Clinical Aesthetics - issue 7 by The Intermedia Group

Issue 7

THE ART OF LIPOSCULPTURE

THE VAGINA REVOLUTION

By France Medical

DOCTORS WEIGH IN ON LIQUID RHINOS

Introducing SculpSure®

Submental Fat Treatment

SculpSure Submental is the only FDA-cleared and TGA-listed hyperthermic laser for non-invasive lipolysis of the area under the chin for individuals with a BMI of up to 43. No other non-invasive submental treatment has delivered a patient satisfaction rate of 100%, with clinical trials delivering up to 24% reduction within the treated area.2 Your patients can achieve great results without painful needles or surgery – all in 25 minute treatment sessions.

To find out more, contact Cynosure infoaustralia@cynosure.com cynosureaustralia.com 1 Cynosure clinical data on file, Cynosure, Inc. 2 Single treatment with an average reduction in fat volume as measured by MRI; Clinical and Histological Evaluations of a 1060nm Laser Device for Non-Invasive Fat Reduction - John W. Decorato., FACS. Rafael Sierra, PH.D., Westford, MA, 2014 © 2018 Hologic, Inc. ALL RIGHTS RESERVED. Cynosure and SculpSure are registered trademarks of Hologic, Inc. A Smarter Way to Sculpt is a trademark of Hologic.

A Smarter Way To Sculpt

CONTENTS CLINICAL AESTHETICS is brought to you by SPA+CLINIC, a trusted information source that has been driving the profitable direction of the spa and clinical aesthetics professional sectors in Australia since 1999. CLINICAL AESTHETICS launched in 2015 as a service to aid in the expansion of medical aesthetics services by doctors and surgical clinics, and owners and managers of allied clinical facilities, to maximise patient outcomes while effectively increasing profits. The protocol inclusion of non-medical professional and clinical aesthetics practices and therapies, along with wellness-based skin and body wellbeing programs are being found by leading medical practitioners to, sometimes dramatically, improve the results achieved by invasive medical procedures. Practitioners are either expanding their own range of services along with relevant staff expansion, or forging alliances with other professional. It’s a win-win, with increased profits, enhanced patient satisfaction and a rapidly expanding referral base. Within you will learn of the benefits your peers are reaping, and perhaps get some ideas to keep you ahead of the ever expanding competition. We look forward to your feedback and input.

4 TO FILL OR NOT TO FILL 8 SAFEGUARDING PATIENTS 12 RISE OF THE SUPER FACIAL

Issue 7

08 18

20 THE VAGINA REVOLUTION 30 SAVE THE DATE 34 THE DIMPLE DILEMMA

On The Cover

Endermologie is the only 100% natural, non-invasive, non-aggressive mechanical skin stimulation technique that naturally reactivates cells’ metabolism. Essential on the slimming and anti-aging market, the CELLU M6 ® is now a brand that fulfills beauty therapists as well as men and women every day all over the world. The working principle of an endermologie® treatment is to stimulate the skin surface to reactivate dormant cellular activity while completely respecting the body and the skin’s ecology. It is based on two exclusive patents for the body and the face, whose results keep being scientifically proven (over 145 scientific studies). FRANCEMEDICAL.COM.AU THE ART OF LIPOSCULPTURE

THE VAGINA REVOLUTION

By France Medical

DOCTORS WEIGH IN ON LIQUID RHINOS

published by BHA MEDIA Pty Ltd 41 Bridge Rd, Glebe NSW 2037 ph: 02 9660 2113 fax: 02 9660 4419

managing director Intermedia Simon Grover

managing director BHA Media Glenn Silburn

editor Nadine Dilong

national advertising manager Bernadette Borg

graphic designer Leanne Hogbin This publication is published by BHA MEDIA Pty Ltd (the “Publisher”). Materials in this publication have been created by a variety of different entities and, to the extent permitted by law, the Publisher

accepts no liability for materials created by others. All materials should be considered protected by Australian and international intellectual property laws. Unless you are authorised by law or the copyright owner to do so, you may not copy any of the materials. The mention of a product or service, person or company in this publication does not indicate the Publisher’s endorsement. The views expressed in this publication do not necessarily represent the opinion of the Publisher, its agents, company officers or employees. Any use of the information contained in this publication is at the sole risk of the person using that information. The user should make independent enquiries as to the accuracy of the information before relying on that information. All express or implied terms, conditions, warranties, statements, assurances and representations in relation to the Publisher, its publications and its services are expressly excluded save for those conditions and warranties which must be implied under the laws of any State of Australia or the provisions of Division 2 of Part V of the Trade Practices Act 1974 and any statutory modification or re-enactment thereof. To the extent permitted by law, the Publisher will not be liable for any damages including special, exemplary, punitive or consequential damages (including but not limited to economic loss or loss of profit or revenue or loss of opportunity) or indirect loss or damage of any kind arising in contract, tort or otherwise, even if advised of the possibility of such loss of profits or damages. While we use our best endeavours to ensure accuracy of the materials we create, to the extent permitted by law, the Publisher excludes all liability for loss resulting from any inaccuracies or false or misleading statements that may appear in this publication. Copyright © 2018 BHA Media Pty Ltd.

CL INI CA L A EST H E T I CS | 3

TO FILL OR

NOT TO FILL

The non-surgical or liquid rhinoplasty saw a big spike in demand last year, but itâ&#x20AC;&#x2122;s one of those procedures thatâ&#x20AC;&#x2122;s either loved or hated by doctors. By Nadine Dilong 4 | CL INI CA L A EST H E T I CS

Injectable rhinoplasty before and after by Dr William Mooney

ith thousands of rhinoplasties performed in Australia every year, the nose job is still one of the most popular plastic surgery procedures, requested by countless patients wanting to straighten, decrease (or in rare cases, increase) the size, or change the shape of their noses. Rhinoplasties are among the most complicated procedures requiring years of training, skill, and extreme attention to detail as every millimeter counts. It can take up to a year for the swelling to go down completely to reveal the final result, and with patients getting more impatient every year (isn’t it ironic?), it’s no surprise more and more people are opting for a quick fix: liquid rhinoplasties. The non-surgical nose job involves filler injections into the nose to even out asymmetries and visually improve the appearance of the nose. It’s quick, relatively painless, and requires no downtime – the perfect alternative to surgery? The opinions are divided. ENT surgeon Dr Dan Robinson says he’s seen a steady increase in demand for liquid rhinoplasties recently. “Approximately 75% of my practice is focused on rhinoplasty,” he explains, “the major change which I have seen over the last five years has been the increase in the non-surgical augmentation. Fillers have the advantage of not requiring any downtime from a surgical point of view. Grafts do involve a rhinoplasty to facilitate placement of the graft and have the distinct advantage over fillers in that they are permanent. My preference in relation to augmentation of the nose is to use grafts.” He isn’t alone with this preference; President of the Australasian Academy of Facial Plastic Surgery (AAFPS), Dr George Marcells, explains “non-surgical rejuvenation is gaining popularity as

patients become more accepting and aware of what can be achieved with fillers. However, the surgical option is still more popular for anyone wanting lasting changes to their nose.” “It cannot address breathing difficulties. As well, the results are not long-lasting. They cannot make a large nose smaller. There is a risk of infection, inflammation and possibly skin loss and scarring.” As with every medical procedure, it’s vital to be in the hands of a qualified, experienced practitioner. Injecting hyaluronic acid based fillers into the nose doesn’t seem like a big procedure, but an “ in-depth knowledge of facial anatomy and an understanding of the nuances of different dermal filler substances are the keys to success,” says Marcells. A botched liquid nose job can not only end in the before mentioned results like inflammation and scarring, but it can be much more severe as in the case of a Chinese woman who was blinded in one eye last year after one of the injections hit a nerve. The person who administered the injection wasn’t qualified, and had offered their services via messaging platform WeChat. The fact there haven’t been any reported cases of severe complications involving nose injections in Australia, and the increasing de-stigmatisation of non-surgical cosmetic procedures may be the reason why liquid nose jobs are on the rise, despite their being a short-lived fix. Dr Joseph Hkeik from All Saints Clinic has been performing liquid nose jobs for over 10 years. “Our clients are always thrilled as soon as I hand over the mirror. A liquid nose job can make a huge difference, to smooth a bump, widen or build the bridge, define the tip. A lot of my CL INI CA L A EST H E T I CS | 5

Injectable rhinoplasty side view before and after by Dr William Mooney

clients won’t proceed with surgery after having the liquid nose job, although if they are looking to reduce the size of their nose we will refer them on,” he explains. While he agrees that the procedure doesn’t come without the risks, including an unsatisfactory outcome, Dr Hkeik says the choice of injector determines the outcome. “I will normally asses the concern and create a tailored approach for that individual’s needs. There are so many cases that can benefit from a liquid nose job,” but a thorough consultation in the hands of a qualified practitioner is crucial. Another advocate of injectable rhinoplasties is ENT and Facial Plastic Surgeon Dr William Mooney, who performs two to three liquid nose jobs every single day. “Demand is skyrocketing,” he says. “What I started doing initially [in 2004] was, patients who had a rhinoplasty, who had maybe a micro-divot or a dent in their nose, I would use some filler to patch up that area, if they had perhaps had a rhinoplasty somewhere else and they did not want to have a revision rhinoplasty procedure. I then started performing this procedure on my own rhinoplasty patients if they had any deficit, which of course is very rare. Then it increased to more and more patients who did not want to have a formal rhinoplasty procedure but felt that they could improve the shape of their nose with filler.” The rest, as they say, is history. “With careful and detailed use I can now use it to straighten noses, lift the tip of the nose, stop the nose from dipping when the patient smiles, and it’s an exciting, fantastic and useful modality. “ In contrast to many doctors who dislike the treatment as it’s only temporary, Dr Mooney says that’s what he loves about it 6 | CL INI CA L A EST H E T I CS

as it gives patients the freedom to ‘test-drive’ their new nose. “We usually trial it with saline first,” he explains, “Saline is the solution you have in a drip and you can inject it safely into the tissue and it disseminates/fades away after about 10 minutes. This is the only time in cosmetics that you can try before you buy.” “Using the saline helps us in three ways: It shows the patient the outcome pretty accurately, it tells me how much filler they are going to need, and it shows both my patient and I the likelihood of success of an injectable rhinoplasty.” He then offers the patient semi-permanent HA fillers or permanent Polyacrylamide, but recommends starting with the HA fillers first. As quick and seemingly easy this procedure is, Dr Mooney stresses the complexity of it and consequential need for a highly skilled practitioner. “You really need to get someone who understands the dynamics of the nasal form and function and can assess the shape of a nose in a 3D manner and marry that to a patient’s requests, gender, ethnicity and total facial shape. It’s a very complicated algorithm that we have to use to produce the ideal injectable rhinoplasty outcome.” The morale of all this? Liquid nose jobs seem to be either loved or hated by doctors, and while they’re no substitute for a surgical rhinoplasty, they’re a great alternative for some patients. Cosmetic Surgeon Dr Ronald Feiner agrees, saying “In fact it would be unfortunate to have undergone surgical rhinoplasty in circumstances where fillers can correct the aesthetic deficit.” He has been performing non-surgical nose jobs for eight years, and just like every other doctor interviewed for this article, has seen a steady increase in demand for the procedure. It’s safe to say the 'liquid noses' are here to stay.

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TREATMENT TABLES

THERMAL ROOMS

MANICURE

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PEDICURE

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Safeguarding Patients Public safety should always come first in the cosmetic medical industry, so the new ‘Professional Performance Framework’ recently announced by the Medical Board of Australia is supported by everyone, especially the CPCA.

ustralia’s senior medical college, the Cosmetic Physicians College of Australasia, is committed to ensuring that medical experience, safety and training is paramount when it comes to practitioners performing cosmetic medical treatments. For this reason it strongly supports the recent announcement by the Medical Board of Australia of “a Professional Performance Framework to ensure all registered medical practitioners practise competently and ethically throughout their working lives”. CPCA President Dr Douglas Grose 8 | CL INI CA L A EST H E T I CS

emphasised the importance of the MBA’s twin priorities that: • t he community in Australia “has high levels of trust in doctors and expects medical practitioners to provide safe care to patients”; and • t he Professional Performance Framework “will support doctors to take responsibility for their own performance and encourage the profession collectively to raise professional standards and build a positive, respectful culture in medicine that benefits patients and doctors”. Dr Grose pointed out that “the College has already developed a continuing

professional development standard and framework which exceeds the requirements of the Medical Board”. Dr Grose said that the CPCA encourages other professional Colleges to follow their lead and mandate that doctors must spend time with other similarly qualified doctors, both being observed and observing others, in the work place to ensure that members who are not performing to the standard are detected early by their peers.” The new MBA framework proposes registered doctors take part in at least 50 hours of continuing professional development (CPD) every year - which includes a mix of

reviewing their performance, measuring their outcomes and updating their education. Dr Grose commented: “We totally support the Medical Board’s proposals in this area.” The proposed Professional Performance Framework has 5 pillars: •S trengthened continuing professional development; •A ctive assurance of safe practice; •S trengthened assessment and management of medical practitioners with multiple substantiated complaints •G uidance to support practitioners; •C ollaborations to foster a positive culture of medicine. Dr Grose said the CPCA also commends the Medical Board’s proposed Professional Performance Framework recommendation for “an integrated approach that will help improve public safety and better identify and manage risk in the Australian healthcare setting” by: •m aintaining and enhancing the performance of all doctors practising in Australia through efficient, effective, contemporary, evidence-based CPD relevant to their scope of practice; and •p roactively identifying doctors who are either performing poorly or are at risk of performing poorly, assessing their performance and if necessary, supporting their remediation. Dr Grose summed up: “The CPCA totally endorses the Medical Board’s commitment to developing a process which supports medical practitioners to maintain and enhance their professional skills and knowledge and remain fit to practise medicine. “Most importantly the recommendations are designed to improve public safety.” With the latest developments in medical technology triggering an explosion in the public popularity of non-surgical treatments such as cosmetic injectables, Dr Grose also warned: “I highly recommend that someone wanting injectables for the first time goes to a doctor who is a member of the Cosmetic Physicians College of Australasia for expert advice on what is the most suitable treatment. “The single most important skill is to know who to treat and who not to treat. Profit-based shopping centre outlets just want your money; but our members must follow our code of conduct which includes the insistence that only treatments which benefit the patient will be performed, not treatments which are only

“Australia’s senior medical college, the Cosmetic Physicians College of Australasia, is committed to ensuring that medical experience, safety and training is paramount when it comes to practitioners performing cosmetic medical treatments.”

beneficial to the bank account of the injector.” The CPCA represents 200 doctors across Australia dedicated to and focused upon the safest practice and highest clinical standards in cosmetic medicine – via professional assessment, diagnosis and treatment of patients’ aesthetic concerns managed through non-invasive and minimally invasive strategies available to registered medical practitioners. CPCA President Dr Douglas Grose noted: “Ours is a field of great public interest. The primary task of the College is to advance the highest principles of professionalism in the management of our patients’ aesthetic concerns. “And it is with this ‘safety-first’ goal as our priority, that we seek to encourage patients, current and prospective, to engage our experienced professional members for such assessments and treatments.” Dr Grose emphasised: “In Australia today, members of the public can avail themselves of cosmetic treatments from a wide variety of establishments. Our key point of difference is that we are all doctors – and we have among our Members and Fellows some of the most experienced, busiest and best-established doctors practicing in this field in Australia. Indeed we include several pioneers of the field. “In addition, we conduct a rigorous professional development and continuous medical education program for our members. And we are in the process of developing what we foresee as becoming Australia’s most advanced training program for cosmetic medical practitioners. “We therefore offer direct medical professionalism, cosmetic and full-person medical expertise, and the certainty and security that comes with assessment by a doctor who is dedicated to, and has specifically trained in, this field of medical work.” Importantly, Dr Grose added that this is “also a field of significant government interest” and hence the “task of the College is to interface with government in order to bring about the best regulatory outcomes for our patients. “As Australia’s senior medical college pertaining to cosmetic medicine, we are constantly encouraging government to more closely monitor and regulate the cosmetic medicine industry, while balancing the enforcement of high standards with the imperative of ensuring fair competition to deliver the best outcomes for patients. CPCA.NET.AU CL INI CA L A EST H E T I CS | 9

PROMOTION

LPG endermologie : ®

Leading the way to medical aesthetic and anti-ageing techniques 93% of women are looking for natural solutions for their beauty*.

or 30 years, LPG ® has been developing, manufacturing, and marketing advanced, patented endermologie® technology worldwide for the medical, paramedical, aesthetic and sports markets. The effectiveness of the advanced treatments delivered by the French company has been supported not only by the 80,000 referral centers worldwide, but also by 145 scientific studies, 32 of which published by Medline.

FIGHT FOR NATURAL BEAUTY BY LPG® Over the last few years, the beauty market has headed towards quick offers, with immediate results. Customers are seeking efficient solutions and visible results in no time. Simultaneously, women are paying particular attention to the harmful effects that beauty treatments can have on their bodies. The world of aesthetics is today therefore facing a crucial dilemma: offering aggressive, invasive and quick fix treatments with no long-term guarantee, or offering solutions that take into account the body’s health? With the launch of the 10th generation of the Cellu M6®, LPG ® more than ever claims its committed brand values. A strong brand, proud of its positioning that uncompromisingly fights for natural beauty.

NEW CELLU M6® ALLIANCE PATENT The technological innovation presented with the new range of Cellu M6 ® is a pure revolution. Breaking away from the combination of two independent 10 | CL INI CA L A EST H E T I CS

“Thanks to a range of specific treatment heads and to numerous possible settings, it enables early and gentle tissue mobilisation for antalgic effect and quick results.” motorized rolls, after years of research, it now associates motorised roll and flap, two patents which have made the success of LPG ®. It’s a synergy of patented technologies for new automated tissue mobilisation. • Targeted elimination of localised fat • Natural synthesis of collagen, elastin (+46%**) and hyaluronic acid (+80%**) • Firmed skin (+71%***), orange peel aspect is smoothed (+67%***) This new treatment stimulates, in a single setting, lipolysis and endogenous collagen, elastin and hyaluronic acid production, for a complete action on the figure with simultaneous slimming and anti-aging treatments.

NEW SKIN ALLIANCE IDENTITY SENSOR Stomach, saddlebags, cellulite or sagging skin… you no longer need to choose between slimming and anti-ageing. A highly customised complete and pleasant endermologie® treatment is defined depending on: •S kin type •C ritical areas •D esired treatment duration (from 10 to 40 minutes) Cellu M6® offers full made-tomeasure treatments, for visible results as of the 3rd session.

IMPROVE MEDICAL AESTHETICS EXPERIENCE More than just a beauty treatment, the draining and anti-fibrosis properties of LPG ® techniques allow to treat connective tissue transformations (burns, scars, fibrosis…), circulatory disorders (venous and lymphatic) and muscular pathologies (lesions, contractures…). Thanks to a range of specific treatment heads and to numerous possible settings, it

enables early and gentle tissue mobilisation for antalgic effect and quick results. Based on cellular stimulation, the new Cellu M6® Alliance technology allows to mobilise healthy and damaged tissues beyond the capabilities of the human hand. Whether it be for aesthetics (endermologie®), or therapeutic (endermothérapie®) use, the LPG® patented treatment heads deliver intense yet always pleasant stimulation on the skin surface to reactivate natural physiological processes in-depth: • Stimulation of natural lipolysis • F luid drainage • Vascularisation acceleration • Edema and fibrosis improvement • Muscular preparation and recovery Over the last decades, LPG ® techniques have become a standard of care for many aesthetic surgeons, fat freezing clinics, burn centers and liposuction clinics worldwide. Take the lead in natural medicinal aesthetic solutions today… #NoHeat #NoCold #NoWaves #NoScalpel #NoSideEffects #NoPain #NoInjections #NoFibrosis #NoCellDeath #NoChemicalProducts

CL INI CA L A EST H E T I CS | 11

Rise of the

SUPER FACIAL Taking traditional facials to the next level – in only 30 minutes.

hat do you get when you combine oxygen exfoliation technology, radiofrequency skin tightening and ultrasound dermal infusion into one sleek, table-top device? You get the geneO+ Super Facial. Boasting triple action facial technology and a quick 30-minute service time, the geneO+ platform aims to offer time-pressed clients the same clinical standard results afforded by individual facial treatments that can typically take an hour or more per service. The ‘Super Facial’ experience begins with the application of a nutrient-dense gel enriched with hydrating and anti-ageing ingredients such as hyaluronic acid and retinol. This is followed by treatment with a vibrating oxygenation handpiece fitted with a unique exfoliating tablet comprised of sodium bicarbonate and citric acid. When the tablet collides with the treatment gel, CO2 micro bubbles gently burst over the skin to oxygenate skin cells, allowing them to better absorb the gel’s active skin corrective ingredients. The tablet simultaneously exfoliates dead skin cells to instantly improve skin texture, and the intensity of application can be quickly adjusted during treatment via buttons on the handpiece. The service can then be followed with a “TriPollar” skin tightening massage which engages radiofrequency energy to induce instant contraction of collagen fibres and 12 | CL INI CA L A EST H E T I CS

stimulate fibroblast activity for an immediate skin tightening and facial contouring effect. Skin is left soft, smooth, firm and plump with an added youthful lift. The oxygenating effect also relieves eye puffiness and revitalises dull complexions, making the geneO+ Super Facial an ideal pre-party treatment, or as part of a long-term skin preservation plan that addresses wrinkles, congestion, enlarged pores and hyperpigmentation. The platform treats the décolleté and hands in addition to the face and neck, allowing therapists to provide comprehensive skin rejuvenation treatments with complete comfort and no post-treatment downtime. One advocate of the geneO+ Super Facial is Cherie Tippett, owner of Simply Elegant — an ABIA award-winning medispa salon for three consecutive years. “Whether our clients do a single treatment or a series, we are seeing remarkable changes,” she says, adding that, “geneO+ is fast becoming our number one device.” With numerous features in beauty and lifestyle magazines and appearances on shows such as Dr. Oz and Fox Health, what exactly is it about the Geneo+ platform that makes it stand out from other facial devices flooding the market? “Essentially, the geneO+ Super Facial offers a point of difference that we haven’t seen before,” Kane Hammond, CEO of The Global Beauty Group explains.

“It caters to time-poor, career-oriented professionals and busy mums and dads, who wish to take an advanced approach to skincare and anti-ageing, but simply don’t have hours to spare in the treatment room from week to week.” While the Super Facial certainly is an ‘express treatment’, this doesn't suggest that clients are deprived of benefits. “geneO+ technology condenses the benefits of an oxygen facial, microdermabrasion facial, radiofrequency skin tightening treatment and ultrasound skincare infusion facial into one fast, yet totally relaxing, 30 minute session,” Kane says. “To administer such a treatment plan with individual devices would literally take hours.” “This is why the geneO+ Super Facial has been so favourably received since its launch onto the aesthetics market,” he explains. “It’s redefining the traditional facial to better suit the needs of modern men and women.” And it’s not only the clients who benefit from the quick treatment times. With such streamlined facial technology, beauty business owners can now cut typical facial treatment times in half, freeing up space for more appointments and bigger profits while maximising day-to-day productivity. To find out more about the abundant business benefits of geneO+, call The Global Beauty Group on 1300 006 607 or visit THEGLOBALBEAUTYGROUP.COM.AU

Before and 12 weeks after 2nd SculptSure Series of Submental area. Courtesy of B. Katz, MD

Melting Away Self-Consciousness A double chin can have a tremendous effect on one’s confidence. So it’s no surprise submental fat reduction treatments have been taking off.

ave you ever accidentally turned your front phone camera on and seen your face appear on the screen from the most unflattering angle possible – including a double chin that rivals The Little Mermaid’s Ursula? Yes, we’ve all been there. It’s a confronting moment making many run to the closest mirror and analyse their chin from every angle, vowing to remember to always keep it up when talking to someone. Keeping your head high is one option, undergoing a fat-reduction treatment another (and much more effective). It’s safe to say the chin is having a bit of a moment when it comes to body sculpting. As an area that’s impossible to target with a diet and exercise approach for those wanting to get rid of stubborn fat pockets, a double chin can be a frustrating body part. According to a study by Cynosure and McCrindle, a whopping 93% of Australian women believe their body shape could be improved. While most are concerned about their abdomen, thighs, and arms, the chin comes in at a surprising fourth place with 18% of women wanting to enhance their jawline. While there are several non-surgical options to reduce submental fat including cryolipolysis and injections, clients feel most confident to treat the area with laser. Cynosure’s SculpSure raises the temperature of body fat with a 1060nm laser to precisely disrupt and destroy fat cells under the skin, which are then eliminated from the body. With a fat reduction of up to 24%, SculpSure is the first FDA-approved laser body sculpting

What do women want to change? 18% Excess hair on face, arms 25% Wrinkles 18% Excess body fat - chin

Excess body fat concerns Australian women the most

31% Excess body fat - arms 61% Excess body fat - abdomen

Chin 18%

36% Flanks (love handles) 21% Stretch marks

Arms 31%

43% Thighs

Thighs 43%

Abdomen 61%

treatment and has recently been cleared for the submental area. SculpSure impresses with its short treatment time of only 25 minutes, and no side effects or downtime afterwards making it one of those treatments clients can literally have during their lunch break. It’s advised patients come back for a second treatment two to three months after to achieve optimal results. With an almost unheard of 100% satisfaction rate among patients during Cynosure’s clinical trial last year, Managing Director Dennis Cronje thinks it’s a game-changer in the submental fat-reduction market. “We know there is a significant demand in this market for chin fat reduction and Australians are now able to eliminate unwanted fat under the chin with no side effects, needles or downtime.” And judging by the results, this is only the beginning of the rise of submental laser fat reduction. CL INI CA L A EST H E T I CS | 13

Consider Self-Sufficient Treatments Time is money, so wouldn’t it be nice if you could offer treatments that don’t require staff?

The Thermal Rock Room can be used by several clients at once

The Salve-in-terra is completely self-sufficient

n an industry that relies so heavily on handson treatments and the human touch, it may sound counter-intuitive to offer services that don’t require staff to be there, but it may be a lucrative addition to your medispa or salon. Already hugely popular overseas, thermal experience rooms not only have the benefit of being self-sufficient, but can also serve several clients at once. Spa Vision CoFounder Neil Owen explains: “Facilities available in Australia are very much treatment room focused. In other parts of the world there has been big investment in thermal experience areas that can be enjoyed without a therapist.” “They are complemented usually with relaxation areas and hydrotherapy and are often part of a package."

While the initial investment to create such an experience is higher, Owen argues that the capacity to service several guests at one time without having to rely on ‘one-to-one treatments’ and the associated overheads can really change the business model and revenue potential dramatically. “It’s important to know that you don’t have to be a large facility to incorporate thermal experiences into your business. Rasul (Arabic bathing) and similar experiences, such as the Salve-in-terra are

ways of allowing your guests to experience a treatment that doesn’t require a therapist adding a new dimension to your offering. Plus, you’re differentiating yourselves from competitors,“ says Owen. Of course, nothing replaces the human touch, but if you’re looking to expand your offering, it might just be worth it to think outside the box and explore the possibilities that come with thermal rooms. FOR FURTHER INFORMATION, VISIT SPAVISION.COM

Beauty Never Looked So Good Total Face Group introduces a new rewards program, Totally For You. By Jo Hannah, CEO and Managing Director at Total Face Group

ooking good has become even more rewarding, earning points from their next appointment and new with the launch of our new industry-leading clients can register online or simply make a purchase rewards program, Totally For You, created to thank at their nearest clinic to join Totally For You. Total Face our loyal customers. So, how does it work? For every Group clients can check the balance of their points at dollar a client spends at Total Face Group they are gifted any time by calling their preferred clinic. They’ll also a point. These points can then be redeemed on fullreceive an email update at the beginning of each month priced treatments or products, either in clinic or online. Jo Hannah detailing the number of points they have earned and the A lot of time and consideration was invested into the total amount of credit available on their account. development of Totally For You. Total Face Group was the first Additionally, the program gives members the opportunity to and only group of aesthetic clinics to be listed on the Australian be invited to exclusive events where they can learn more about new Stock Exchange and we are thrilled to now be offering an treatments and products, as well as the ability to earn extra points. industry-leading rewards program to our clients, who are the There are numerous benefits for our clients including no sign-up fee reason for the growth of Total Face Group and we couldn’t think and the ability to redeem at their next appointment. The program is of a better way to say thank you, not only for their loyalty, but also available at all TFG clinics nationwide. also for entrusting us with their cosmetic care. The loyalty program has been offered to Total Face Group We understand cosmetic treatments require regular visits clients in Queensland (formally Cozmedics) for the past five and a commitment to maintenance, but the impact they have years and has been highly successful building client loyalty and on confidence is priceless. This program allows us to reward retention, made evident through increased visits to clinics as well our clients with more of the products and treatments they love, as an increased spend on retail products. and that’s what we’re truly excited about. For further information on Total Face Group and Totally Existing Total Face Group clients will automatically start For You please visit TOTALFACEGROUP.COM

14 | CL INI CA L A EST H E T I CS

Expanding Business Beyond The Medical Space Founder of Sales Catalyst, Neil Osborne explains an efficient way to inject (pardon the pun) new income streams via profitable new services.

ustralia has amongst the highest rate of spend on minimally invasive and non-invasive procedures, per capita, in the world. The Mordor report estimated that during 2016, the Australia Aesthetic medical device market was worth $3.81 billion, with an expected compound growth rate of around 11.61 percent over the next five years. Add to that the compound growth projections for the global laser aesthetics market of nearly 8% over 2017-2021, and you have an almost perfect sales growth opportunity. Many medispas have already taken the plunge into the Aesthetic area, but some have found there’s few stumbling blocks to overcome. One of the biggest, is building trust amongst clients.

After two years in this new area, Kylie Scarfe, co-owner of Vamp Cosmetic Clinic in Newcastle, had these words of advice for those considering the move into Aesthetics: 1. Embrace the world of devices “At first, we didn’t realise what devices could do for our clients, and once we did, we were amazed how effective they were. Injectables are great, but our greatest growth has come through new devices. Most important though, is to choose devices that provide results-based treatments.” 2. Build a great team around you and commit to educate them “Put in place some type of professional development so your team can retain and develop their interest in their work.

WANT TO GROW YOUR AESTHETIC BUSINESS

It’s vital to keep them engaged in what they’re doing and the new advancements in technology, if only to ensure that they don’t become bored and their work doesn’t become too ‘procedural’.” 3. Stay knowledgeable and keep learning “An important part of growing your business is to keep up with the changes in the market – don’t rest on any successes you have. It’s important to choose a reputable company for your device choices, who offers solid post-sales support for those inevitable breakdown situations.” Based on Kylie’s comments, the Aesthetic world is alive, rapidly growing and open for those wishing to add a new vertical business to their medical practice.

DAY 1

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Happy Life, Happy Skin

16 | CL INI CA L A EST H E T I CS

Not only is Dr Howard Murad the founder of the first modern doctor brand of clinical skincare products, but he’s also an advocate of the holistic, whole-body approach to youthful skin. Here, the ‘skin guru’ explains why skincare alone isn’t enough… You’ve been in the skincare industry for over 25 years, do you think people are taking better care of their skin nowadays than back then? How have skincare routines changed? Life has changed so rapidly that the way we take care of our skin has definitely evolved. Our environment has changed so our skin needs have as well. We need modern skincare to address environmental aggressors that didn’t exist years ago. These aggressors – from blue light from digital devices, pollution from cars and smog, infrared radiation from warming devices like stoves, etc. – can cause visible signs of ageing. Murad’s City Skin Age Defense Broad Spectrum SPF 15, for example, is a revolutionary, multi-active 100% mineral sunscreen that truly goes beyond sun defence to offer complete protection, shielding skin from five environmental factors: blue light, pollution, infrared radiation, UVA, and UVB.

You believe in a holistic approach to healthy, glowing skin. Can you elaborate on this?

“While efficacious products are very important, at Murad we also want to reach people every day and inspire them to take a more balanced, empowered, and positive approach to health and wellbeing.”

What I have discovered through my decades of research is that over time there’s a reduction of water in our tissues – this is a common pathway to ageing, disease and dehydration. As our cells lose their integrity, we become more vulnerable to different factors and we can say that life is simply a slow process of continual dehydration. With that, there are several ways in staying hydrated, including an internal and external approach to skincare. From eating water-rich nutrients, to exercising regularly, all of which can help increase hydration from within and promote healthy and hydrated cells.

In today’s modern world, technology allows us to work and communicate from anywhere… anytime. There are social media pressures. Commutes are getting longer and longer. Expectations have increased, etc. All these factors contribute to stress, which can have profound implications on our skin and health. So, we need to give ourselves a break, talk to a friend, take a walk outside and/or read positive affirmations – these small adjustments each day will ultimately help you with your overall well-being and happiness.

There are so many skincare brands on the market nowadays. What sets Murad apart?

How important are regular professional skin treatments and which ones do you recommend?

I believe that the skin is a window to our entire body. It reflects what’s going on inside our mind, body and soul: are you happy? Do you feel fulfilled in your life? Are you under stress? Our wholeperson approach to skincare is unique to Murad. Today, we are faced with unrelenting levels of stress and it shows first and foremost on our skin, so we have to adjust how we take care of it. While efficacious products are very important, at Murad we also want to reach people every day and inspire them to take a more balanced, empowered, and positive approach to health and wellbeing.

I recommend a professional facial once a month – more if you can! There are some things that we can’t achieve at home and so seeing a professional for regular maintenance is just as important as using great homecare products.

You believe in affirmations and the connection between mental health and healthy skin. Is a positive attitude more important than the right skincare? Why? We can all set the temperature in a room to our liking and from time to time, we need a temperature check on our own emotions.

What kind of salon or Medispa is a good fit for Murad skincare? Murad is a clinical collection of professional and retail products that fits so many different salon environments. We have in-depth, clinical treatments that give immediate visible results as well as longer term skincare solutions… and all without the downtime usually associated with effective professional peels and procedures. If your salon, medispa or clinic is focused on the whole person, if you want to deliver the best results to the clients that you care for, if you love to see happy, healthy people glowing from the use of the best skincare, you’re a good fit for Murad! CL INI CA L A EST H E T I CS | 17

MY PASSION BEHIND

LIPOSCULPTURE

18 | CL INI CA L A EST H E T I CS

After a personal encounter with liposculpture, Dr Heckenberg was so impressed with the result, it sparked a desire to learn the art of body sculpting. By Dr Meaghan Heckenberg

am a Virgo and I have always been told Virgos are perfectionists. I don’t follow astrology but it is in my nature to do the best job I can possibly do, so I would have to agree that I strive for perfection. Liposculpture is a procedure I turned to when I was 34 years of age (17 years ago). My outer thighs (saddlebags) were large compared to the rest of me and always bugged me. No amount of dieting or exercise would make them disappear, until I had liposculpture. Despite all my exercise, the liposculpture surgeon made me realise I was never going to change my body shape that way. I don’t think I could have lost more weight without becoming malnourished, so I was actually relieved to hear that. Liposculpture truly changed my body shape when my outer thighs, inner thighs and knees were treated and the results were permanent. Clothes fitted better, I felt and looked better - everything was better!

One of Dr Heckenberg’s patients before and 3 months after liposculpture

I wanted to be a ‘master of one’. This is why I chose to only do liposculpture. In fact, my procedures take longer now than they did when I first started as I have become more fastidious in refining them. I also use very narrow cannulas which take longer to get the fat out but the results are smoother. Procedures may take 4-6 hours and I only tend to operate on one patient per day. There are many cosmetic surgeons who don’t like doing liposculpture because it takes such a long time to do. It requires a lot of patience to get it right, and it cannot be rushed. I believe I have the right

be experienced in the procedure but the surgeon needs to have a good eye. Drawings are made on the skin before the procedure which is very important as they represent the planning. A powerful numbing drug is injected into litre bags of saline, along with a drug that greatly constricts blood vessels, so there’s virtually no blood. The solution is injected into the fatty tissue, making it firm and dense. After the numbing drug has had time to work, the liposculpture begins. Through tiny incision points in the skin (3-5mm), long, thin, blunt cannulas are moved back and forth through the fatty

“Rather than being a ‘Jack of all trades’, I wanted to be a ‘master of one’. This is why I chose to only do liposculpture.” As a doctor, I have always loved doing procedures. My own experience with liposculpture all those years ago gave me the inspiration to learn how to do it myself and help other women. It wasn’t until 2007 when I had the time to dedicate two days per week for two years to learn liposculpture, amongst other cosmetic procedures. When I finished my fellowship with The Australasian College of Cosmetic Surgery, I had the intention of concentrating on only doing that procedure. I have realised, during my medical career, now spanning 26 years, that the highest level of surgical skill is gained by doing the same procedure often. Rather than being a ‘Jack of all trades’,

aptitude for the procedure plus I don’t want to stop until I get it right. Patients are mildly sedated so they don’t mind if it takes hours to do. The time goes very quickly for them. They would rather it take many hours as they want to get the best results. There is essentially no alternative to this procedure. No amount of non-invasive fat reducing devices (e.g. fat freezing devices) will be a substitute to what I do. Liposculpture is truly body sculpting and not indiscriminate fat removal. By removing fat from certain areas allows me to create a better shape, more harmonious curves and more aesthetically balanced proportions. It’s an artistic side of medicine. Not only does the operator need to

tissue which is located between the skin and the muscle. The tiny holes at the end of the cannula grab onto the soft fat cell when the cannula moves back and forth through the connective tissue. The cannula is connected to a suction machine taking away the fat cell from the site of disruption. Only fat is removed as it is soft and liquidlike. The liposculpture is controlled by the movement of the cannula, which is why it is a very operator dependent procedure. The ideal candidate for the procedure is a person of normal weight who has isolated areas of fat that are resistant to diet and exercise. There's no need to change his or her lifestyle after liposculpture as the procedure is not a weight loss tool. It is purely body sculpting, and it is changing lives. CL INI CA L A EST H E T I CS | 19

The

VAGINA REVOLUTION Vaginal atrophy and other female-only concerns are still mostly a taboo topic. Vaginal rejuvenation clinic, The Jade Room, wants to change that.

2 0 | CL INI CA L A EST H E T I CS

ne of the many great things about The Jade Room is that it was born entirely from personal experience and an awareness of a real need for the treatment they provide. In [2014] business founder Sarah Korbel was diagnosed with breast cancer and, following a bilateral mastectomy and the removal of her ovaries, Sarah was plunged into early menopause. Due to the nature of her cancer, Sarah was unable to take HRT or other hormone based treatments and was left to struggle with severe symptoms such as vaginal atrophy and hot flushes and night sweats. Fellow business founder, Dr Sally Lyttleton, was and is Sarah’s GP. Sally recommended that Sarah take part in a trial of the Mona Lisa Touch Laser System that was being undertaken at the Royal Women’s Hospital in Randwick. In Sarah’s words the treatment “changed her life” – meaning that the treatment returned a level of normality and sexual function and provided real respite from her menopausal symptoms. The experience prompted Sarah, together with Sally and business woman Stephanie Belton, to start The Jade Room, a medical clinic providing vaginal regeneration treatments and advice and support in the area of vaginal health. The clinic is situated in the Doctors on Darling surgery rooms in Balmain, Sydney, and staffed entirely by female medical practitioners. No referral is required prior to treatment. The vaginal regeneration treatment can: •T reat vaginal atrophy (the thinning and drying of vaginal tissue due to lack of estrogen) • I mprove sexual function; •R educe vaginal dryness; •T ighten the vagina and vulva and reduce vaginal laxity; • I mprove stress urinary incontinence or weak bladder; •R educe vaginal burning sensation and/or itching; •A lleviate painful sexual intercourse and dyspareunia; •N ormalise vaginal flora and reduce infection The Jade Room regeneration process involves an intra vaginal laser treatment which delivers a precise amount of heat to the vaginal walls and tissues. The treatment stimulates new collagen and elastic fibre production and improves blood flow. In addition, CO2 fractionated laser stimulates new cell production, effectively increasing protein, fibre, water, and blood supply within connective tissue and restoring fullness, moisture and elasticity to surface and deep vaginal tissues. Many of the symptoms of vaginal thinning and atrophy such as dryness, irritation, painful intercourse and fissuring, may be significantly reduced or even disappear with minimal treatment side effects or discomfort. The treatment itself is five minutes of laser light applied to the vagina via an inserted probe. For most women, this is experienced as a sensation of slight warmth or vibration. A complete course of treatment involves 3 separate laser treatments administered approximately four to six weeks apart. Although benefits may be felt after the first or second treatment, the full course of three treatments is required for optimal benefit. After 12 months, a further single top-up treatment may be useful. The Jade Room has been open for business for half a year and

Sarah and her team have learned many things through talking to their patients and to many other women keen to learn about ways to treat the symptoms of menopause.

WHAT THE TEAM HAS LEARNED SO FAR • Most pre-menopausal women know very little about what to expect from menopause; • Most women are heavily impacted by society’s view of menopause – i.e. that it signifies the end of a women’s sexuality, that the pain and discomfort of menopause are inevitable and that it is really not a subject that anyone wants to talk about; • Many sources of advice on menopause and sexual function focus on the need to maintain sexual function for the benefit of a partner or a relationship – rather than for the primary benefit of the woman in question; • Many menopausal and post-menopausal women have or had severe symptoms including dryness and loss of sexual function and all would choose to treat these symptoms if a safe and effective solution was available; • A significant proportion of women suffer from stress incontinence – usually but not always, following child birth. Again, many women are advised that this is an inevitable part of having children and is something that must simply be endured; • W hilst many women are comfortable seeking cosmetic treatments for their face, the vagina is a different story. If you are not in the market for a “designer vagina” but are truly suffering from stress incontinence or the symptoms of menopause, you want a safe and effective medical procedure administered by a healthcare professional that you can talk to.

WHAT NEEDS TO HAPPEN As long as society tells a woman that menopause is the beginning of the end of her sexuality, we can’t expect women to be open and comfortable about discussing it. As long as society tells women that the majority of them suffer from stress incontinence but offers only methods of dealing with it rather than treating it, they are unlikely to seek effective treatment. So, the story has to be taken to them. The key aim for 2018 is to expand The Jade Room’s discussion groups and forums providing information and advice around menopause, stress incontinence and vaginal health. They want to persuade women of the importance of seeking and obtaining treatment and of maximising their health, wellbeing and sexual function for their whole lives. The treatment of sexual dysfunction in ageing men is a $3 billion industry. Should the treatment of women be any different? THEJADEROOM.COM.AU CL INI CA L A EST H E T I CS | 21

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evance Therapeutics has furrowed a few brows at Allergan, the home of Botox, with clinical trial results demonstrating that its new neuromodulator can reduce frown lines for around six months – almost double the three to four months Botox achieves. In an official statement, Revance said its next-generation neuromodulator, DaxibotulinumtoxinA (RT002), achieved “topline results in alleviating glabella lines in two pivotal Sakura Phase 3 trials”. The California-based bio-technology company tested the new injectable on the glabella lines (frown lines and wrinkles between brows) of more than 600 patients in the trials. Both trials met the company’s primary goal of “delivering highly statistically significant improvement in reducing the severity of glabella lines” with 73.6 and 74 percent of patients respectively achieving at least “a two-point improvement from their baseline” at Week 4. In addition, the patients received “highly statistically significant” results in glabellar reduction at every time point evaluated up to 24 weeks – and “the median duration for patients treated with RT002 to return to baseline wrinkle severity was nearly 27 weeks”. Revance CEO Dan Browne, said the trial results prove it is scientifically and clinically possible to create a significantly longeracting neuromodulator with duration of six months. Moreover, RT002, which is created using Revance’s proprietary peptide technology “eliminates the need for human- and animal-based components which carry a potential risk of transmitting pathogens”. Treatment of glabella lines is the most popular aesthetic procedure for injectable neuromodulators such as Botox, Dysport and Xeomin, accounting for nearly a third of the US$3.6 billion sales in global neuromodulator sales last year. According to Revance, patients and physicians alike identify “duration” as the most important attribute of an injectable aesthetic treatment. At this stage the company is aiming to have RT002, which has been in the making for over 15 years, on the market in 2020.

Clinical

MICRO NEEDLING

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FLASH Before

For Collagen Induction and Scar Reduction.

After

CLINICAL AESTHETIC NEEDLING For best results, it is important to keep the skin hydrated and protected from the sun and harsh environment to keep it healthy and strong.

MEDICAL MICRO NEEDLING PEN

Laser hair removal has never been this quick.

n 2016, over 1 mio laser hair removal treatments were performed in the US alone according to research conducted by the American Society for Aesthetic Plastic Surgery, making it the third most popular non-surgical treatment of all behind anti-wrinkle injections and filler. While we don’t know the exact numbers for Australian hair removal clients, it’s safe to say the treatment would be at least – if not more – popular here than overseas considering our beachy, outdoor lifestyle. A lot of Aussies basically live in swimwear and therefore care about their looks, including having smooth, hairless bodies. 40% of laser hair removal clients are between the age of 35 and 50, with millennials representing roughly 33%, but the one thing they all have in common is wanting quick, painless treatments that offer long-lasting, beautiful results. ClinicalPRO’s Magma System is the world’s fastest laser system shooting 62 shots in 20 seconds. What does that mean from a clinician’s perspective? It means you can treat more patients in a day without compromising the quality of your treatment. The IPL applicator of the Magma allows effective and safe hair removal.

A Professional’s Fractional Needling Therapy System, Medical Micro Needling System works with Stretch Marks, Acne Scar Removal, Pigment

As the applicator treats a 10cm x 10 area in 20 seconds, you can treat an entire back in just seven minutes. Moreover, the treatment is made more comfortable for clients thanks to the Magma’s Advanced 4°C Constant Cold-Touch Contact Cooling. As the Sapphire frame tip is at a constant cool temperature, patients’ discomfort from the laser’s heat sensation is significantly reduced, which allows clinicians to operate at a comfortable room temperature. The Magma comes with a 1064nm Nd:YAG Laser, a 808nm Diode Laser, and the IPL Applicator, and with its ﬂexible conﬁguration, the Magma allows practitioners to combine the IPL and laser technologies in the one system, creating highly customisable treatments for each individual patient and their unique concerns. Another handy addition to the Magma is the Melanin-meter, which collects live readings of melanin concentration levels in the patient skin and recommends a treatments program accordingly, therefore allowing better control, increase efficiency and reduced risks across all skin types. FOR MORE INFORMATION, VISIT CLINICALPRO.COM.AU

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Thou Shalt Have a Laser/IPL Education And Training Program

Cosmetic clinics are busy and the demand for noninvasive cosmetic procedures is skyrocketing. Great for business, but what about patient and staff safety? Bravura Managing Director, Elissa O’Keefe explains the fundamentals clinics have to put in place. 24 | CL INI CA L A EST H E T I CS

osmetic clinics are busy 4173:2017 Safe use of lasers and and the demand for intense light sources in health care (1) non-invasive cosmetic are expected to be released as a procedures is skyrocketing. Great final document in the next few for business, but what about patient months and they state that one and staff safety? What are the such element is that for premises Elissa O’Keefe fundamentals that clinics have that have lasers or intense pulsed to put in place to ensure that the light (IPL) that “criteria and policy public is protected when they are being for continuing education and training treated with regard to staff education? programs for clinicians, nurses and medical The Draft Australia/NZ Standard laser service personnel shall be established.”

Furthermore, the standards advise that a laser or IPL service provider is obligated to ensure staff have the appropriate training for use of any laser or IPL equipment and anyone who engages with or uses laser or IPL equipment is expected to be trained in safe use of the equipment. Responsibility is clear and shared. This article examines one element of a comprehensive standard policy and procedure for continuing education and training programs, the key performance indicators necessary for assessing beginning competency for using laser and/or IPL. It is an extract of a tool that can be used by clinic owners, principals, mentors and clinical trainers. The tool has been designed to allow the laser/IPL user and their mentor(s) to have a comprehensive instrument to use to assess the key performance indicators (KPI) required for the safe and effective application of laser and/or intense pulsed light treatments. Once all the KPI have been performed safely and adequately, observed by the mentor/clinical trainer and assessed, autonomous practice may be commenced with a further appropriate amount of supervision as determined by the facility. The KPI presented here are not intended to be exhaustive and are reliant upon a collaborative approach to learning and judicious clinical decisionmaking done within an appropriate scope of practice. There are six areas that the KPI are grouped under: Laser safety theory/ education, preparing a safe laser room/ equipment, performing an initial/ continuing patient consultation, obtaining informed consent, patch testing and performing treatment. Failure to comply with KPI that are marked with an “*” is considered a critical breach and requires immediate suspension of the treatment and debriefing as per clinic protocol.

1. LASER SAFETY THEORY/ EDUCATION Expectations according to the draft standards would be that the staff member has completed an accredited laser and/or IPL safety course and: 1. I s able to explain the scientific underpinning of how and why lasers and Intense Pulsed Light (IPL) devices operate 2. C an identify the tissue interactions when using lasers and IPL

3. I s able to identify and interpret the legal and insurance considerations for the use of laser and IPL technologies in Australia including their own state/ territory legislation, health service or local standard operating policy and procedure and adheres to these. 4. Has an understanding of the safety precautions required when using lasers and IPL in clinical practice 5. Identifies potential risks and identifies resources to develop safety plans for the use of lasers and IPL in a clinical setting 6. Classifies, explains and selects appropriate lasers for the variety of clinical presentations they will be encountering.

2. PREPARING A SAFE LASER ROOM/EQUIPMENT A safe workplace is mandatory under national laws (2) and this should be ingrained for health professionals already. The use of lasers/IPL is no exception. Some of the KPI for ensuring that the treatment room and surrounds is compliant are that the staff member: 1. I dentifies the safety measures required to protect clients, operators and other staff undergoing IPL and laser* 2. Reviews and follows relevant federal, state or territory, and local legislation, regulations or standards and workplace procedures for use of laser equipment* 3. E nsures equipment is operating effectively according to manufacturer instructions and that maintenance is up to date* 4. C an identify where the AU/NZ Standards and clinic standard operating policies and procedures are located in the clinic* 5. Checks for biomedical engineering seal of safety and labelling on laser/IPL* 6. Ensures reflective surfaces are covered* 7. Sets up and takes down equipment as per manufacturer instructions, safety data sheets and workplace laser safety procedures* 8. R emoves potentially flammable, combustible items* 9. C hecks fire extinguisher is accessible and ensure it has been tested* 10. I dentifies emergency controls* 11. P repares treatment area considering reflective equipment and risk of fire* 12. Provides protective eyewear for client, self and other persons in treatment area 100% of the time*

13. C omplies with environmental safety measures for laser plume, masks, and smoke evacuation* 14. Ensures infection control principles are adhered to for all attachments before and after use on the client*

3. PERFORMING AN INITIAL/ CONTINUING PATIENT CONSULTATION Patient care is paramount and again, national standards (3) dictate the expectations in clinical practice. KPI included in this section ensures that the staff member: 1. I dentifies client’s relevant medical history and asks about any changes since last treatment* 2. Ensures that where medicallyrelated contraindications and special precautions are established, documented medical approval is obtained by the client prior to treatment* 3. D etermines Fitzpatrick skin type correctly* 4. Obtains relevant information to determine client’s requirements* 5. Identifies any contraindications or considerations* 6. C onsults with client to review goals and previous treatment 7. Actively encourages and responds to client feedback 8. A scertains realistic expectations 9. I dentifies client characteristics relevant to planning IPL or laser treatments using observation and relevant diagnostic equipment 10. N egotiates management of selected treatment in relation to other treatments or lifestyle factors 11. I ntroduces clients to light therapy and other treatments including medical grade skin care to optimize outcomes 12. Explains the science of the equipment being used 13. E nsures client has realistic expectations* 14. Takes baseline photos 15. Discusses patch test and results and performs one if appropriate (See Section 5) 16. Describes skin sensations, skin healing, skin reactions 17. Observes and communicates condition of skin, areas of body to be treated, extent of area to be treated 18. Reinforces the need for multiple treatments and maintenance 19. O btains informed consent* (See Section 4) 20. O btains financial consent* CL INI CA L A EST H E T I CS | 25

4. OBTAINING INFORMED CONSENT Informed consent is a person’s voluntary decision about medical care that is made with knowledge and understanding of the benefits and risks involved (4). The staff member being assessed: 1. D iscusses alternatives and planned treatment and reviews the client understanding of treatment program 2. C ommunicates what would be an anticipated clinical journey 3. A scertains realistic expectations 4. Advises client of possible physical effects of IPL or laser treatments (e.g. skin sensation and microcrusting) and home care required 5. Explains any expected side effects and possible adverse outcomes that may be encountered* 6. Discusses responsibilities of the practitioner and the client within treatment plan and negotiate client compliance 7. C onfirms agreed treatment plan with client and completes a signed client consent form*

5. PATCH TESTING Patch testing is mandatory as part of some insurance policies. KPI for this competency area include: 1. O btaining informed consent* 2. S etting the client at ease by explaining the sensation of the test before commencing 3. S electing a small area with similar hair and/or skin to proposed treatment area 4. Determining the need for anaesthetic 5. S electing therapeutic parameters based on client consultation and analysis 6. Applying a small number of pulses to nominated test area 7. Recording settings and observing immediate reactions* looking for an end point to assist in designing safe and effective treatment. 8. Responding to patient complaint/ discomfort, and adverse effects* 9. S electing post-treatment skin cooling products and applies according to treatment plan and client reaction to patch test. 10. W aits an appropriate time and observe and record skin response.

6. PERFORMING TREATMENT Working within scope of practice (5), patient safety, staff safety, minimal side 26 | CL INI CA L A EST H E T I CS

effects, no adverse outcomes, patient treatment satisfaction and staff job satisfaction are all goals when performing a laser or IPL treatment. The KPI to achieve these goals is that the staff member: 1. O nly performs treatments that are within their scope of practice* 2. Ensures informed consent has been completed* 3. P repares a safe laser room/equipment (See Section 2) 4. C ollects keys/inputs PIN code 5. Ensures the machine is ready for use 6. Washes hands* 7. C leanses and prepares treatment area as required 8. P hotographs the treatment area prior to the treatment 9. C hecks that all jewellery has been removed by client and practitioner or taped where not removable 10. C onsults with client to review goals and existing treatment program plan to reflect contraindications arising since the last treatment 11. A nswers questions and reiterates realistic expectations 12. Operates control panel on equipment according to manufacturer instructions 13. A djusts equipment treatment settings according to treatment plan and/ or adjusts therapeutic parameters judiciously 14. Follows safe practice protocols and uses IPL or laser equipment safely 15. Applies coupling gel where required 16. Reviews and adjusts treatment program plan to reflect treatment and outcomes 17. Identifies potential hazards throughout treatment procedure* 18. Uses a mask and smoke evacuator (2cm from target) where appropriate 19. P erforms a test shot according to treatment settings and in an area relevant to treatment site 20. S tarts treatment on least pain sensitive areas 21. W orks sequentially on target area, minimising overlap unless it is part of the treatment plan 22. H as an awareness of where the laser beam is pointing in between treatment pulses 23. P laces laser on “Standby” or off when not in use* 24. O bserves immediate skin reaction and level of client comfort 25. R esponds to patient complaint/ discomfort, and adverse effects*

26. R esponds to any client feedback and questions 27. C leans skin treatment area afterward where required 28. S elects immediate post-treatment skin products and applies according to treatment plan and client reaction to treatment 29. D iscusses treatment evaluation strategies 30. Advises client regarding post-treatment home care 31. R e-affirms any special precautions to be followed by client in period leading up to next treatment 32. C leans and stores laser equipment according to manufacturer instructions and workplace procedures 33. Disposes of waste 34. W ashes hands 35. P hotographs treated skin areas at completion of treatment service if indicated 36. C ompletes laser or IPL post-procedure documentation 37. Stores keys or locks PIN pad. Specific and measurable KPI with regard to a beginner using laser or IPL are essential for patient safety, meeting workplace safety standards, reducing litigation and ensuring staff retention are an essential component of clinical governance in cosmetic clinics. To request a copy of the KPI tool that can be used for this please contact info@bravuraeducation.com

References: Standards Australia (2017). Safe use of lasers and intense light sources in health care (DR 4173:2017). Commonwealth of Australia (2016). Model Work Health and Safety Bill. Australian Government (2017). National Safety and Quality Health Service (NSQHS) Standards. General Medical Council (2015). Consent guidance: patients and doctors making decisions together. London: General Medical Council.  Nursing and Midwifery Board of Australia (2015). Codes, Guidelines & Statements.

WHAT MAKES OUR INDUSTRY TICK? Take part in one of the most comprehensive studies about the Australian Aesthetics Market.

ustralians are increasingly focused on their appearance. We have amongst the highest rate of spend on minimally invasive and non-invasive procedures, per capita, in the world. And a recent report by Mordor Intelligence shows the potential for even further growth. The report estimates the Australian Aesthetic medical device market was $3.81 billion during 2016, with an expected compound growth rate of around 11.61%. But despite the booming market stats, there’s a yawning gap of real business information available to Clinic and Practice owners, to help them make better decisions for growth. Business owners need answers. Given there’s a huge potential market for non-invasive procedures, something needed to be done. In answer to that, the Sales Catalyst has commissioned Taverner Research to undertake independent research into the Australian Aesthetics Market, to find out what makes our marketplace tick. The study is specifically designed to gather, consolidate and share market information on where aesthetic businesses fit within the market, and the exact dynamics that are influencing

Where do you fit in the

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*Terms and Conditions apply. See www.thesalescatalyst.com.au/research

business growth. The research focuses on three key areas: 1. Demographics of the aesthetic industry: location, size, turnover 2. Aesthetic treatment trends: what’s growing, what’s declining, service pricing 3. M arketing and advertising influences: social media, client attraction and client conversion rates Neil Osborne, founder of the Sales Catalyst, believes it’s crucial that the ground-breaking research be collected and consolidated by a thirdparty expert, to ensure the autonomy of the information. “With the global laser aesthetics market projected to grow at a compound growth rate of nearly 8% over 2017-2021, it’s vital for business owners to have accurate, real-time information on the Australian marketplace. This research study gives business owners the opportunity to participate and contribute their data, so that everyone benefits from the knowledge.” The research results will provide aggregated details on business turnover, trends, client conversion rates, pricing and the success of social media to drive business growth. The study officially opened on 1 February, 2018. To take part, go to THESALESCATALYST.COM.AU/RESEARCH and add yourself to the list for invitations and early advice of the results. By contributing to the study, you can win 1 of 5 Apple Watch Series 3 and, more importantly, you’ll find out exactly how you compare to the market and contribute to its growth.

The SALES CATALYST has commissioned Taverner Research to undertake independent research into the Australian Aesthetics Market. The study is specifically designed to gather, consolidate and share market information that assists Business Owners and Practice Managers in making better informed decisions.

MEDIA PARTNERS:

RESEARCH PARTNER:

Australian Aesthetic Industry Market Research Study

Take the survey NOW and contribute to this independent study at www.thesalescatalyst.com.au/research and receive a FREE Australian Aesthetic Industry Market Research Executive Summary

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SAVE THE DATE Looking to network, learn, and stay ahead of the curve? There are plenty of conferences and events to attend this year.

CUTERA UNIVERSITY CLINICAL FORUM 2018 When: March 3-4, 2018 Where: Sofitel Melbourne on Collins The Cutera ANZ team invites you to Cutera University Clinical Forum 2018, an exclusive event for innovative practitioners. The 2018 program features presentations by a panel of renowned practitioners and aesthetic innovators, lead by Jill Lezaic, MD. An exciting and full two-day agenda has been designed to further your clinical knowledge and increase your competitive edge. Join to share your challenges and successes, network with your peers, and learn advanced techniques for effective clinical results.

COSMOPROF WORLDWIDE BOLOGNA When: March 15-18, 2018 Where: Exhibition and Trade Center, Bologna, Italy For 50 years, Cosmoprof Worldwide Bologna has been the leading 360° worldwide event for the professional beauty sector and an international platform for the cosmetics and wellness industry. Vast numbers of exhibitors, visitors and buyers from overseas are turning this event, year after year, into a proper international “hub” where professionals and decision makers meet to develop their business. For its 2018 edition, Cosmoprof Worldwide Bologna aims to facilitate networking and business opportunities for companies, retailers and professionals visiting the show, creating a tailor made fair to meet the specific needs of each sector, both under the perspective of exhibitors and attendees.

BEAUTY EXPO MELBOURNE When: March 24-25, 2018 Where: Melbourne Convention and Exhibition Centre The need to stand out from the competition is as strong as ever, with recent 2016 census data revealing that since 2011, the amount 3 0 | CL INI CA L A EST H E T I CS

of Australians working in beauty and fitness services has surged by 25 per cent, driven by Sydney and Melbourne. Beauty Expo Melbourne will provide a platform for visitors to gain a competitive edge by learning the latest techniques in trends like micropigmentation, men’s grooming, and brows; as well as discovering products that will satisfy consumer purchasing trends toward Australian-owned and independent beauty brands.

NON-SURGICAL SYMPOSIUM When: June 14-17, 2018 Where: Gold Coast Convention Centre This not-to-be-missed event seizes the opportunity to explore the hottest topics related to the medical aesthetic field. NSS Australia has become the premier non-surgical event in Australasia, selling out of trade booths and registrations for the past few years. The theme for 2018 is ‘The Great Debates’, with each session to showcase the points and counterpoints to debates, panel discussions, case by case analysis and sessions on hot topics and pearls. The rich three-day program covers all the bases, so you can return to your practice and patients with a complete picture of the latest advances in the medical aesthetic arena.

A5M CONFERENCE 2018 When: August 3-4, 2018 Where: Sofitel Melbourne on Collins Building the bridge between aesthetic and internal medicine is at the core of the Australasian Academy of Anti-Ageing Medicine (A5M); their focus is to provide tailored medical education to practitioners across the aesthetic, anti-ageing, integrative medicine and allied health professions. A5M provides the skills, resources and knowledge to advise clients on how to live a healthier and longer life. The annual A5M Conference in August is a fantastic opportunity to learn and meet other practitioners in your field.

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Training Inner Health For Outer Beauty How evidence-based training is supporting aesthetics professionals to connect inner health and outer beauty. By Helen Anton, Director, A5M

he continued integration internal causes of external and of the aesthetics industry chronic conditions, the ACAAM with conventional and Program will focus on examining complementary medicines has the impact that the Pillars of seen a rise in clinicians adopting Ageing: exercise and lifestyle, diet a multidisciplinary and holistic and nutrition, supplementation, Helen Anton approach to aesthetic medicine. hormonal/metabolic imbalance Educational programs teaching and genetic factors, have on integrated and personalised treatment the ageing process, inflammation and models are empowering aesthetic medicine aesthetic conditions. practitioners to achieve outer beauty The aesthetic industry is thriving transformations. It is by understanding the with innovation, new technologies and root cause of skin conditions and premature treatments available to address and manage ageing associated with modern lifestyle skin conditions. It is vital professionals choices, environmental influences, chronic are equipped to identify symptoms and diseases and metabolic imbalances, that understand the root cause of external ageing. practitioners have the foundations to tailor By embracing an integrative, preventative specific treatment protocols to provide model that considers a whole-body patients with better aesthetic outcomes. approach, ACAAM delivers an advanced, Building the bridge between aesthetic evidence-based postgraduate certificate that and internal medicine is at the core of prepares dermal therapists, aestheticians the Australasian Academy of Anti-Ageing and cosmetic nurses with the best practice Medicine (A5M); our focus is to provide tools to effectively provide personalised tailored medical education to practitioners treatment to clients. With the knowledge across the aesthetic, anti-ageing, integrative and skills, you have the foundations to work medicine and allied health professions. alongside allied health and medical peers to Our internationally recognised program, develop an integrated treatment plan with a the Australasian Certification in Antilong-term health focus. Ageing Medicine (ACAAM) reflects the As the global population ages, antichanging needs and expectations of the ageing medicine is one of the fastest Australian client base for an integrated growing specialties. In the changing approach to their health, wellbeing, and landscape, accreditation by an independent aesthetic outcomes. provider is essential for professionals eager Representing the industry’s increased to deliver impartial and scientificallydemand for interventions that address backed advice.

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ACAAM provides the skills, resources and knowledge to advise clients on how to live a healthier and longer life. The program’s three core modules are; 1. Anti-ageing medicine and its impact on longevity and the ageing process; 2. The impact of nutrition and detoxification on the ageing process; and 3. Metabolic disorders and the ageing process. Additional electives allow participants to further explore their personal interests with a choice of numerous A5M professional workshops each year. Once graduated, you can be confident your ability to work with clients is providing a holistic medical treatment. By addressing the cause and the symptoms you will become a trusted practitioner that clients will return to, time and time again. Beyond academics, ACAAM offers not only a strong foundation for continual learning, but the opportunity to build a referral network of like-minded professionals from varying medical and allied health professions. Our annual A5M Conference in August is a fantastic opportunity to learn and meet other practitioners in your field. Join the community of aesthetic and health professionals with A5M that value inner health and outer beauty. A5M is a recognised service provider of the anti-ageing industry and provider of accredited educational programs for professional development points by ANTA, ATMS, APAN, ACN, ACP, PSA and more. A5M.NET

2018 A5M Conference CONNECTING INNER & OUTER HEALTH Preventative • Integrative • Innovative 3–5 AUGUST 2018 MELBOURNE, AUSTRALIA Attend Australasia’s premier evidence-based anti-ageing medical conference promoting integrative, preventative and personalised health. 2018 A5M Conference will focus on: • Future directions of medicine • Emerging health concerns • Toxins, biotoxins and genomics • Behavioural and lifestyle interventions for the management of chronic disease • Metabolic and hormonal health issues • Clinical innovations and new technologies in aesthetic medicine • Aesthetics, skin and inflammation • New research in stem cells and Platelet Rich Plasma (PRP) • And much more!

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The Dimple Dilemma Cellulite is undoubtedly one of the most frustrating body issues for women, which is why it’s not surprising more and more opt for a professional treatment of the unsightly dimples.

hat used to be double D-cup breasts in the 90s, is now the full, round bottom. Our postKardashian era is truly obsessed with large bums, but ironically, those of us who are naturally ‘blessed’ with a full behind often hate it, not least because of the one thing that often accompanies the curves: Cellulite. Not even Kim K can escape the thigh dimples as paparazzo shots revealed last year, and while that’s somewhat comforting to know for a lot of women, there is no denying most of them would do anything to get rid of the ‘cottage cheese’ look. Unfortunately, diet and exercise has little effect on cellulite with a whopping 90% of women affected by the stubborn dimples, compared to only 10% of men. Some women develop cellulite as they get older, but others get it as early as in their teenage years – in other words, it’s one of those things the majority of women deal with every time they want to put on a short dress or feel they have to reconsider going to the beach, selfconscious about how their thighs look. Needless to say, many women would do more than diet and exercise in order to

3 4 | CL INI CA L A EST H E T I CS

get rid of their cellulite. − one in three to be exact. This is where Syneron Candela’s VelaShape III comes in. The VelaShape III device employs a combination of modalities: • Infrared light (IR) heats the tissue up to 3mm depth • Bi-polar radio frequency (RF) heats tissue up to 15mm depth • Vacuum ensures precise delivery of energy The combination of IR and vacuum coupled RF technologies causes deep heating of the fat cells, their surrounding connective fibrous septae and the underlying dermal collagen fibers. This promotes an increase in circulation, lymphatic drainage, cellular metabolism and collagen depositing. The result is a reduction in skin laxity, volume, and an improvement in skin structure and texture with a visible reduction of cellulite after as little as one treatment. As the treatment itself is fast (10min per area), uncomplicated, and relatively painless (a sensation of heat can be felt towards the end of the treatment), it’s perfect for busy patients who can’t afford

any downtime. The device has experienced great popularity both nationally and internationally with clinic owners and doctors loving the visible results of VelaShape III. “The VelaShape III system provides the market with a technological evolution in cellulite treatments. I am confident that I can offer my patients a treatment that is going to improve their cellulite. In fact, VelaShape III is a great investment for building patient loyalty, while improving our medical prestige,” says Dr Adriana Ribé from Ribé Clinic. With a 97% patient satisfaction rate, VelaShape III is one of those treatments your patients will most likely come back for more for, especially when they not only see the great result, but can measure it. In various clinical studies, patients report an average circumference reduction of 1-3 centimeters post-treatment, and a recent study of 35 patients demonstrated a 29% reduction of the thickness of the fat layer (between baseline and the 1-month follow up). FOR MORE INFORMATION, VISIT SYNERON-CANDELA.COM

VelaShape III ®

Non-surgical Non-invasive No downtime Comfortable

Mastering body treatments Cellulite Treatment • Skin Tightening • Body Contouring

Gain visible results for your patients in as little as one treatment with VelaShape III VelaShape III is the perfect, non-surgical answer for treating those ‘problem areas’ that cause patients to feel so displeased about their body image. Powered by elos technology, VelaShape III combines IR (infrared), bi-polar RF (radio frequency) and vacuum to precisely heat the tissue up to 3mm and 15mm depth respectively. This results in a localised reduction in skin laxity, volume and an overall improvement in skin structure and texture. Proven Clinical Results In various clinical studies, patients report an average circumference reduction of 1-3 centimetres post treatment.1,2,3 A recent study of 35 patients demonstrated a 29% reduction of the thickness of the fat layer (between baseline and the 1-month follow up) as well as 97% patient satisfaction.1

Before

After 3 Treatments

Before

After 3 Treatments

Before

After 3 Treatments

Before

After 3 Treatments

Combining the treatment benefits of asap cellulite + skin tightening treatment and VelaShape III. Results achieved after three treatments. These photos have not been re-touched or digitally enhanced.

Talk to us about how this award-winning treatment could benefit your clinic. Visit www.syneron-candela.com or call 1300 (CANDELA) 226 335.

SCIENCE. RESULTS. TRUST. References 1. Adatto et al, Reduction in adipose tissue volume using a new high-power radio frequency technology combined with infrared light and mechanical manipulation for body contouring. Lasers Med Sci 2014. 2. Wanitphakdeedecha R, et al. Treatment of cellulite with a bipolar radiofrequency, infrared heat, and pulsatile suction device: a pilot study. J Cosmet Dermatol. 2006 Dec;5(4):284-8. 3. Sadick NS, et al. A prospective clinical study to evaluate the efficacy and safety of cellulite treatment using the combination of optical and RF energies for subcutaneous tissue heating. J Cosmet Laser Ther 2004;6:187–90. ©2018. All rights reserved. This marketing material may include registered trademarks, trade-names and brands in certain jurisdictions of Syneron - Candela group of companies. SYNCAN0021