Cosmetic Innovations Q2 2019

Q2 / 2019 AN INDEPENDENT PUBLICATION DISTRIBUTED ON BEHALF OF MEDIAPLANET WHO TAKE SOLE RESPONSIBILITY FOR ITS CONTENTS

CAROLINE PAYNE “In the age of Instagram, Love Island and high street treatments by non-medical practitioners, a focus on safe and appropriate cosmetic surgery has never been more important.” » p2

DR PAUL CHARLSON “Ethical considerations are vital in aesthetics where there is a massive pressure to appear ‘selfie-ready’.” » p4

DR RAHUL DOSHI “As the popularity of cosmetic dental treatments continues to rise, it is important that you are aware of the options available to you.” » p6

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Cosmetic procedures are founded in excellence, not social media In the age of Instagram, Love Island and high-street treatments by nonmedical practitioners, a focus on safe and appropriate cosmetic surgery has never been more important.

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lastic surgery is not regulated in the UK, but confidence with treatment centres on excellence in the field and a belief that innovations evolved to the patient’s benefit, from enhanced body imaging to hi-tech liposculpture and laser.

Insta-surgery Our culture is increasingly image-focused. Powered by social media, trends rise and fall more quickly than ever and cosmetic surgery trends follow suit. Regularly, we trust Instagram pictures more than

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written facts. In 2019, it’s never been easier to access cosmetic procedures, and for these reasons, it’s vital we have a conversation about the right and wrong way to undertake a procedure.

A lack of plastic surgery regulation across the UK Choosing your cosmetic surgeon is a big decision and one that should be taken extremely seriously. This is because the lack of regulation for cosmetic practice in the UK means that anyone can practice without surgical or even medical (for

In 2019, it’s never been easier to access cosmetic procedures, and for these reasons, it’s vital we have a conversation about the right and wrong way to undertake a procedure. “

non-invasive procedures) qualifications. Innovations rely on research and audit to be certified as safe, but the truth is these can be harmful if in the wrong hands.

CAROLINE PAYNE Consultant Plastic Surgeon and member of the British Association of Aesthetic Plastic Surgeons (BAAPS)

Trust in excellence and qualifications Safet y and confidence in your surgeon or doctor has always been paramount as errors happen when there is poor planning and corners are cut. Ensure you look up your surgeon to check they are affi liated with renowned bodies of excellence and check the treatment on offer, as no one else will do this for you.

Patient first Cosmetic procedures have evolved and boomed worldwide, but at the heart of every procedure and

innovation, patient safety must always be put first. It is a mantra t hat is sad ly lack ing in many cosmetic clinics. Not only that, a full and thorough psychological assessment should be carried out, to ensure people are having surgery for the right reasons.

Read more at healthawareness.co.uk MEDIAPLANET

Speeding up recovery times for post-op patients Interview with: MR HIROSHI NISHIKAWA Consultant Plastic, Reconstructive and Aesthetic Surgeon, The Westbourne Centre, Birmingham

A pioneering method of anaesthesia for cosmetic procedures speeds up recovery time. So much so that many patients who undergo surgery can be home the same day.

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hen pat ient s have to stay in hospital after an operation, it's usually due to t he side - ef fec t s of t he general anaesthetic they've been given, says Mr Hiroshi Nishikawa, Consultant Plastic, Reconstructive a nd Aest het ic Su rgeon at The Westbourne Centre in Birmingham.

General anaesthetic takes time to wear off, so patients often feel nauseated and generally out of sorts.

Also, because a tube has been passed down their airway to help them breathe, they may have a sore throat.

However, for 10 years, surgeons at The Westbourne Centre have been using a pioneering method of anaesthesia, combining local anaesthetic with sedation which — depending on the patient — can have fewer or no side-effects.

W it h t h i s t e c h n iq u e , lo c a l anaesthetic is injected around the operative site by the surgeon, wh ich m a kes t he a rea nu mb, while sedatives and analgesics are administered intravenously by an anaesthetist.

Administering local anaesthetic with sedation There are various benefits with this technique, explains Mr Nishikawa.

“The sedatives keep the patient still and comfortable during surgery,” he says. “It's as though they're having a snooze.”

Within a few minutes of the operation being finished, the patient is normally wide awake and sitting up. They generally won’t be experiencing any headaches or nausea and, as they haven't needed a breathing

General aneasthetic takes time to wear off, so patients often feel nauseated and generally out of sorts.” tube, they don't have a sore throat.

But the real advantage of local anaesthetic with sedation is the speedy post-operative recover y period. The drugs are fast-acting and quickly expelled by the body, which means patients can have an operation yet be home the same day.

It is, however, important to use this technique selectively. In the vast majority of cases there are no complications and patients can go home within a couple of hours, providing there is a friend or family member to look after them post-operatively.

Local anaesthetic with sedation isn't suitable for major operations where a body cavit y has to be opened, such as brain surgery or cardiac surgery; but it can be used safely for many cosmetic procedures including breast surgery, abdominoplasty, fat grafting, eyelid surgery, rhinoplasty and facelifts.

The way forward for surgical procedures As with any operation, the patient is very carefully monitored throughout the procedure; but this technique does require more operative precision and care. It requires skilled and highly trained anaesthetists and surgeons working closely together as a team. Surgical technique is never compromised and, in the right hands, it’s remarkably safe.

Ultimately, Mr Nishikawa and his colleagues believe that local anaesthetic with sedation is the way forward for surgical procedures, “Why stay in hospital for longer than you need? The least admission time a patient has, the better.”

Written by: Tony Greenway

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Non-surgical aesthetic procedures are unregulated in England and Wales Aesthetic medicine encompasses a range of treatments, from skin peels, mesotherapy, laser treatments to thread lifting, minor surgical procedures and injectable treatments. Just because it is ‘appearance based’ does not make safety any less important than for other medical procedures.

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n England and Wa les, t he aesthetic medicine industry is unregulated. Many procedures are carried out in non-clinical environments, by non-clinicians.

Psychologist, Johari talked about ‘unconscious incompetence’, which can be applied to practitioners who are unaware that they are incompetent. The annual Doctors appraisal framework, which helps to identify unconscious incompetence, is not universal among other clinical practitioner groups and certainly not in the ‘beauty industry’.

It is not always the practitioner’s fault; there are unscrupulous training providers who provide inadequate training and falsely certify practitioners, so they think they are competent.

Cosmetic practitioner training is voluntary Any procedure needs to be carried out in a safe environment by an appropriately trained individual. Guidelines a r o u n d w h at c o n s t it u t e s a n

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appropriate standard of practitioner and trainer have now been set out by the Joint Council for Cosmetic Practitioners (JCCP) and their standards organisation, the CPSA. However, the register of who is trained to the correct standard is voluntary and many practitioners are not registered.

But, with these guidelines now in place, there is no excuse for practitioners to be ignorant of what is required.

Commercial aspirations and medical ethics and don’t always match In my view, many issues in aesthetic treatment result from the approach of the practitioner. It is about ethics and knowledge. A good practitioner will ensure they have the required knowledge and skills, and operate in an appropriate environment. They will understand about the ethics of medical treatment, which is often at odds with commercial concerns and patient demand. They are able to assess patients for physical and

You really do get what you pay for and research before purchase is vital.” psychological issues which may compromise outcome.

This ethical approach may means excluding patients who might be unsuitable for treatment or referring them elsewhere. I would argue that, without significant clinical training, a practitioner is not able to do this.

Written consent is the bed rock of performing a treatment and again requires a knowledge of effects and side effects of treatment. The problem is many practitioners who get training focus on the technical aspects of performing a procedure rather than assessment, ethics and dealing with post procedural issues.

Young people tend to opt for cheaper practitioners Ethical considerations are vital in aesthetics where there is massive

DR PAUL CHARLSON FRCGP MBCAM DRCOG DOccMed DPD President, BCAM

social media pressure to appear ‘selfie ready’. This tends to drive the young into asking for treatment.

This group often visit budget practitioners. It is difficult to have a viable business charging the prices that are sometimes quoted. Budget practitioners cut corners.

Examples of this might include cheap, poor-quality laser machines or imported dermal fillers or botulinum toxin with no quality controls, lack of adequate insurance and unclean premises with no provision for clinical waste, nor the materials or skills to deal with minor or major medical issues. Often, these practitioners are mercurial with no website or emergency arrangements nor are willing to see patients with issues.

If I was a patient, what should I need to know about my practitioner?

I would ask about their clinical background and what training they have in aesthetics. I would enquire how

many of the procedures they have performed. On visiting the clinic, I would assess the environment and ask about follow up arrangements. I would consider whether the practitioner has behaved ethically.

It is understandable but concerning that the public are often ‘unconsciously incompetent’ about choosing their aesthetic practitioner. As in many things, you really do get what you pay for and research before purchase is vital.

The British College of Aesthetic Medicine has a list of well-trained Doctors and Dentists on their website bcam.ac.uk MEDIAPLANET

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Dental cosmetics: Minimally invasive, maximum effect

DR RAHUL DOSHI BDS (Lond.)

LDSRCS (Eng.)

Over the last few years, dental cosmetic processes have improved, with more innovative tools at a dentist’s disposal, enhancing the overall patient experience. Dr Rahul Doshi, the President of the British Academy of Cosmetic Dentistry (BACD), shares his insights on the recent advances in cosmetic and implant dentistry.

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here are some key areas that have been totally transformed to refine the standard of dental care now available. Digital scanning and 3D printing technology are now at the forefront of many professions – including dentistry – so practitioners can produce 3D models to show patients what results could be achieved through treatment. Consequently, people are not only able to better understand their oral health, but are also becoming more engaged with the treatment process, thus fostering more positive patient-practitioner relationships.

The British Academy of Cosmetic Dentistry (BACD) remains an advocate of high-quality and ethical cosmetic dentistry. It believes in following minimally invasive processes in order to achieve maximum function and aesthetics. This can be achieved very discreetly, using the wide variety of techniques that are now available to cosmetic dentists.

Educating clients about their options With the latest materials, for example, dentists can employ an additive approach, meaning that the natural tooth tissue is preserved for certain techniques.

Patients looking to improve the appearance of their teeth may request treatment for veneers, but what they might not realise is that cosmetic orthodontics could be an optimal treatment option instead.

Modern composites could also provide a minimally invasive solution, which is not only more comfortable for the patient, but also ensures long-lasting treatment outcomes. This is a result of the nanotechnology that is used to alter the teeth at a microscopic level, and create exceptional polishes and tooth colour to achieve superior aesthetics.

Trust our accredited dentists As the popularity of cosmetic dental treatment continues to rise, it is important that you are aware of the options available to you.

This will ensure that you can benefit from the best that modern dentistry has to offer and ensure that the dentist treating you has the right training.

BACD accredited dentists, for instance, have demonstrated their extensive skills and knowledge, as well as their ability to utilise some of the most advanced technologies and techniques in the UK. Patients who seek treatment from a BACD accredited dentist can have confidence that they are receiving the highest quality care from a professional who uses the latest dental equipment and materials.

Read more at healthawareness.co.uk

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DR PIXIE MCKENNA Doctor and TV Presenter

In medicine, there is no such thing as a bargain Whether it’s to turn back the clock, boost confidence or finally get to grips with that embarrassing bodily part, aesthetic medicine is now mainstream in clinical practice.

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nlike conventional visits to the doctor, in this sphere of medicine, patients aren’t looking for a diagnosis, but rather an inter vention. They have an agenda for change, and they understand it is a commercial market.

For the first time in their lives they are consumers where healthcare is concerned. It’s an entirely different experience to the NHS and one that can be quiet daunting for some.

I welcome the freedom patients have to alter, enhance and update their appearance. Despite being a doctor for more than half my life, I am personally still terrified of needles and squeamish about procedures.

So, although I have been told countless times on social medial that I would benefit from Botox, a nose job and even a face lift, if I’m honest, the fact I’m such a bad patient just puts me off.

Don’t be embarrassed to have aesthetic surgery, but do talk to a GP first That said, I totally understand the desire of many of my own patients, friends and peers to have, as they term it, ‘work done’. It’s nothing to ashamed or embarrassed about but equally, I feel it is always something worth taking to a healthcare professional about.

A s a GP, I don’t sit t here in judgement, but I do sit there as someone who can generally give

It terrifies me when patients recount how they ‘shopped around’ and ‘got a great deal’ for their procedure rather than how they researched thoroughly and got a ‘great doctor’.” you a good steer for the credentials of a clinic, so it’s always worth asking. Too many patients navigate this journey alone, encouraged and enticed by glossy brochures and bold claims. But ultimately, credibility is key in this industry.

It terrifies me when patients recount how they ‘shopped around’ and ‘got a great deal’ for their aesthetic procedure rather than how they researched thoroughly and got a ‘great doctor’. In medicine there is no such thing as a bargain, so one should always beware of offers that are too good to be true.

My golden rules for finding a good surgeon It is essential to look at the pedigree of the practitioner, see testimony of previous work and ensure the after care is as good as the intervention.

With any medical procedure, things can go wrong, so there should always be a contingency plan.

For me there are a few golden rules. Do your research and always ask for case histories. Involve your GP where possible, in particular if

you have any concerns. Ensure the after care is as good as the actual care. Check both the clinic and the clinician are fully registered and indemnified. And remember, what you want may not necessarily be what you need.

Your surgeon should be realistic about your expectations If someone won’t treat you, it is highly likely they think you won’t get the outcome you want. That, to me, is the mark of good clinician; doing what you need not what you want.

Thankfully, the vast majority of clinics are heavily regulated, rigorous about upholding best practice and realistic when it comes to managing patients’ expectations.

As a patient, if something doesn’t feel right, there is a high chance it is not right for you. Aesthetic medicine is all about choice and it is a very beautiful thing when it is done brilliantly.

Ultimately that’s what ever y patient deserves, and they should engage the best clinician to do a brilliant job. We need to keep our eyes open to not just the good, but also the bad and the ugly in this beautiful industry.

Read more at healthawareness.co.uk MEDIAPLANET

THE FACE AND BODY CLINIC Feeling comfortable in your own skin From time to time, we all have issues about the way we look, whether it’s our skin, hair or body.

Sometimes, a change to our daily beauty regime can make a difference. But if it doesn’t, an ongoing problem can easily end up affecting our self-confidence and self-esteem.

It’s not surprising then that people turn to surgery and other invasive treatments in a bid to address their body issues.

Surgery is not the answer for the vast majority of beauty-related problems.

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