MEDIcalSPAS REVIEW-NOV 2014 by Medical Spas Review

NOVEMBER ISSUE 2014

ANNE BOLDUC Group Publisher & President EDITOR IN CHIEF Guy J. Jonkman

the aesthetics business review

SENIOR EDITOR Bernard Burt

the medicine environment of the future –TODAY

18 ESTABLISHING YOUR AESTHETIC SERVICES, PRODUCTS AND ENVIRONMENT What is a promotional package? These packages directly or indirectly ‘up-sell’ and ‘cross-promote’ other related services and/or products from your medical spa. Here’s an example: Your client’s/patient’s primary concern may be that she has cellulite on her thighs. She views the Anti-Cellulite treatment as being the answer to her problem. Each person’s condition is unique and requires a personalized long-term program, which may be designed by the therapist following a consultation with the client/patient.

Monica T. Brown Bernard Burt Jon Canas Dr. Ronald Klatz Raoul Andrews Janet McCormick

EDITORIAL Hannelore R. Leavy Jonathan Paul de Vierville Shirley Meerson Douglas Preston Dr. Robert Goldman Melinda Minton

SEND EDITORIAL INFORMATION info@MedicalSpasReview.com or P.O. Box 2699 Champlain NY 12919-2699 Fax (450) 833-2444 Please forward all advertising material, insertion orders to: Northeast Group / MEDICAL SPAS REVIEW 12 Nepco Way, Plattsburg, NY 12903-3961 (450) 833-2400 • Fax: (450) 833-2444

the aesthetics business review

These programs are quite often accompanied by a high price tag, which may dissuade her from entering the program. The promotional packages therefore play a crucial role in capturing that business.

20 ENFORCING NON-COMPETITION AGREEMENTS IN MED SPAS: Is there adequate consideration? The use of non-competition agreements is becoming very popular in med spas but enforcing these agreements is becoming even more difficult. A non-competition agreement is designed to prevent employees from taking clients, patient lists or other confidential information with them when they leave the med spa. To have an enforceable non-competition agreement (also known as a “restrictive covenant”), there must be adequate consideration in return.

the medicine environment of the future –TODAY

SUBSCRIPTIONS Yearly subscriptions prices in the United States are US $68 for 1 year, US $108 for 2 years, US $138 for 3 years. Canada are CDN $98 for 1 year, CDN $158 for 2 years, CDN $198 for 3 years. International US $148 for 1 year US $228 for 2 years, US $278 for 3 years. Send payment to: P.O. Box 2699, Champlain, NY, 12919-2699 6-12 WEEKS FOR FIRST ISSUE MEDICAL SPAS REVIEW Chief Operating Officer, ANNE BOLDUC Systems Manager, DANIEL DOREY Director Human Resources, ESTHER AMAR Treasurer, STARR WYLKIE Group Publisher, ANNE BOLDUC Chief Editor, GUY J. JONKMAN MEMBER International Spa Association American Academy of Anti-Aging Medicine American Med Spa Association

Adequate consideration? Just what exactly is that?

22 BUYER SAYS. SELLER SAYS. DIFFERENT VIEWS OF THE SAME TRANSACTION.

e-mail: info@MedicalSpasReview.com This issue is published by Publicom Inc. CP 399 Place d’Armes, Montreal, QC H2Y 3H1 (450) 833-2400. Postage paid in Montreal, QC and Plattsburgh, NY. POSTMASTER: PLEASE SEND ADDRESS CHANGES TO MEDICAL SPAS REVIEW, P.O. BOX 2699, CHAMPLAIN NY 12919. Nothing contained in this publication shall constitute an endorsement by Medical Spas Review of any

information contained in this publication. The publication and/or ownershareholders directors, disclaim any liability with respect to the use of reliance of any such information. The information contained in this publication is in no way to be construed as a recommendation or approval by Medical Spas Review of any industry standard, or as a recommendation of any kind to be adopted by or binding upon any spa owner. Reproduction of any portion of this issue by any means (facsimile or electronically, for example) is strictly forbidden. Editorial supplied must be accompanied by return postage. The publisher assumes no

24 SEVEN ANTI-AGING SKIN SAVING SECRETS … THAT EVERY PATIENT – AND PHYSICIAN SHOULD KNOW Often misunderstood and maligned, getting a bit of sun everyday can yield big health benefits. A number of studies observe that the incidence of hypertension and cardiovascular disease correlates with latitude and rises in winter, but a biological cause has remained unclear. Martin Feelisch, from the University of Southampton (United Kingdom), and colleagues completed a study that suggests that sunlight alters levels of the small messenger molecule, nitric oxide (NO) in the skin and blood, reducing blood pressure.

responsibility for return of unsolicited photographs or manuscripts. Subscriber: Send subscription inquiries and address changes to: Circulation Department, Medical Spas Review, P.O. Box 2699, Champlain NY 12919. Give old and new address, including postal code and the address label from most recent issue. Allow six weeks for change. Printed in Canada. Legal deposit number 500073-D. US POSTAGE PERIODICALS PAID AT PLATTSBURGH NY 12903. ISSN #1199-0600. MEDICAL SPAS REVIEW reserves the right to accept or reject advertisers and/or advertising material. Medical Spas Review is not responsible for the advertising contents in this magazine.

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MEDI CAL SPAS

Promotional Package

TREATMENTS ARE OFTEN ACCOMPANIED BY A HIGH PRICE TAG

E S TA B L I S H I N G Y O U R AESTHETIC SERVICES, If you have a business opportunity that you would like to share with us, contact us at: info@ medicalspaconsultant.com Cheryl Whitman, founder and CEO of Beautiful Forever

PRODUCTS AND ENVIRONMENT By CHERYL WHITMAN, Founder and CEO Beautiful Forever

www. medicalspasuccess.com

What is a promotional package? These packages Here’s an example: directly or indirectly ‘up-sell’ and

Your client’s/patient’s primary concern may be that she has cellulite on her thighs. She views the Anti-Cellulite treatment as being the answer to her problem. You, as the educated professional, however, have the knowledge that there are many other factors

‘cross-promote’ other

that play into her problem with cellulite. For example her diet, the amount of daily exercise, the level of

related services and/or

toxins in her body, and perhaps the absence of a homecare regime. Each person’s condition is unique

products from your

and requires a personalized long-term program, which may be designed by the therapist following a

medical spa. 20

MEDI CAL SPAS • November 2014

consultation with the client/patient. www.medicalspasreview.com

MEDI CAL SPAS

SO PROMOTIONAL PACKAGES THEREFORE PLAY A CRUCIAL ROLE IN CAPTURING THAT BUSINESS

Promotional Package

These programs are quite often accompanied by a Second, from a business perspective, you want her to high price tag, which may dissuade her from entering experience as many services and products from your the program. The promotional packages therefore business as possible, to allow you to generate play a crucial role in capturing that business for two maximum revenue. primary reasons. First, in order for her to obtain

Below is an outline of areas to consider when constructing your promotional program. Once she sees the results, she will be a packages: desired results, she must complete the recommended

walking advertisement for your business.

Guidelines to Use When Constructing Promotional Packages ■ Choose result- orientated treatments that already have exposure and combine them with other services that will compliment the effectiveness of the treatment. ■ Include home care products in the promotional packages where applicable. This will allow the client/patient to experience your products, while increasing the potential results. ■ Offer the client/patient savings in one of two ways. Either discount the total price of the package by a set percentage, or enhance the value of the package by including free treatments or products and then promoting the savings with a dollar value.

Example # 1: Anti-Cellulite $1800 (Series of 4 Treatments) Cellulite is a normal skin condition caused by a build up of toxins in the body that collect in fatty areas like the abdomen, thighs, and arms. Experience the following non-invasive therapies and products to minimize the appearance and firm and tone the body. ■ Lymph Drainage, Relaxing Body Treatment ■ Mesotherapy Session ■ Nutritional Assessment

www.medicalspasreview.com

Example # 2: Sweet Surprise $1300 (save $274) Rejuvenate your skin with these minimally invasive, non-surgical procedures. In just two hours you can be back at work, looking and feeling younger. ■ IPL Photo Facial Rejuvenation ■ Botox Cosmetic (1 area) ■ Restylane (2 syringes)

Tailor-make your treatment package wherever necessary to accommodate your clients/patients varying needs and reward them for their patronage.

MEDI CAL SPAS • November 2014

MEDI CAL SPAS

Non-Compete Agreement

NON-COMPETITION AGREEMENTS IS POPULAR IN MEDSPAS

ENFORCING NON-COMPETITION AGREEMENTS IN MED SPAS: IS THERE ADEQUATE CONSIDERATION? By RENEE E. COOVER, JD

Renee Elise Coover rcoover@thierschlaw.com practices with Thiersch & Associates in Chicago, Illinois. Thiersch & Associates specializes in med spa law.

For more information contact Thiersch & Associates, (312) 981-0990 Thiersch@thierschlaw.com

The use of non-competition agreements is becoming very popular in med spas but enforcing these agreements is becoming even more difficult. A non-competition agreement is designed to prevent employees from taking clients, patient lists or other confidential information with them when they leave the med spa. To have an enforceable non-competition agreement (also known as a “restrictive covenant”), there must be adequate consideration in return.

dequate consideration? Just what exactly Similarly, if a new employee signs a non-compete is

that?

Every

contract

requires agreement as a condition of employment, the

“consideration” which is the benefit each employment itself is also adequate consideration.

party expects to get from entering into the contract. However, what happens if you want an existing The consideration must be adequate enough to employee to sign a non-compete agreement to protect constitute an enforceable contract. In the the interests of your business? If the existing employee employment context, when an employee is “at will” signs an agreement promising not to compete during meaning he or she can be terminated at any time or subsequent to (for a specified time) his or her without cause, the employment itself constitutes employment, adequate consideration.

that

employee’s

continued

employment adequate consideration? Well…it depends.

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www.medicalspasreview.com

MEDI CAL SPAS

BUT ENFORCING THEM IS BECOMING DIFFICULT

Non-Compete Agreement

For continued employment to be adequate to enforce a period does not begin to run until the date the non-compete agreement on the existing employee, the agreement is signed, even if it is amending a previous employment must last a sufficient amount of time. non-compete agreement.

For more information: American Med Spa Association americanmedspa.org

For example, if a new employee signs a non-compete and the employer fires the individual the next day, it So what does this mean for employers? If a company would not be fair to restrict the employee from uses non-compete agreement for its employees, the competing for years in the future. According to Illinois employee must work for the company for a minimum law, the same may hold true for existing employees of two years. Or the employer must give the employee that sign non-compete agreements.

some additional form of consideration – a signing bonus or a promotion- to support the non-compete

In a recent decision, the Fifth District of the Illinois agreement. Appellate Court held that to enforce a non-compete agreement, “there must be at least two years … of If you are unsure about the enforceability of your continued employment to constitute adequate current non-compete agreements or want advice on consideration.”1 This means that the employee must how to draft enforceable non-compete agreements for be employed, under the terms of the non-compete your employees, be sure to consult with an agreement, for two years before the non-compete is experienced attorney who can guide you through the enforceable against the employee. And the two –year process. ■

1 Diederich Insurance Agency, LLC v. Smith, 952 N.E.2d 165, 351 Ill. Dec 792 (Ill.App. 2011). This opinion came down from the 5th District. Although the Fifth District only encompasses a small part of the state, Courts look to the decisions in other districts when making rulings and thus, this ruling may be followed by other districts in the State. www.medicalspasreview.com

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MEDI CAL SPAS

Transaction

MEDICAL PRACTICES ARE VALUED AT 2X ADJUSTED NET INCOME

Buyer Says. . . Seller Says. . . Monte Zwang is a principal of Wellness Capital Management, providing cash flow and financial strategies to businesses in the wellness industry. Monte has been a consultant for more than 25 years, teaching entrepreneurs and company leaders in health care, real estate, food and beverage, day spa, resorts and hotels, and retail industries the strategies of cash flow management. For more information visit: www. WellnessCapital.com

Different Views of the Same Transaction. By MONTE ZWANG

SELLER SAYS: "It's time to sell. I've got an established medical spa location and great clientele. I want to move on with my life." BUYER SAYS: "I want to buy a medical spa business. Can you find me a turnkey situation in great location with limited local competition and a motivated seller?" SELLER SAYS: "Here are my financial statements, leases and contracts. I've been waiting for an update of my financials since June from my CPA". BUYER SAYS: "I've never been in the industry, but because of my vast corporate experience, I know that by bringing my marketing and accounting experience, I can increase the sales, profitability, and value of any business I buy."

MEDI CAL SPAS â&#x20AC;˘ November 2014

BROKER SAYS: "Most medical practices are valued at 2x Adjusted Net Income and 65% of Gross Revenue. Most medspa businesses are valued at 4x Adjusted Net Income and 45% of Gross Revenue." SELLLER SAYS: "My financials need to be tweaked to show a net profit. I put a lot of personal expenses through the business and not all of the sales are showing on the financials (wink-wink). I want the asking price of the business to be based on what I claim the collections and business expenses to be, not what is shown on the financial statements and tax returns." BUYER SAYS: "How did you come up with the value? I'd like a business that has growing income, and is profitable. I don't want to pay anything for the business value, only asset value."

www.medicalspasreview.com

MEDI CAL SPAS

MEDICAL SPAS ARE VALUED AT 4X ADJUSTED NET INCOME SELLER SAYS: "A buyer can make a lot more money than I did if they raise prices, change the therapist's compensation program, bring in a medspa partner, and negotiate a new lease." BROKER SAYS (TO SELLER): "You are selling what you have today; revenue, cash flow, assets, and liabilities.You are not selling blue sky or business based on changes the buyer could make. Be aware of the importance of the Curb Appeal of your business. The financial, operational, and physical presentation of the business should look the way you would want it to see it if you were going to buy it yourself."

(3) a lease that is in place and probably lower than today's market rate (4) training and transition by the seller and the benefit of the seller's experience, (5) established business procedures and systems (6) established trade name and location that clientele identifies with this type of business (7) existing clientele that can be marketed to and built upon and (8) the ability to walk in and operate a going business."

BROKER SAYS (TO BUYER): "You are buying the business as it exists today; assets, liabilities, and cash flow. When you negotiate a price, there should be adequate cash flow to service the debt. The lease on the premises should be of adequate length to service the debt."

Some other thoughts that help the deal get done. A successful transaction should remain completely confidential until it closes. An asking price is a starting point. The actual purchase price is finalized as negotiations progress. When one side tries to "win" or dominate the transaction, it's unlikely that the deal will be completed. When buyer and seller respect each other's perspective and enter negotiations with an attitude of cooperation, it is more than likely that a transaction will close to everyone's benefit.

SELLER SAYS: "Why should I pay for business value? I can build a facility from scratch in that new retail development downtown and save some money."

Wellness Capital Management brokers the sale of medical practices and businesses in the health, wellness, fitness, and spa industries.

BROKER SAYS (TO BUYER): "You are purchasing a known commodity and your investment carries less risk. You are banking on your ability to maintain and grow from and established base of business.You are not starting from ground zero. Some of the benefits of buying an existing business are (1) established sales, profit, and cash flow (2) working equipment that is installed, functioning, and licensed

For more information, please visit our website. If you are a buyer or seller, we're happy to offer you a free initial consultation.

www.medicalspasreview.com

Transaction

We can be reached via e-mail (Monte@WellnessCapital.com) or telephone 888.727.5489. We look forward to hearing from you.

MEDI CAL SPAS â&#x20AC;˘ November 2014

MEDI CAL SPAS

Anti-Aging

SKIN SERVES AS THE FIRST-LINE IMMUNOPROTECTIVE DEFENSE

Seven Anti-Aging Skin Saving Secrets … That Every Patient – and Physician Should Know By DR. RONALD KLATZ, MD, DO, President, and DR. ROBERT GOLDMAN, MD, PhD, DO, FAASP, Chairman, respectively, of The American Academy of Anti-Aging Medicine (A4M; www.worldhealth.net)

SKIN IS THE BODY'S LARGEST ORGAN AND PERFORMS THREE CRITICAL FUNCTIONS: • TO SERVE AS THE FIRST-LINE IMMUNOPROTECTIVE DEFENSE • TO MAINTAIN WATER AND SALT BALANCE WITHIN THE BODY • TO CUSHION DELICATE INTERNAL ORGANS QUITE SIMPLY, SKIN IS THE BODY’S ANTI-AGING SURVIVAL SUIT.

ften misunderstood and maligned, getting a individuals to ultraviolet (UVA) light from tanning lamps bit of sun everyday can yield big health for two sessions of 20 minutes each. In one session, the benefits.A number of studies observe that the volunteers were exposed to both the UVA rays and the heat incidence of hypertension and cardiovascular of the lamps. In another, the UV rays were blocked so that

disease correlates with latitude and rises in winter, but a only the heat of the lamps affected the skin. The results biological cause has remained unclear. Martin Feelisch, suggest that UVA exposure dilates blood vessels, from the University of Southampton (United Kingdom), significantly lowers blood pressure, and alters NO and colleagues completed a study that suggests that metabolite levels in the circulation, without changing sunlight alters levels of the small messenger molecule, vitamin D levels. Further experiments indicate that prenitric oxide (NO) in the skin and blood, reducing blood formed stores of NO in the upper skin layers are involved in pressure. The researchers exposed the skin of 24 healthy mediating these effects. The study authors write that: “our data provide mechanistic insights into an important function of the skin in modulating systemic [nitric oxide] bioavailability which may account for the latitudinal and seasonal variations of [blood pressure] and cardiovascular disease.”

MEDI CAL SPAS • November 2014

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MEDI CAL SPAS

SKIN MAINTAINS WATER & SALT BALANCE WITHIN THE BODY

Anti-Aging

[Donald Liu, Bernadette O Fernandez, Alistair Hamilton, Explaining that: “The strongest predictors of UV were Ninian N Lang, Julie M C Gallagher, Martin Feelisch, et al. temporal proximity to noon, deviation from winter solstice, “UVA Irradiation of Human Skin Vasodilates Arterial and clear skies,” the researchers write that: “In future sun Vasculature and Lowers Blood Pressure Independently of safety promotions, adults should be encouraged to wear Nitric Oxide Synthase.” Journal of Investigative Dermatology, sunscreen on cloudy days because UV is still high and 20 Jan. 2014.]

conditions can change rapidly. They need reminders to rely more on season and time of day when judging UV and the

While ultraviolet (UV) radiation is generally lower in need for sun safety.” intensity in the winter months, experts remind us to wear [Peter A. Andersen; David B. Buller; Barbara J. Walkosz; sunscreen, hats, and protective clothing to protect against Michael D. Scott; Julie A. Maloy; Gary potential skin damage. Peter A. Andersen, from San Diego R. Cutter; Mark D. Dignan. “Environmental Cues to UV State University (California, USA), and colleagues collected Radiation and Personal Sun Protection in Outdoor Winter data on 3,937 skiers and snowboarders at 32 high-altitude Recreation.” Arch Dermatol, November 2010; 146: 1241 ski resorts in western North America during a two-year 1247.] period. The team measured direct, reflected, and diffuse UV at 487 points using handheld meters, and interviewed study subjects about their sun protection measures. The team found that sun-protection behaviors on ski slopes didn't consistently increase when UV levels were elevated. While most adults wore more sunscreen and reapplied it more often on the slopes when UV was higher, such as on sunny days at noon, they didn't often wear hats or protective clothing on those days. As well, they noted that cold temperatures, not UV levels, most influenced when skiers and snowboarders were more adequately protected, such as more fully covering their bodies and using goggles.

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Anti-Aging

SKIN CUSHIONS DELICATE INTERNAL ORGANS Skin cancer is the most common form of cancer in the In this article, we share seven anti-aging skin saving United States. The two most common types of skin secrets, supported by scientific evidence, to help you and cancer—basal cell and squamous cell carcinomas—are your patients to maintain healthy skin. highly curable, but can be disfiguring and costly. Melanoma, the third most common skin cancer, is more #1.ACHIEVE A HEALTHY GLOW,BUT AVOID A BURN dangerous and causes the most deaths. The majority of Among women, frequent sunburns in your 20s may sharply these three types of skin cancer are caused by exposure to raise your risks of future skin cancers. Abrar A. Qureshi, ultraviolet (UV) light. The overall incidence of skin cancer from Brown University (Rhode Island, USA), and has been on the rise – increasing nearly eightfold during a colleagues assessed data collected on 108,916 women, ages 39-year period, among middle-aged men and women. 25 to 42 years at the study’s start, enrolled in the Nurses' From 1970 to 2009, among white, non-Hispanic adults, the Health Study II. Following the subjects for 20 years, the incidence of skin cancer increased 4.5-fold among men team observed that those who had at least five blistering and 24-fold among women. In particular, women under sunburns when they were 15 to 20 years old were at a 68% age 50 showed a marked increase in melanoma.

increased risk for basal cell carcinoma and squamous cell

[“What is skin cancer?” US Centers for Disease Control & carcinoma of the skin, and an 80% increased risk for Prevention;

melanoma. Those who were exposed to the highest

http://www.cdc.gov/cancer/skin/basic_info/what-is-skin- amounts of cumulative ultraviolet radiation in adulthood cancer.htm, accessed 6 May 2014. Lowe GC, Saavedra A, had no increased risk for melanoma, but had a 2.35-fold Reed KB, Velazquez AI, Dronca RS, Markovic SN, Lohse CM, and 2.53-fold increased risk for developing basal cell Brewer JD. “Increasing incidence of melanoma among carcinoma and squamous cell carcinoma of the skin. The middle-aged adults: an epidemiologic study in olmsted study authors submit that: “In a cohort of U.S. women, we county, Minnesota.” Mayo Clin Proc. 2014 Jan;89(1):52-9.]

found that sun exposures in both early life and adulthood were predictive of [basal cell carcinoma] and [squamous cell carcinoma] risks, whereas melanoma risk was predominantly associated with sun exposure in early life.” [Shaowei Wu, Jiali Han, Francine Laden, Abrar A. Qureshi. “Long-term Ultraviolet Flux, Other Potential Risk Factors, and Skin Cancer Risk: A Cohort Study.” Cancer Epidemiol Biomarkers Prev June 2014 23:1080-1089.]

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MEDI CAL SPAS

SKIN IS THE BODY’S ANTI-AGING SURVIVAL SUIT

Anti-Aging

#2. PINE BARK The protein pathways of PI3K, MAPK and STAT3 are thought to be involved in the development of up to 70% of melanomas. Protein pathways like these help cancer cells multiply and spread, so there is scientific interest in devising effective ways to shut these pathways down. Leelamine, a compound present in pine bark, could be the first of a new unique class of drugs that will simultaneously target these key protein pathways. Leelamine works by shutting down cholesterol transport and its movement around the cancer cell. By shutting down cholesterol transport and movement, the exceptionally active survival communication that cancer cells require is shut down. The end result is death of the cancer cell. Submitting that:“This

#3. OMEGA-3 FATTY ACIDS Following on from animal studies that suggest that omega3 fatty acids exert a protective effect against photoimmunosuppression and skin cancer, Lesley Rhodes,

study is the first report demonstrating that leelamine is a

from The University of Manchester (United Kingdom), and lysosomotropic, intracellular cholesterol transport colleagues enrolled 79 men and women, ages 22 to 60 years, inhibitor with potential chemotherapeutic properties to consume either a supplement containing 5 g of omega-3 leading to inhibition of autophagic flux and induction of fatty acids (70% eicosapentaenoic acid [EPA] and 10% cholesterol accumulation in lysosomal-endosomal cell docosahexaenoic acid [DHA]), or a control pill, daily for compartments,” the study authors write that: “the findings three months. The subjects were then exposed to the of this study show the potential of leelamine to disrupt equivalent of 8, 15, or 30 minutes of summer midday sun cholesterol homeostasis for treatment of advanced stage using a light machine that emitted solar-simulated cancers.” radiation. The team observed that immunosuppression [Kuzu OF, Gowda R, Sharma A, Robertson GP. “Leelamine was 50% lower in subjects who took the omega-3 mediates cancer cell death through inhibition of intracellular supplement and were exposed to 8 or 15 minutes of cholesterol transport.” Mol Cancer Ther. 2014 Mar 31.]

simulated sunlight, as compared to people who did not take the supplement. The study authors conclude that: "Oral [omega-3

fatty

acids]

appear

abrogate

photoimmunosuppression in human skin, providing additional support for their chemopreventive role.” [Suzanne M Pilkington, Karen A Massey, Susan P Bennett, Naser MI Al-Aasswad, Khaled Roshdy, Lesley E Rhodes, et al. “Randomized controlled trial of oral omega-3 PUFA in solar-simulated radiation-induced suppression of human cutaneous immune responses.” Am J Clin Nutr., March 2013 97: 646-652.] www.medicalspasreview.com

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Anti-Aging

SUNLIGHT ALTERS LEVELS OF NITRIC OXIDE IN THE SKIN #4. GREEN TEA

#5. RESVERATROL

Green tea contains between 30 and Resveratrol, a polyphenol found in red wine, is known to 40%

water-extractable have anticancer properties; however, scientists had thought

polyphenols, and is particularly that it was metabolized so quickly by the body that it would abundant catechins – most notably, be ineffective in clinical trials. Nevertheless, researchers at epigallocatechn gallate (EGCG), for the University of Leicester's Department of Cancer Studies which some studies suggest a and Molecular Medicine in the United Kingdom have beneficial effect on cardiovascular found that this is not the case. Professor Karen Brown and health and weight management. colleagues found that resveratrol can still be taken into cells Lesley E. Rhodes, from the University of Manchester after it has been metabolised into resveratrol sulfates. Once (United Kingdom), and colleagues enrolled 14 healthy men in the cell, enzymes then break down the sulfate and women, average age 42.5 years, with fair skin, metabolite, converting it back to resveratrol again. In fact, and gave them low-dose green tea catechin the results appeared to show that resveratrol may be more supplements at a daily dose of 540 mg in effective once it has been generated from resveratrol sulfate combination with a vitamin C dose of 50 mg, for 12 because the cellular concentrations achieved are higher. weeks. The effects of the supplements were Encouragingly, the study also showed that resveratrol quantified by exposures to UV light before and after generated from resveratrol sulfate is able to slow the supplementation. Results showed that levels of growth of cancer cells by causing them to digest their own metabolites of green tea catechins increase in skin internal constituents and stopping them from dividing. fluid after supplementation, and erythema (skin "Our study was the first to show that resveratrol can be redness) levels were reduced after the 12-week regenerated from sulfate metabolites in cells and that this supplementation period. The team also observed that resveratrol can then have biological activity that could be whereas UV exposure increased key markers of useful in a wide variety of diseases in humans,” said inflammation, green tea supplementation reduced that Professor Brown. "Importantly, we did all our work with effect. The study authors submit that the data suggests that clinically achievable concentrations so we are hopeful that green tea exerts: "protection against sunburn inflammation our findings will translate to humans.” and potentially longer-term UVR-mediated damage.”

[KR Patel, C Andreadi, RG Britton, E Horner-Glister, A

[Lesley E. Rhodes, Gemma Darby, Karen A. Massey, Kayleigh Karmokar, S Sale, et al. “Sulfate metabolites provide an A. Clarke, Tristan P. Dew, Mark D. Farrar, et al. “Oral green intracellular pool for resveratrol generation and induce tea catechin metabolites are incorporated into human skin autophagy with senescence.” Sci Transl Med. 2013;5:p. and protect against UV radiation-induced cutaneous 205ra133.] inflammation in association with reduced production of proinflammatory eicosanoid 12-hydroxyeicosatetraenoic acid.” British Journal of Nutrition, 28 January 2013.]

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MEDI CAL SPAS

SUN-PROTECTION BEHAVIORS ON SKI SLOPES DIDN’T INCREASE WHEN UV LEVELS WERE ELEVATED #6. MILK THISTLE

Anti-Aging

#7. UPCOMING BIOTECH BREAKTHROUGHS

Silibinin, the extract of milk thistle, kills skin cells mutated Tiron, a novel antioxidant compound that inhibits cell by UVA radiation - which makes up about 95% of the sun’s death due to reactive oxygen species, protects against UVradiation that reaches Earth. Rajesh Agarwal, from the A sunlight. Mark Birch-Machin, from Newcastle University University of Colorado Cancer Center (Colorado, USA), (United Kingdom), and colleagues completed laboratory and colleagues subjected human skin cells pretreated with tests that identified the capacity for Tiron to protect against silibinin to UVA radiation. The team observed that the rate UV-A radiation, finding that the compound offered 100% at which these damaged cells died increased dramatically. protection of the skin cells. Further, the team observed that Specifically, the study shows that pretreatment with Tiron also protected cells against mitochondrial DNA silibinin resulted in higher release of reactive oxygen damage. species (ROS) within the UVA-exposed cells, leading to [Oyewole AO, Wilmot MC, Fowler M, Birch-Machin MA. higher rates of cell death. The study authors conclude that: “Comparing the effects of mitochondrial targeted and “These results suggest that silibinin may be beneficial in localized antioxidants with cellular antioxidants in human the removal of UVA-damaged cells and the prevention of skin cells exposed to UVA and hydrogen peroxide.” FASEB J. skin cancer.”

2014 Jan;28(1):485-94.]

[Sreekanth Narayanapillai, Chapla Agarwal, Cynthia Tilley, Rajesh Agarwal. “Silibinin Is a Potent Sensitizer of UVA Radiation-induced Oxidative Stress and Apoptosis in Human Keratinocyte HaCaT Cells.” Photochemistry and Photobiology, Volume 88, Issue 5, September/October 2012, Pages: 1135–1140.]

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MEDI CAL SPAS

Anti-Aging

SKIN CANCER IS THE MOST COMMON FORM OF CANCER All patients should be urged to wear sunscreen, the 2. The daily use of a broad-spectrum sunscreen slows, and singlemost basic intervention for skin cancer, because:

may even prevent, sags and wrinkles – the hallmarks of aging skin. Maria Celia B. Hughes, from the University of

1. Sunscreen not only provides protection against the Queensland (Australia), and colleagues asked 903 damage that can lead to skin cancer, but it shields the p53 Australian men and women, ages 55 years and younger, to gene, a gene that works to prevent cancer. While it is use a broad-spectrum sunscreen daily, and/or to consume generally accepted that sunscreen helps to minimize a dietary supplement of beta-carotene (30 mg) daily. burning, whether sunscreen helps to prevent skin cancers Subjects were followed for a four-year period, with has been the subject of some debate. Elke Hacker, from the dermatological assessments conducted to analyze changes Queensland University of Technology (Australia), and in skin appearance. The researchers found that the daily colleagues have elucidated the molecular mechanism of sunscreen group exhibited no detectable increases the sunscreen. The team confirmed previous findings that aging at the end of the study term. Further, the subjects sunscreen protects against all three forms of skin cancer: who used sunscreen daily showed 24% less skin aging, as BCC (basal cell carcinoma); SCC (squamous cell compared to those who used sunscreen periodically. No carcinoma); and malignant melanoma. Further, these effect was seen for beta-carotene supplementation. researchers observed that sunscreen is effective at shielding [Maria Celia B. Hughes; Gail M. Williams; Peter Baker; Adele the p53 gene, a gene that works to prevent cancer.

C. Green. “Sunscreen and Prevention of Skin Aging: A Randomized Trial.” Annals Internal Medicine, Vol 58, Nr. 11,

[Hacker E, Boyce Z, Kimlin MG, Wockner L, Pollak T,Vaartjes June 4, 2013.] SA, Hayward NK, Whiteman DC. “The effect of MC1R variants and sunscreen on the response of human melanocytes in vivo to ultraviolet radiation and implications for melanoma.” Pigment Cell Melanoma Res. 2013 Aug 21.]

To learn the latest anti-aging skin saving secrets, visit The World Health Network, www.worldhealth.net, the official educational website of the A4M and your onestop resource for authoritative anti-aging information. Be sure to sign up for the FREE Longevity Magazine® eJournal, your weekly health e-newsletter featuring wellness, prevention, and biotech advancements in longevity.

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PHYSICIANS ARE MIRED IN THE TREATMENT AGERELATED DISEASE AS IT OCCURS

Rejuvenation

YOUR CHOICE: Treat Aging or Treat Disease

By BILL SARDI

is unlikely that physicians are going to adopt what has just been described in the journal of Rejuvenation Research. The reason is that physicians are mired in the treatment age-related disease as it occurs, and the habit of affixing a billing code number to an insurance claim to receive reimburse for treatment rendered, rather than intervention at the molecular level to slow the aging process itself.

Not only are doctors brain washed into prescribing a pill for every disease, but so are patients. Will they ever break the habit? How does humanity get started on such a program? Restriction of calories, even for a short period of time (short duration fasting) activates the Sirtuin 1

The latter would prevent agerelated disease from ever occurring, but there is no www.medicalspasreview.com

diagnosis of premature aging and no insurance billing code number for â œ ageing prevention â ? either. Dr.Vadim Fraifeld of Ben-Gurion University of the Negev, says a paradigm shift that only recently became imaginable would be to treat aging rather than the outcome of aging, which is disease. [Rejuvenation Research 8: 207-10, 2006] Dr. Fraifeld says aging and agerelated disease are indistinguishable from each other.

DNA repair gene.

By focusing on slowing the aging process instead of treating each disease, a more proactive rather than defensive MEDI CAL SPAS • November 2014

MEDI CAL SPAS

Rejuvenation

PHYSICIANS MUST INTERVENE AT THE MOLECULAR LEVEL TO SLOW THE AGING PROCESS strategy towards health and longevity could be achieved. Dr. Fraifeld suggests this can be accomplished through epigenetics, the manipulation (switching) of existing genes to reverse inherited changes in gene function (aging) rather than alteration of the sequence of DNA or insertion of new genes.

A very low calorie diet, or the red wine molecule resveratrol, inhibit histone deacetylase so that genes remain silenced.

Of particular interest is the fact that resveratrol also suppresses homocysteine accumulation, mimicking what folic acid accomplishes as well. [Clinical Chemistry Laboratory Medicine 43:1084-8, 2005] This This is called epigenetic control. After physical is another likely reason why resveratrol continues to development of the human body, which requires exhibit unusual anti-aging properties. expression (activation) of many genes for the purpose of childhood growth, the post-developmental era of The challenge here is to get the public to depart from life could involve efforts to silence (inactivate) genes its over-reliance upon doctoring and begin to self used for growth which in later life may facilitate the prescribe their own brand of anti-aging medicine. Not development of tumors, viruses, bacteria, etc. only are doctors brain washed into prescribing a pill for every disease, but so are patients. Will they ever While there are ~30,000 human genes, a very short list break the habit? How does humanity get started on of just two gene-controlled mechanisms, DNA such a program? Restriction of calories, even for a methylation and histone deacetylation, are responsible short period of time (short duration fasting) activates for gene silencing and lifespan extension. the Sirtuin 1 DNA repair gene. This is remarkable if humans could find out how to Resveratrol and folic acid supplements would be the manipulate just these two epigenetic mechanisms. It self-prescribed youth medicines of longevity seekers. appears this can be accomplished by consumption of just two dietary supplements. Only a few people are likely to catch on to this remarkable possibility. So far, folic acid and red wine The following explanation gets a bit technical. resveratrol pills have not become as much of a Methylation of DNA (the donation of a methyl group) sensation as the current faddish enthusiasm for is a major biological controller of gene silencing. Folic human growth hormone, Goji berries and noni juice, acid, a B vitamin that inhibits the formation of an which appear to be distractions to the pursuit of undesirable blood protein called homocysteine, health and longevity. facilitates methylation and therefore gene silencing. When it comes to aging, the best defense is a good Histone deacetylation is where an enzyme (histone offense. â&#x2013; deacetylase) is inhibited so that bands of DNA remain tightly wrapped around histones, thus preventing the reading of DNA instructions. When DNA is coiled tightly around histones, genes are silenced. 34

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THE

Bio Energy

THE MONTECARLOSPA CONCEPT IS UNIQUE IN THE WORLD

UNION OF NEW

TECHNOLOGIES B y LY D I E G A L A S S O

MEDI CAL SPAS • November 2014

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USING THE LATEST SCIENTIFIC KNOWLEDGE OF BIOENERGY

Bio Energy

he montecarlospa concept is unique in the world and has been developped using the latest scientific knowledge of bioenergy combined with traditional spa technics and the best nature has to offer. It is specially innovative with its personal energy check up, which is precise, quantified and allows to identify the imbalance in the circulation of the meridians often the cause of physical and emotional perturbations. According to the energy check up, the therapist selects the appropriate vibrations of precious stones (emerald, ruby, topaze, diamond, saphire) needed to elevate the energy level of the person. The technics used (scrub, massages, bath, body wrap...) which are either invigorating, calming or stabilizing are specially adapted to suit the personal needs of the client. The alliance of colors, salts, precious stones powder and oils combined with massage technics optimize the effects of slimming, anti-stress, anti-aging, tonifying or circulatory treatments. The union of new technologies with traditional treatments define the particularity of our "savoir faire ".

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MEDI CAL SPAS â&#x20AC;˘ November 2014

MEDI CAL SPAS

THE MONTECARLOSPA CONCEPT COMBINES BIOENERGY

Bio Energy

MONTE CARLO

SPA CONCEPT

MED

uring the energy check-up, we explain what the human body's energy is to the client. We describe in brief the different types of energy and their circulation in the body. This check-up allows to evaluate the energy balance of the person and to identify by measuring with the Biofeeback (at the level of the meridian Ting points) 4 general types of imbalance which could be the cause of the emotional or physical troubles. (Chrong Mo; Tae Mo; Yang Keo ; Yin Keo)

According to the check-up evaluation we propose different treatments and natural products (minerals, precious stones powder, colors and essential oils). These products enhance the effects of massage and peeling technics. The combination of these treatments, balance the energy to restore blocked energy circulation of the organs and their function (by stimulation or dispersion) defined by the check-up. ENERGY CHECK-UP METHODOLOGY 1Â° ENERGY CHECK UP OF THE MONTE CARLO COMBO IN TREATMENT ROOM - Choose the check up file in client's language and note the date, name, sex. - Using the biofeedback, check the general body energy of the client and therefore the therapist should check her/his own general energy. - If the energy of the therapist is lower than the one of the subject: use the white ray of the light instrument. Pass it over the central meridian (conception vessel) from the head to the feet. This certifies that the therapist is charged with positive energy. 46

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WITH TRADITIONAL SPA TECHNICS AND THE BEST NATURE HAS TO OFFER

Bio Energy

A- Mesurement of the Ting points with the Biofeedback - Identification of blocked energy in the meridian either in excess or insufficient - Determine the Yin or Yang nature of the client - Choose the dominant meridians to balance, by stimulation of the element concerned B- Analysis of the check up to choose the adequate treatments according to the objective C- Determine the best adapted products and treatment technics: the color, the precious stones powder, bath salts, essential oils, which sense to stimulate and which meridian to balance 2° ENERGY CHECK UP PROTOCOL This check up allows to liberate energetic blockages that may generate emotional and physical disturbances. These could be linked to: Environmental agressions that can fragilise your energy of defense (electromagnetic, ecological...) Cellular memories that can generate energy circulation blockages Energy leakages due to scars (surgery...)

METHODOLOGY Treatment area control 1° Control energy of the area with the Lecher antenna at 15.3 and 17.6 to insure the positive cosmotelluric energy Therapist energy control 1° Verify the therapist cosmotelluric balance at 15.3 and verify the toxin elimination at 17.6 chest level 2° Verification of the five energy centers at 2.5 Client energy check up - Observation of the client's dominant element - Verification of the five energy centers vibration with the Lecher Antenna at 2.5 - Verify cosmic (yang) and telluric (yin) at 15.3 on chest • Control cosmic state at 12 (above head) • Control telluric state at 8 (feet level) - Verify lymphatic toxin elimination at 2.1 at 3 levels left and right (above breast, below breast and groin) - Verify energetic toxin elimination at 17.6 chest area Measurement of the meridians with the Acmos Biofeedback - Measure the general energy of the client and the therapist - Measure the Ting points of each meridian • measure left and right fingers: lung (Lu), large intestine (Li), pericardium (P), triple warmer (TW), heart (H), small intestine (Si) • measure left and right toes : bladder (B), gall bladder (GB), stomach (St), liver (Liv), spleen pancreas (Spi), kidney (Kid) Choose of points to stimulate withal the Quantacmos light This check up allows to identify the imbalances and allows it to restore by: - Stimulation of energy points and compensation of vibrational deficiencies with the natural waves selected in the Acmos range of minerals, essential oils, trace-elements, homeopathy, colors. www.medicalspasreview.com

MEDI CAL SPAS • November 2014

MEDI CAL SPAS

Bio Energy

THE MONTECARLOSPA CONCEPT DEFINES A “SAVOIR FAIRE”

MONTE CARLO

COMBO

The treatments will be selected according to the personal requirements of the client revealed in the energy check up. - Identification of the imbalance of the four Marvellous Vessels - TCHRONG- MO : Anarchy of the energy measure - TAE MO : Disharmony between the upper and lower parts of the body - YANG KEO: Excess energy all over - YIN KEO : Insufficient energy all over If necessary choose of points to stimulate which correspond to an imbalance expressed by the patient (tiredness, sinus, depression, skin problems, stomach swelling): see technical form The methodology of the different types of scrub: - Stimulating clockwise movements on the meridians insuficient energy - Dispersing anti-clockwise movements on the meridians excess energy - Stabilizing lengthwise by frictional movements followed by clockwise tonifying movements on all meridians when the patient is in balance.

MEDI CAL SPAS • November 2014

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MEDI CAL SPAS

THROUGH THE UNION OF NEW TECHNOLOGIES WITH TRADITIONAL TREATMENTS

Bio Energy

Choice of massage: - Manual lymphatic drainage - Yang massage on the back plus external and posterior areas of arms and legs - Specific massages adapted to the yin type, either circulatory or harmonizing; which, are predominantly on the anterio-internal area of the arms and legs, and also on the abdominal area, with stimulation of the lymphatic ganglions Choice of five element products selected, according to the client energy checkup Green: anti-stress (wood element) Red: tonification performance (fire element) Yellow: stimulation for slimming (earth element) White : anti aging, oxygenation (metal element) Blue: circulatory, anti-inflamatory ( water element) Choice of products: All products contain essential oils that react in synergy with each product - Choice of the oil massage colors - Choice of scrub salts with precious stones powder: with vibrations selected according to the five element needs of the client • Green (emerald) • Red (ruby) • Yellow (topaz) • White ( diamond) • Blue ( Saphire) Choice of senses to stimulate: • Sight : wood element, (liver - gall bladder) create peaceful atmosphere with greenlight • Taste: fire element, (heart - small intestine) recommend bitter savories and create atmosphere with redlight and candles • Touch: earth element (spleen! pancreas - stomach) predominance of manual therapies and lymphatic drainage, create atmosphere with yellow and orange lights • Smell : metal element (lung - large intestine) create a pleasant olfactive environnement and create atmosphere with white light • Hearing : water element (kidney - bladder) create a pleasant musical environnement with a blue light atmosphere For each element; diet, exercise, and specific music may be recommended CHARACTERISTICS OF A DOMINANT ELEMENT Wood dominant element Season of influence: Spring & March till May 20th Morphology :Tall like a tree or short as a bush Character: Determined, likes to work sometimes excessively Behaviour: Tends to get agitated when things are not going as wanted Emotions: Anger Organs and functions concerned: Liver, gall bladder, muscles www.medicalspasreview.com

MEDI CAL SPAS • November 2014

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