Atléan

BTCP

Adoderm www.adoderm.com lisabeth-Selbert-Stasse 5 D-40764 Langenfeld Germany +49 (0) 2173 / 101 91 80 p +49 (0) 2173 / 101 91 82 f

Varioderm Varioderm Fine Line Varioderm Plus Varioderm Subdermal

Non-animal Hyaluronic Acid

Atrium Medical www.atriummed.com Rendementsweg 24, LIII 3641 SL Mijdrecht The Netherlands 31.297.230.420 p Atrium Australia-Pacific www.atriummed.com L1 Bridgepoint 3 Brady Street Mosman NSW 2088 61.2.9960.0169 p

Advanta ePTFE Facial Implants

Dual-Porosity ePTFE

BioPolymer GmbH & Co. KG www.biopolymer.info Bahnhofsplatz 4 D-56410 Montabaur Germany 0049 2602 83868 0 p 0049 2602 83868 20 f

MATRIDEX® MATRIDUR® MATRIGEL®

Dispensed Shelf Life Price Measurement

Ski n Req Test uir ed

Sources Outside U.S. Product

Rec o Reh nstitu ydr ted ate / d Ref rig era tio n

DERMAL FILLERS & INJECTABLES Product Listings

N/A

2 x 1.0 ml syringes

Wide selection of oval 5 years and round strands, and other configurations

$285-$400 Varies depending on size and with/without attached trocar

Regulatory Information

CE Mark

CE Mark/TUV

Cleared in Australia

DEAE Sephadex

$250 - $350

Prollenium Medical Technologies ReDexis www.revanesse.com Revanesse 10670 Yonge St Revanesse Ultra Richmond Hill, ON L4C 3C9 Canada Toll Free 866.353.3015 905.508.6716 f

Hyaluronic Acid

$175 - $225 per cc

Cleared in Canada. U.S.Pending

Q-Med AB www.q-mediesthetics.com Seminarjegatan 21, SE-752 28 Uppsala, Sweden +46 18-474 90 00 p

Restylane Restylane Touch Restylane Perlane Restylane Sub-Q Restylane Lipp Restylane Vital

NASHA gel - a non-animal hyaluronic acid, stabilized with BDDE.

No No No No No No

0.7ml syringe 0.7ml syringe 0.7ml syringe 0.7ml syringe 0.7ml syringe 0.7ml syringe

18 months

$275 per cc

No No No No No No

FDA Cleared FDA Cleared FDA Cleared FDA Cleared FDA Cleared FDA Cleared

Rofil Medical Int’l N.V. www.rofil.com Heusing 16 4817 ZB Breda The Netherlands +31 (0) 76 5315670 p

Beautical 2 Beautical 5 REVIDERM Rofilan

Poly Acrylamide Poly Acrylamide Dextran - Sephadex Hyaluronic Acid

No No No No

Yes Yes Yes Yes

4 syringes/.05ml 4 syringes/1.0ml 4 syringes/1.0ml 2 syringes/1.0ml

2 years 2 years 2 years 2 years

$150 $190 $336 $235

No No No No

Not FDA Cleared

Tissue Science Laboratories www.tissuescience.com Victoria House,Victoria Road Aldershot, Hampshire GU11 1EJ United Kingdom (01252) 333.002 p

Permaco™

Porcine Dermis processed to yield a sterile collagen matrix

Various sizes of sheet goods 1mm in thickness

2 years in U.S. 5 years in E.U.

Varies according in size

FDA Cleared

may-june 2008 | www.aesthetictrends.com

CE Mark Not FDA Cleared

19—

Sun Protection Product Listings

Company Product Active Ingredients

SPF Size Form Rating

Abella Skin Care, Inc. www.abellaskincare.com 4240 Oak Circle Boca Raton, FL 33431 877.622.3552 p 561.620.7888 f

SPF 45 SPF 30+ SPF 30+ SPF 30+ SPF 30+

SolarShade ColorShade Light ColorShade Medium ColorShade Dark ColorShade Ebony

Octinoxate 6.50% & Titanium Dioxide (micronized) 4% Zinc Oxide 3% & Octinoxate 3% Zinc Oxide 3% & Octinoxate 3% Zinc Oxide 3% & Octinoxate 3% Zinc Oxide 3% & Octinoxate 3%

4 oz.(125 ml) 1.7 oz.(50 ml) 1.7 oz.(50 ml) 1.7 oz.(50 ml) 1.7 oz.(50 ml)

Cream Based Cream Based Cream Based Cream Based Cream Based

Professional Price $9.50 $12.00 $12.00 $12.00 $12.00

Suggested Price $21.00 $24.00 $24.00 $24.00 $24.00

Additional Information: Introduces the newest addition to their uniquely formulated protective sun care products; is mineral based, utilizing ultra-micronized titanium dioxide and zinc oxide as its active sunscreen ingredients. Oxybenzone free. ColorShade is non-oxidating pigment.

Allergan www.mdforte.com www.ViviteSkinCare.com 2525 Dupont Drive Irvine, CA 92612-1599

VIVITÉ® Daily Facial Moisturizer with SPF 30

Olive leaf extract, Vitamin E; Vitamin C; Superoxide SPF 30 dismutase; Licorice root; Suncreens

1.7 oz. (50 ml) Lotion

M.D.FORTÉ® Total Daily Protector SPF 15

Transparent zinc oxide; Vitamin E; Allantoin

SPF 15

2.5 oz (75g)

M.D.FORTÉ® Aftercare Environmental Protection Sunscreen SPF 30

Transparent zinc oxide; Vitamin E; Allantoin

SPF 30

2.5 oz (75g)

$24.50

$49.00

Lotion

$7.50

$15.00

Lotion

$12.50

$25.00

Additional Information:Based on exclusive GLX Technology™, the ingredients in VIVITÉ® Daily Facial Moisturizer with SPF 30 work synergistically to protect and rejuvenate the skin from the outside in and the inside out.Appropriate for all skin types, this light daily moisturizing sunscreen creates a protective barrier that shields from damaging UVA/UVB rays while simultaneously penetrating into the dermis to deliver glycolic acid and antioxidants that help nourish healthy, vital-looking skin.M.D.FORTÉ® Total Daily Protector SPF 15: The perfect daily-use lotion to protect the face, neck, chest, and hands against UVA/UVB exposure.Glycolic free. Recommended by The Skin Cancer Foundation as safe and effective sunscreen. M.D.FORTÉ® Aftercare Environmental Protection Sunscreen SPF 30 : Provides higher levels of transparent zinc oxide for higher levels of broad-spectrum UVA/UVB protection. Ideal for use following glycolic acid peels and laser procedures as directed by your physician. Glycolic free. Recommended by The Skin Cancer Foundation as safe and effective sunscreen. BioTherapeutic www.bio-therapeutic.com 2244 1st Avenue S. Seattle,WA 98134 800.976.2544 p

Shade™ 30

Ethylhexyl Methoxycinnamate, EthylHexyl Salicylate, Benzophenone-3, Butyl Methoxydibenzoylmethane,

SPF 30

6oz.Professional Chemical 3oz.Retail

6 oz.$19.95 3 oz.$11.55

3 oz.$23.10

CosMedical Technologies www.cosmedicaltechnologies.com info@cosmedicaltechnologies.com 3961 SW 47th Avenue Davie, FL 33314 954.587.8989 p 800.275.3627

Replenishing Sunblock SPF 36

Micronized Zinc Oxide, Aloe Vera, Beta Carotene, Colhibin and Elhibin, Cucumber Extract

SPF 36

1.7 oz. (50 ml) Pump Bottle

Contact Mfr.

$34.00

Aqua Guard Sunblock SPF 30

Micronized Titanium Dioxide, Ethylhexyl p-Methoxycinnamate

SPF 30

4 oz. (120ml)

Self-Locking Pump Bottle

Contact Mfr.

$18.00

Green Tea Sun Splash SPF 25

Parsol 1789 (Avobenzone) Octocrylene, Green Tea Extract, Aloe Vera

SPF 25

4 oz. (120ml)

Self-Locking Pump Bottle

Contact Mfr.

$18.00

Tinted Moisturizer SPF 15

Titanium Dioxide,Vitamins A&E, Hyaluronic Acid

SPF 15

1.7 oz. (50 ml) Pump Bottle

Contact Mfr.

$30.00

Additional Information:Replenishing Sunblock SPF 36– Delay premature aging with this state-of-the-art formula with Micronized Zinc and exclusive botanicals that help prevent the breakdown of collagen and elastin.Ideal for daily facial wear and can be used around the eyes.Formulated for all skin types. Aqua Guard Sunblock SPF 30– Sweatproof and non-irritating, this light waterproof formula provides maximum full spectrum face and body protection.Ideal for active lifestyles and sensitive skin, this sunscreen contains 70% less potentially irritating chemicals than most commercially available waterproof formulations. Green Tea Sun Splash SPF 25– Showers your body with antioxidant green tea and Vitamin E while protecting against damaging UVA/UVB sunrays.This daily antioxidant protector is waterproof, lightly textured and leaves your skin feeling pampered and protected. Tinted Moisturizer SPF 15– This lightly textured tinted facial moisturizer protects and hydrates your skin with Vitamin E and hyaluronic acid and gives skin a healthy vital glow. Daily use provides full spectrum sun protection and helps protect against premature aging and skin cancer.It can be worn alone or under makeup and is gentle enough to be used around and even on the eyelids.

20 —

may-june 2008 | www.aesthetictrends.com

Sun Protection Product Listings

Company Product Active Ingredients CosMedix www.cosmedix.com 3715 Northside Pkwy. Building 200 Suite 200 Atlanta, GA 30327 800.267.6334 p

SPF Size Form Rating

Professional Price

Suggested Price

Reflect SPF 30 Natural UV Protection

Titanium Dioxide 15%

SPF 30

4 oz.(120 ml)

Sunscreen

$21.00

$42-$63

Protect Daily Moisturizing UV Protection, SPF 17

Zinc Oxide 7.02%

SPF 17

1 oz.(30 ml)

Moisturizer

$21.00

$42-$63

Serious Protection SPF 28 Sunscreen

Zinc Oxide 11.6%;Titanium Dioxide 0.67%

SPF 28

3.3 oz.(100 ml) Sunscreen

$20.00

$40-$60

Additional Information: Reflect - The only natural spray-on sunblock on the market that blocks the full spectrum of UVA/UVB/UVC rays.Reflect is excellent for outdoor activities, and can be worn on both the face and body.In addition to micronized titanium dioxide, Reflect contains L-glutathione, a potent anti-inflammatory to protect skin cells from free radicals.Protect - A daily, therapeutic, moisturizing sunscreen to hydrate dry or stressed skin.Natural emollients, including jojoba, wheat germ oil, and glycerin, nourish skin and protect natural moisture factors while ZinClear™ blocks damaging ultraviolet radiation.Serious Protection - The newest addition to the CosMedix sunscreen family, Serious Protection utilizes natural titanium dioxide and zinc oxide in a facial-quality formula to fully protect skin from head to toe. Serious Protection blocks both ends of the UV spectrum, making it a necessary final step in clinical treatments.

Dr. Michelle Copeland Skin Care www.drcopelandskincare.com 1001 Fifth Avenue New York, NY 10028 866.833.7546 p

SPF 40 Lotion Mist Sunblock

Clear Zinc Oxide, Antioxidants, Aloe

SPF 40

4 oz.(120 ml)

Daily Moisturizer with SPF 20

Clear Zinc Oxide, Antioxidants (Vitamins A & E), Lipoic Acid

SPF 20

Sunless Tanning Bronzer w/ SPF 15 Lip Protector with SPF 15

N/A

$30.00

4 oz.(120 ml)

Bottle with Sprayer Tube

N/A

$48.00

SPF 15

4 oz.(120 ml)

Tube

N/A

$32.00

SPF 15

.5 oz.(15 ml)

Jar

N/A

$18.00

Additional Information: SPF 40 Lotion Mist Sunblock– Developed by renowned New York plastic surgeon, Dr.Michelle Copeland this lotion-mist is the only high SPF product in a spray mist.Gentle yet effective, it provides SPF40 protection to block both UVA/UVB rays and is PABA free with soothing Aloe to reduce inflammation.Great for travel and safe for children. Prevents sun-induced skin damage. Daily Moisturizer with SPF 20 – this unique moisturizer with SPF-20 protection from UVA/UVB rays is hydrating without clogging pores, contains Vitamins A & E and Lipoic acid powerful antioxidants for smooth, supple, youthful skin. Sunless Tanning Bronzer w/ SPF 15– this luxurious sunless tanning bronzer contains SPF 15 protection for a safe golden glow all year round.Contains antioxidants to leave your skin smooth,supple and radiant. Lip Protector with SPF 15– provides a powerful blend of antioxidants to prevent chapping, cracking and dryness - while erasing fine lines around the lip area.Plus its SPF-15 protects lips from harsh ultraviolet rays.

Fallene, Ltd. www.totalblock.com 2555 Industry Lane West Norriton, PA 19403 1.800.332.5536 p 610.630.6202 f

Cotz

Jan Marini Skin Research, Inc. www.janmarini.com 6951 Via del Oro San Jose, CA 95119 800.347.2223 p 408.362.0140 f

Antioxidant Daily Face Protectant SPF 30

Titanium Dioxide, Zinc Oxide

SPF 58

2.5 oz (75 ml)

Powder

N/A

$26.99

Additional Information:Total Block introduces the newest addition to their uniquely formulated protective sun care products.COTZ is mineral based, utilizing ultra-micronized titanium dioxide and zinc oxide as its active sunscreen ingredients.

Octinoxate, Octisalate, Benzophenone and Avobenzone

SPF 30

2 oz.(60 ml)

Lotion

$21.00

$50.00

Additional Information:Daily Face Protectant SPF 30 combines a cutting edge microscopic sponge encapsulation system and PhytoMelanin™ plant extract that mimics human melanin and provides further UV and antioxidant protection.

may-june 2008 | www.aesthetictrends.com

21—

Sun Protection Product Listings

Company Product Active Ingredients

SPF Size Form Rating

June Jacobs Spa Collection www.junejacobs.com 460 Park Ave. New York, NY 10022 866.586.3522 p

Oil Free Sunscreen Mist SPF15

Allantoin Oil/Aloe Vera Oil Extract/Dimethicone/ Octinoxate/Octisalate/Oxybenzone

SPF 15

4 oz.(120 ml)

Micronized Sheer SPF30

Pomegranate Oil Extract/Green Tea Oil Extract/Algae, Extract/Titanium Dioxide/Zinc, Oxide/Ethylhexyl/ Methoxycinnamate/Ethylhexyl Salicyate

SPF 30

Advanced Sun Resistance SPF30

Pomegranate Oil Extract/Green Tea Oil Extract/ Allantoin Comfrey Root Oil Extract/Aleo Vera Oil E xtract/Octinoxate/Octisalate/Meradimate/ Oxybenzone/Parsol 1789 (Avobenzone)

Mist

Professional Price

Suggested Price

N/A

$36.00

3.7 oz.(110 ml) Sunscreen

N/A

$32.00

SPF 30

3.7 oz.(110 ml) Sunscreen

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Perfecting Body Hydrator SPF 30

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22 —

Silkscreen

Octinate7%,Octocrylene2%,Octtisalate4.86%, and Oxybenzone 3%

SPF 30

1.7 oz. (50 ml) Ultra light facial lotion in an airless pump

$34.00

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Additional Information:To neutralize free radicals and enhance a healthy appearance we have added green tea extract,white tea extract and vitamin C.Also, Hydrolyzed Silk to moisturize and condition and to reduce the appearance of fine lines and wrinkles.This product is non-greasy, fragrance free and absorbs oil. Silkscreens’active filtering agents are organic vs.a block like zinc oxide which is inorganic.These agents absorb the UV rays (100% UVB, short wave UVA).(Ultraviolet radiation is generally broken down into three forms: UV-A, UV-B, or UV-C.Only UV-A and UV-B energy reaches the skin, and only UV-B is associated with the severest forms of skin damage such as wrinkles, sunburn or melanomas). Silkscreen is not waterproof.

may-june 2008 | www.aesthetictrends.com

Roundtable

Cynosure

Six physicians come together to share their experience with the increasingly popular laser-assisted lipolysis technology known as the Smartlipo. Featured here are some of the clinical experts who have integrated the Cynosure Smartlipo with TriActive into their practices. Visit the ATnT website and click on the ATnTechnologies PodCAST interviews™ Series that will allow you to also listen to an exclusive interview with CEO Michael Davin of Cynosure. Gain perspective on the marketplace through the experience of one of the top manufacturers today.

Benjamin

De Corato

Di Bernardo

Katz

at t

Smartlipo™ with TriActive

laser n & light technology

laser & light technology

Klainer

Dr. DiBernardo The Smartlipo is a minimally invasive

surgical procedure designed to liquify fat and tighten

What is the clinical mechanism of combining Smartlipo and TriActive and therapies?

tissue. After the Smartlipo procedure we then try and aspirate out as much of the fat and cellular debris as possible. The remaining materials would be left in the body to be reabsorbed and/or eliminated by the body naturally. The TriActive allows us to speed up the

Dr. Benjamin TriActive is utilized to facilitate contour

healing and waste elimination process. The patients

smoothing. Clinically, the use of TriActive therapy

can experience some edema and swelling, which is to

enhances the smoothness of Smartlipo.

be expected after any surgery. The TriActive begins

Dr. DeCorato This is a two-part process - Smartlipo

to reduce these effects with its cooling head, diode

thermally affects the area by heating the fat through the

lasers, and massaging action by stimulating the body’s

use of laser energy and causes contraction of the treated

circulatory and lymphatic systems.

area. Swelling occurs and the use of the TriActive (deep

Dr. Katz The use of TriActive after Smartlipo is a great

lymphatic massage) allows for faster recovery time, is less

benefit in the treatment process for patients because of

edematous, and decreases the amount of swelling.

its massage and laser capabilities. It reduces swelling

may-june 2008 | www.aesthetictrends.com

23—

laser & light technology

and bruising as well as helps with the overall result of the cellulite treatment and improves recovery time.

Dr Klainer The clinical mechanism of combining TriActive and Smartlipo lies in the properties of the TriActive. Through the rhythmic massage and the laser diodes, blood flow to the treated area is enhanced and lymphatic channels are opened. This improves the speed with which the edema is absorbed.

What are the clinical advantages of using the TriActive in combination with Smartlipo? Pre-op? Post-op? Dr. DeCorato Routinely I use TriActive post-op. Rarely pre-op, unless a patient comes to me with

problems from a liposuction procedure performed by

How does this type of comprehensive treatment differ from conventional liposuction?

another physician. I normally provide 4 treatments with the TriActive after liposuction. You find that one can achieve a more controlled result, more postoperative manipulation. Rarely can one achieve total symmetry. It is very rare. Usually there is more fat in

24 —

Dr. Benjamin This treatment non-invasively provides

one area with one side always a little different. With

for an additional modality of therapy that helps me to

this combination procedure, we can get a better,

improve upon the outcome of lipolysis procedures.

more asymmetric result. By applying TriActive post-

Dr. DeCorato Smartlipo is an adjunct to liposuction.

op, I can control swelling and response.

Aspiration techniques are used, supplying energy to

Dr. DiBernardo Some of the obvious advantages

disrupt the fat cells to disrupt and tighten the skin by

of both the technologies is they are both minimally

transmitting energy. I want to get the effect of less

invasive and extremely well tolerated by the

swelling. It’s a way that I can control it very easily.

patients. On the clinical side, pre-op the TriActive

Dr. DiBernardo With conventional liposuction, any post-

increases blood flow to the area that will be

op treatments such as endermology or massage would

treated, stimulates the lymphatic system to begin

usually begin 4 to 6 weeks after the procedure. When

to aid in waste removal, and softens the area and

combining Smartlipo and TriActive, due to the minimally

the bands of septa, making the physical nature of

invasive nature of laser lipolysis and the gentleness of

standard liposuction less taxing for the physician.

the TriActive, you can begin TriActive treatments 24 to 48

Post-op the TriActive treatments can be started

hours after the surgical procedure.

nearly immediately after a Smartlipo or standard

Dr. Katz When using a laser the main difference,

liposuction procedure. The TriActive stimulates

particularly with Smartlipo, is that it tightens the skin

increased blood flow to the treated area, increases

which we don’t normally see in conventional liposuction.

lymphatic drainage, and decreases the post-

It removes fat and eliminates areas of loose, baggy skin.

operative edema and swelling normally associated

We use a very tiny cannula (1mm), which is less traumatic

with the procedure.

to the skin with a faster recovery time. The procedure is

Dr. Katz Suction and laser, improving cellulite,

done with local anesthesia. Conventional liposuction is

reducing swelling and lumpiness after, faster

normally performed under general anesthesia.

recovery time.

Dr. Klainer In my practice I have used the TriActive after

Dr. Klainer I do not use the TriActive pre-

liposuction for 3 years with excellent patient and clinical

operatively. Post-operatively I believe the patients

response. I have since continued the use of the TriActive

experience faster healing times, faster edema

with my Smartlipo patients.

absorption, and improved skin contraction.

may-june 2008 | www.aesthetictrends.com

Smartlipo to my practice my percentage of corrections

has steadily decreased. With that being said, the

Have your patient outcomes changed as a result of using TriActive? Dr. DeCorato Yes. Seeing results faster due to less swelling, looking for results 5-6 weeks for very dramatic improvement as opposed to 3-4 months. Six months for final results. As long as the patient is happy – in this day and age – they want the results rapidly with change in contour and clothing size. We take post-op photographs at 5-6 weeks (normally we would not take post-op photos that early). Dr. DiBernardo The TriActive appears to reduce the post-op edema and swelling, which from the patients’

TriActive is used as an additional tool to soften the area and help to re-modulate the fat, minimizing the need for touch-ups. Dr. Katz If one compares the touch-up rate after liposuction with Smartlipo, there is a significant improvement. A current study shows a significant difference, which is attributable to the precision that we

laser & light technology

with the liposuction procedure. First off, since adding

get with using the two devices together: 12% standard lipo vs 3% Smartlipo with an average change of 3–4 mm. Dr. Klainer I feel that the rhythmic massage of the TriActive decreases post-operative irregularities which is the most common concern for patients, therefore improving patient satisfaction with all liposuction procedures.

perspective, leads them to even faster recovery. My patients feel they are returning to normal activities faster with the additional TriActive treatments.

Dr. Katz Yes. Shortens recovery – more comfortable postoperatively with less bruising and swelling. Dr. Klainer My patients appear to respond faster in their comfort level and in the speed of the skin contraction when TriActive is used.

What is your protocol for using TriActive before and after a Smartlipo procedure? Dr. Benjamin I am in the process of implementing a consistent program where a patient would have two

treatments per week prior to surgery, two treatments

How has the need for correction following liposuction changed as a result of integrating TriActive in the procedure?

3-4 weeks post-surgery. This will be accessed and manipulated on a regular basis. Dr. DeCorato It depends on the patient and is usually seen as pre-op deformities from patients coming from other doctors. Primary cases are first-time lipo patients, and we don’t treat pre-operative but post-operatively

Dr. DeCorato We have a no-charge policy for revisions

in packages of 4 treatments free of charge at intervals

(instead of correction), if they agreed to something and

of 2 times per week, at a minimum of 1 time per week

didn’t get the results. I have seen patients come to me

immediately after liposuction. Initial treatments are used

with extraordinary results because they want perfection.

to reduce swelling and help to reach rapid results.

The bar has been raised. Not a drop in percentage

Dr. DiBernardo Pre-op: I like to have the patients

of revision. This procedure has helped to perfect the

complete 4 to 6 treatments before the Smartlipo

treatment even further in my experience.

procedure, beginning 2 to 3 weeks out. Post-op: I will

Dr. DiBernardo Corrections have always been an issue

have the patients follow up with an additional 6 to 8

may-june 2008 | www.aesthetictrends.com

25—

laser & light technology

treatments (2 per week). Dr. Katz Post-op typically, starting about 2 to 3 weeks,

1 or 2 times per week for 3 or 4 weeks, with a rapid recovery time. Dr. Klainer I offer all of my patients TriActive, commencing 1 month after surgery. I recommend a series of 10 treatments over a 4 to 5 week period.

How does offering combination therapy helped you to increase patients’ loyalty to your services (return rate, new treatment acceptance, etc…)? Dr. Benjamin Return rate and new treatment acceptance are projected to increase along with an increase in new patient

visits.

What are the benefits of combining TriActive and Smartlipo for your practice? Dr. Benjamin Thus far, I have not changed my fee structure. I have implemented the therapy to enhance outcomes. Patient care and in turn their knowledge of our caring programs which in turn produces consistently superlative results becomes the standard of my practice. This becomes the associated word via patient to potential patient contacts. Dr. DeCorato Reaching rapid results quicker. I need to counsel them that this is a process. The patients don’t come out of surgery looking the way they expect. All patients react differently to this trauma, but ultimately the treatment gives the result they were looking for. Dr. DiBernardo As a Plastic Surgeon, I practice total body sculpting, and I incorporate systems that help

Dr. DeCorato Patients love the feeling. The tissue is not hard, not as swollen, and it helps to increase a higher standard of customer service within the industry. The more comfort your patients feel is important, and we’re giving them the customer service they deserve. It is important to understand that this is still surgery, and there are risks. We try to minimize risk, but it is an invasive procedure, and we need to do it properly. Dr. DiBernardo Both the Smartlipo and TriActive have been very well received by my patient base, and their satisfaction rate is very high. Having my patients come back to my practice for additional post-op treatments has given me additional opportunities to see them, continue to monitor their progress and introduce them to some of the other procedures I offer. It is a win-win…for both the patient and my practice. Dr. Katz It translates into people coming in for more procedures, treatments such as: sunspots, spider veins, lesions. Patients are more apt to try multiple procedures beyond the Smartlipo because they feel a connection to the practice.

me maximize the patient’s end results. It also helps separate my practice from what other physicians are

offering in my community. I have now incorporated the TriActive treatments into the majority of my liposuction and Smartlipo procedures. Dr. Katz People are appreciative of post-operative care, instead of a follow-up. It increases loyalty with

How do you market the combination of TriActive treatments with a Smartlipo procedure to your patients?

the patients, and they see it as the practice providing

26 —

above and beyond traditional care.

Dr. Benjamin We see success in using in-house marketing

Dr. Klainer The greatest benefit is that I can offer

through advertising available treatments. We emphasize

my patients shorter recovery times, decreased risk of

the combination of these two modalities as routine at no

irregularities, and overall better results.

cost to the patient as part of my contouring treatment with

may-june 2008 | www.aesthetictrends.com

from the surgical aspect and is a plus for us. We want

Dr. DeCorato We advertise a 4 post-op TriActive

to retain our patients for future procedures for our body

treatment package as part of the cost of the procedure.

contour and facial surgery. Patients can return to work

We also offer our cellulite package to either a new

within 5 days, depending on how extensively they are

liposuction or Smartlipo patient at a reduced rate,

treated. Recovery time for the neck area is within 2 days,

compared to the cellulite treatments that we internally

3 days for neck compression, and then at night for the

offer our current patient base.

next 1–2 weeks. Recovery time for a leg procedure is 4-5

Dr. DiBernardo Discussions about the TriActive are

days, as long as they wear the compression garment for at

now part of the consultation process for both standard

least 2 to 4 weeks.

liposuction and Smartlipo. The costs of the additional

Dr. DiBernardo The TriActive is the most comfortable

TriActive treatments are included in the overall price of

laser procedure I offer in my practice. The majority of

the liposuction or Smartlipo procedure. Including the

patients also say they can feel the treatment helping to

TriActive procedure in my consult has also allowed me to

“flush out” their systems. The patients believe that the

differentiate my services from others in my area offering

additional TriActive treatments are helping them return to

similar services. The patients see the added value and my

normal activities much sooner.

desire to help them achieve the best results possible.

Dr. Katz Very happy with results. Fast recovery with local

Dr. Katz The Smartlipo procedure sells itself, so we do

anesthesia and very little side effects. Some patients take

very little marketing. People ask for the procedure by

only one day of recovery time after the procedure and

name. Marketing efforts include quarterly newsletters

back to work the next day. We have

with articles about Smartlipo that have helped other

them use compression garments

patients see the benefits. We also have a patient lecture

for 3 days with neck procedures

series in our office. Patients are spreading the word about

and 2 weeks for the body as

Smartlipo. Very often I see patients who are referred by

opposed to the normal 6

family or friends. My patients are happy with results.

weeks compression garment

Word of mouth is a powerful marketing tool.

/ healing period. One

Dr. Klainer I do not market the combination therapy other

should make sure the

than to my surgical patients.

garment fits properly.

laser & light technology

the Smartlipo and TriActive.

Patients order the compression garments themselves from a source

10.

we refer them to, either a

What feedback have you received from patients who have received a Smartlipo treatment with TriActive?

retailer or online. Some garment companies suggested are: My Secret, very caring people, Rainey Wear, and Veronique.

Dr. Benjamin Thus far, patients are very satisfied with the

Dr. Klainer All of the

results, and they also refer other patients to do the same.

patients who have been

Dr. DeCorato They love the results after TriActive. The

treated with combination

treated area is firm, there is visible improvement, the

therapies felt that their

swelling is taken out of treated area, is temporary and

recovery was easier and

softer, more comfortable. The treatment is like going to

faster than what they had

the hair salon - not a procedure. It puts some distance

anticipated.

may-june 2008 | www.aesthetictrends.com

27—

laser & light technology

marketTRENDS Aesthetic Device Industry Update By Anthony Vendetti, Editorial Advisor

Noted for being ranked third on the 2006 Forbes.com/ StarMine list among Stock Pickers in Health Care Equipment & Supplies and Maxim Group’s Director of Research and Senior Healthcare Analyst, Anthony Vendetti has joined the Editorial Advisory Board of Aesthetic Trends. Each issue he will provide our readers with sound advice and market trend information to support physicians in our industry.

2008 MARKET OUTLOOK Companies with new technology introductions, deep R&D development pipelines, and high exposure to overseas markets should emerge as industry leaders, in the opinion of the Maxim Group analyst team. Companies relying solely on aggressive sales and marketing campaigns could become laggards. While we forecast subdued growth in 2008, Maxim believes that the collective pipeline for product introductions supports our current 8%-13% y/y growth outlook for the industry.

INNOVATION AND INTERNATIONAL DISTRIBUTION Innovation and international distribution should set leaders apart from laggards in 2008. The aesthetic industry has evolved rapidly over the past two years; however, the strategies for success have largely remained constant, albeit with a few minor changes. Maxim continues to believe that companies with large installed bases coupled with a strong development pipeline of new technologies will remain industry leaders. While Maxim Group believes that

28 —

aggressive sales and marketing campaigns are also still vital in order to remain competitive, we do not believe that this strategy alone will yield above average performance through 2008. The campaigns must be supported with technology innovation. Therefore, companies that adopt and/or maintain product differentiation strategies (introducing substitute products with superior qualities or products that complement existing applications in the physician practice) should continue to outperform. The major risk in 2008 is pricing, in our opinion, given the weak economic conditions in the United States. Typically, superior technologies command premium pricing and have not been affected by the economy. However, a protracted recession combined with the credit crunch could impact the non-core market, particularly medi-spas. As a result, we believe that companies with a diversified customer base, both in terms of physicians (core and non-core) and geographically, will be able to mitigate pricing risks. Accordingly, we believe that companies with a large and growing international presence will have an advantage over those exclusively focused on North America. Key areas of international growth include many regions within the E.U. and APAC regions, and we expect certain companies to place a greater emphasis on increasing both direct and indirect distribution channels abroad to further penetrate these regions.

PRODUCT LAUNCHES Prospective product launches could support growth in 2008. Several new and prospective product launches should help drive revenue in 2008. Thermage’s launch of its CL tip (cellulite) in March ’08 could prove to be a significant

may-june 2008 | www.aesthetictrends.com

growth driver for the company as the procedure is designed to provide over six months of efficacy, which is longer than many other light and/or laser-based procedures currently on the market. Thermage is a publically traded medical device company that develops and markets radiofrequency (RF) technology for aesthetic applications. Thermage went public in November 2006. www.thermage.com Cynosure introduced two complementary products for its Smartlipo and Affirm systems at AAD ‘08, which we believe should improve the functionality of these systems and help support their continued uptake through 2008. Additionally, we believe the international deployment of the Smartlipo platform (expected 2Q08) bodes well for the company. Cynosure, Inc. is a publicly traded medical device company that develops and manufactures an array of laser and lightbased technologies for aesthetic and cosmetic treatments. CYNO went public in 2005. www.cynosure.com Syneron released its LipoLite system for laser-assisted liposuction in 2Q08, which could prove to be a growth driver for the company given the continuing demand for the Smartlipo system and its relatively low penetration levels in the domestic market (we estimate single digits). Additionally, the company’s recently-introduced VelaShape appears to be gaining significant traction. Syneron Medical manufactures and distributes medical aesthetic devices that are powered by its proprietary, patented ELOS combined-energy technology of bi-polar Radio Frequency (RF) and optical energy (either laser or light). Syneron went public in August 2004. www.syneron.com Candela’s cellulite bodyshaping product is scheduled to hit the market 1Q09. Candela Corporation is a publicly traded medical device company that develops, manufactures, and markets laser and light-based technologies for applications in the aesthetic market. www.candelalaser.com

ThermaTip™CL

By Mitchell Chasin, M.D.

Nearly 90 percent of post-pubescent

help combat the appearance of cellulite

improvement in the appearance of

women experience some degree of

but are either invasive (liposuction,

cellulite, Thermage opted to wait to

cellulite. Cellulite is a condition that

injections) or require numerous visits

launch their cellulite treatment until

occurs when the skin becomes dimpled,

and provide short-term results. In

they had completed long-term studies

usually on the upper posterior, anterior

an effort to offer a more effective

that provided single treatment efficacy

thighs, and buttocks area.

alternative to other therapies, Thermage lasting at least six months. Recent

launched its ThermaTip™ CL treatment

follow-up field marketing evaluations

debated and are believed to be linked to

tip and Cellulite procedure in March

have shown patients who have results

metabolism, physiology, hormones, diet,

2008.

lasting more than one year.

and lifestyle. Physiological disorders

include abnormal hyperpolymerization of

21-month period,

the fibrous septae and connective tissue,

Thermage studied

changes in fat cell size and shape, and

various treatment

chronic venous insufficiency. While good

technologies and

diet and exercise may help prevent some

methods until

women from experiencing excessive

they perfected

cellulite, most women who have followed

a combination

rigorous diet and exercise routines still

of parameters

cannot significantly improve or eliminate

that provided

their cellulite without some kind of

the best results

clinical intervention.

and allowed for the most comfortable

The causes of cellulite have been

Over a

The technical advantage comes from the patented ThermaCool™ System and delivery of monopolar capacitive radiofrequency (RF) energy which uniformly provides volumetric heating deep into the dermis and subcutaneous tissue to improve elasticity and equilibrium of the fibrous septae and collagen connective tissue while at the same time increasing circulatory system health. The technical advantage comes from

treatments within reasonable time

the patented ThermaCool™ System

THERMAGE TECHNOLOGY

periods. Despite an FDA clearance

and delivery of monopolar capacitive

in October of 2006 for the temporary

radiofrequency (RF) energy which

Many therapies have been used to

at t

A Single Treatment, Non-Invasive Option for Improving Cellulite

laser n & light technology

laser & light technology

may-june 2008 | www.aesthetictrends.com

29—

laser & light technology

approximately 25 to 50 percent higher than other treatments if you factor the amount of hours required for repeat visits.

THERMAGE CELLULITE PROCEDURE

The Cellulite procedure by

Thermage starts by choosing ideal candidates with appropriate expectations. Results will vary from little change to considerable improvement. Thermage provides a Glynoid Lipodystrdophy Scale to clinicians wanting to evaluate appropriate Before Treatment (Left) and After Treatment (Right).

patients. Only candidates with grade II or grade III are considered appropriate.

uniformly provides volumetric heating

visits over a period of months. The fact

Patients should be in good physical

deep into the dermis and subcutaneous

that Thermage is only one treatment

shape, within 10 to 15 pounds of their

tissue to improve elasticity and

means that patient compliance is 100

ideal weight, and able to maintain

equilibrium of the fibrous septae and

percent; and as most clinicians know,

weight stability for long periods of time.

collagen connective tissue while at the

compliancy is a big issue when trying to

Their skin should have only mild to

same time increasing circulatory system

achieve successful results and satisfied

moderate laxity.

health. Over time this helps smooth

patients. Second, Thermage studies

The Cellulite procedure by Thermage starts by choosing ideal candidates with appropriate expectations.

30 —

The patient’s weight, measurements,

have proven that

and photographs should be taken

the effects last

pre-treatment and at various intervals

at least one year

up to six months to document the

and probably

improvements. Thermage provides

much longer. This

extensive guidelines demonstrating

means periodic

how to measure and take photographs.

dimples and improves skin texture. The

re-treatments to maintain efficacy are

new cellulite treatment tip has a deeper

not required. Third, the ThermaTip CL

is important to properly mark the

heating profile (4.3mm) similar to the

is available to its entire installed base

treatment areas. Skin laxity reveals

new ThermaTip DC treatment tip for

of physicians without any upgrade

cellulite. Therefore, draw vectors

Body Shaping but possesses a modified

or additional investment in capital

(arrows) in the direction you desire

cooling parameter that exerts more

equipment.1 Comparable devices on

contraction and circle problem areas

specific effects on cellulite.

the market (including Alma’s Accent,

such as “saddle bags.” Always mark

Syneron’s VelaShape, Cynosure’s

patients while they are standing, and

ThermaTip CL ADVANTAGE

TriActive LaserDermology, and Eleme’s

then apply the treatment grid when

SmoothShapes) typically require

the patient is lying down. It is also

four important advantages compared to

an investment of approximately

important to mark the buttock crease to

other therapies on the market. First, it

$50,000 to $125,000 to get started.

avoid treating over this area as this may

requires only one treatment compared

Fourth, procedure profitability is quite

flatten the area, which is not desired by

to other therapies that can require 6-14

high given that hourly revenue is

most patients.

The ThermaTip CL appears to have

may-june 2008 | www.aesthetictrends.com

While assessing the patient it

Select the appropriate size pulse

significant results. Not all patients

count treatment tip. Tips are available

will achieve these same results. 3-D

in 900 and 1200 REP counts. Depending

black-and-white images were taken

on the size of the treatment area, most

with a Canfield Vectra system. At

patients will require 600-900 pulses per

four months, the post-op photos show

thigh area. Follow the treatment level

smoothing in the treated areas. The

settings provided by the manufacturer

Vectra can also be used for guaging

and treat to the level that is hot but

the depth of tissue before and after

tolerable for the patient. Treat using the

the treatment. Pre-treatment areas

recommended staggered pass technique

can be monitored for visible signs at 4

which is circle-square-circle-square

months post-op and the same area is

and distal to proximal. One to four

almost smooth.

staggered passes are recommended

over the marked areas. The number of

in skin tightening for more than

passes will depend on the severity of the

five years with more than 450,000

cellulite and treatment pulses available.

procedures completed worldwide.

The average treatment takes up to 2

It is a safe and effective treatment

hours.

with very high satisfaction rates as

Mitchell Chasin,

reported by a 14-physician, multi-

M.D. is the

and may only be due to temporary

center consensus panel study written

Medical Director

swelling. Patients should have no

by Jeffery Dover, M.D., and Brian

of Reflections,

lasting discomfort after the procedure

Zelikson, M.D.2 Given my personal

Center for

and can return to their normal routines

experience and success using Eyes

Skin and Body.

immediately.

by Thermage™ and other Body by

Since the 1990s

Thermage™ treatments, I anticipate

Dr. Chasin

Results may not occur immediately

Thermage has been the leader

REFERENCES 1

nticipated ThermaTip CL (for A Cellulite) Launched at ADD; Pacific Growth, Equity Research, Thermage, Inc., Feb. 4, 2008, DeGiralama, D.M.

esults of a survey of 5,700 Patient R Monopolar Radiofrequency Facial Skin Tightening Treatments: Assessment of Low-Energy, Multiple-pass Techniques Leading to End Point Algorithm. Dover, J.S., Zelikson, B., and the 14 member panel, Dermatology Surg. 2007; 33:900-9007, September 2007.

EXPECTATIONS AND RESULTS

the new Cellulite procedure to fulfill

has devoted himself fully to the field

Thermage clinical studies have

the need for an improved cellulite

of Laser, Aesthetic, and Cosmetic

recorded patients with moderate to

treatment.

Medicine. Dr. Chasin is a Diplomate of

laser & light technology

the American Board of Laser Surgery, a Fellow of the American Society for Laser Medicine and Surgery, and a member of the International Society of Cosmetic Laser Surgeons and American Society of Cosmetic Dermatology and Aesthetic Surgery. Dr. Chasin also serves as a nationwide lecturer and teacher himself. He is often seen on TV and is frequently quoted in magazines and journals nationwide. For more information, please contact Dr. Chasin at 973.740.2444 or visit his site at Before Treatment (Left) and After Treatment (Right).

may-june 2008 | www.aesthetictrends.com

www.reflectionscenter.com.

31—

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Long after the shorts and tank tops have been packed away, people continue to head to Agape Medical Spa. 460 hair removal and skin rejuvenation treatments every month. See how they got there. CandelaGetThere.com

product listings

Evolving Aesthetic Technology Laser & Light Technology Ultrasonic Devices

spotlight THERMAGE ThermaTip™ CL

Introducing the Cellulite procedure by Thermage and new ThermaTip™ CL treatment tip

By using new

procedural guidelines and the ThermaTip CL treatment tip, collagen connective tissues

According to a recent study nearly 90% of women

are restored and circulation

experience some degree of cellulite, and the demand for noninvasive cellulite treatments in the U.S. is expected to nearly

is improved to help smooth skin and reduce the appearance of

double to over 750,000 procedures per year by 2011.

cellulite.

This treatment is ideal for patients who have tried diet and

Results vary from subtle to dramatic. Generally

exercise or even other cellulite treatments without success. Now

improvements may be immediately visible and continue to

they can benefit from:

improve for up to six months. Results are long-lasting and

• A single treatment with no surgery, injections, or

depend on your skin condition and the aging process.

• Smoothing of dimples and improved skin texture

• Long-lasting results

downtime

Thermage

510.782.2286

www.thermage.com

may-june 2008 | www.aesthetictrends.com

33—

evolving aesthetic technologies Product Listings Source

Aesthera www.aesthera.com 6111F Southfront Road Livermore, CA 94550 877.275.4779 p Ageless Aesthetics www.agelessaesthetics.com 6500 S Quebec St. #270 Denver, CO 80122 877.721.7975 p

Product

Aesthera Photopneumatic (PPx) System

Technology

Photopneumatic Technology

Specifications / Treatments

Price

400-1200 nm, 33-10 j/cm2, 2ms

$29,000

Additional Information: 1 yr. warranty. 25% Vitamin C lipid soluble serum.

Ultra

Micro current, Ultrasound, Light Therapy ,

Exfoliation, wrinkle treatments, product penetration and non-surgical facelifts

Cont. Mfr.

Quantum

Micro current

Non-surgical Facelifts

Cont. Mfr.

Additional Information: Equipment includes training and specialty products. Units are touch-screen operated and contain multiple pre-programmed treatments.

Alma Lasers www.orionlasers.com 6555 NW 9th Avenue Suite 303 Fort Lauderdale, FL 33309 954.229.2240 p 954.229.8310 f

Sonata

Diode

Harmony

AFT, Long Pulse

Harmony / Pixel

Nd:YAG. Q-Switched Nd:YAG, Pulsed UVB 2940 nm Er:YAG

Repetition rate up to 3 Hz, spot 10 x 12 mm, Fluence 5-100j/cm2, pulse width 10-400 msec, contact cooling, electrical 110, weight of unit 44 lbs., cart 92 lbs. Dimensions WxDxH unit 8”x12”x18” cart 15”x25”x28”. For hair removal treatments. Uses light from wavelengths 250 up to 950. Electrical 110, wt unit 88lbs cart 88 lbs.Size of unit WxDxH 26”x18”x16”cart 22”x22”x30”. For skin rejuvenation, vascular and pigmented lesions, tattoo removal, hypopigmentation, leg veins, hair removal, skin resurfacing treatments. Fractional ablative skin resurfacing.

$67,000 $109,700

Contact Mfr.

Additional Information: Harmony - Advanced Fluorescence Technology and Lasers in one unit. *Unit is $39,700.You build your own unit.Each handpiece is priced so you can pick and choose by application: Acne 420nm $5,000,Vas and Pig 540nm $5,000, SR 570nm $5,000, HR 650nm $5,000, UVB $15000, Long Pulse Yag $15,000, Q-Pulsed Yag $20,000, Erbium $18,000.Now available – the ST handpiece. IR handpiece for Skin Tightening.New tip for the Q-Switched Yag handpiece for more treatments.New home care acne treatment available. Aesthetic Technologies www.parisianpeel.com Aesthetic Technologies, Inc. 2150 West 6th Ave., Ste. J Broomfield, CO 80020 800.262.4412 p CoolTouch, Inc. www.cooltouch.com 9085 Foothills Blvd. Roseville, CA 95747 800.378.7222p

Cutera www.cutera.com 3240 Bayshore Blvd. Brisbane, CA 94005 888.4CUTERA p

34 —

Elite

Ultrasound

1 & 3 MHz. 2.2 watts/cm2 Modified CW & Pulse Modes. For skin rejuvenation treatments.

$5,900

Laser-Assisted Lipolysis and Skin Tightening

$99,950

Additional Information: 1 yr. warranty. 25% Vitamin C lipid soluble serum.

CoolLipo

1320nm Nd:YAG

Additional Information:Now FDA cleared! CoolLipo™ photo-acoustically disrupts fat cells, simplifying aspiration of adipose tissue while promoting skin tightening from the“inside-out” through the collagen enhancing effects of 1320nm wavelength.The CoolLipo™ 1320nm laser is an ideal adjunct to conventional liposuction.

Pearl

2790 nm YSGG

Skin Rejuvenation

Titan

Tailored Infrared Light

Skin Rejuvenation

Additional Information: Pearl Laser skin renewal.Treats wrinkles, uneven texture, discoloration and mild acne scarring.

may-june 2008 | www.aesthetictrends.com

$45,000$90,000 $40,000$85,900

evolving aesthetic technologies Product Listings Source

Product

Technology

Specifications / Treatments

Price

Cynosure, Inc. www.cynosure.com 5 Carlisle Road Westford, MA 01824 800.886.2966 p 978.256.6556 f

Smartlipo

Dermawave Mesotherapy Systems LLC www.dermawaveusa.com 15693 83rd Lane North Loxahatachee, FL 33470 866.769.3011

No-Needle Mesotherapy™ System

Electroporation technology. Dual wavelength diode laser cluster with three sequences of electrical waveforms. May be used, at physician discretion, in combination with specially formulated gels and topicals.

For treatment of congested areas of tissue characterized as cellulite. Facial and deep fat applications.

$45,000

Edge Systems www.edgesystem.net 2277 Redondo Avenue Signal Hill, CA 90755 800.603.0102 p 562.597.0148 f

HydraFacial™ HydraFacial™ Wave

Serum-based skin resurfacing. Other options: crystal & crystal-free microdermabrasion, LED light therapy, lymphatic and cellulite massage therapy.

Non-irritating, hydrating skin resurfacing with active serums –for all skin types and ethnicities. Exfoliates and extracts painlessly while simultaneously bathing the skin with active serums which thoroughly cleanse, exfoliate, hydrate & provide residual antioxidant protection.

$24,500 $16,875

UltraCam™Color UV Camera

UV and Natural Light Photography for Skin Analysis

Uncovers patient’s unique skin conditions and instantly documents them with a Polaroid color or UV picture.

$3,495

1064 nm Nd:YAG

Laser Body Sculpting

Contact Mfr.

Additional Information: Affirm is the first microrejuvenation which uses the exclusive mid-infrared Combined Apex Pulse™ (CAP) technology.This technology stimulates collagen production throughout the entire treatment area.Through precise thermal manipulation of the epidermal and dermal tissue, it remodels collagen through the papillary dermis to promote collagen production and skin tightening.

Additional Information: HydraFacial™ produces results equivalent of some laser treatments. Marketing package, trade-out, free-disposables and financing available. Edge provides essential medical spa equipment and full service; assistance with equipment needs, financing, training and full marketing & customer support.

Flip 4 www.flip4.ca 2142 Leonard de Vinci Suite 80 Saint-Julie, Quebec, Canada 450.649.4244 p

Max7

Hoya ConBio www.conbio.com 47733 Fremont Blvd. Fremont, CA 94538 800.532.1064 p 510.445.4550 f

RevLite™

LED

For skin rejuvenation and acne treatments.

$19,950

Additional Information: Patent pending. Also for oily, dry, combination and aging skin.

EO Q-Switched Nd:YAG with PhotoAcoustic Technology Pulse™ (PTP)

Featuring PhotoAcoustic Technology Pulse™ (PTP) Contact Mfr. designed to produce peak energy output for all skin types. With four wavelengths (1064nm, 532nm, 585nm, 650nm) for the treatment of skin rejuvenation, wrinkle reduction, tattoo removal, epidermal & pigmented lesion removal, vascular lesion removal, hair removal, and acne scar removal.

Additional Information: Available accessories for the RevLite are the PurpuraLite™ exclusive chromophore-clearing compression tool; MultiLite™ handpieces for 585nm and 650nm converted wavelengths; MultiSpot handpiece offering four spot sizes from 2-8nm.

may-june 2008 | www.aesthetictrends.com

35—

evolving aesthetic technologies Product Listings Source

Innovative Med Inc. www.imibeauty.com 4 Autry, Suite B Irvine, CA 92618 877.779.9492 p 949.458.7416 f

Product

Technology

Infinity Teeth Whitening Systems

Teeth whitening with LED Light Available in a single mouthpiece or a dual model with two mouthpieces for treating two patients at once

Hand Light Therapy System

LED Red and Infrared Pulsed Light

Specifications / Treatments

Price

405+/-2nm>=80/cm2.Works to whiten teeth in only one Contact Mfr. appointment of three 7minute treatments,by combining our exclusively formulated whitening gel containing a proprietary catalyst that boosts the whitening power when the LED light is applied. Red 625+/-5nm>=60/cm2,Infrared 840+/-10nm>=40/cm2 Contact Mfr. Combines the two wavelengths in a specifically programmed pulsed sequence for skin rejuvenation of the hands.

Additional Information: Each system comes complete with 50 boxes each containing 3 treatment procedure packs with Whitening Gel and applicator, chap stick protector, and maintenance spray to help maintain the whitened teeth. Small spacesaving tabletop teeth whitening systems.

36 —

Lumenis www.lumenis.com 2400 Condensa Street Santa Clara, CA 95051 408.764.3000 p

Aluma® Skin Renewal

Myotonology, Inc. www.myoinc.com 1187 Coast Village Rd, Ste.247 Santa Barbara, CA 93018 877.969.2811 p

Microcurrent Facial Toning System

Palomar www.palomarmedical.com 82 Cambridge Street Burlington, MA 01803 800.725.6627 p

LuxIR Fractional™ Infrared Handpiece

Fractional deep heating

Deep heating for pain relief and smoother, tighter skin (not yet cleared by FDA).

$45,000

Revitalight www.revitalight.com 119 W. Hubbard, Suite 300 Chicago, IL 60610 312.527.0131 p

Revitalight

LED

For skin rejuvenation and acne treatments.

Starting at $5,995

RF FACES Technology

For wrinkle reduction and skin tightening.

$69,900

Faradic, alternating microcurrent tones muscles and skin. Galvanic current used for Iontophoresis skin treatment.

$8,995

Additional Information: Utilizes vacuum to conform skin to allow heating of dermis.

160Ua-960Ua and 3Hz-100Hz

Additional Information: Myotonology® is a patented microcurrent facial toning process with proven clinical efficacy that can be combined with numerous other cosmetic procedures such as IPL, Microdermabrasion, Chemical Peels, and more.

Additional Information: Helps diminish fine lines, wrinkles, age spots on the face, neck and hands by promoting collagen firmness.

Silhouet – Tone www.silhouettone.com 7 Champlain Commons St. Albans, VT 05478 800.552.0418 p

Soli-Tone

LED, Micronized HF polarized currents

Acne,redness,pigmentation,photoaging and lifting.

Contact Mfr.

SoundSkin www.soundskin.com 429 South Main Street Oswego, IL 60543 888.596.5277 p

SmartSound

Ultrasound / E-Stim

2.2 mhz. 2 watts/cm2 Modulated CW & Pulsed modes. For facial treatments.

$14,500

Additional Information: Combination system. SmartGel ultrasonic gel.

may-june 2008 | www.aesthetictrends.com

evolving aesthetic technologies Product Listings Source

Sound Surgical www.vaser.com 357 S. McCaslin Blvd., Ste. 100 Louisville, CO 80227 888.471.4777 p

Sybaritic, Inc. www.sybaritic.com 9220 James Avenue South Minneapolis, MN 55431 800.445.8418 p 952.888.8887 f Synergie™ by Dynatronics www.dynatronics.com/aesthetic 7030 Park Centre Drive Salt Lake City, UT 84121 800.874.6251 p 801.568.7711 f Syneron www.syneron.com 100 W. Beaver Creek Rd. #6 Richmond Hill, Ontario, Canada 561.357.5827 p

Product

LipoSelectionSM only by VASSER®

Technology

VASSER® UltraSound

Specifications / Treatments

Price

Body sculpting of delicate to fibrous areas.

Fee-Per Procedure

Additional Information: Assisted Lipoplasty.

Dermosonic LaserPeel Soft-MET

Ultrasound/Suction Massage Modified Erbium:YAG

For temporary reduction in the appearance of cellulite. For skin resurfacing and skin rejuvenation.

$20,000 $39,995

Synergie AMS (Aesthetic Massage System)

Vacuum massage for body and face

FDA Cleared for cellulite, skin tightening and toning and body contouring treatments.

$14,995

ReFirme ST

Bi-polar Radiofrequency and Infrared Light elos combination of Bi-Polar radiofrequency (RF), infrared light energies, plus negative pressure and tissue manipulation. elos -RF / infrared / suction

For skin tightening via wrinkle reduction.

Cont. Mfr.

FDA cleared for circumferential reduction and cellulite reduction.

Cont. Mfr.

For the treatment of cellulite.

$64,900

Solid-Tip Sapphire Handheld Anesthetic Device

Contact skin cooling for laser treatments.Works with wavelengths between 532 and 850nm.

$995

VelaShape VelaSmooth

Additional Information: Patented ELOS technology. Telsar Laboratories Inc. www.telsar.com #1 Environway, Suite 100 Wood River, IL 62095 800.255.9938 p

DermaChiller4

Additional Information: FDA Cleared.

Thermage www.thermage.com 25881 Industrial Blvd. Hayward,CA 94545 510.782.2286 p

ThermaTips

Capacitive Radiofrequency (CRF)

For Smoothing, tightening and contouring

Contact Mfr.

Tyrel, Inc. www.myzeno.com 515 W. Greens Road, Ste. 725 Houston,TX 77067 281.880.6541 p

Zeno

Clear point technology

For mild to moderate inflammatory acne treatment.

$225 MSRP

may-june 2008 | www.aesthetictrends.com

37—

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LASER & LIGHT technologY Product Listings

Source Product Technology Wavelength (nm)

Aerolase www.aerolase.com 777 Old Saw Mill River Rd. Tarrytown, NY 10591 914-345-8300 p 914-345-8303 f

LightPod Neo XL LightPod Neo XT LightPod Era

X X

X X X

X X

X X X

Nd:YAG Nd:YAG Erbium:YAG

1064 1064 2940

Energy Output (J/cm2)

Up to 255 Up to 318 Up to 38

Pulse (ms)

0.65 0.65-1.5 0.30

Price

$44,500 $46,500 $43,500

Additional Information:Neo is the only hair removal laser that offers pain-free treatment on tanned and darker skin with no skin cooling. All LightPod lasers are compact (22 lbs.), portable and maintenance-free.

American Medical Bio Care www.medicalbiocare.com 1201 Dove Street, Suite 520 Newport Beach, CA 92660 949.477.5795 p

OmniLight FPL

Novalight FPL

BioCell www.medidermlaser.com 105 Freeman Rd Charleton, MA 01507 512.326.1025 p

MediDerm LRS

biolitec www.biolitec.com 515 Shaker Road E. Longmeadow, MA 01028 800.934.2377 x 246 p

Ceralas D

Ceralas D 15/810 Ceralas G5 LRS

Xenon Flash Lamp w/ Fluorescent Filters Diode

400-1200

Up to 90

Up to 1.5

$79,000

400-1200

Up to 55

1.5-50

$49,000

Additional Information: Cleared for the treatment of pigmented lesions, tattoo removal and permanent hair reduction. Up to 1Hz, multi-functional: leg vein, skin rejuvenation, hair removal handpieces, and external cooling system. X

Er:YAG

2940

Up to 1

3,6 & 9 Hz

$34,999

Diode

980

0.01 -15

$35,000

Diode

810

0.01 -25

Diode

532

0.01 -50

0.01-99.9 sec & CW 0.01 to 99.9 sec & CW 0.1-CW

Additional Information: Low-powered, virtually painless Erbium YAG with no downtime

$35,000 $37,500

Additional Information: Fiber Optic Delivery Systems & Introducer Kit for ELVeS System; protective eyewear. Several other accessory packages available. Handpieces, fiber optic delivery systems, and protective eyewear.

Candela www.candelalaser.com 530 Boston Post Road Wayland, MA 01778 800.821.2013 p

AlexTriVantage™ GentleLASE Family GentleMAX GentleYAG Family Light Station Smoothbeam SmoothPeel Vbeam Aesthetica Vbeam Perfecta Vbeam Platinum

X X X X X

X X X X X X X X X

X X X X X X X X

Q-switched Alexandrite Alexandrite Alexandrite + Nd:YAG Nd:YAG Fluorescent Pulsed Light Diode Erbium YAG laser

755 ,532, 1064 755 755, 1064 1064 417-1200 1450 2940

Pulsed Dye Pulsed Dye Pulsed Dye

595 595 595

3-12 J/cm2 10-100 Up to 600 Up to 600 Up to 60 Up to 25 Max en.750 Max fl. 4 Up to 20 Up to 40 Up to 40

50ns, 140 1.5-100 0.250-300 0.250-300 10-500 ms 250 2,4,6Hz

$84,500/ up $69,900-$98,500 $129,000/ up $69,900-$109,900 $49,900 $59,900 $39,900

.45-40 .45-40 .45-40

$69,900 $96,500 $86,500

Additional Information: Patented Integrated Dynamic Cooling Device (DCD) included with most units protecting the skin and ensuring patient comfort. Standard minimum 1 yr. warranty up to 5 years depending on the model. Full range of spot sizes from 1x5mm and 3x 10mm up to 18mm. Candela lasers and light-based systems offer the choice of a complete range of innovative technologies for optimal treatment. The flexibility to meet your specific needs today, then easily upgrade as you expand your practice. The value that comes from cost-effectively growing your business – step-by-step, with the leader in aesthetic laser and light-based technology for over 37 years.

38 —

may-june 2008 | www.aesthetictrends.com

THERAPY

acn e hai r re mo va ski n re l juv en tat too ation re vas mova cul l ar wri nkl e re duc tio n

LASER & LIGHT technologY Product Listings

Source Product Technology Wavelength (nm)

Energy Output (J/cm2)

CoolTouch, Inc. www.cooltouch.com 9085 Foothills Blvd. Roseville, CA 95747 877.858.2665 p

Up to 24

CoolTouch CT3 CoolTouch CTEV Varia

X X X

Nd:YAG Nd:YAG Nd:YAG

1320 1320 1064

Up to 500

Pulse (ms)

50 NA .3-500

Price

$54,995 $45,000 $59,950

Additional Information:VARIA - Varizoom handpiece w/ 3-10mm adjustable spot size. Pulsed cryogen cooling with pre- & post-cooling. CT3 -10mm spot size, pulsed cryogen cooling with pre-, mid- & post-cooling. CTEV - Energy output is 10W max. Automated fiber pull-back device, 600μm reusable & single-use fiber, accessory packs. CureLight, Ltd. www.curelight.com 240 Main Street, Suite C Gladstone, NJ 07934 908.470.4005 p

Clear100XL

Multiclear

Intense Blue and Near Infrared Light

405-420 850-900

$26,950

Proprietary High Intensity Plasma Light

296-315 UVB; 360-370 UVA1; 296-315/360-370 blend; 405-420 blue

.05-2.4 .1-150 1-40

.5-20

$47,000

Additional Information: Clear100XL - Reduce wrinkles, acne, wound & post-surgical healing, pore reduction/skin rejuvenation and skin radiancy. Dual Head Full Coverage. No accessories needed. Multiclear - Delivers safe, effective, phototherapy for multiple common aesthetic and medical skin disorders such as Stretch Marks, Psoriasis,Vitiligo, Acne, Keloids, PDT, Morphea and Actinic Keratosis.

Cutera (formerly Altus Medical) www.cutera.com 3240 Bayshore Blvd. Brisbane, CA 94005 888.4CUTERA p

CoolGlide CV CoolGlide Excel Solera Solera Titan

X X

Xeo

X X X

X X

Nd:YAG Nd:YAG Pulsed Light Infrared light

1064 1064 560-1200 1100-1800

10-100 5-300 6-40 5-70

Nd:YAG & Pulsed Light

1064 & 600-850

Up to 300

10-100 1-300 Automatic Closed Loop Photometric 1-300

$70,000 $95,000 $75,900 $75,900 $100,000-$135,000

Additional Information: All Cutera products are upgradeable to the next innovation, protecting your initial investment.The Xeo features Navigation software to allow the user to set the ideal parameters for each individual patient’s needs ensuring the optimal clinical benefits and patient safety. Cutera now offers Pearl, a 2790 nm wavelength device for skin resurfacing that maximizes patient outcome with minimal downtime. Cynosure, Inc. www.cynosure.com 5 Carlisle Road Westford, MA 01886 800.886.2966 p 978.256.6556 f

Acclaim™ Affirm™ Apogee® Elite™ Cynergy™ Cynergy III™ Cynosure PL™ PhotoSilk Plus™ TriActive™

X X X

X X

X X X X

X X X

X X

Nd:YAG Nd:YAG/Xenon Pulsed Light Alexandrite Alexandrite & Nd:YAG Pulsed Dye & Nd:YAG Pulsed Dye, Nd:YAG & Intense Pulsed Light Intense Pulsed Light Intense Pulsed Light Semi-Conductor

1064 1140/560-950 755 755 /1064 585/1064 585/1064/560-950

300 8/20 50 300 300 300

.04-300 3/5-35 0.5-300 0.4-300 0.5-300 0.3-300

Contact Mfr. Contact Mfr. Contact Mfr. Contact Mfr. Contact Mfr. Contact Mfr.

560-950 500-950 808

30 30

5-50 5-50

Contact Mfr. Contact Mfr. Contact Mfr.

Additional Information: Treat all skin types including tanned skin. Upgrade to add more applications.

40 —

may-june 2008 | www.aesthetictrends.com

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LASER & LIGHT technologY Product Listings

Source Product Technology Wavelength (nm)

Energy Output (J/cm2)

DermaMed International, Inc. www.quadraq4.com 394 Parkmount Road PO Box 198 Lenni, PA 19052 888.789.6342 p

Up to 20 Up to 20 Up to 20

DermaVista www.dermavista.com 800.333.5773 p West 800.767.6765 p East Dusa Pharmaceuticals www.dusapharma.com 25 Upton Drive Wilmington, MA 01887 877.533.3872 p Edge Systems www.edgesystem.net 2277 Redondo Avenue Signal Hill, CA 90755 800.603.0102 p 562.597.0148 f Europro www.europroequipment.com 3952 Camino Ranchero Rd., Building #2 Camarillo, CA 93010 866.633.5273 p Focus Medical, LLC www.focusmedical.com 23 Francis J Clarke Circle Bethel, CT 06801 866.633.5273 p

Quadra Q4 Platinum Quadra Q4 Gold Quadra Q4 Silver

X X X

X X

Intense Pulsed Light Intense Pulsed Light Intense Pulsed Light

X X

500-1200 500-1200 500-1200

Pulse (ms)

10-110 10-110 10-110

Price

$49,500 $39,500 $29,500

Additional Information: Patented Low Voltage Xenon flashlamp for little or no discomfort. One (1) multi-pulsing handpiece for hair removal and pigmented/vascular lesions and acne. Sixteen (16) pre-programmable settings for ease of use. The Cold Light VascuTouch

LED Radio Frequency

$6,995 $4,995

Fluorescent Lamp

417

N/A

$8,425

CW CW

$1,500 $1,500

Additional Information:The Cold Light – For rejuvenation (photo facial) stimulates tissue growth, collagen reprod, and rosacea. VascuTouch – For the treatment of vascular lesions.

Del Sol™ Handheld LED Light Therapy System

LED - Red/Infrared LED - Blue

800-1000nm 420nm

N/A

Additional Information: Red/Infrared light for skin rejuvenation, blue light for oily & acne-prone skin. Unique sequenced pulse for optimal red/infrared light therapy results. Unique focusing cone for concentrated treatments on hard-to-get areas. Phytoscan

HFD Cold Laser

430-750

0.3-0.5

N/A

$9,000 to $18,900

2940

Up to 20

300

$75,000

2940 1064 1064, 532, 585,650 640-1200, 530-1200 510-1200, 420-1200 800-1400

Up to 20 Over 250 Over 15 10-50

300 0.5 to 100 10 0.5 to 1000

$65,000 $64,900 $87,900–$114,900 $54,900

Additional Information: Skin Rejuvenation, Cellulite. Optional upgrade – Hair Removal.

NaturaLase Fract.ER NaturaLase ER NaturaLase LP NaturaLase QS NaturaLight

X X X

X X X X

X X

Er:YAG, Fractionated Erbium and Traditional Erbium Traditiona Er Long Pulse Nd:YAG Q-Switched Nd:YAG Pulse Light System (IPL)

Additional Information: NaturaLase QS comes with 1000mJ or 2000 mJ of 1064nm light.The doubled wavelength of 532 is 500 mJ or 900 mJ and the other wavelengths are 585 with 360mJ and 200 mJ or 650nm with 560 mJ or 310 mJ.The NaturaLase Er is upgradeable to the Fract Er by adding a new handpiece. The NaturaLase LP has 60 watts of output power.The NaturaLight has 40X10 mm Spot size and all handpiece wavelengths are included.

may-june 2008 | www.aesthetictrends.com

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LASER & LIGHT technologY Product Listings

Source Product Technology Wavelength (nm)

Energy Output (J/cm2)

Fotona www.fotona.eu www.fotonamedicallasers.com www.saratogadiagnostics.com 1415 1st Street South Suite 5 Willmar, MN 56201 Toll free 888-555-4113

Fotona XP Max Dualis XP Plus Dualis XP Fidelis XP Dualis SP Fotona SP+ (Combination Er/Nd:YAG) Dualis XS Fidelis XS Fotona QX

X X

X X X X X X

X X

Dualis VP

X X X X X X X X X

X X X X X X

Price

X X X X X X

Long Pulse Nd:YAG Long Pulse Nd:YAG Long Pulse Nd:YAG Long Pulse Nd:YAG Long Pulse Nd:YAG Long Pulse Er:YAG

1064 1064 1064 1064 1064 2940

Up to 600 Up to 600 Up to 400 Up to 300 Up to 400 Up to 3 J

0.1-300 5-200 5-200 5-50 5-200 0.1-1.5

$104,500 $84,500 $71,500 $51,500 $99,500 $128,000

X X

Long Pulse Er:YAG Long Pulse Er:YAG Q-switched Nd:YAG KTP Nd:YAG Long Pulse Nd:YAG KTP Nd:YAG

2940 2940 1064 532 1064 532

Up to 3 J Up to 1 J Up to 12.7 Up to 6.3 Up to 400 Up to 30

0.1-1.5 0.1-1.0 4-6ns 4-6ns 5-200 1-150

$79,500 $69,500 $89,500

X X

Pulse (ms)

$98,500

Additional Information: No disposable costs. Multiple handpieces available suited for specific applications and optimized for maximum efficiency. All systems include VSP technology, Electronic Feedback Control for added safety, efficacy, ease-of-use and peace-of-mind. All systems calibrate automatically - no manual or periodical calibration necesarry. Fotona XP MAX, DualisXP Plus, DualisXP scanner supported with 65x65 mm Tx area, multiple scanner spotsizes. DualisSP scanner supported with 35x35 mm Tx area. Spotsizes: Fotona XP MAX 2-20 mm, DualisSP 0.45 - 12 mm (Er:YAG), 2 - 8 mm (Nd:YAG), DualisXP Plus 2 - 10 mm, DualisXP 2 - 8 mm, FidelisXP 2 - 8 mm, DualisXS 0.45 - 12 mm, FidelisXS 0.45 - 10 mm, Fotona QX 2 - 8 mm, DualisVP 2 - 7 mm (Nd:YAG), 2 - 6 mm (KTP).

Genesis Biosystems www.dermagenesis.com 1500 Eagle Court Lewisville,Texas 75057 888.577.PEEL (7335) P

Chromolite Regenlite Regenstation

X X X

X X

X X X

X X

Intense Pulsed Light Pulsed Dye Laser Pulsed Dye Laser + IPL

535 - 1200 585 535 - 1200

25 9 25

5 350-450 350-450 , 5 msec

$44,300 $89,900 $119,900

Additional Information: All systems offered with a Customized looping waiting room DVD & flat panel TV/DVD player.

Hoya ConBio MedLite Lasers www.conbio.com 47733 Fremont Blvd. Fremont, CA 94538 800.532.1064 p

Medlite ®C3 Medlite® C6

EO Q-Switched Nd:YAG

1064, 532

Up to 12

5-7 ns

Cont. Mfr.

EO Q-Switched Nd:YAG

1064, 532, 585, 650

Up to 12

5-20 ns

Cont. Mfr.

Additional Information: Available accessories for the MedLite C6 are the PurpuraLite™ exclusive chromophore-clearing compression tool; MultiLite™ handpieces for 585nm and 650nm converted wavelengths; MultiSpot handpiece offering four spot sizes from 2-8mm.

42 —

may-june 2008 | www.aesthetictrends.com

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LASER & LIGHT technologY Product Listings

Source Product Technology Wavelength (nm)

Energy Output (J/cm2)

Innovative Med Inc. www.imibeauty.com 4 Autry, Suite B Irvine, CA 92618 877.779.9492 p 949.458.7416 f

0-22 mw/cm2

Multi-Wave Light Therapy - Super Red - Royal Blue - Pure Green - Infrared Ultra Rev Light - Red - Blue

X X

Pulsed Diode LED

X X

0-500

Price

$13,000

630 440 525 880

X X

Pulse (ms)

LED-Red + Ultrasound LED-Blue + Ultrasound

$195 $195

3 mhz/2 watts 3 mhz/2 watts

Additional Information: Our Multi-Wave light therapy unit has three colors + infrared in each of its three pads.With this unit you are able to select pre-programmed or custom combinations of lights (red, green, blue, infrared) and pulses allowing you to treat multiple symptoms at once or just one specific problem at a time.Touch screen option available for an additional cost.The Ultra Rev Lights are small hand-held LED wands with Ultrasonic. Iridex/Laserscope www.iridex.com 1212 Terra Bella Avenue Mountain View, CA 94043 650.962.8100 p

Aura i Gemini

X X

Lyra i VariLite

X X

Venus i

X X

KTP Nd:YAG KTP

Nd:YAG Diode-Pumped KTP Direct Diode Er:YAG

532 1064 532 1064 532/940

1-240 Up to 990 Up to 100 5-900 950

1-50 10-100, 1-100 20-100 5-100

$72,500 Contact Mfr.

2940

200-2000 mj

300 mcs

$67,000

$72,500 $56,500

Additional Information: Aura i - includes 1-5 mm continuously. Adjustable VersaStat i. Lyra i - Includes 1-5 mm continuously. Adjustable and 10 mm fixed VeraStat i. Venus i - Includes Smartscan Plus: 1 mm to 25 mm, Lens cell handpiece: 1,3,5. Gemini - Includes 1-5 mm continuously. Adjustable and 10 mm fixed VersaStat i. Lasering USA www.laseringusa.com 2246 Camino Ramon San Ramon, CA 94583 866.471.0469 p

SLIM E30 MiXto SX Velure S5 MiXto VX Velure S5 Velure S8/15 Velure S8/30 Velure S800

X X X

X X X X X

X X

CO2 Diode Diode Diode Diode Diode

10.6 532 532 808 808 808

0-30 0.1-5 0.1-5 10-450 10-450 10-600

10-1000 10-1000 10-9990 10-9990 10-1000

$73,500 $45,800 $30,400 $20,000 $22,100 $54,400

755 755 1064/532 750 1064/532

Up to 40 Up to 40 2-12 Variable to 25 2-12

3-300 var. 3-300 var. 10ns 0.000075 0.000005

Contact Mfr. Contact Mfr. Contact Mfr. Contact Mfr. Contact Mfr.

Additional Information: Patent Pending MiXto SX and MiXto VX technology. Light Age www.lightage.com 500 Apgar Drive Somerset, NJ 08873 732.563.0600 p 732.563.1571 f

Light BioScience, LLC www.lightbioscience.com 933 First Colonial Rd, #204 Virginia Beach,VA 23454 888.647.6219 p

EpiCare™ LP EpiCare™ LPX Q Clear™ (QS) Ta2 Eraser™ Q-Clear™ (LP)

X X X X

X X X X X

X X X

Alexandrite Alexandrite Nd:YAG Alexandrite Nd:Yag

Additional Information: Light Age scientists invented the alexandrite laser, and Light Age pioneered and leads this technology. Unlike others, EpiCare™ LP and LPX are designed for serious LHR - they treat All Skin Types I - VI. Both have unique, next-generation features and by-far the best ROI. EpiCare™ LPX is the premier alexandrite system on the market: the most effective, lowest cost, and fastest system available. Q-Clear™ is a compact, portable, highly cost effective dual wavelength Nd:YAG laser system. Quoted laser system parameters often seen and compared in the market can be misleading. Please contact Light Age for detailed information regarding aesthetic laser products. GentleWaves Pro GentleWaves SelectHandheld Model

X X

LED LED

may-june 2008 | www.aesthetictrends.com

590 590

4.0mW/cm2 4.0mW/cm2

Variable from cont. to 1 msec pulses

$32,500 $19,500

43—

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LASER & LIGHT technologY Product Listings

Source Product Technology Wavelength (nm)

Energy Output (J/cm2)

Lumenis www.lumenis.com 2400 Condensa Street Santa Clara, CA 95051 408.764.3000 p

10-100 10-40 10-225 10-100 10-40 10-100 15-45 90-150 3-90 90-150

Lumenis 1-Lightsheer Lumenis 1-IPL Lumenis 1-Multispot LightSheer ET™ LightSheer ST™ LightSheer XC™ IPL™ Quantum SR IPL™ Quantum DL VascuLight Elite

Diode IPL Nd:YAG Diode Diode Diode Intense Pulsed Light Nd:YAG Intense Pulsed Light Nd:YAG UV UV

X X X X X X X X

Bclear ReLume

X X

800 515-1200 1064 800 800 800 560-1200 1064 515-1200 1064

Pulse (ms)

5-400 3-100 2-20 5-400 5-100 5-400 6-26 5-38 1-75 5-38

Price

$149,900 Varies Varies $79,900 $64,900 $124,900 $84,900 $70,900 $129,900 $70,900 $59,900 $69,900

Additional Information:Lumenis One-Lightsheer – Spot 9x9,integ.cooling,multiple applications.Lumenis One-IPL – Spot 35x15 mm & 15x8 mm, integ. cooling. Lumenis One-Multispot –Spot 3,8 ,9 mm,integ.cooling,addt’l heads. LightSheer ETTM – ChillTip hand-piece.LightSheer STTM – ChillTip handpiece. LightSheer XCTM – ChillTip handpiece,12x12mm spot size IPLTM Quantum SR – Spot:34 x 8 mm.Upgradeable,simple,optimized pre-sets, spot size:6 mm with Integrated RealTime Cooling,touch screen.VascuLight Elite – Multi-application, optimized pre-sets,spot;ITL – 45x10mm, Nd:YAG:6mm.Bclear – For psoriasis/vitiligo treatments.ReLume – For repigmentation treatments. Med-Aesthetic Solutions www.medaestheticsolutions.com 2033 San Elijo Ave, Suite 200 Cardiff by the Sea, CA 90249 760.942.8815 p 505.341.2575 f

iPulseTM i200+ iPulseTM i400 MAStique Light

MedSurge Advances, Inc. www.medsurgeadvances.com 14850 Quorum Drive, Ste. 120 Dallas,TX 75254 972.720.0425 p

Asclepion MeDioStar XT Asclepion MCL 30 Dermablate Asclepion TattooStar R Quantel Medical Aramis II Quantel Medical Prolite II Quantel Medical Virdis Derma

X X X

X X

X X X

X X

Intense Pulsed Light Intense Pulsed Light LED (4 wavelengths, Micro Current and High Frequency in one )

530-1200 530-1200 Blue-470 , Green-525,Yellow-590 , Red-640

0 -0 0-20 Up to 29

10-110 10-110 Variable with 6 pre-sets

$34,995 $49,995 $16,995

Additional Information:The iPulseTM i400 combines advanced IPL technology with striking design and versatility.Special features include a video touch screen with sound.Patented constant s pectrum of light and unique square pulse delivery is more energy-efficient and achieves long-lasting results in hair removal,skin rejuvenation,treatment of pigmented/vascular lesions and acne. The 8.9 cm2 constant spectrum treatment head rapidly treats large areas with less discomfort.The mini glass filter is available for smaller areas.Settings are pre-programmed for easy use. iPulseTM i200+- Patented constant spectrum of light technology.Unique square pulse delivery achieves long-lasting results in hair removal,skin rejuvenation,treatment of pigmented/ vascular lesions and acne with one handpiece.8.9 cm2 spot size and mini glass filter handpieces.Easy-to-use pre-programmed settings for treatment and skin type.MAStique Light -Non-invasive and non-ablative High-frequency (HF) and Micro Currents enhance the effects of four distinct wavelengths of LED phototherapy. X

X X X

X X

X X X

Diode Laser Er:YAG Laser Q-switched Ruby Laser Er: Glass Laser Intense Pulsed Light DiodePumped KTP Laser

808 2940 694 1540 530 - 1200 532

Up to 90 1 - 100 Up to 23 Up to 126 15 - 44 Up to 110

Up to 500 400 40 3.3 20 - 72 15 - 150

Contact Mfr. Contact Mfr. Contact Mfr. Contact Mfr. Contact Mfr. Contact Mfr.

Additional Information:MeDioStar XT - Step Pulse technology,12 mm spot size (standard);6,10,and 14 mm tips available;automatic spot size detection,integrated skin cooling. MCL 30 Dermablate - built-in smoke evacuation and filter system.VarioSpot handpiece:1-6mm spot size adjustable handpiece,tips can be sterilized. TattooStar R - Ergonomic design;Homogeneous hexagonal spot through microlens array;Auto spot size detection;Tattoo and pigmented lesion removal.Aramis II - Cooling System:virtually painless treatment. Prolite II - Operator selectable filters in one handpiece (530/550/580/610/615) - spot size 10 x 20 mm. Virdis Derma - Small and portable,optional scanner. Norseld www.norseld.com 9 Claxton St., S. Australia 5000 618.8231.9000 p Norseld USA Medical Laser Engineering 2284 Main St. Concord, MA 01742 978.318.9996 p

44 —

Dual Yellow Ylite

X X

Copper Bromide Copper Bromide

578 & 511 578

300 75

FEM Micropulsed $68,000 FEM Micropulsed $58,250

Additional Information: Contact scanner with 6 & 10mm spot, contact and non-contact handpieces, 0.6-1.0mm spot.DualYellow comes complete with scanner and the Ylite comes complete with fully functioning applicator.The optimum wavelength and pulse duration provide ideal and mostly single treatments for most vascular, pigmented and seborrheic keratoses lesions.By stimulating new collagen formation in the upper papillary dermis by non-ablative resurfacing, scars, warts and stretch-marks can all be treated or improved with the Dual Yellow laser.The complete skin enhancement solution for sun and age damage, wrinkles, skin blemishes, stretch-marks and acne.

may-june 2008 | www.aesthetictrends.com

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LASER & LIGHT technologY Product Listings

Source Product Technology Wavelength (nm)

Novalis www.novalismedical.com 1719 W. Kennedy Blvd. Tampa, FL 33606 866.627.4475 p

Clareon™ Clareon SR Clareon HR Clareon AR Clareon VR Solarus™ Solarus SR Solarus HR Solarus AR

X X

X X X

Energy Output (J/cm2)

Pulse (ms)

Price

Pulsed Light Pulsed Light Pulsed Light Pulsed Light

550-1200 630-1200 420-1200 500-61/740-1200

Up to 45 Up to 45 Up to 45 Up to 35

30/50/70 30/50/70 30/50/70 30/50/70

$44,900 and up incl. handpiece

Pulsed Light Pulsed Light Pulsed Light

530-1200 630-1200 420-1200

10-20 15-35 Up to 35

20/40/60 20/40/60 20/40/60

$34,900 and up incl. handpiece

515-1100

Up to 65

Up to 25

$49,500

10-40 150 mW/cm2 - 4.5 J/cm2 R: 150 mW/cm2-4.5J/cm2 B: 90 mW/cm2-48J/cm2 R: 150 mW/cm2-4.5J/cm2 B: 90 mW/cm2-65J/cm2

10-100 Pulsed CW or Pulsed

$74,500 Contact Mfr. $37,500-39,500

CW or Pulsed

Contact Mfr.

Additional Information: Clareon – Patented Kr/Xe Flashlamp technology. Up to 1 Hz.

OptoGenesis www.optogenesis.com 5912 Northwest Place Austin,TX 78731 512.451.3333 p

EpiCool™ Platinum/HR SR

OPUSMED www.opusmed.com 306-3333 Graham Blvd. Montreal(Quebec) H3R 3L5 Canada 866.678.7633 p

F1 Diode Laser™ LumiPhase-R™ LumiPhase-R/B

Intense Pulsed Light

Additional Information: PhotoFace™ Rejuvenation. Hair Removal for all skin types. Superior sapphire cooling.

X X X

LumiPhase-R/IR

X X

Diode LED LED

810 660 630/405

LED

630/850

Additional Information: LumiPhase products: Laminar air flow for comfort, optical positioning functionality for maximum beam uniformity.

Palomar www.palomarmedical.com 82 Cambridge Street Burlington, MA 01803 800.725.6627 p

StarLux™ System MediLux™ System EsteLux™ System Q-Yag 5

X X X

X X X X

X X X

Pulsed Light & Nd:YAG Pulsed Light Pulsed Light Q-switched YAG laser

500-1200, 1064 500-1200 500-1200 1064/532

Up to 700 Up to 45 Up to 40 Up to 12.5

LED LED LED LED

415 nm 633 nm (for PDT) 830 nm 633 nm

48 J/cm2 96 J/cm2 66 J/cm2 126 J/cm2

0.5-500 10-100 10-100 3 +/- 1 ns

$89,900 $52,900 $42,900 $50,000

Additional Information:Wavelengths vary by handpiece. PhotoTherapeutics, Inc. www.phototherapeutics.com 2720 Loker Ave.West, Suite C Carlsbad, CA 92010 800.743.8150 p 760.607.0288 f

OmniLux Blue™ OmniLux PDT™ OmniLux Plus™ OmniLux Revive™

X X

$24,950$34,950

Additional Information: 2 yr. warranty, Platform Technology (interchangeable heads), Loyalty Counts Plan, Key to Success Plan,Wound Healing, Pain Relief and PDT for non-melanoma skin cancers Tx.

may-june 2008 | www.aesthetictrends.com

45—

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LASER & LIGHT technologY Product Listings

Source Product Technology Wavelength Technology Wavelength Energy Energy Output Output Pulse Pulse 2 (nm) (nm) (J/cm(J/cm ) 2) (ms)(ms)

Radiancy www.radiancy.com 40 Ramland Road South Suite 10 Orangeburg, NY 10962 845.398.1647 p

Mistral SkinStation Duet WhisperNG SPR SpaTouch Pro

X X

X X X

X X X X X

X X X

X X X X

LHE (Light Heat Energy) LHE (Light Heat Energy) LHE (Light Heat Energy) Er:YAG, Extended Ablation LHE (Light Heat Energy) LHE (Light Heat Energy)

400-1200 nm 400-1200 nm 400-1200 nm 2940 nm 400-1200 nm 400-1200 nm

4-15 J/cm2 3-10 J/cm2 3-10 J/cm2 8.5 J/cm2 3-10 J/cm2 3-10 J/cm2

Up to 80 ms 10-35 ms 10-35 ms 300 ms 10 ms 10-35 ms

Price

$45,000 $32,990 $24,990 $39,990 $19,900 $19,900

Additional Information: Skin Station - 3 yr. warranty and assorted Light Unit Assemblies.WhisperNG - Patented Extended Ablation handpiece and fractional handpiece. Reliant Technologies, Inc. www.fraxel.com 464 Ellis Street Mountain View, CA 94043 888-4FRAXEL (437-2935)

Fraxel re:store™laser Fraxel re:fine™ laser Fraxel re:pair™ laser

Rhytec www.rhytec.com 130 Turner Street, Bldg. 2 Waltham, MA 02453 888.4rhytec p 781.419.9402f

Portrait PSR3

Sciton www.sciton.com 845 Commercial Street Palo Alto, CA 94303 650.493.9155 p

Profile™-MP Contour™ ClearScan™ ThermaScan™ BBL™ Profile-S ClearScan™ Profile-S ThermaScan™ Profile-S Contour™ Profile-S BBL™ Profile-D ClearScan™

Erbium-Fiber laser Single Mode Fiber laser Fractional CO2 laser

1550 1410 10600

4 - 70 mj/ MTZ 5-20 mj/ MTZ 5-70 mJ/MTZ

0.5 - 3 0.5 - 3 0.1 - 2

Contact Mfr. Contact Mfr. Contact Mfr.

Additional Information: Fraxel re:store™ laser is FDA cleared for the treatment of pigmented lesions,soft tissue coagulation,melasma,periorbital wrinkles,skin resurfacing,acne scars and surgical scars and actinic keratoses.Fraxel re:fine™ laser is FDA cleared for the treatment of pigmented lesions,melasma,periorbital fine lines,skin resurfacing,texture and tone. Fraxel re:pair™ laser is FDA cleared for the treatment of wrinkles,rhytids,furrows,fine lines,textural irregularities,pigmented lesions,soft tissue ablation,coagulation and resurfacing and vascular dyschromia. X

Non-contact Plasma Energy

1-4 J/cm2

4 - 16 ms

$69,900 Disposable nozzles - $1,750/pkg of 5

Additional Information: Ergonomic handpiece, disposable delivery nozzle, Hi-Def Marketing program, PR support, 1-yr limited + optional extended warranty. Effectively treats acne scars, fine, moderate and deep wrinkles of the face and body, improves skin tone, texture and elasticity, removes discoloration, tightens skin and treats benign skin lesions/actinic keratoses. X X X

X X X X X X

X X X X X X X X X X

X X X X X X

X X X X X X X X X X

Modular platform Er:YAG module Nd:YAG module Nd:YAG module Pulsed Light module Nd:YAG Nd:YAG Er:YAG Pulsed Light Nd:YAG

Various 2940 μm 1064 nm 1319 nm 400-1400 nm 1064 nm 1319 nm 2940 nm 400-1400 nm 1064 nm

Up to 400 45 Watts Up to 400 Up to 80 Up to 30 Up to 400 Up to 80 45 Watts Up to 30 Up to 400 J

0.1-200 0.1-50 0.1-200 10-200 Up to 200 0.1-200 10-200 0.1-50 Up to 200 0.1-200

Cont. Mfr. $19,500 $19,500 $23,000 $30,000 $54,500 $54,500 $54,500 $54,500 $82,000

Additional Information: Configurable; up to 5 laser modules. Scanning systems – computerized. Integrated cooling and Smart Filters. 15mm x 30mm spot size and 30mm x 30mm spot size on various units. Sybaritic, Inc. www.sybaritic.com 9220 James Avenue South Minneapolis, MN 55431 800.445.8418 p 952.888.8887 f

LaserPeel Soft-MET NannoLight SkinClear SpectraQuattro

Synergie™ by Dynatronics www.dynatronics.com/aesthetic/ 7030 Park Centre Drive Salt Lake City, UT 84121 800.874.6251 p 801.568.7711 f

Synergie LT1 Synergie LT2 Synergie Elite LT Red Pad XP Blue Probe

X X X X

X X

Modified Erbium Laser Intense Pulsed Light System Q-Switched Nd:YAG Laser Intense Pulsed Light System

2940 410 - 1400 532 & 1064 410-1400

Up to 127 Up to 50 Up to 19 Up to 40

300 ns 1-30 10 ns 5-30

$39,995 $42,995 $29,995 $34,995

3J-6J 500mW-1000mW 6J/ 5 cm2 1000mW 6J/ 5 cm2 1000mW 8J/8”X10” 7500mW 6J/ 5 cm2 500mW

Yes No Yes

$3,995 $3,195 $4,495 $1,995 $1,595

Additional Information: Six filters available. Requires only one handpiece. Active contact cooling. X X X X

X X X X X

All product are Bio Stimulatory Light with Super Luminous Diodes

660-880 660-880 660-880 880 405-880

Additional Information: 2 yr.Warranty. LT1 delivers 6 joules in 30 seconds. Interchangeable red/ near-infrared and blue probes available. LT2& Elite LT deliver 6 joules in 30 seconds. Interchangeable red/ near infrared probes, pads, and blue probes available. Elite LT comes with internal tutorial and treatment protocol guide. Equipment manufactured in an FDA scrutinized facility.

46 —

may-june 2008 | www.aesthetictrends.com

acn e hai r re mo va ski n re l juv en tat too ation rem vas ova cul l ar wri nkl e re duc tio n

LASER & LIGHT technologY Product Listings

Source Product Technology Wavelength (nm)

Syneron Medical www.syneron.com 100 W. Beaver Creek Rd. #6 Richmond Hill, Ontario Canada 561.357.5827 p

Aurora AC Aurora DS/DSR Aurora SR Polaris DS Polaris Vascular Polaris WR Galaxy

X X

Diode/RF Optical Energy Combined with Bipolar RF electrical energy Diode/RF Diode/RF Diode/RF elos-Diode

X X

Comet

400-980 580-980 580-980 800 900 900 580-980

elos-Diode/RF

Energy Output (J/cm2)

6-18 L, 5-20 RF Optical plus 5-20 RF 5-20 RF Up to 25 & 20 Up to 140 & 100 Up to 140 light Up to 200 RF 50/50 J/cm2 RF

Pulse (ms)

Up to 200 Up to 100 Up to 100 Short N/A N/A Up to 200 Up to 2 Hz

Price

$89,900 $84,900 $79,900 $69,900 $69,900 $79,900 $84,900 $104,900$155,900 $89,900

Additional Information: Aurora AC – 3 yr. warranty. No disp. costs. Aurora DS/DSR – Both applicator heads included for treatment of hair removal and vasc/pigm. lesions. Aurora SR – 3 yr. warranty. Applicator heads incl. Polaris DS – 3 yr. warranty. Spot 8 x 12 mm, cooling. Polaris Vascular – 3 yr. warranty. No disposable costs. Polaris WR – 3 yr. warranty. No disposable costs. Galaxy – 3 yr. warranty. No disp. cost. 5 application heads avail. Comet – 3 yr. warranty. Spot 12 x 15 mm. Telsar Laboratories www.telsar.com #1 Environway, Suite 100 Wood River, IL 62095 800.255.9938 p

Softlight

Thermage www.thermage.com 4058 Point Eden Way Hayward, CA 94545 510.782.2286 p

ThermaCool

Viora, Inc. www.vioramed.com 30 Montgomery Street Suite 660 Jersey City, NJ 07302 877.384.8032 p 201.332.4200 f

WaveLight www.wavelight-laser.com Am Wolfsmantel 5 91058 Erlangen, Germany +49/91 31/61 86-140 p

Nd:YAG

1064

$55,00

Additional Information: This is the only laser licensed to use Carbon Lotion for hair reduction on all skin types. New and used laser systems are available.

Radio Frequency

N/A

200

N/A

$39,950

Additional Information: Non-Ablative.Tips are interchangeable by application. For the non-invasive treatment of facial wrinkles rhytids. Single-use sterile treatment tip that delivers RF energy to the deep layers of the dermis while protecting the epidermis with cryogen cooling spray.

Axiom

Intense Pulsed Light

390 – 1200nm

>40 J/cm2 @ 25x50 mmspot

25-75 msec single pulse programmable multi pulse mode

$54,900

Additional Information: Comes with all 4 applications as interchangeable lamps w/ONE handpiece; cooling gels not necessary due to TLC technology; largest spot size 25x50 mm (12.5cm2); 3 multi-size reduction windows; intuitive menu-driven touch screen; 1 yr. full-service warranty/2-day loaner; training DVD; 40 Lbs.; client brochures included; 5 languages available; repetition rate of 1.5 seconds; ask about our Viora Support Program (VSP). ARION MYDON BURANE BURANE XL SINON TALOS

X X

X X X X

Alexandrite Long Pulse Nd:YAG Long Pulse Er:YAG Long Pulse Er:YAG Q-switched Ruby Excimer

755 1064 2940 2940 694 -

5-40 10-450 0.1-113 0.1-141 Up to 14 -

5-40 .05-90 350 350 20 -

$69,500 $72,800 $37,000 $68,750 $82,000 $125,000

Additional Information: Large area scanner (90 x 65mm). Skin Cooling (air). Handpieces 1.5, 3, 5, 10mm hair and vascular with contact or air cooling. Up to 250ms thermal. Pigmented skin; Spots: 3, 4, 5mm long pulse. For psoriasis, vitiligo and atopic dermatitis.

may-june 2008 | www.aesthetictrends.com

47—

Source

48 â&#x20AC;&#x201D;

Device

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Ultrasound Devices Product Listings

Technology

Mechanism of Action

Regulatory Status

List Price

Liposonix www.sybaritic.com 9220 James Avenue South Minneapolis, MN 55431 800.445.8418 p 952.888.8887 f

LipoSonix System

Ultrasound

Fat cells disrupted by sound waves

CE Pending FDA Pending

Contact Mfr.

Sound Surgical Technologies www.sybaritic.com 9220 James Avenue South Minneapolis, MN 55431 800.445.8418 p 952.888.8887 f

Vaser System

Ultrasound

Fat cells disrupted by sound waves

CE Cleared FDA Cleared

$90,000 or $1500 upfront; $395 per procedure

Sybaritic, Inc. www.sybaritic.com 9220 James Avenue South Minneapolis, MN 55431 800.445.8418 p 952.888.8887 f

SlimLine Capsule DermaSonic

Heat / Oxygen / Light Ultrasound / Suction Massage

Heated air, oxygen and light-emitting diode CE Cleared Tissue heated by sound waves, stimulates new tissue production

N/A $20,000

Ulthera Inc. www.sybaritic.com 9220 James Avenue South Minneapolis, MN 55431 800.445.8418 p 952.888.8887 f

Ulthera System

Ultrasound

Tissue heated by sound waves, stimulates new tissue production

CE Cleared FDA Pending

Cont. Mfr.

UltraShape Ltd. www.sybaritic.com 9220 James Avenue South Minneapolis, MN 55431 800.445.8418 p 952.888.8887 f

Contour I

Ultrasound

Mechanical and sound waves induce disruption of fat cells

CE Cleared

Cont. Mfr.

may-june 2008 | www.aesthetictrends.com

Liability Issues for Medical Spas and Aesthetic Practices By Megan K. Packard, Professional Liability Solutions, LLC

at t

legal n case of the month

legal case of the month

In my last article, I touched on

involved. With the key points of

are specific to the state in which

some common sense ways to ensure

where liability issues can arise, this

you will open your medical spa or

that you practice effective risk

article aims to help those planning

aesthetic practice, as well as other

management within a practice that

to open, or in the process of opening,

business specifics that are true to

incorporates aesthetic procedures –

a medical spa or aesthetic practice

your particular situation.

whether in a medical spa or simply

to think about where potential

an integrated aesthetic practice.

problems can arise.

On a regular basis, I speak

Knowledge is power, and

with physicians and lay business

thinking about the “what

owners who are planning to open

ifs” will only help to

medical spas or aesthetic practices

strengthen the medical

and have little awareness of the

spa or aesthetic practice

potential liability issues that can

you plan to open.

Some key points, though, are

It is essential to understand the issues one should be aware of ahead of time, rather than to be reactive only when a problem presents itself.

arise from these types of practices. It is essential to understand the issues

CORPORATE LIABILITY ISSUES

common for all to think about. The

one should be aware of ahead of

kind of ownership structure selected

time, rather than to be reactive only

it best to structure my new medical

depends on how the risk will be

when a problem presents itself.

spa or aesthetic practice?” This

distributed and the profits will be

is a challenging question with no

shared. Incorporating your business

aesthetic practice is exciting and very

right answer. It involves a variety of

will provide limited liability to you

fulfilling for the healthcare providers

distinct legal issues, many of which

as the physician owner or lay owner.

Opening a medical spa or an

A question I often get is, “How is

may-june 2008 | www.aesthetictrends.com

49—

legal case of the month

Limited liability means that the

flow of payments between providers

unlicensed practice of medicine.

individuals running the business are

and organizational entities and

And most states make the unlicensed

typically insulated from the liabilities

what is allowable by your state law.

practice of medicine a felony.

of the corporation itself. This is true

I encourage all individuals, from

so long as the business is properly

physician to the lay entrepreneur,

purposes is the question of

capitalized and administered with

who are interested in owning and

supervision. Not only is it important

the necessary corporate formalities.

operating a medical spa to determine

to know which procedures the

Remember, though, the physician

what is allowable before they open

healthcare provider can perform

or other healthcare professionals

their doors.

legally within the scope of licensure,

can still remain personally liable for

but it is essential to know which

professional negligence (malpractice)

PRACTICE LIABILITY ISSUES

treatments and procedures require

that happens with that practice

supervision from a physician. If

setting.

who work within a medical spa or

supervision is required but does not

aesthetic practice, and what they

occur and a negligent act occurs

do, can also create liability issues.

(malpractice), the physician is

The legal structure of the business

has other implications such as tax

Performing procedures outside the scope of one’s licensure can constitute the unlicensed practice of medicine. And most states make the unlicensed practice of medicine a felony.

The types of healthcare providers

Many states have rules

liable directly for failing to properly

and regulations regarding

supervise that healthcare provider.

licensure and the practice

The physician is also vicariously

of medicine. In most

liable since the non-physician

states, the “practice of

healthcare provider is serving as

medicine” is defined in

the physician’s “agent.” Failing to

terms such as “diagnosing

understand physician supervision

and treating disease.” related implications – how the

Courts often define this term broadly

business is taxed differs from LLC to

and, therefore, can incorporate many

“C” to “S” corporation – or who can

of the treatments and procedures

actually own a professional medical

provided by the medical spas and

corporation. Many states have laws

aesthetic practices as the “practice of

that prohibit non-physicians from

medicine.”

owning shares of a professional

medical corporation (“corporate

providers must take care not to

practice of medicine laws” that are

step over the boundaries of the

so often referred to) or from splitting

scope of their licensure. Performing

fees with a physician.

procedures outside the scope of

one’s licensure can constitute the

The “fee-splitting” and “anti-

Non-physician healthcare

kickback” considerations require that physicians and lay owners pay careful attention to the ownership structure and profit-sharing arrangements that are created among owners, partners, marketing companies, product companies, etc. It is also important to understand the

50 —

Also important for liability

may-june 2008 | www.aesthetictrends.com

director has never touched a laser, yet is responsible for overseeing the standard of care for the laser procedures performed within that medical spa? This is true for the nonphysician staff as well. Make sure all personnel with direct patient care are properly licensed and trained for what they will do within the practice.

legal case of the month

explain to a court that your medical

POLICIES AND PROCEDURES

Besides performing proper

credentialing on all healthcare providers, it is important for those who own a medical spa or aesthetic practice to ensure there are written policies and procedures in place. Without policies and procedures in place, how can an individual

requirements is simply inviting

to regulate the specialty of the

potential liability.

physician who can serve as medical

director for medical spas. Such

Many medical spas have what

Cheryl Whitman, CEO of medical

is the case in Florida, where only

spa consulting business Beautiful

board-certified or board-eligible

Forever, refers to as a “rubber stamp

dermatologists or plastic surgeons

medical director.” The medical

are the only “specialists” who can

director has loaned use of his/her

act as medical directors/supervising

name but is rarely, if ever, actually

physicians for medical spas they do

on-site seeing patients or overseeing

not own (in other words

how operations run. Without proper

for “satellite offices”).

attention from a medical director,

the medical spa or aesthetic practice

are exacerbated in a

may incur a higher number of

medical spa or aesthetic

patient complaints, incomplete

practice when proper

medical records and other necessary

credentialing reviews

documentation, and ultimately

of the healthcare staff

higher likelihood of malpractice

do not take place. The

claims.

owners (physician or non-physician)

Liability issues

providing direct patient care in the medical spa know what to do in case of an adverse outcome, or even when they should get the physician involved. Simply telling the staff through verbal communication is not enough. Put it in writing! Liability issues can grow out of lack of a

Without proper attention from a medical director, the medical spa or aesthetic practice may incur a higher number of patient complaints, incomplete medical records and other necessary documentation, and ultimately higher likelihood of malpractice claims.

want to ensure the medical

written manual for all to reference

beginning to pass laws that require

director or supervising physician

and use as a guideline for the

a medical director to be on-site or

is properly licensed and trained in

practice.

provide the patient a good faith

all procedures, whether or not they

exam. Other states are beginning

have direct patient care. How do you

lack of consent forms also creates

In addition, many states are

may-june 2008 | www.aesthetictrends.com

Along these same lines, the

51—

legal case of the month

liability issues. An informed consent document provides the patient with all the information material for making a decision about treatment. It provides all information that would make a difference in the patient’s decision to have, or to forgo, a given therapeutic treatment. The consent form should include the risks and the benefits of said treatment that are reasonably significant to the patient’s decision-making process. It is important that the consent forms are signed by the patient to document they have actively given their consent to treat.

GENERAL LIABILITY ISSUES

As an owner of a medical spa or

practice. Two key areas of general

aesthetic practice, liability issues can

liability for medical spas are products

occur as soon as a patient is on your

liability and advertising liability.

property, such as in your parking

lot or walking through your front

and sell a variety of products,

(deceptive) advertising in any

door. General liability issues stem

from facial creams to nutritional

form. Be aware of advertising

from negligent acts resulting from

supplements. Even if the medical

that makes guarantees or makes

Many medical spas distribute

Even if the medical spa or aesthetic practice is not manufacturing the product, liability still exists from selling the product to the patient.

spa or aesthetic practice

false and misleading claims about

is not manufacturing the

treatments or their therapeutic

product, liability still exists

potential (especially for supplements

from selling the product to

and creams). This can happen in a

the patient. Many medical

variety of ways: in-person from one

spas will brand their own

of the healthcare providers or staff

line which is manufactured

members of the medical spa, the

the operation of the medical spa or

by another company. Realize that

physical media you have (advertising

aesthetic practice–such as bodily

this directly creates liability when

in the medical spa and print ads) and

injury to patients (not malpractice),

you place your practice name on the

online media, including email.

property damage, and personal

products.

injury or advertising injury. For

52 —

Statements should be truthful and

lend to the “possible” outcomes–

example, a patient injures himself

ADVERTISING LIABILITY

not guaranteed outcomes. Pay

by tripping over the rug in your

particular attention to the medical

reception area. This is not a medical

claims about the types of treatments

spa’s website. While it can serve a

professional liability claim, but rather

and the outcomes, especially if

great purpose in creating awareness

negligence that stems from simply

guarantees are made. The FTC

and driving business to the spa or

owning the medical spa or aesthetic

prohibits “false and misleading”

aesthetic practice, it is important

Advertising liability can arise from

may-june 2008 | www.aesthetictrends.com

This has to do with hiring, firing, and

no matter how much foresight and

liability claims from statements made

all the other nuances that go into

planning go into your business. This

or from before-and-after photos that

having employees, from claims of

is why insurance that handles these

may be deceptive.

discrimination in hiring, to wrongful

various forms of liability is essential

discharge, or sexual harassment,

to protecting the medical spa or

OFFERING ADVICE ONLINE

to name just a few. These are

aesthetic practice that you have built.

Be careful of the health advice

common to all medical practices and

As the famous quote goes, “If you

given online, as this can create a

businesses that employ individuals to

fail to plan, you’re planning to fail.”

patient-provider relationship. Some

work within the practice setting.

So, plan for all the potential liability

states may prohibit this or could

issues and put into place effective

construe it as the unlicensed practice

and regulations can create liability

ways to reduce these potential pitfalls

of medicine or even unprofessional

for the medical spa and aesthetic

in your new medical spa or aesthetic

conduct because it may be viewed

practice. If required, the HIPAA form

practice.

as advice given without physically

should be part of the initial patient

seeing the patient. Think about the

forms. In releasing or sharing records

Megan K.

way contact is structured so that

with other providers, follow HIPAA

Packard is the

the information provided is generic

guidelines to ensure there is no

educational and not specific to the

violation of patient privacy. If HIPAA

Executive Vice

individual’s condition. Again, this is

is inapplicable, a privacy policy

to avoid creating a patient-provider

should be implemented and utilized

relationship without actually seeing

as part of the standards set within the

that person as a patient.

medical spa or aesthetic practice. It

Documentation and HIPAA rules

just makes good risk management

EMPLOYEE LIABILITY ISSUES

practices!

Besides the vicarious liability

Opening a medical spa or an

President for Professional Liability Solutions, LLC, an independent agency that specializes in providing personalized, comprehensive insurance and riskmanagement solutions for healthcare

(for malpractice purposes) that your

aesthetic practice is exciting and very

employed healthcare providers can

fulfilling for the healthcare providers

create for the medical spa or aesthetic

involved. With the key points of

Charlotte and Chicago, Professional

practice, there are other potential

where liability issues can arise, this

Liability Solutions has been helping

areas where the owner has liability.

article aims to help those planning to

healthcare professionals protect their

For instance, if your staff gets injured

open, or in the process of opening, a

practices and assets for over 15 years.

on the job, you, as the owner, are

medical spa or aesthetic practice to

Megan works from the Charlotte office,

liable for those work-related injuries

think about where potential problems

where she focuses her business on the

and illnesses. This is why most states

can arise. Knowledge is power, and

medical spa, aesthetic, anti-aging, and

have in place some form of a worker’s

thinking about the “what ifs” will

wellness segments of the healthcare

compensation system. Worker’s

only help to strengthen the medical

industry. Megan received her degree

compensation systems were designed

spa or aesthetic practice you plan to

from the University of Virginia. For

to eliminate litigation for on-the-job

open.

more information, please contact Ms.

injuries.

A well-thought-out business plan

Packard at 800.372.3268, or email

Another area of potential liability

professionals. With offices in both

should include ways to minimize the

her at mpackard@pls-medmal.com

that owners of medical spas or

liability associated with medical spas

or by visiting their website at www.

aesthetic practices need to be aware

and aesthetic practices. Ultimately,

professionalliabilitysolutions.net.

of is employment practices liability.

though, some liability always exists

may-june 2008 | www.aesthetictrends.com

legal case of the month

to regularly review it for potential

53—

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medical spas

By Cheryl Whitman, Founder and CEO of Beautiful Forever

at t

According to Business

is an ever-changing landscape

Finding the right guide is the key for

Communications Co., Inc. (February

of opportunities and potential

many physicians who are entering

2005), the anti-aging market is

pitfalls that requires fast thinking

an unfamiliar business, or expanding

projected to reach approximately

and adaptability. Conventional

an existing practice, a landscape that

$72 billion by 2009. If you make the

approaches, which include business

is highly competitive and requires a

right moves now, you could help set

and marketing plans, are necessary

different mindset and approach from

the “gold standard” by which all

but just part of the strategy needed

conventional medicine.

medical spas will be judged in 2009.

to excel – especially in the medical

And, you could stay in business for

spa and aesthetic

years to come – but only if you can

practice industry

face some of the biggest challenges

in 2008, which

head on.

hasn’t been completely

IS BUSINESS WAR?

mapped. Some

important tactics

While there is some argument on

this point, there is no doubt that solid

medical n spas

Meeting Medical Spa Challenges in 2008

Each member of your staff should be able to answer the following about your business: How do we compete? Where do we compete? How do we conduct ourselves? How do we know whether we’re winning or losing? If you can do that, you can keep on top of the market.

include:

comparisons can be made between unified strategic doctrine (a company-

Choosing the right mentor/ coach/consultant

Watching your competition– and your step

wide language and decision-making

system), as well as a clear definition of

knowledgeable advisors who can

against? If you don’t have a clear

victory.

help ease your transition to medical

picture of your competitors, how will

spa or aesthetic practice owner.

you stand out from the crowd?

business and war. Both require a

Like war, business competition

There are successful and

may-june 2008 | www.aesthetictrends.com

Do you know whom you are up

55—

medical spas

Remaining compliant

about teamwork.

Not only must you follow current

The real lesson of war, of course, is

compliance regulations, but also

prepare for new policies and laws that

staff apprised of your goals and

“It is so important to keep your

are on the horizon.

expectations while making them part of the process from the start,” says

Purchasing or leasing the best equipment at the right price

Dr. Dawn Hunter, DC, consultant

point is to create the team spirit you

Whether you purchase new, lease

and former medical spa owner. “The

and pay as you earn from procedures,

need to succeed. Each member of

or buy used through trusted brokers

your staff should be able to answer

(especially those who deal in items

the following about your business:

from practices that closed shortly

How do we compete? Where do

after they opened their doors), make

we compete? How do we conduct

sure you are choosing the equipment

ourselves? How do we know whether

that will give you the best return on

we’re winning or losing? If you can

your money (ROI) – and provide the

do that, you can keep on top of the

services your target market wants.

market.”

When choosing technology, be sure to consider each item’s efficacy,

YOUR GREATEST ASSETS

cost per treatment, initial costs,

Success and adaptability go hand in hand, especially in an industry that

Success and adaptability go hand in hand, especially in an industry that continues to grow and change with the needs and desires of an ever-expanding, and continuously aging, market.

and change with the needs and desires of an ever-expanding, and

manager must also be involved in

continuously aging,

the hiring and training of the staff,

market. You need

working with vendors, contracting for

several things in place

cleaning services and the removal of

and usage. Before deciding on the

to help you meet those needs and

medical waste, ensuring compliance

best equipment for you, know your

desires, including:

with various regulatory agencies, and

patients and their needs.

56 —

continues to grow

renewing any licenses required for

The right spa director/manager

the personnel and office. Further, your

Controlling cash flow

office manager must have excellent

Exaggerated revenue and

business operations of your practice.

communication, organizational, and

growth projections are common in

This includes supervising everything

management skills, along with good

the excitement of a new business,

that happens in your office, including

business sense and the ability to

so meeting expenses can become

office management, implementation

handle multiple priorities. The new

an issue for new medical spa and

of procedures, case management and

emerging customer who pays cash

aesthetic practices. Plan your work

processing, records management,

for services is more demanding and

and work your plan to keep finances

collection and reporting of statistics,

has more choices of places to go for

in line.

and accounting functions. Your

similar services.

Your manager oversees the

may-june 2008 | www.aesthetictrends.com

The right staff–and the know-how to keep the rest from making it through the second interview As you and your office manager

new hire succeed,” says Heather

potential trouble, consider having a

Rogers, Office Manager at Brevard

professional assessment done every

Plastic Surgery and Skin Treatment

year so you can correct as you move

Center. “My goal as a manager is

forward.

work to build your team, be sure to

to hire top-notch people who are

build multiple interviews by other

service-oriented, as well as friendly

people who are working with you to

employees into the process. Because

and courteous. Having input from the

achieve your dreams of success. Do

your staff will need to work together

whole staff helps make sure every

not leave this to chance.

as a cohesive team, their input during

member of our team fits.”

your hiring process is extremely

The best assets you have are the

“DISTINCT OR EXTINCT” – TOM PETERS

important. Not only does this give you

Training, training, training

another perspective on a candidate’s

your practice the best place for it?

appropriateness for a specific position,

training so your staff can keep up

but also begins the process of

with trends and new technology, as

Marcy Street of Doctor’s Approach

building relationships between your

well as understand what to do when

Skin & Hair Care. “I have worked

employees. Providing an excellent

things don’t go as planned. Take the

very hard to establish myself in my

benefits package that includes full

time to teach your staff

medical coverage, 401k, even tuition

about contraindications

for continuing education, will be some

and how to handle them.

of the perquisites the best applicants

Provide an employee

will be expecting.

manual – a key item

“I have found that the more

you should develop and

involved our staff is in evaluating

maintain from the very

prospective employees, the more

beginning. In addition to

responsibility they feel to help the

training for your staff, you will need

medical practice, and I have set

to keep up on the latest techniques

very high standards for myself and

and business practices. Poor

my staff. My patients know this and

training and oversight are the most

have very high expectations for my

common shortfalls. Because it takes

aesthetic practice – and they know I

experience before you can recognize

will do what it takes to exceed their

Institute continuous education and

What are you offering, and why is “My name is my brand,” says Dr.

Your ultimate goal is to differentiate your practice by providing services, products, or solutions that convince your target market that what you have is infinitely more desirable than what your competition is offering.

expectations. Plus, they will tell all their friends.”

Your brand is what will – or should

– draw patients to you. Build a unique niche that drives the demand of your target market. Keep the following in mind as you continue to build your spa/practice:

Your biggest challenge is attracting and retaining patients

There is no doubt that word-of-

mouth is the most effective form

may-june 2008 | www.aesthetictrends.com

57—

medical spas

of marketing for your business. However, include internal marketing using your current database to begin the rest of your marketing efforts because it is lower in cost than other marketing strategies and can be extremely effective. Determine all other forms of marketing you will use and create a marketing plan that is reviewed quarterly, with attention to tracking all of your leads.

Know why patients should choose you over the competition and get that point across Show your target market the Cheryl

uniqueness and benefits provided by your practice. Consider sharing

be customer service-oriented and

Whitman is

patient testimonials to get more

marketing driven.

recognized

attention for your services. Don’t

internationally

forget holding an Open House to

differentiate your practice by

as a pioneer

generate buzz and attract media. The

providing services, products, or

in the field

Your ultimate goal is to

Because your new patients and target market are very likely to be more demanding, be prepared to roll out the red carpet.

solutions that convince

of medical

your target market

spa business

that what you have

consulting. She is a published author,

is infinitely more

a popular speaker, and has been a

desirable than what

beauty-industry consultant for more

your competition is

than 20 years. As founder and CEO of

offering.

Beautiful Forever, Cheryl spearheads a successful team of medical spa

most important element will be the

58 —

benefits you can offer your current

BE READY TO ADAPT

consultants and business professionals.

and potential patients.

In addition, Cheryl developed the

Charles Darwin said it best: “It is

not the strongest of the species that

Medical Spa Success System, a

Customer service is king – treat your patients like royalty Because your new patients and

survives, nor the most intelligent, but

revolutionary program that provides

the one most responsive to change.” It

a turnkey educational success system

is no secret that the aesthetics industry

and consulting services package

target market are very likely to be

is in a state of constant flux. Whether

to help clients jumpstart brilliantly

more demanding, be prepared to

it is emerging technology, shifting

successful medical spa businesses.

roll out the red carpet. You are now

trends, the economy, or a combination

For more information, please call

providing a luxury service, so you

of everything, you must be ready to

1.877.SPA.MEDI or go to

will need to present yourself as

adapt. Your response to the challenges

www.medicalspaconsultant.com or

such every inch of the way. This is

ahead is what will help you set the

www.medicalspasuccess.com.

a retail business that means it must

standard for your success.

may-june 2008 | www.aesthetictrends.com

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Business Consultant Cheryl Whitman CEO, Beautiful Forever Medical Spa Business Consultant, Inc.

Thousands of hours of medi-spa experience packed into one comprehensive system. The Medical Spa Success System walks you through every step of the process to create a profitable medi-spa. Eliminate barriers and reduce the cost of start-up. The Medical Spa Success System not only provides you with all the information you need to succeed, but also includes a bonus CD-ROM which contains:

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featured medical spa

medical spas

Jonathan Dental Spa

Hawthorne, New Jersey By Cindy Vandruff, Editor in Chief

Passersby on Hawthorne’s renowned

so that not only can they walk out with a

dental experience an enjoyable one

Lafayette Avenue can’t miss the

feeling of oral rejuvenation, but the skin

for his patients. “My goal is to make a

glimmering new sign boasting “Jonathan

on their hands will also have a sense of

beautiful smile something achievable

Dental Spa,” a new concept created by

youthfulness. Each operatory is equipped

for all those who come in search of one,

Jonathan Abenaim, D.M.D. But the

with its own television for patients to

and I try to create small miracles in the

outdoor fixture is not the only way this

enjoy during procedures, and DVDs are

form of Extreme Dental Makeovers.” His

innovative center for cosmetic and implant

available to be watched via special wrap-

practice focuses on all aspects of cosmetic

dentistry differs from its predecessors,

around projection glasses.

and implant dentistry, from tooth-colored

neighbors, and local competitors.

fillings to the popularized Zoom whitening

qualitative amount of time with each

to bonding, porcelain veneers, and

comfy leather chairs, comfy cushions, and

patient, tending to specific issues, needs,

implants.

an I-Joy massaging recliner; help yourself

and interests, and always discusses

to complimentary coffee, tea, or juice from

all treatment options until a patient

many to Jonathan Dental Spa has been

Enter the modern waiting area with

Dr. Jonathan Abenaim spends a

The newest procedure to attract

the bar; and grab a healthy snack prior to sitting down and enjoying your minimal wait. (This is perhaps the only office in the medicinal world in which patients complain that their wait was too short.) After being

“ My goal is to make a beautiful smile something achievable for all those who come in search of one, and I try to create small miracles in the form of Extreme Dental Makeovers.”

greeted personally by the

60 —

friendly staff, you will be ushered into a

is satisfied with the knowledge and

Glam Smile. Dr. Abenaim’s philosophy

sterile treatment area that is filled with the

comfortable with his or her directives.

of helping all those who want to better

soothing scents of aromatherapy candles

During treatment, patients can request an

their smiles, regardless of financial

and oils, all subtle and distracting from

aromatherapy heated eye pillow to lessen

background, truly comes into play with

the normally overwhelming “dental-office

the nerves (if any still exist) and enter

the introduction of these extremely

smell.”

a deeper state of relaxation. For post-

affordable veneers. Glam Smile Veneers

appointment freshness, a warm, moist

also require less alteration and removal of

patients are given the option of having a

cloth is offered.

original teeth, and a quicker end-result:

bonus hot paraffin wax hand treatment,

a beautiful smile. His patients have been

During a hygiene appointment,

Dr. Abenaim strives to make the

may-june 2008 | www.aesthetictrends.com

educated about the wonders of modern

“ With this patented technology we can do a smile makeover with little to no drilling or pain in under one hour.”

dentistry. We strive to spend time with the patients and listen to their concerns, whether it is fear or financials. We always find a way to make it work in people’s lives. This is not your mother’s dental

medical spas

featured medical spa

office; this is the new wave of dentistry where we don’t only treat teeth, but most

raving about this innovative, conservative

Abenaim believes in maintaining certain

option, and all have been satisfied with

standards of care; and in order to ensure

the impressive results. “We constantly

that all components and materials comply

have patients who want a smile makeover,

with safety standards and are lead-free,

Jonathan Dental Spa

but the cost of traditional veneers is very

much of his lab-work is done in the office

Jonathan M. Abenaim, D.M.D.

prohibitive. With this patented technology

by computer or is sent out to a U.S.-

262 Lafayette Avenue

we can do a smile makeover with little to

accredited dental lab. “If we are not using

Hawthorne, NJ 07506

no drilling or pain in under one hour.”

our Cerec Robot to make the crowns in

973.423.4460

our office, we use only the most accredited

www.jonathandentalspa.com

Jonathan Dental Spa has recently

pitched in with “greener” efforts to

and trustworthy U.S. labs to gurantee

provide a healthier, more organic

our work.” Dr. Abenaim’s approach to

approach to dentistry. Because the office

dentistry is one of conservation as well; he

uses digital X-rays, patients are exposed

tries his hardest to save and strengthen

to 90% less radiation than regular X-rays.

teeth rather than immediately remove

Computerized patient files and charts limit

them. For example, he frequently places

the amount of paper used and conserve an

porcelain onlays rather than full crowns,

immense amount of trees. Dr. Abenaim

a technique that functions in preserving

also does not place any mercury-based

and strengthening the tooth and further

amalgam fillings which many physicians

limits the decay. “Many patients hate the

feel can compromise health. Instead,

fact that they have caps/crowns. With a

fillings are made of tooth-colored

porcelain onlay we can not only preserve

composite or porcelain which provide

the tooth but also make it look and feel

for a more natural finish. To obtain

like nothing was ever done to it.”

cheaper materials, many dental offices

will outsource their dental labs, but Dr.

where patients are pampered and

The Jonathan Dental Spa is a place

may-june 2008 | www.aesthetictrends.com

importantly, we treat people.

Jonathan Abenaim, D.M.D. was born in Montreal, Canada, and graduated from Yeshiva Univesity in New York with a B.A. and a major in Biology. He then continued his studies at the University of Pennsylvania School of Dental Medicine, graduating with honors in several disciplines including Prosthetic Dentistry, Endodontics, and Pain Management. His most cherished award is the E. Howell Smith Award in Prosthetic Dentistry which he received upon graduation. Dr. Abenaim attended an Advanced Implant Prosthodontic Residency at Nova Southeastern University and then improved his knowledge and skills in Oral Implantology at the Atlantic Coast Dental Research Clinic in Palm Beach, FL. He has subsequently been awarded Fellowship in The International Congress of Oral Implantologists.

61—

Sweep Away The Signs of Aging. Introducing a particle-free micro-resurfacing system featuring 7 combinations of bristle treatment tips, adjustable vacuum pressure, and skin-specific solutionâ&#x201E;˘ delivery. Ideal for treating acne, early age lines, uneven skin texture, hyperpigmentation, photo-damage, pre-PDT, surgical scars, and improving overall skin health. ÂŽ

One System. Three levels of treatment.

Skincare reinvented beautifully.

product listings

Microdermabrasion

spotlight

Med-Aesthetic Solutions Salt-A-Peel™

The restorative benefits of salt, one of nature’s healing minerals,

Technology activates treatment

are well known. Since salt occurs naturally in the body and works

when the handpiece comes

fast to purify and soothe, it is the ideal ingredient for safe, effective,

into contact with tissue and

non-invasive skin renewal. The Salt-A-Peel MacroDermabrasion

turns off when the handpiece is

Therapy proprietary crystal delivery system uses water-soluble,

removed.

non-toxic salt as a gentle, natural abrasive to gently abrade the skin

and draw out impurities. Patients see immediate results: healthier,

pressure, not a vacuum,

smoother skin.

efficiently removes the

Adjustable positive

topmost layers of skin (stratum

When followed by treatment with our patented

DermaPhoresis™ ultrasound module, skin renewal benefits are even

corneum) without excessive flushing/redness (erythema), edema,

more dramatic. With Salt-A-Peel MacroDermabrasion Therapy,

or trauma to the area. And larger areas of skin can be covered with

patients enjoy longer-lasting results in fewer treatments with virtually

fewer passes, minimizing discomfort and expediting treatment time.

no downtime. Salt-A-Peel MacroDermabrasion Therapy’s advanced system of products works together to provide an effective, non-

DermaPhoresis for Healthier, More Vibrant Looking Skin

invasive approach to reduce the appearance of:

Skin renewal therapy is greatly enhanced when proven ultrasound

• Fine lines and wrinkles

technology is combined with antioxidant-rich MAStique™ Skin

• Sun damage

Care Products. The MacroTouch® 3 MHZ Ultrasound treatment

• Age spots

gently penetrates deep into the skin to deliver the MAStique Skin

• Uneven skin tone

Care Masque, a proprietary formulation containing multivitamins,

• Scarring

Alpha Hydroxy Acids (AHAs) and fibroblast stimulators to improve

• Stretch marks

elastin and collagen production.

Gentle abrasion of the skin with healing, non-toxic salt results

Med-Aesthetic Solutions

in a smoother peel and boosts the clinical effects of skin repair. The

760.942.8815

MicroPro S10 MacroDermabrasion System with Smart Sensing™

www.medaestheticsolutions.com

may-june 2008 | www.aesthetictrends.com

63—

MICRODERMABRASION Product Listings Source

Vacuum Mobile/ Product Flow Control Weight (lbs) Handpiece

Aesthetic Solutions www.dermaglow.com 651 Canyon Road Novato, CA 94947 888.345.4569 p

DermGlow II DermGlow II MD

Dual Dual

DermGlow EST

Yes

Yes/32 Yes/32 Wheels Yes/12

Glass, Aluminum Disposable Tips

Aesthetician Unit Price

M.D. Unit Price

On-site full training, technical and mktg support

$8,750 N/A $4,750

N/A $10,500 N/A

One day on-site advanced training

N/A

$16,900

N/A

$12,900

$6,900

$8,900

Disposables

Training

Aluminum Oxide or Sodium Bicarbonate $2-$4

Warranty & Accessories: Lifetime warranty with 24-hour loaner. HEPA filtration.Trade-in program.

Aesthetic Technologies www.parisianpeel.com 14828 W. 6th Avenue, Unit B-9 Golden, CO 80401 800.262.4412 p

Prestige Esprit

Dual Vacuum/ Compres.

Yes/80 Yes/46

Proprietary ergonomic design w/ sterilizable immersible cartridge tips

$3.50

Warranty & Accessories: 1 yr. warranty

Ageless Aesthetics www.agelessaesthetics.com 5889 Greenwood Plaza Blvd. Suite 400 Greenwood VIllage, CO 80111 877.721.7975 p

ClairDerm (models 1, 2, & 3)

Via Control Knob

Yes/15

Aluminum, plastic Tips & Crystals w/ cellulite roller / light therpay combo

Warranty & Accessories: 3 yr. warranty. Low cost per treatment at under $1.15. Client brochures, specialty products, and consent forms available. ClairDerm3 now available with combined cellulite roller & light therapy handpiece.

Altair Instruments www.diamondtome.com 321 Aviador St., Suite 113 Camarillo, CA 93010 805.388.8503 p

DiamondTome

Variable

Yes/27

Diamond tipped wands

$0.50

Video On-site Training

$10,250

$10,400

Warranty & Accessories: 1 yr. warranty, HEPA filters, filter pads, and assorted wands. Four grit sizes.

Bella Products www.bellaproducts.com 27136 Burbank Foothill Ranch, CA 92610 877.550.5655 p

BD II BD II-ASM BD II-ASP BD M II BD M II-MAX Bella Micro

Yes Yes Yes Yes Yes Yes

Yes/24 Yes/26 Yes/27 Yes/36 Yes/41 Yes/16

Aluminum Poly carb caps; Direct particle abrasion

Warranty & Accessories: 1 yr. warranty.

64 â&#x20AC;&#x201D;

may-june 2008 | www.aesthetictrends.com

$3-$3.50

Video on-site

$11,950 $13,950 $15,950 $19,950 $21,950 $4,950

MICRODERMABRASION Product Listings Vacuum Mobile/ Source Product Flow Control Weight (lbs) Handpiece Disposables Training

Aesthetician Unit Price

DermaMed USA www.megapeel.com P.O. Box 198 Lenni, PA 19052 888.789.6342 p

MegaPeel Platinum

Yes

Yes/32

MegaPeel Gold

Yes

Yes/25

MegaPeel Silver

Yes

Yes/25

Autoclavable; detachable; condition specific tips

M.D. Unit Price

$2.50 per treatment $3.50 per treatment $3.00 per treatment

Intensive on-site;Video; Workshops; Seminars; Mfr. Corp. office

N/A

$19,500

N/A

$15,000

$12,500

N/A

$.50- $5.00

On-site

N/A

$13,900 - $14,500

$.50- $5.00

On-site

$12,900

N/A

$0.50

Yes

$4,999

$5,900

N/A

Starts at $13,900

$11,450

$11,800

$7,500

$7,850

N/A

$22,465

N/A

$8,500

Warranty & Accessories: 1 yr. warranty, includes accessories and skin care products.

DermaSweep® www.dermasweep.com 7251 Galilee Road Suite 160 Roseville, CA 95678 916.772.9134p

DermaSweep MD

Variable

Yes/26

DermaSweep Pro

Variable

Yes/26

DermaSweep Mini

Variable

Yes/8

Particle Free, Autoclavable Stainless Steel 7 Different treatment tips

Warranty & Accessories:1 yr. warranty, extended warranty options. 7 different treatment tips, 7 different Skin Specific Solutions ™

Edge Systems www.edgesystem.net 2277 Redondo Avenue Signal Hill, CA 90755 800.603.4996 p 562.597.0148 f

Delphia

Dual

Yes/24

Delphia™ Del Sol Plus

Dual

Yes/30

Delphia IIe Plus

Dual

Yes/30

Diamond Delphia

Dual

Yes/24

Crystal, Lymphatic masssage optional LED lights and crystal micro, Lymphatic and Crystal-free Optional Lymphatic massage & LED lights optionalCrystal-free

$.55 - $3.00

Full certification On-site, local courses & video

Warranty & Accessories: 1 yr. warranty, overnight loan program. 4 lbs. crystal and 10 tips included.

emed www.silkpeel.com 31340 Via Colinas, Suite 101 Westlake Village, CA 91362 888.848.3633 p

Focus Medical, LLC www.focusmedical.com 23 Francis J Clarke Circle Bethel, CT 06801 866.633.5273 p

SilkPeel Dermalinfusion System

Dual

Yes/30

Diamond-tipped handpiece; autoclavable; crystal-free

$9.95 tips only

On-site certification

Warranty & Accessories: 1 yr. warranty, extended warranty options. 11 combinations of grit sizes.Three choices of topical solutions.

NaturaBrador

Yes

Yes/30

Reusable, Plastic, Disposable

$1.00-$1.50

Video & on-site

Warranty & Accessories: Massage therapy attachment.

may-june 2008 | www.aesthetictrends.com

65—

MICRODERMABRASION Product Listings Source

Vacuum Mobile/ Product Flow Control Weight (lbs) Handpiece

Genesis Biosystems www.dermagenesis.com 1500 Eagle Court Lewisville,TX 75057 888.577.PEEL (7335) p

AccelaFuze AccelaGen M2 - Turbo M2 M1 Infusion Peel

Programmed Programmed Yes Yes Yes Yes

Yes/39 Yes/34 Yes/19 Yes

Disposables

Dual-Mode Dual-Mode Ergonomic Dual-Mode Handpiece with DualLumen, Color-Coded Tubing Set

Bio-Barrier Tips $.50-$3.00

Training

Hands On Onsite and Online

Aesthetician Unit Price

N/A $13,995 N/A N/A $8,495 $12,995

M.D. Unit Price

$17,995 $16,995 $15,995 $12,995 N/A $12,995

Warranty & Accessories: 3 yr. warranty. Plug-N-Peel Closed Canisters, Handpiece, Crystal and Crystal-Free Disposable Tips, CoolBreezeâ&#x201E;˘ LED Lights, Blue, Red,Yellow

ImageDerm www.imagederm.com 3032 Dolores Street Los Angeles, CA 90065 818.500.9034 p

ImageDerm

Dual

Yes/30

Reusable Delrin Tip

Warranty & Accessories: Full 5 yr. warranty. M.D. unit has 3-feature function.

Innovative Med Inc. www.innovativemedinc.com 4 Autry , Suite B Irvine, CA 92618 877.779.9492 p 949.458.7416 f

PortaPeel 1050 PortaPeel Pro 4150 Silver PortaPeel Pro 4150 Gold Setereh 1150 Setereh 2150 MD

Yes Yes Yes Yes Yes

Yes/14 Yes/16 Yes/18 Yes/35 Yes/37

$3.00

Full Training with Manual

$8,500

$10,700

$2-$4.00

Comprehensive manual, technical support & marketing support

$4,500 $4,800 $6,800 $9,500 N/A

N/A N/A N/A N/A $12,000

$14,500 N/A

N/A $18,995

Ergonomic, patented handpieces; disposable, reusable, metal & crystal free avail., disposable tips for face & body

Warranty & Accessories: Setereh systems: 5 yr. warranty. Portapeel systems: Lifetime Warranty. All of our systems can be used for crystal free microdermabrasion as well.We accept trade-ins, loaners available.

Lumenis www.lumenis.com 2400 Condensa Street Santa Clara, CA 95051 408.764.3000 p

SkinScape SkinScape Plus

Single Dual

Yes/22 Yes/30

Autoclavable small & large handpieces Aluminum/ disposable tips

Warranty & Accessories: 1 yr. warranty. Education and marketing materials.

66 â&#x20AC;&#x201D;

may-june 2008 | www.aesthetictrends.com

$2.80 $2.80

Intensive On-site training

MICRODERMABRASION Product Listings Vacuum Mobile/ Source Product Flow Control Weight (lbs) Handpiece Disposables Training

Mattioli Engineering www.matteng.com 4200 Wilson Blvd., Suite 750 Arlington,VA 22203 877.628.8364 p

Aesthipeel™ Ultrapeel® Pepita Ultrapeel® Crystal

3 Pre-set Positions Dual/Count Variable

Yes/17

Plastic/Glass

$3.00-$9.00

No/39 No/44

Glass Pyrex/reusable Glass Pyrex/reusable

$3.00-$9.00

1 day on-site

Aesthetician Unit Price

M.D. Unit Price

$3,675

N/A

$10,710 N/A

N/A $13,860

$13,900

$16,500

Warranty & Accessories: Carrying case, 2 yr. warranty, next day loaner program, external comp. delivery kit, sealed plastic corundum containers, safety filter, vacuum and compression mode.

Med-Aesthetic Solutions www.medaestheticsolutions.com 2033 San Elijo Ave, Suite 200 Cardiff by the Sea, CA 90249 760.942.8815 p 505.341.2575 f

Salt-APeel™ MacroDermabrasion Therapy

50 lbs

Proprietary aluminum design, with no mess auto control

$3/treatment

Warranty & Accessories: Proprietary crystal delivery system uses water-soluble, non-toxic salt. Pre-packaged salt containers and disposable 0.1 micron ULPA Filter waste containers. Positive and negative pressure system with little to no redness. Natural salt for superior results. Patented DermaMask and MacroTouch® 3 MHZ Ultrasound module for Physician model. Marketing support program.Three year warranty parts and labor.

Raja Medical www.rajamedical.com 6542 Hypoluxo Rd, #171 Lake Worth, FL 33467 561.868.4600 p

Sapphire Abrastim

Yes/15

Stainless steel, Sapphire heads

$5.00

1 day

N/A

$14,500

On-site, manual, PP presentation

$10,900

$13,500

Warranty & Accessories: 2 yr. warranty.

Science Innovative Aesthetics www.scienceaesthetics.com 30 Montgomery Street Suite 660 Jersey City, NJ 07302 201.332.4100 p

Aurora

Yes

Yes/46

Stainless steel, 9 different tips, autoclavable

$.40 per filter, one filter per treatment

Gemini

Dual, pin point crystal flow control

Yes/55

Crystal - flexible, w/disposable plastic caps. Crystal Free stainless steel w/9 different tips

$1.50 for alum. ox. crystals, varies per treatment

Warranty & Accessories: 2 yr. warranty with next day loaner, 100 filters plus ultrasonic cleaner included with purchase, marketing material, tech-support, additional filter inside machines, quietest machines on the market (ask about our trade-in program). Gemini includes 2 (4 lbs.) bottles of crystals, closed loop system.

may-june 2008 | www.aesthetictrends.com

67—

MICRODERMABRASION Product Listings Source

Vacuum Mobile/ Product Flow Control Weight (lbs) Handpiece

Sciton www.sciton.com 845 Commercial Street Palo Alto, CA 94303 650.493.9155 p

MicroLaserPeelâ&#x201E;˘

N/A

Yes/wheels

Disposables

Training

Aesthetician Unit Price

M.D. Unit Price

Large area scanner

None

In-office

N/A

$19,500 module

Stainless steel disposable tips

$3.00

Video on-site training

$9,950

$11,950

$10,995

Warranty & Accessories: 10 to 40 microns in 5-micron steps.

Silhouet-Tone USA www.silhouettone.com 7 Champlain Commons St. Albans,VT 05478 800.552.0418 p

S.T. Peel

Yes

Yes/65

Warranty & Accessories: 3 yr. warranty. Disposable tips. Manual included, complete marketing tools. Rotational projection handpiece.

Sybaritic www.sybaritic.com 9920 James Avenue South Minneapolis, MN 55431 800.445.8418 p 952.888.8887 f

SkinBella

N/A

Yes/ 22 lbs Cart 32 lbs

Ultrasonic Applicator

$2.50

On-Site Advanced Training

Warranty & Accessories: 1 yr. warranty included with extended warranty available. Professional and retail skin care products, marketing kit and cart included.

SoundSkin Corporation www.soundskin.com 429 South Main Street Oswego, IL 60543 888.596.5277 p

SmartPeel - Esthetician

16 settings + lymphatic

SmartPeel-M.D.

Yes/18

Acetyl copolymer with full range of accessories

Yes/23

$1.50

On-site by specialist

$10,500

N/A

$13,500

32 settings

Warranty & Accessories: 1 yr. warranty, parts & labor with dual probe lymphatic drain module, dual SmartFilter viral barrier system to 0.1 microns.

68 â&#x20AC;&#x201D;

may-june 2008 | www.aesthetictrends.com

MICRODERMABRASION Product Listings Vacuum Mobile/ Source Product Flow Control Weight (lbs) Handpiece Disposables Training

Syneron Medical www.syneron.com 100 W. Beaver Creek Rd. #6 Richmond Hill, Ontario, Canada 800.445.8418 p

Libra

Variable

Yes/34

Custom disposable tips $.50-$1.00

Aesthetician Unit Price

M.D. Unit Price

Video on-site training

N/A

$9,995

Warranty & Accessories: 1 yr. warranty. Education and marketing materials.

Vibraderm, Inc. www.vibraderm.com 2100 N. Hwy 360 Suite 1502 Grand Prairie,TX 75050 800.494.7181 p

Vibraderm

None

Yes/21

High-Tech Aluminum Alloy

None

On-site training included

$18,100

Ergonomic stainless steel design; 10-13tips depending on model; auto-clavable

$.30/filter

Manufacturer support Manufacturer support

$10,900

$11,900

$15,900

$16,900

Warranty & Accessories: 1 yr. warranty.

Viora, Inc. www.vioramed.com 30 Montgomery Street Suite 660 Jersey City, NJ 07302 877.384.8032 p 201.332.4200 f

Pristine - Diamond System

Single

Yes/28

Marquis â&#x20AC;&#x201C; Diamond and Crystal System

Dual

Yes/35

$.30/filter

Warranty and Accessories: Pristine - 2 yr. warranty with next day loaner. Esthetician unit sold with 10 DPeel tips; M.D. unit sold with 13 DPeel tips; 100 disposable filters, 25 client brochures, 1 poster, ultrasonic cleaner; system manual. Marquis - 2 yr. warranty with next day loaner. Esthetician unit sold with 10 DPeel tips; M.D. unit sold with 13 DPeel tips. Diamond Peel-100 disposable filters, 25 client brochures, 1 poster, ultrasonic cleaner. Crystal Peel -10 plastic caps.

Vita Medical Technologies www.vitamedtech.com 1286 University Avenue, #264 San Diego, CA 92103 619.795.7953 p

Beauty Skin

Dual

Yes/20

45 degree angle Teflon handpiece; reusable or disposable tips

$1.50

On-site by representative

$7,900

$7,900 Dual Motor

Warranty & Accessories: 2 yr. warranty, parts & labor. 2 handpieces; abrading and peeling.Variety of tip sizes available.

may-june 2008 | www.aesthetictrends.com

69â&#x20AC;&#x201D;

0ATIENT STRESSED ABOUT PAIN

70 —

may-june 2008 | www.aesthetictrends.com

plastic surgery

By Maurice P. Sherman, M.D.

efficiency of the probes required

necrosis or scarring events. Revision

date back to the late 1970s when

high energy settings. The probes

rates in studies also seemed to be

Europeans such as Georgio Fisher

themselves were large diameter

reduced by at least 50%.

and others described a selective

with sharp edges, and the hollow

localized fat removal procedure using

canulas had insufficient capability of

ULTRASONIC EMULSIFICATION

suction canulas. Scuderi, in 1987,

aspirating the ultrasonic emulsified

first reported using ultrasonic energy

fat. Due to inefficient distribution of

emulsification of the fat revolves

for lipoplasty. The first generation

the ultrasonic energy, where most

around the concept of avulsion versus

of ultrasonic devices was an SMEI

of the energy was directed at the tip

emulsion. In traditional liposuction,

device, which utilized 4-6mm solid

along with imprecise infiltration of

surgical skill cannot overcome the

probes. Lysonix, 1996, developed a

tumescent solution, a high rate of

potential issues associated with the

second generation ultrasonic device

complications was reported in 8-14%

tearing or avulsion of tissues seen

which had a golf-tee shape at the end

of all procedures. These

of a 5mm canula with a 2mm lumen

complications consisted

for simultaneous aspiration. Finally,

of seroma formation,

in 2002, a third generation ultrasonic

prolonged indurations, skin

device marketed by Sound Surgical

necrosis, hypopigmentation,

Technologies, termed the VASER®

prolonged swelling, and

System, became available and was

scarring from “end hits”

marketed as LipoSelection®.

producing burns and

The idea of ultrasonic

at t

Body contouring procedures

The pulse mode lowers the amount of energy delivered to the target, while maintaining efficiency of emulsification.

cellulitis. This figure contrasts

with a suction canula. This traumatic

HISTORY OF THE ULTRASOUND METHOD

markedly with a 2% overall

avulsion technique is caused when

complication rate with VASER

the fat is introduced into the lumen of

lipoplasty, with elimination of skin

the canula, and then sheared off by

The early ultrasonic systems

were less than optimal. The low

may-june 2008 | www.aesthetictrends.com

plastic n surgery

VASER® Lipoplasty

71—

plastic surgery

the movement of the canula back and

for fat. Nerves, blood vessels, and

target, while maintaining efficiency

forth.

connective tissue remain relatively

of emulsification. The VASER

undisturbed, promoting smoothness

platform includes a precision fluid

tissue trauma, leading to unevenness

of contouring with precise sculpturing

management system, which integrates

of fat removal with inconsistent

and contouring finesse. Strain and

infusion and suction, and permits

precision and potentially uneven

fatigue on the surgeon during the

accurate measurement of tumescent

results. This technique is associated

removal process is significantly eased;

infiltration by plus or minus 1cc.

with more painful recovery along with

and because of the reduction of

elongated recovery time. Physician

tissue trauma, there is low to minimal

VASER TREATMENT

position fatigue can limit cases, or

pain development post-operatively.

This action produces non-selective

By altering the probes, amount of energy utilized, and the continuous VASER versus pulsed modes, any areas of fat collection throughout the body can be treated.

72 â&#x20AC;&#x201D;

After marking the patient in the

The VASER (which

traditional manner and standard

stands for Vibration

prepping and draping, a wetting

Amplification of

infusion consisting of a standard

Sound Energy at

tumescent Kleinâ&#x20AC;&#x2122;s solution is infused

Resonance) features

at a ratio of 1.5 - 2cc per every

small diameter, solid

expected cc of fat removal. The

probes which require

infusion serves as thermal protection,

only a 4mm incision

as well as a medium for delivery of

limit time spent on each case; and

for access.

the ultrasonic energy and aids in

with more tissue trauma, there is an

formation of the emulsion. A10- to

inability to control finesse of the fat

ultrasonic mode which is varied

20-minute wait before ultrasonic

removal. This contrasts with emulsion

according to the type of tissue

application ensures a dry field with

seen with delivery of ultrasonic

treated. The pulse mode lowers the

almost total absence of blood in the

energy, which is tissue selected

amount of energy delivered to the

aspirate. VASER probes are inserted

There is a pulsed and continuous

may-june 2008 | www.aesthetictrends.com

harm non-fatty tissues. The vents also prevent clogging of the canula and tubing.

The emulsified fat is collected

in containers, with the aspirated fat showing a significant reduction in blood staining compared to traditional techniques. Foam padding is then applied to the treated areas, in addition to an elastic compression garment that is placed on the patient. Postoperative instructions include immediate ambulation with full activity beginning in 7-10 days. We

Before (Left) and After Abdomen Treatment (Right). Photos Courtesy Maurice P. Sherman, M.D.

remove the foam padding after three days but instruct our patients to

through the skin ports which are

2.9mm probe is available for very

wear compression garments for four

either screwed or sutured to the

fibrous tissue seen in male patients or

weeks. We also highly suggest use

inside of the incised access sites.

in revision cases. The 2.2mm probes

of Endermologie Massage Therapy

are also available for more precise

starting three weeks after the

design of the solid probes

use in delicate areas such as the neck

surgery, and consisting of eight to ten

redistributes the ultrasonic energy

and face.

weekly sessions.

from the tip to the sides and

disburses the energy in a more

application of the ultrasonic energy,

efficient manner. Hence, there is

a creamy fat emulsification will be

ADVANTAGES OF THE VASER TREATMENT

a 50% less energy requirement

The proprietary side grooved

Several minutes into the

seen exiting the insertion ports.

compared to previous systems.

Generally, the VASER usage is

energy utilized, and the continuous

The canulas are blunt and passed

confined to 1 to 1.5 minutes of usage

VASER versus pulsed modes, any

through tissues easily with less

per every 100cc of

trauma. For body work, 3.7mm

tumescent solution

diameter probes are used, and the

infiltrated into a given

probes come with 1, 2, and 3 rings

area. Emulsification

at the distal tip. The 3-ring probe

is followed by

produces more disbursement of the

aspiration using a

ultrasonic energy away from the

proprietary Vent

tip, and the 1-ring probe produces

Xâ&#x201E;˘ Canula. The

more concentration of the ultrasonic

canula comes in

energy at the tip.

multiple diameter sizes and is of a

non-aggressive design with a blunt

areas of fat collection throughout

that can be altered specifically for

tip. The handle is vented to provide

the body can be treated. The main

the amount of fibrous nature of the

continuous uninterrupted suction

VASER advantages include ease of

treated areas. Additionally, a 3-ring,

without suction surges which may

fat aspiration, more precise aspiration

These variations produce probes

By altering the probes, amount of

The benefits include better sculpting of tissues, especially of a fibrous nature, faster overall surgical time, significantly less work for the surgeon with less bruising and discomfort for the patient, secondary to the reduced tissue trauma from evacuation of the fat.

may-june 2008 | www.aesthetictrends.com

73â&#x20AC;&#x201D;

plastic surgery

and body contouring, easier recovery

reduction techniques provides for a

or wound breakdown. Excellent

secondary to minimal production

definitive noticeable amount of skin

post-operative nipple sensation

of pain, discomfort, and bruising.

contraction compared to traditional

has been reported in my patient

Perhaps the most significant

liposuction. This quality is especially

experience.

advantage in my practice is the

desirable in breast liposuction for

ability to produce skin contraction/

reduction. This characteristic also

FACE AND NECK TREATMENTS

retraction with use of more superficial

permits simultaneous treatment of

application of the ultrasonic energy,

the axillary breast roll seen in many

the small diameter 2.2mm probes

which can enable us to utilize the

patients. VASER breast reduction

combined with the VASER mode for

VASER System in place of surgical

is also seen in mastopexy patients

pulsed application of the ultrasonic

resection of excess skin in many

permitting reduction of the breast

energy allows for the surgeon to

situations.

mass with minimal bleeding,

work very close to the dermis in

In the face and neck, the use of

and maintenance of the vascular

thin subcutaneous fatty areas such

BREAST REDUCTION TECHNIQUE

network of the breast tissue, leading

as the neck. Safe contraction of

to reduced incidence of skin necrosis

this tissue is promoted since greater

The use of VASER in breast

than 50% reduction of applied ultrasonic power is used compared to previous ultrasonic devices. The emulsification also provides the ability to avoid over aggressive use of the suction canula.

UPPER ARM TREATMENT

In the upper arms, this contraction

quality permits VASER liposuction in both the deep and superficial levels to reduce bulk, stimulate skin Before (Left) and After Abdominoplasty Treatment (Right). Photos Courtesy Maurice P. Sherman, M.D.

contraction, and potentially avoid the need for brachioplasty. In the lateral back, the surgeon is presented with the challenge of typically fibrous fat with difficult passage of the standard liposuction canula.

Because of the ability to switch

probes to match tough fibrous tissue type, efficient treatment of both excess fat and redundant skin can be performed, leading to excellent contour shaping without skin resection. For similar reasons, the abdomen also responds favorably Before (Left) and After Upper Arm Treatment (Right). Photos Courtesy Maurice P. Sherman, M.D.

74 â&#x20AC;&#x201D;

may-june 2008 | www.aesthetictrends.com

to these qualities and may permit the surgeon to avoid a horizontal

months later. In my practice now,

etching in the abdominal skin

and for the previous six years,

mimicking the high definition of “two

VASER technology continues to be

packs” or “six packs” seen in male

an indispensable tool in all forms of

and female body builders.

body lipoplasty.

VASER CLINICAL OUTCOMES

In conclusion, I feel technological

Maurice P.

advances seen in the VASER

Sherman, M.D.,

Ultrasonic System, along with

is a specialist in

education in the optimal use of this

Cosmetic, Facial

device, produce excellent clinical

Plastic, and

outcomes without the complications

Reconstructive

formerly associated with previous

Surgery. Dr.

generations of ultrasonic emulsification systems. The benefits include better sculpting of tissues, especially of a fibrous nature, faster overall surgical time, significantly less work for the surgeon with less bruising and discomfort for the patient, secondary to the reduced tissue trauma from evacuation of the fat. We do not worry about increased complication rates and do expect to see a significant reproducible degree of skin contraction.

Newer modalities such as Laser

Lipolysis under the marketed trade labels of “Smart Lipo” and “Cool Lipo” have emerged over the past 1-1/2 years based upon their claim for skin contraction. Whether the lower abdominal scar as seen with abdominoplasty procedures. The pubic mons area also can be treated vigorously with the VASER despite its typical fibrous nature.

Additionally, certain physicians

such as John Millard, M.D., in Colorado have developed high definition VASER contouring

VASER or Laser Lipolysis Systems produce the same or more skin contraction is yet to be answered; however, in several antidotal cases in my practice where Laser Lipolysis and VASER were used in comparable body areas on the same patient, no difference in skin contraction was ascertained in comparing the

plastic surgery

techniques which produce desirable

Sherman has gained a distinguished reputation as a creator of the “Natural Look” in cosmetic surgery. For the past 19 years, Dr. Sherman has been in private practice both in Vista and La Jolla, Scripps Memorial Hospital campus, and is now located centrally in Del Mar at the Del Mar Cosmetic Medical Center. Triple boarded in Cosmetic Surgery, Facial Plastic Surgery, and Otolaryngology, he also serves on committees at the San Diego County Medical Society and is an Associate Clinical Professor of Surgery at UCSD, teaching at Veterans’ Administration Hospital in La Jolla. Dr. Sherman has lectured widely since coming to the San Diego area and has been a faculty member at numerous national meetings on cosmetic surgery. He initiated and donated his services to the Face To Face Program in San Diego for cosmetic restoration of battered and abused women, and has hosted numerous visiting physicians in his clinic who have observed his surgical techniques.

post-operative results three to six

may-june 2008 | www.aesthetictrends.com

75—

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practice management

UNDERSTANDING STATE TRENDS By Leslie Pollard, BSM, MLSO and Editorial Advisory Member

safety. Some states have or are

devices? Should there be delineation

article which took a broad stroke at

in the process of enacting specific

between more aggressive and

understanding the entities involved

laser safety regulations, based on

less aggressive procedures? Must

and the tasks to be undertaken to

the federal guidelines that require

the laser operator be a physician?

build a reproducible and responsible

these facilities to not only follow

What training will be required of

laser safety compliant office program,

these laser safety rules, but may also

the physician for operating and

this article will attempt to look at the

require registration of equipment,

supervising the operation of these

roles that individual states take and

facilities, operators, or Medical Laser

devices, and how will this process

how each cosmetic laser office setting

Safety Officers for each facility. If

be documented? What “Physician

might best be prepared to meet

a state does not specifically reflect

Extenders” (PEs are Physician

existing or approaching compliance

laser safety regulations, any facility

Assistants, Registered Nurses,

issues.

with medical lasers is expected to

Advanced Nurse Practitioners,

at t

As a continuation of last month’s

follow the existing and most current

Aestheticians, Cosmeticians) may

OSHA and ANSI Standards

federal standards on Laser Safety in

operate these devices? What training

Healthcare Facilities

The federal government plays

a very valuable role in providing

(Current revision

up-to-date laser safety guidelines

ANSI Z136.3;

for the healthcare environment that

3-2005).

practice n management

Laser Safety in the Cosmetic Practice–Part II

The federal government plays a very valuable role in providing up-to-date laser safety guidelines for the healthcare environment that all facilities should consider when developing their safety programs.

all facilities should consider when

The Federal Laser

developing their safety programs.

Safety Standards and

OSHA is a federal entity that has

OSHA Regulations

used these guidelines to develop

continue to revise standards to

will be required of these laser

regulations which help laser facilities

embrace new laser and light based

operators? What should be the level

ensure that everyone who works

facilities such as medical spas.

of supervision of PEs? What is the

with these devices is informed and

Questions such as the following are

physician liability?

can participate in his or her own

in major flux: Who may operate these

may-june 2008 | www.aesthetictrends.com

These are a few of the questions

77—

practice management

Aesthetician and/or Cosmetologist may operate these devices with onsite supervision

reacted quickly with what information was available at the time, sometimes resulting in confusing rules that

Aesthetician and/or Cosmetologist

continue to deal with increasing

may actually increase the level of

may operate these devices with off-

pressure from reports of patient

irresponsible cosmetic business

site supervision

injuries, reports of unlicensed and

practices. Some states await the

improperly supervised and trained

outcome of other states or more

cosmetic laser spa personnel, pressure

standardized controls. Some states

from those in the industry desiring

have provided position statements

information was perhaps helpful for

help to ensure the safety of both

that may temporarily act as a compass

manufacturers and those interested in

patients and staff, and pressure from

to all constituents and the public so

looking into establishing a cosmetic

existing profit centers protecting

that they might know the direction of

laser service business to begin the

their positions. There is also the

the board before actual regulations

process of their own investigation.

pressure of media attention of both

are recommended. Many states are

However, today, as one might access

the excitement of new technology

in the process of due diligence on the

a variety of these databases, the result

being marketed as well as deserved

subject.

would probably be conflicting reports

attention to poor outcomes and injury

and information. States will often be

from some of these procedures.

well-intentioned informational

Through the Internet and various

Unlike the early days of laser surgery in the 1980s and 1990s, we no longer depend simply on the wavelength or bandwidth of emissions with adjusting power outputs.

• Level of supervision of laser operator not defined A few years ago, this type of

defined quite differently from one

resources,

database to another. The reason is

many have

twofold. As this process is evolving

attempted

very quickly, the age of the database

to provide

and the frequency with which it is

simple, straight

updated is imperative. Also, if the

forward

actual research is not performed,

databases that

the interpretation of the data can be

REGULATION AND OVERSIGHT

categorize the states into groups in

quite different from one author to

the following categories:

another. Unless the actual supporting

• Only physicians may operate these

documents are available to enable the

Therefore, the state medical

boards are being asked to react to a perceived need for more regulation and oversight. Some states have

78 —

• PA and/or ANP and/or RN and/or

that are facing each state as they

reader to see possible explanations

lasers • PA and/or ANP and/or RN and/or

and details about education, training, (Continued on page 86)

may-june 2008 | www.aesthetictrends.com

PRESS CORNER

Artes Medical Plans to Restructure to Cut Costs

BioForm Medical Acquires Facial Aesthetic Nerve Ablation Technology

device for aesthetics indications.

“We are building a leading

medical aesthetics company. We believe this new treatment will offer

Medical technology company Artes

an effort to reduce costs in line with

BFRM) announced that it has

therapy for the treatment of frown

expected revenue.

acquired substantially all of the assets

lines. Many patients in our consumer

of privately-held Denver, CO, based

research surveys have indicated that

“re-align” its overall cost structure

Advanced Cosmetic Intervention,

they choose not to receive neurotoxin

toward its prior 2008 revenue

Inc. (ACI) and associated technology

treatment due to fear of losing facial

guidance of $13 million to $16

rights for $12 million cash, plus

expressions, or fear of injections with

million. Meanwhile, it will continue

future royalties

a toxin,” stated

expanding its sales force for the

and a potential

Steven Basta, CEO

injectable implant ArteFill, which is

sales-related

of BioForm Medical.

used as a wrinkle treatment.

milestone. This

“We believe that

acquisition

the synergy of

The company said the goal is to

BioForm Medical, Inc. (NASDAQ:

patients an attractive alternative

Medical Inc. said it is restructuring in

this product with

provides

Artes said it believes it has enough

BioForm Medical, a leading

our Radiesse dermal filler will be

medical aesthetics company, with a

terrific. We have a differentiated,

commercially-available technology for

long-lasting filler, and in the coming

local nerve ablation.

years we hope to offer physicians a

new treatment option for frown lines.

ACI’s device, sometimes also

referred to as the GFX device in prior

This is part of our commitment to

media reports, is currently cleared

partnering with physicians to offer

via a 510(k) by FDA to create RF

them improved aesthetic treatment

heat lesions in nerve tissue. The

options that can grow their practices.”

ACI device uses minimally-invasive

cash, along with anticipated ArteFill

bi-polar radiofrequency energy

BioForm Medical Inc.

sales, to fund the company through

selectively to weaken nerve signal

866.862.1211

the first quarter of 2009.

transduction with durable effects.

www.bioform.com

Shares of Artes fell 8 cents, or 6.7

percent, to close at $1.12.

The use of this technology on

nerves that control the muscles of the forehead may reduce the appearance of frown lines, or glabellar furrows. BioForm Medical expects to conduct

Bio-Therapeutic Presents the bt-analyze™

clinical studies specifically intended to support an FDA application

Artes Medical 888.ARTEFILL (278.3345) www.artesmedical.com

Bio-Therapeutic is pleased

seeking clearance to market this

to release the bt-analyze™ skin

product for the treatment of frown

identification system. Part of Bio-

lines. The Company expects to also

Therapeutic’s bt-gear™ line, the

seek a CE mark and certain other

bt-analyze provides an accurate and

international registrations of the ACI

essential assessment of the skin’s

may-june 2008 | www.aesthetictrends.com

79—

PRESS CORNER moisture contents. The bt-analyze is tiny in price

edge, age-defying technology

and analytical capability will serve

available today, including the Bio-

our business well as we work to grow

and size, but large on performance.

Ultimate Platinum® microcurrent

and innovate.”

Measuring less than 3.5 inches

system, Bio-Synthesis™ light

in length, the bt-analyze weighs

activated rejuvenation system, Bio-

years of experience to the role,

less than ¼ of a pound and holds a

Oxygen™ oxygen infusion system,

having successfully built brands

minuscule price of $95, making it

Bio-Brasion™ microdermabrasion

and launched products at a number

an ideal fit for all forward thinking

system, Bio-Dermology™ cellulite

technologists looking to get their tech

system, and bt-GEAR Tools and

on!

Technology of Convenience. The

Delman brings nearly twenty

company is an FDA and ISO

of consumer companies including

leader in anti-aging technology,

registered device manufacturer, and

LeapFrog Enterprises, Eastman

was established in 1974, and

all equipment is safety tested and UL/

Kodak, and Kraft Foods. “Sharon is

is headquartered in Seattle,

CSA listed. Ongoing clinical trials

a results-driven marketing executive

Washington. With worldwide

with the University of Washington

with a substantial track record. We

distribution, Bio-Therapeutic supplies

ensure proven efficacy and results.

look forward to what her energy

Bio-Therapeutic, Inc., the world

and strategic insights will do for our

skin therapists with the most cutting Bio-Therapeutic, Inc.

company,” continued Connors.

800.976.2544

www.bio-therapeutic.com

class,” said Delman. “I am excited to

“Cutera’s products are best in

build on the strong foundation Cutera has established with physicians to deliver highly efficient and effective

Cutera Announces Sharon Delman as Vice President of Marketing

aesthetic treatments that build patient self-esteem. I look forward to working with some of the best minds in the aesthetic laser space and building

Cutera, Inc., a leading provider of

laser and other light-based aesthetic

Cutera’s leadership position in antiaging laser technology.”

systems for practitioners worldwide, announced that Sharon Delman

Cutera, Inc.

joined the company as Vice President

888.4CUTERA

of Marketing. Sharon will lead all

www.cutera.com

aspects of marketing globally for Cutera.

“We are delighted to have

a marketer with such diverse experience join our team,” said Kevin

New Day Spa Association Advisory Board Announced

Connors, President and CEO of

80 —

Cutera. “Sharon’s outlook is global,

and she displays a strong customer

Executive Director of the Day Spa

and consumer focus. Her broad vision

Association and the International

may-june 2008 | www.aesthetictrends.com

Hannelore Leavy, President and

PRESS CORNER Chairperson of

2008, which Medicis had submitted

the Corporate

in late 2007. Subject to approval of

Alliances &

the BLA by the FDA, Medicis intends

Sponsorships

to commercialize Reloxin in the U.S.

Committee.

in accordance with the long-standing

Eric Light

arrangement between Medicis and

continues to be

Ipsen. Changes from the original

Chairperson of the

BLA submission relate primarily to

Medical Spa Association announced

DSA International Chapters, while

sponsorship and ownership of the

the new 2008 to 2009 Day Spa

maintaining his position as President

filing. The substantive elements

Association Advisory Board. Leavy

of The Strawberry Hill Group,

of the original submission remain

states, “With great pride, I am

supervising the North and Latin

unchanged.

pleased to announce that Rosemary

American markets. Dr. Stephen

Weiner, owner of The Brass Rose Day

Schleicher, F.A.C.S. is the Day Spa

Chief Executive Officer of Ipsen, said:

Spa & Salon in Blairstown, NJ, has

Association’s Medical Advisor.

“We are pleased to have responded

graciously agreed to maintain the

Schleicher is founder and director of

to the administrative issues raised by

reigns as Chairperson of the DSA

the DermDX Centers for Dermatology

the FDA in coordination with Medicis

Advisory Board for another year.”

in Northeastern Pennsylvania.

in a timely and efficient manner.

Jean-Luc Belingard, Chairman and

Together with Medicis, we look

Skip Williams, Vice President of

Spa Operations Consulting Services,

Day Spa Association

forward to working diligently with the

remains Chairperson of the Day

201.865.2065

FDA to obtain a successful marketing

Spa Association Education and

www.DaySpaAssociation.com

approval. Given Ipsen’s botulinum

Trade Show Committee. Monique

toxin positive track record on a global

Iacobacci remains Chairperson of

basis, we look forward to entering

the Charity Events Committee. The

the North American market following

DSA Membership Committee will be chaired by Ana Loiselle-Donahue, of the SECRET Salon & Spa By Design.

Ipsen and Medicis Announce Submission of Reloxin BLA in Aesthetics to the FDA

FDA approval of Reloxin.”

“We are pleased to announce

this submission of the BLA for Reloxin in aesthetics with FDA,”

Larry Oskin, President of

Marketing Solutions headquartered

in Fairfax, VA, will be the new

(Euronext:IPN) announced that Ipsen

Chairperson of the DSA PR & Media

has submitted a Biologics License

Relations Committee. The DSA

Application (“BLA”) for the botulinum

Industry Research Committee will

toxin type A, Reloxin®, in aesthetic

be chaired by Erika Mangrum of

indications (glabellar lines) to the U.S.

said Jonah Shacknai, Chairman and

the Iatra Day Spa, which has four

FDA’s Division of Dermatology and

Chief Executive Officer of Medicis.

successful locations in Raleigh,

Dental Products, within the Center

“Both the Ipsen and Medicis teams

NC. The DSA Legislative Affairs

for Drug Evaluation and Research.

have worked diligently with FDA

Committee is now chaired by Ruth

This BLA submission by Ipsen is

to determine the best solution for

Nuckols Cox of the Sharman, TX,

intended to address the concerns

submitting Reloxin in aesthetics.

based Bella Fontana Spa.

cited by the FDA when it declined

We thank everyone involved, and

to file the Reloxin BLA in January

extend our appreciation to FDA for

Mike Carter is the new

Medicis (NYSE:MRX) and Ipsen

(Continued on page 84)

may-june 2008 | www.aesthetictrends.com

81—

meetings & January 2008

The American Academy of Cosmetic Surgery – AACS 24th Annual Scientific Meeting January 17 - 20, 2008 Rosen Shingle Creek Resort Orlando, FL Contact: Moira Murphy 312.981.6762 p www.cosmeticsurgery.org The Orlando Dermatology & Aesthetic Conference – ODAC January 18 – 21, 2008 Buena Vista Palace Orlando, FL Contact: Beth-Ellen Keyes 646.453.5709 www.orlandoderm.org American Academy of Facial Plastic & Reconstructive Surgery – AAFPRS 14th Annual Winter Symposium on the Latest Advances in Facial Plastic Surgery January 18 - 22, 2008 Vail Marriott Mountain Resort and Spa Vail, CO Contact: Ollie Edwards 703. 299.9291, ext 237 p oedwards@aafprs.org www.aafprs.org

February 2008

American Academy of Dermatology – AAD 66th Annual Meeting February 1 - 5, 2008 San Antonio,TX Contact: Robin Downey 866.503.SKIN (7546) www.aad.org Advances in Cosmetic Medical Dermatology – ACMD MauiDerm 08 Advances in Cosmetic Medical Dermatology February 25 - March1 , 2008 Grand Wailea Resort Maui, Hawaii Contact: ACMD Administrative Office www.acmd-derm-hawaii.coml

82 —

March 2008

Medical Spa Expo March 23 - 25, 2008 Los Angeles Convention Center Los Angeles, CA Contact: Reed Exhibitions 800.363.3631 p www.spaandresortexpo.com Dermatology Nurses’ Association – DNA 26th Annual Convention March 25 - 28, 2008 Las Vegas Hilton Las Vegas, NV Contact: DNA@ajj.com 800.454.4DNA (4362) p www.dna.inurse.com

American College of Obstetricians And Gynecologists – ACOG 56th Annual Clinical Meeting May 3 - 7, 2008 Ernest N. Morial Convention Center New Orleans, LA Contact: acm@acog.org 202. 638.5577 www.acog.org/acm

China Beauty Expo May 20 - 22, 2008 Shanghai New International Expo Center Shanghai, China Contact:Vanessa Kuhlmann +49 711 490 890 0 beauty@businessmediachina.com

April 2008

American Society for Laser Medicine & Surgery – ASLMS 28th Annual Meeting April 2 - 6, 2008 Gaylord Palms Resort Kissimmee, FL Contact: Dianne Dalsky 715.845.9283 p dianne@aslms.org www.aslms.org American Academy for Anti-Aging Medicine–A4M 16th Annual International Congress April 25 - 27, 2008 Gaylord Palms Resort & Convention Center Orlando, FL Contact: Aaron Smith 800.558.1267 p www.worldhealth.net

June 2008

Cosmetic Boot Camp 4th Annual Meeting June 12 - 15, 2008 Broadmoor Resort Colorado Springs, CO 888.355.3675 p www.cosmeticbootcamp.com International Esthetics, Cosmetics and Spa Conference – IECSC June 28 - 30, 2008 Las Vegas Convention Center Las Vegas, NV Contact: John Clarke 800.624.3248 info@iecsc.com www.iecsc.com

May 2008

American Society for Aesthetic Plastic Surgery – ASAPS/ASERF Annual Meeting May 1 - 6, 2008 San Diego Convention Center San Diego, CA Contact: Linda Stanton 800.364.2147 p www.surgery.org may-june 2008 | www.aesthetictrends.com

July 2008

American Academy for Anti-Aging Medicine – A4M July 17 - 19, 2008 Washington, DC Contact: Aaron Smith 800.558.1267 p www.worldhealth.net

events 2008 American Academy of Dermatology–AAD Academy ’08 Summer Meeting July 30 - August 3, 2008 Chicago, IL Contact: Robin Downey 847.330.0230 p www.aad.org

August 2008

Face & Body–Spa & Healthy Aging Annual Conference & Exhibition 15th Annual Meeting August 16 - 18, 2008 Moscone North San Francisco, CA Contact: Faceandbody@allured.com 630.653.2155 p www.faceandbody.com

September 2008

Medical Spa Expo September 8 - 10, 2008 Jacob Javits Convention Center New York, NY Contact: Reed Exhibitions 877.271.6789 American Academy of Family Physicians –AAFP Annual Scientific Assembly September 17 - 21, 2008 San Diego, CA Contact: Sondra Biggs 800.874.2237 x 5360 p www.aafp.org American Academy of Facial Plastic & Reconstructive Surgery–AAFPRS Annual Fall Meeting September 18 - 20, 2008 Promer House Hilton Chicago, IL Contact: Ollie Edwards 703. 299.929 p oedwards@aafprs.org www.aafprs.org

American Academy of Otolaryngology Head and Neck Surgery–AAOHNS 2008 Annual Meeting & OTO EXPO September 21 - 24, 2008 McCormick Place Convention Center Chicago, IL Contact: Irma Chavez 703.519.1557 p www.entnet.org

October 2008

International Society of Cosmetic and Laser Surgeons–ISCLS 17th Annual Meeting October 2 – 5, 2008 Las Vegas, NV Planet Hollywood Resort Contact: info@thesentergroup.com 312.981.6799 p www.iscls.org International Esthetics, Cosmetics & Spa Conference–IECSC October 4 - 6, 2008 Orlando/OC Convention Center Orlando, FL Contact: John Clarke 800.624.3248 p info@iecsc.com www.iecsc.com American Society of Plastic Surgeons– ASPS 77th Annual Scientific Meeting October 31 - November 5, 2008 McCormick Place West Chicago, IL Contact:ASPS/PSEF Registration 800.766.4955 p www.plasticsurgery.org

November 2008

American Society for Dermatologic Surgery–ASDS 35th Annual Scientific Meeting November 6 - 9, 2008 J.W. Marriott Orlando, FL 847.956.0900 p www.asds.net may-june 2008 | www.aesthetictrends.com

American College of Phlebology–ACP 22nd Annual Congress November 6 - 9, 2008 Marco Island Marriott Resort Golf Club & Spa Marco Island, FL Contact: Dana DePonzi 510.834.6500 p www.phlebology.org American Academy of Ophthalmology–AAO joined with European Society of Ophthalmology -SOE Annual Meeting November 8 - 11, 2008 Georgia World Congress Center Atlanta, GA Contact: Meetings Department 415.561.8500 x320 p www.aao.org International Spa Association–ISPA 18th Annual ISPA Conf. & Expo November 10 - 13, 2008 Las Vegas, NV Contact: Jennifer Spencer 888.651.4772 p www.experienceispa.com American Society of Cosmetic Dermatology and Aesthetic Surgery – ASCDAS 7th Annual Meeting and Exhibition December 4-7, 2008 The Wynn Las Vegas Resort Las Vegas, Nevada Contact: Larry Bodkin 850.531.8330 p lbodkin@ascdas.org

December 2008

American Academy of Anti-Aging Medicine–A4M 16th Annual World Congress on Anti-Aging Medicine and Regenerative Biomedical Technologies December 11-14, 2008 Venetian Hotel Las Vegas, NV Contact: Aaron Smith 800.558.1267 p www.worldhealth.net

83—

PRESS CORNER

(Continued from page 81)

its willingness to work with us on a

in their aesthetic medical practices.

to offer solutions to new procedures

resolution in a timely fashion. We

He will further expand sales of

which are in high demand, including

continue to believe the Reloxin BLA is

the Company’s product portfolio,

laser-assisted liposuction. The Aspire

strong, and anticipate entering in the

which includes iPulse™ Intense

platform will complement the broad

growing, multi-million dollar aesthetic

Pulsed Light Systems, Salt-A-Peel™

range of aesthetic applications offered

botulinum toxin market in the U.S.

MacroDermabrasion Therapy, and the

by Palomar’s flagship StarLux® 500

upon FDA approval.”

Mastique Light™ Skin Rejuvenation

laser and pulsed-light platform.

System.

“Greg is very results-oriented and

brings a thorough understanding of aesthetic sales and marketing to the MAS team,” said Allan

Medicis

Danto, President and COO. “As an

liposuction with the Aspire platform

602.808.8800

experienced sales professional, he

and Stylus Sculpter handpiece is to

www.medicis.com

has achieved the highest levels of

utilize unique tip designs and selective

recognition for meeting and exceeding

and efficient wavelengths for melting

sales goals.”

fat and providing the desired thermal

Ipsen www.ipsen.com

effects on surrounding tissue. Med-Aesthetic Solutions, Inc.

760.942.8815

Caruso commented, “The unveiling

www.medaestheticsolutions.com

of the Aspire platform and Stylus

Med-Aesthetic Solutions names Regional Sales Manager

Chief Executive Officer Joseph P.

Sculpter handpiece is the culmination of years of research directed to absorption of light by fat. Our system

Palomar Unveils New LaserAssisted Liposuction Platform

Med-Aesthetic Solutions, Inc.,

(MAS) a global provider of practice

uses optimal wavelengths to melt fat and provide the appropriate amount of heat to the surrounding tissue. As

building solutions and aesthetic

technologies, announced that Greg

(Nasdaq: PMTI), a leading researcher

platform is based on sound scientific

Stevenson has been appointed

and developer of light-based systems

principles developed and tested by

Regional Sales Manager for the

for cosmetic treatments, announced

Palomar’s research and development

the unveiling of its latest innovation in

organization, which is preeminent in

Northwest and Rocky Mountain States.

Palomar Medical Technologies Inc.

aesthetic laser technology at the 28th

84 —

Palomar’s approach to laser-assisted

with all Palomar products, the Aspire

the light-based aesthetic industry.”

annual conference of the American

Society for Laser Medicine & Surgery

Sculpter liposuction laser-assisted

The Aspire Platform and Stylus

(ASLMS) in Kissimmee, FL, April 2-6.

handpiece are pending FDA clearance

In his new role, Stevenson will be

Palomar displayed a new platform

and should be available for shipment

responsible for driving regional sales

called the Aspire™ aesthetic laser

in the third quarter 2008.

of the multi-part, Med-Aesthetic

platform and Stylus™ Sculpter laser-

Solutions strategic practice building

assisted liposuction handpiece in booth

Palomar Medical

services, which provide physicians

#507 in the ASLMS exhibit hall. The

800.PALOMAR (725.6627)

with tools to optimize opportunities

Aspire platform will allow Palomar

www.palomarmedical.com

may-june 2008 | www.aesthetictrends.com

PRESS CORNER Achieve Flawless Skin with Two New Multi-functional Products TNS Ultimate Daily Moisturizer + SPF 20 and Environmental

• Hyaluronic acid

which is the largest printed directory

• Caffeine

of its kind. Sue Llewellyn, who was

• Green tea extract

art director of Luxury SpaFinder, will continue to oversee art direction and

SkinMedica, Inc.

design of Luxury SpaFinder Interactive

877.944.1412

publication in her new position as

www.skinmedica.com

Director of Global Publishing.

Defense Sunscreen™ SPF 30+ improve skin with ingredients naturally found in the body to promote a healthy, youthful complexion. NEW TNS Ultimate Daily Moisturizer + SPF 20 is the ultimate in fighting environmental aggressors from the inside out. This moisturizing formula guards against the destructive effects of free radicals and shields skin against the sun’s harmful rays. Benefits: • TNS™ (Tissue Nutrient System) – exclusive to SkinMedica • UVA and UVB protection • Helps improve skin tone and texture • Powerful combination of natural antioxidants

Environmental Defense Sunscreen

SPF 30+ is a full-spectrum, longlasting UVA/UVB sunscreen, with antioxidants that protect against free radical damage. This oil- and fragrance-free sunscreen moisturizes, hydrates, and protects with the following ingredients: • Z-COTE® Max™ • Parsol® MCX

Luxury SpaFinder Interactive will

be published in Japanese, French, German, Italian and Spanish, as well

Luxury SpaFinder Magazine Becomes Luxury SpaFinder Interactive – Expands Global Reach to Six Languages

as English, and will be available on SpaFinder’s network of global SpaFinder websites, increasing potential readership to an additional six million consumers annually. SpaFinder

SpaFinder, Inc., the largest spa

owns and operates the leading

media company, announced that

spa lifestyle and wellness website,

Luxury SpaFinder Magazine will

SpaFinder.com, with additional Internet

become Luxury SpaFinder Interactive,

domains in France, Italy, Germany,

replacing the print magazine

Spain, and Japan. The company’s

effective with the July edition.

worldwide spa directory, Global

Luxury SpaFinder Interactive will be

SpaFinder, is a yearly print publication

published monthly in six languages

for consumers and travel agents.

and will immediately expand the

magazine’s global circulation from

expands our reach and presence in

200,000 to over one half million spa

Europe, Asia, South America, and

lifestyle enthusiasts. The launch of the

beyond,” said Pete Ellis, Chairman

interactive publication also underscores

& CEO of SpaFinder. “It’s a big plus

the company’s commitment to green

for our advertisers as we tap into

initiatives.

enormous demand among Gen-X and

Gen-Y consumers for spa and wellness

Melisse Gelula, spa beauty Editor

“Luxury SpaFinder Interactive

of Luxury SpaFinder and former travel

information and the expansion of the spa

editor for Fodor’s Travel Publications,

market worldwide. Spa-goers are truly

has been named Editor in Chief of

global and online, and that’s where they

Luxury SpaFinder Interactive. Sarah

are going to be in greater numbers.”

Day, who was previously the print magazine’s production director, will serve as Vice President of SpaFinder’s Global Publishing Group and will oversee the new interactive publication

SpaFinder, Inc.

as well as the company’s worldwide

212.924.6800

spa directory, Global SpaFinder,

www.Spafinder.com

may-june 2008 | www.aesthetictrends.com

85—

practice management

(Continued from page 78)

delegation and supervision, policy,

advanced practice licensed

and standard operating procedure

healthcare professionals (PA, ANP,

documentation, the intent of the state’s regulation is often lost when

possibly RN). • Depending on the level of training

trying to place it into a short form

and education of the laser operator

category.

and also depending on the integrity

of the process documentation,

Once a state regulatory body or

medical board begins the process of

supervision will be assessed as on-

responsibly looking at all of the issues involved, the basic philosophy and

site or off-site. • Off-site supervision requires

intent of those involved will begin to

supervising physician to be

form and will become evident. By

immediately available.

following the process of many states

• Specific levels of training for

that have identified the purpose and

supervising physician, delegate

role of these devices in the healthcare

supervisor, and laser operators are

regulating bodies also communicating

environment market, certain common

specific and must be documented.

to ensure that the proper goals are identified and outcomes are

threads tend to emerge.

It is most interesting today to

follow the work of state task forces

COMMON INCLUSIONS

measurable and responsible. As

• Supervising physician must make

these measurable and responsible

initial patient evaluation.

that are carefully looking at these issues. The future concepts for

• Required training courses must be approved by the medical board.

defining medical spas, competency based training, and concepts of

• IPL and radiofrequency devices

treatment difficulty may well be found in the notes of these well represented task forces.

• Ablative lasers should be treated

are then responding to help further identify the appropriate roles of nonphysician healthcare professionals

legislative rulings.

(PA, ANP, RN) as well as aesthetician and cosmetology associated boards.

performed internally for each

facility.

evident. Regardless of whether

• Patient documentation, laser safety

differently than non-ablative lasers;

that supporting healthcare boards

included in Medical Board or • Laser Safety Audits should be

Emerging Common Denominators

outcomes are identified, we also see

policies, and standard operating

A real concept for the future will be the consideration of a National Certification for all levels of cosmetic light based device applications.

The common ground is becoming

it is the physician, the device manufacturer, or the consumer

procedures or standing

patient, the common goal is the same.

orders should be in place.

The true goal of all of these efforts

• A meaningful and

is to help ensure the safety of staff

measurable QA program

and patients when working with

documentation is required.

and near these devices, as well as to help ensure that patients are not

physician only operating ablative

COMMON GROUND

injured and may have a reasonable

devices.

expectation of satisfactory outcomes.

• A properly trained physician level

process is the evidence that many

must be involved in a supervisory

states going through the process of

role.

fact gathering are communicating

Education, Training, and Appropriate Supervision

with each other. In some states, we

see the medical boards and the state

regulated or not, these three issues

• Delegation of supervision of the use of these lasers could involve

86 —

A very positive movement in this

may-june 2008 | www.aesthetictrends.com

Whether the industry is to be

energy delivered with the size of the

choices and help to ensure that the

expanding cosmetic light based

target, pulsing frequency, and the

unbiased laser and light based safety

market.

prevention of pulse stacking, or the

information is available to provide a

The very nature of these devices

profile of a laser pulse and its impact

service vested in the expected patient

lays critical ground for education.

on reproducible outcomes. With the

outcomes and to operate a safe and

Although we are still experiencing the

advent of tissue modeling we can

compliant laser safety program. Then

infancy of understanding the benefits

now more specifically anticipate

comes the training required to best

of what light is able to do, we are also

and identify intended chromophores

utilize the equipment that is chosen

in the midst of an expansion of new

or targets, thus using all of these

to have the safest and best possible

knowledge of the nature of light and

variables to target tissue specifically

outcomes.

its interaction with biological tissue.

and improve outcomes.

Unlike the early days of laser surgery

in the 1980s and 1990s, we no longer

It quickly becomes evident that

NATIONAL CERTIFICATION

unbiased and up-to-date education of

depend simply on the wavelength

light mechanics and tissue interaction

be the consideration of a National

or bandwidth of emissions with

is a logical step for any group or

Certification for all levels of cosmetic

adjusting power outputs. This is

individual to take before stepping into

light based device applications.

truly developing into a science of

this marketplace. It is the responsible

With this type of certification, the

photobiology as we witness the

thing to do, not only for the future

educational and training component

knowledge expansion and recognize

patient base, but for the business as

will be not biased by turf or

the importance of other light output

well. Many versions of biological

manufacturer, but will be based

variables. In the early development

light interaction can be found. It will

on real and current science-based

of general laser medicine, we knew

vary on who is telling the story, what

training. Cooperative efforts between

little about the impact of spot size

agendas are behind the story, and

states, medical boards, healthcare

on the depth of tissue penetration,

certainly when the information was

boards, aesthetic and cosmetology

the relationship of time and the

last updated. Again, this identical

licensing boards, and organizations

scenario was seen with the advent of

such as the ASLMS (American Society

surgical lasers. The story is repeating

for Lasers in Medicine and Surgery)

itself with cosmetic lasers, except

will most probably play vital roles in

the technology and our general

this development.

knowledge base have progressed

much further.

laser operators by a responsible

physician who has both the education

For an initial investor of the

practice management

will help make for a healthy and

A real concept for the future will

Supervision of non-physician

technology, it only makes sense to

and training to not only anticipate

become educated into the aspects of

outcomes but also address and

what we know TODAY about light

possibly prevent adverse events is the

and tissue. The key is to access

responsible thing to do.

that information from a source that is providing that education to you

STATE EXAMPLES

for the purpose of providing you

with the most up-to-date, factual,

great strides to help the industry

and unbiased program possible.

ensure public safety with cosmetic

Only then can one even reasonably

laser providers. Three state efforts are

make decisions about equipment

highlighted below:

may-june 2008 | www.aesthetictrends.com

There are many states making

87â&#x20AC;&#x201D;

practice management

Georgia

properly trained physicians may

to the state legislation later this year.

Although not funded yet, the expected

delegate the tasks, and depending on

This task force is working through

“Georgia Cosmetic Laser Services Act”

the level of training and licensure of

some of the fundamental questions

may look similar to what we may find

the operator, what level of supervision

such as the definition of a “Medical

as a comprehensive program in the

is required. The Texas ruling also

Spa,” competency based training and

future. The bill describes a dual level of

specifies the need for appropriate

education of all levels of practitioners,

required competencies based on level

laser safety policies and procedures,

the appropriate supervision required,

of responsibility, licensure, experience,

as well as the use of standing orders.

differentiating the level of intensity

and successful completion of approved

Laser safety program audits are also

of specific procedures, and a variety

laser and light based training programs.

recommended.

of ideas on how to best involve the

This ruling is a combined work from

appropriate licensing and medical

both the state government and state

suggestions are components of the

boards and professional organizations

medical board. Visit the website:

Federal Laser Safety Guidelines

that will need to be involved in the

www.ors.dhr.georgia.gov

recommended for all facilities utilizing

development process. Visit the website:

medical lasers, the ANSI Standards

www.massmedboard.org/public/

Texas

for laser healthcare safety. This laser

med_spa

The state medical board program from

ruling is generally accepted as a goal

Texas called “Laser Rule 193.11” was

for all state cosmetic laser facilities and

developed to work in conjunction with

users in Texas; however, officially the

Texas State Laser Regulations, which

ruling is on hold for further review. Visit

are based on the Federal Laser Safety

the website:

Guidelines for Healthcare Facilities.

www.dshs.state.tx.us/radiation/laser

Many of these issues and

Leslie Pollard, BSM, MLSO was recruited to start a surgical laser program

This program specifies the hours of

at a medical

education and training required for

Massachusetts

center facility

both physicians and delegated laser

The state of Massachusetts has a

in Asheville,

operators. Also specified are to whom

Medical Spa Task Force sponsored

NC where

by the Massachusetts Board of

she established the first laser program

Registration in Medicine. The work

in WNC to the growth of 21 multi-

provided by this program has been quite impressive and will be presented

disciplinary laser systems, as well started and supervised the Minimally Invasive Surgical Team for the Health System, providing multiple technologies for clinical application and teaching and training of physicians, residents, nursing, and surgical technologists in the many facets of laser technology. In 2002, she established her own business, Southwest Innovative Technologies, Inc. to dedicate herself to the education of those in healthcare to new medical technologies and lasers. She provides services to hospital environments as well as medical spas utilizing medical laser technology.

88 —

may-june 2008 | www.aesthetictrends.com

These Doctors Are Among

Michael H. Gold, M.D. Gold Skin Care Center Nashville, TN

Mitchel P. Goldman, M.D. Spa MD La Jolla, CA

The Top

Physicians

George M. Martin, M.D. Dermatology Laser Center of Maui Maui, HI

In Our FielD

David J. Goldberg, M.D. Skin Laser & Surgery Specialists New York, NY Miami, FL

Michael H. Gold, M.D. Chief Medical Officer & Co-Founder

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