Clinical Aesthetics - issue 8

Issue 8

THE LATEST IN-OFFICE SURGICAL PROCEDURES THE TRUTH ABOUT VITAMIN A INFLAMMATION – FRIEND OR FOE? DR KONIKA PATEL SCHALLEN TALKS VAGINAL REJUVENATION

By Syneron Candela

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.

1

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

TM

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 L ATEST TRENDS IN IN-OFFICE SURGICAL PROCEDURES 8 THE TRUTH ABOUT VITAMIN A 10 THE DEEP IMPACT OF FEMALE REJUVENATION

12 LET THE GOODNESS FLOW 18 LET’S CALL IT ‘PRO-AGEING’

08 18

22 INFLAMMATION – FRIEND OR FOE?

On The Cover CO2Re Intima is a non-surgical laser procedure to restore vaginal health with a 100% reported satisfaction rate.1 CO2RE Intima is a medical laser that delivers controlled CO2 energy to the vaginal or vulva tissue – so cells make more collagen – improving skin tone, texture and appearance. CO2RE Intima treats all 3 intimate areas – internal, external and introitus, for the treatment of female rejuvenation and vulvovaginal atrophy. With CO2RE Intima, the hygienic, single-use handpieces assure women of the hygiene they expect of treatments in this intimate area. These treatments are easyto-master and quick, with both internal and external treatments taking 10 - 15 minutes.

SYNERON-CANDELA.COM/AU Reference 1. Arroyo C, Fractional CO2 laser treatment for vulvovaginal atrophy symptoms and vaginal rejuvenation in perimenopausal women. Int J Womens Health. 2017 Aug 28;9:591-595.

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

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Before Lip Lift By Dr Nettle

After Lip Lift By Dr Nettle

Latest Trends In

In-Office Surgical Procedures As increasingly more patients want big results with small procedures, in-office surgical procedures are on the rise.

Plastic Surgeon Dr Warwick Nettle explains.

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n-office surgical procedures can make a tremendous difference to a person’s appearance. It is possible to perform some relatively advanced procedures in office facilities under local anaesthetic, with or without oral sedation. The great benefit of procedures performed in the office is no hospital admission and no general anaesthetic. While this may not necessarily lead to shorter recovery times (as the recovery times for many in-hospital procedures are very short anyway), there is less fuss and bother with no hospital admission, and an increase in patient privacy.

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In-office surgical procedures are enjoying a boom due to the desire for fairly quick and simple, but reliable and impactful facial cosmetic improvements. Lip lift, earlobe reduction and direct brow lift are examples of these procedures. Although lip lift, earlobe reduction and direct brow lift have all been performed for many years, they have generally been performed in hospital under a general anaesthetic. Their popularity is exploding due to the fact that they are now done in the office under local anaesthetic, with or without oral sedation, and the ability to do this is fuelled by

modifications in technique which allow for a safe, reliable, excellent aesthetic outcome.

In-office procedures are either performed without sedation or with oral sedation. The commonest oral sedatives are Valium and antihistamines, although there are many other agents that are used to keep the patient as comfortable as possible.

LIP LIFT Young people generally have a short upper lip with a good amount of upper incisor (front teeth) dental show and very little show of the lower teeth. This inverts with age. Older people have a longer upper lip,

less show of the upper incisors and more show of the lower teeth. A lip lift can make a dramatic improvement in appearance, stripping years off a person and enhancing their look. Some people are born with long upper lips naturally, not due to aging, and they also get a great benefit from lip lift surgery.

After oral sedation, local anaesthetic is infiltrated into the pre-marked region above the upper lip at the base of the nose. Incisions are made, a small segment of skin is removed and a small part of the upper lip is undermined. In a modified lip lift, several of the kinks of traditional lip lift surgery have been removed and the benefits of a traditional lip lift are accentuated. At the same time it is possible to augment the upper lip and lower lip with fat or filler or to permanently increase the volume of the upper and lower lips by mucosal advancement. In mucosal advancement, the inside part of the lip is surgically advanced to increase fullness of the upper or lower lip.

The procedure generally takes approximately one to one and a half hours in the office under local anaesthetic and patients generally find this not at all uncomfortable.

A common sense diet is recommended after the procedure. Soft, mushy foods which do not need very large mouth movements for either biting or chewing are best. Stitches are removed approximately 6 days after surgery and most people are good to be in public within 10 days, so most people take about a week and a half off work for this procedure.

Lip lift surgery is suitable for people with a long lip caused by aging or those who are born with a congenitally long upper lip. For such a simple procedure, it is remarkable how this rebalances the face and results in a much more youthful appearance.

EARLOBE REDUCTION In the same way that upper lips get long and floppy with age, it is common to get long, floppy earlobes. This occurs with age and is frequently related to wearing heavy earrings. Over time, heavy earrings can drag on the ears causing their descent.

There are several different technical ways to reduce the size and floppiness of the earlobe, and the procedure selected depends on your particular situation. The common techniques include wedge excision (like taking out a slice of pizza from the

base of the ear) and removal of the lower pole of the earlobe (by removing the rim of the earlobe).

A marking is made on the ear for earlobe reduction surgery. After appropriate oral sedation the pre-marked segment of earlobe is removed. Stitches are placed; these generally need to be removed approximately a week after surgery.

Ears are relatively easy to hide and with hair camouflage it is possible to be back seeing people within two or three days.

For wearing the hair up above the ears, exposing the newly reduced earlobes, it is generally advisable to wait about a week to 10 days. It is recommended with earlobe reduction surgery to wash and shower and shampoo the hair straightaway as wounds heal better wet than dry. In fact this pertains to almost all wounds in plastic surgery, despite conventional wisdom to keep wounds dry.

DIRECT BROW LIFT / BROW ELEVATION AND SHAPING For many years, brow lifting surgery has been done through incisions concealed by the hair or at the junction of the hairline and forehead. While there are many advantages to this in terms of scar

In the same way that upper lips get long and floppy with age, it is common to get long, floppy earlobes. This occurs with age and is frequently related to wearing heavy earrings.

Before Earlobe Reduction By Dr Nettle

After Earlobe Reduction By Dr Nettle

CL INI CA L A EST H E T I CS | 5

Before Brow Lift By Dr Nettle

After Brow Lift By Dr Nettle

camouflage, the further the incisions are away from the brow the more complicated and less reliable brow elevation and shaping is. Two surgeons in Italy have worked out a very well-camouflaged and reliable method for elevation and shaping of the brow through an incision in the hairs at the very top of the brow. In the past the main problem with an incision in this area was not so much the scar itself, but the indentation of the scar in the skin being subtly visible. The two Italian surgeons have worked out a method to make it extremely difficult to see any contour deformity in this area, and for the wound to heal imperceptibly.

The incisions are marked in the very fine hairs at the top of the brow. After appropriate oral sedation the pre-marked segment of tissue is removed leaving the dermis intact. This is the key to not having a depressed scar in this area.

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The incisions are marked in the very fine hairs at the top of the brow.

Undermining of the skin underneath the brow is performed deep to the hair follicles of the brow to make sure that these are preserved. Various stitches are used to elevate and shape the brow.

Brow stitches are removed approximately six days after surgery. It is generally possible to be back at work or seeing other people approximately 10 days after the surgery with no one being any the wiser. In the worst case scenario it is possible to put some brow camouflage makeup over the incision, or else to have a minor amount of cosmetic tattooing in

this area to make the scar less visible.

Today, In-office surgical procedures are enjoying a boom due to the desire for fairly quick but reliable facial cosmetic improvements. The popularity of lip lift, earlobe reduction and direct brow lift is exploding due to the fact that they are now done in the office under local anaesthetic, and modifications in technique have allowed for safe, reliable, excellent aesthetic outcomes.

Dr Warwick Nettle is the founder and Medical Director of Silkwood Medical, a leading plastic surgery clinic and Medispa located in Bondi Junction, Sydney. Dr Nettle is a world-renowned facial Plastic and Reconstructive Surgeon with over 20 years’ experience. His surgical techniques, artistic flair and natural-looking results have gained him an international reputation as one of the leaders in the field of cosmetic plastic surgery.

SILKWOODMEDICAL.COM.AU

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The Truth About

Vitamin A Arguably one of the most important and effective skincare ingredients, Vitamin A and its derivative, retinol can be found in the vast majority of anti-ageing skincare products, both in professional lines, and cheaper department store brands. But there is so much more to know about Vitamin A in order to achieve the best results. Medik8’s Formulation and Development Director, Daniel Isaacs gives us the lowdown on the anti-ageing wonder ingredient.

In relatively simple terms, can you explain the difference between retinol, retinal, and retinoic acid?

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etinoids is a catch-all term for the vitamin A-derived molecules. Vitamin A (or retinol) is an essential molecule that occurs naturally in the body. Not just for healthy skin but for growth and development.

When vitamin A is not being used by the body, it is stored within the skin cells as retinyl esters. When the body is ready to metabolise it, these esters are converted to retinol, and then to retinaldehyde before ultimately becoming retinoic acid.

Retinoic acid is the active form of vitamin A, the form that is actually utilised by the skin. All forms of vitamin A must be converted to retinoic acid before they can take effect on the skin.

Retinoic acid is also the strongest form of vitamin A. When applied topically, it can significantly reduce fines lines and wrinkles as well as banish grade V acne, but its side effects are equally as staggering.

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Many people experience extreme sensitivity, redness and peeling that can last for up to a year before its benefits are fully realised.

That’s why retinoic acid is only prescribed in extreme cases.

When retinoids are applied to the skin, they join the vitamin A cycle at their respective stages. This means they affect the skin in different ways. Retinol ester products must go through the full vitamin A cycle which means their anti-ageing benefits take a long time to be realised. Retinoic acid, on the other hand, is already at the end of the cycle, so its benefits are unveiled almost immediately.

Most consumers, and maybe even some industry professionals, would not know about the different types of retinoids. Why do you think that is?

It all boils down to lack of research. The anti-ageing benefits of retinol and retinoic acid have been heavily studied for over 50

Medik8’s latest product launch, Crystal Retinal, includes retinaldehyde working up to 11x faster than retinol.

Can a cheap department store product containing retinol make any visible difference to the skin?

It really depends on the quality of the formulation. That being said ultra-cheap brands will often sell retinol that was poorly formulated in order to save money. But that doesn’t mean all cheap brands are ineffective. Likewise, super-expensive brands are not necessarily better than mid-weight brands, they simply capitalise on their luxe factor in order to drives prices up.

To really get a feel of how good a retinol product is, you need to do a little research. Watch out for formulas that have retinol esters such as retinol palmitate on their ingredient list. These types of retinol are extremely weak and often won’t yield the benefits you’re looking for. You should also check that the retinol you’re buying has been formulated with an encapsulation system. If it doesn’t, it’s likely to irritate your skin and cause more harm than good. At Medik8 our range of intelligent retinol products use a unique time release encapsulation system; as the serum or cream is massaged into the skin, the encapsulation breaks down and the retinol is slowly and gradually released into the skin. This means you can enjoy all the benefits of retinol without overwhelming the skin and causing irritation.

What is the percentage of retinoids a product should have in order to be effective?

years. As such, there is a wealth of information and clinical studies to back up their claims.

Next-generation molecules like retinaldehyde and retinyl retinoate have not been studied to the same extent. One possible reason is their instability. In previous years, these molecules could not be stabilised in a skincare formula, so studying their anti-ageing power was of no benefit to anyone.

But now, thanks to exciting developments in the beauty industry, this is no longer the case. In the past few years, Medik8 has utilised a number of advanced encapsulation systems that have allowed us to stabilise many different retinoids. That’s why we’re known as the experts of vitamin A. In 2016, Medik8 stabilised retinyl retinoate for the first time ever in our best-selling r-Retinoate Youth Activating Cream. This ground-breaking serum is 8x stronger than retinol and it can be used in the day as well as the night for accelerated results. Even better, it is completely non-irritating, which means it can be used on the most sensitive of skin types.

We've actually just launched Crystal Retinal. This revolutionary serum-cream is centered around retinaldehyde, a powerful vitamin A derivative that is clinically proven to work up to 11x faster than retinol. Once again, our extensive knowledge of vitamin A has allowed us to develop a formula based around a crystal-shaped encapsulation system to stabilise this molecule and harness its transformative benefits for the skin.

Studies show that as little as 0.01% retinol can improve visible signs of ageing, minimise pore size and even out skin tone and texture.

Obviously, the higher the percentage, the greater the results. But that doesn’t mean you should reach for a maximum-strength formula right off the bat. Retinoids are notoriously irritating in the first few weeks of use, so it’s important to build-up your tolerance gradually.

This gives the skin time to adjust to the active so you can avoid unwanted dryness and irritation. If you’ve never used retinol before, start with a low-strength formula of around 0.3% retinol. After finishing a full course, you may then progress to a higher strength.

Is there any skin type not suitable for retinoids?

We recommend that everyone over the age of 25 includes a retinoid in their regime. For those without any skincare concerns, it helps to prevent the formation of lines, wrinkles and blemishes. For those who are already experiencing signs of ageing, it helps to correct them. Even those with sensitive skin can find a retinoid product that cares for their reactive skin type.

At Medik8, we don’t believe anyone should have to make a choice between anti-ageing results and healthy skin. That’s why we consistently develop anti-ageing skincare that cater to all skin types. For sensitive skin types, we recommend the r-Retinoate Youth Activating Cream. Powered by retinyl retinoate, this advanced serum cream is 8 x more powerful than retinol and completely non-irritating.

Is there a safe form of retinoids for pregnant women?

Retinoids should not be used by pregnant women or those who are breastfeeding. While there is no evidence to suggest that topical retinoids are harmful in these instances, there is also no evidence to suggest that they are 100% safe for use either. That’s why all reputable experts will advise you to cease retinoid use as you prepare for childbirth and move on to breastfeeding.

CL INI CA L A EST H E T I CS | 9

COVERSTORY

The Deep Impact Of

Female Rejuvenation Women have suffered silently from vaginal issues for too long.

Now, non-surgical female rejuvenation treatments are here to help.

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n the realm of medical cosmetic procedures, we’ve reached a point at which almost anything seems possible.

We can create the best version of ourselves with the help of cosmetic treatments, but we can’t forget that it’s often not just about visual changes, but physical and mental ones that have a massive impact on a patient’s quality of life.

A procedure that has been improving women’s wellbeing on many levels is vaginal fractional laser. Although it’s still somewhat of a hush-hush topic for most, a whopping 45%* of women have expressed interest in vaginal rejuvenation treatments, according to a US survey. The main motivator is vaginal atrophy, which is a common post-menopausal symptom due to a lack of oestrogen and can result in decreased lubrication and thinning of the vaginal lining. Other reasons women consider the treatment are the loss of elasticity and tone

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due to childbirth or ageing, the resulting accidental incontinence, and sometimes painful intercourse.

All of the above issues can be improved with the Syneron CO2RE Intima, a fractional laser treatment that delivers controlled CO2 energy to the vaginal or vulvar tissue to promote collagen production. This non-surgical procedure can be done inrooms, achieving effective results that have improved many patients’ wellbeing.

Dr Konika Patel Schallen, M.D. is the Founder and Medical Director of CMA, Centre for Modern Aesthetic Medicine in Jacksonville, Florida where she practices laser and aesthetic medicine, with one of the, as she says, “most rewarding treatments” she performs being the CO2RE Intima.

“I was fortunate enough to be involved in the initial investigations of this technology, which we started in 2014. To be honest, at the time we began studying

the technology, I did not expect the impact it would have on the lives of women. We knew, of course that CO2 laser was the gold standard treatment for tissue remodelling in facial rejuvenation. We also knew how it was changing structure of the skin in an impactful and in many cases life-changing way for burn victims. So, we expected that it would lead to a degree of neocollagenesis and neoelastogenesis of the vaginal and vulvar tissue, but we did not expect the level of improvement that we quickly saw in such a wide variety of symptoms,” Dr Patel Schallen says.

“In our study, we were measuring changes in the Vaginal Health Index in order to measure grades of atrophy, but our patients began, very early on, to tell us about the improvement in their stress incontinence. One after the other, they said the same thing – they didn’t have symptoms of leaking when exercising or coughing.

COVERSTORY We really didn’t expect this; we were really amazed! The impact that it had on our patients in terms of quality of life was so impressive. Really from that point on, it is easily one of the most rewarding treatments that I perform.”

The high satisfaction rate of the treatment was further supported by a study conducted by Dr Patel Schallen and Dr Arroyo, which found the following results: • 94% reported an improvement in vaginal rejuvenation with CO2RE Intima treatment • 100% reported satisfaction with CO2RE Intima treatment •9 4% would recommend CO2RE Intima treatment •8 1% of women reported an improvement in sexual gratification Even though the results speak for themselves, some women may hesitate to undergo a vaginal treatment and might even feel uncomfortable talking about their discomforts and concerns. Dr Patel Schallen wants women to know that they’re not alone with their problems.

“There is nothing to be ashamed of.

Many women suffer from stress incontinence and every woman goes through menopause with a majority having some type of genitourinary symptomatology. Many of these symptoms are uncomfortable or annoying at best and for some women they significantly impact daily living. Sexual health and intimacy are also very important and this is a procedure that has helped many women in the right settings. It is important to have an open conversation with your practitioner to see if this is a procedure that could make a difference,” the doctor says.

The whole process from consultation to treatment is fairly straightforward.

“First, as in every treatment consultation, we need to start with a solid history and physical examination and an assessment of the symptoms that may be indicated for treatment.

We also recommend that the patient has an up to date PAP and that the vaginal exam is performed prior to the treatment. We use a topical lidocaine cream to numb the vulva and introitus externally. There is no anaesthesia necessary internally in the vaginal canal.

Prior to the treatment we wipe the cream and perform the internal treatment with the fractional CO2 using a hand piece designed to treat around the circumference of the vaginal wall. After this the hand piece is changed to treat the vulvar mucosa and any of the labia if the patient is interested in contracting the tissue of the labia. The procedure is only about

10 minutes long and most patients find it generally comfortable.”

As demand for vaginal procedures is growing, the CO2RE Intima is ideal for any clinic looking to branch out into this area as it is TGA approved, offering usually painless treatment options for vaginal atrophy and female rejuvenation. The device comes with four handpieces along with four different modes for fractional resurfacing. The easy-to-learn user interface, along with Syneron Candela’s award-winning customer service will make implementing this service into your business a breeze. Compared to other similar devices, the CO2RE Intima’s compact size means it’s suitable for even small treatment rooms.

Physicians who offer the treatment enjoy the high satisfaction rate and measurable results.

“I am very excited, this is actually one of the most important aspects of my practice currently. Not only do I get a subjective improvement within the patient, but on the physical exam we see an improvement in the vaginal PH and we see a much improved vaginal mucosa,” says Gynaecologist Martin Garcia, MD. A series of three treatments is usually done, however, some patients notice results earlier than that.

“The treatment is excellent. I had three natural vaginal deliveries and had looseness and incontinence for the last five years.

After the second session, I began to notice an improvement in the interior (of the vaginal canal). There was an improvement in sensation during sexual relations. I have told all my girlfriends and the women in my family about this treatment. It’s a really great treatment. My last treatment was three months ago and I still feel great. The treatment was easy and was not painful,” explains a patient from Spain.

With little to no downtime and minimal side effects, it’s a treatment suitable for even the busiest of patients. “In general, side effects have been limited to a few days of swelling, mild discomfort and itching as the tissue begins to heal,” explains Dr Patel Schallen.

For more information about Syneron Candela’s CO2RE Intima, please contact Syneron Candela on 1300 226 335 or visit WWW.SYNERON-CANDELA.COM

*Buzzback Consumer Survey, June 2017 Women’s Sexual Health study of menopausal women, US females, ages 45 and above, who have not experienced a menstrual period in the past 12 months (n=253) CL INI CA L A EST H E T I CS | 11

LET THE

GOODNESS FLOW

While some people feel sick even just thinking about needles, others choose to have a catheter inserted into their arms to feel better.

Nadine Dilong takes a closer look at the ‘wellness trend’ of IV infusions.

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ouldn’t it be nice to have something as simple as a pill to alleviate pain, increase energy, and improve your overall wellbeing? While some people swear by taking daily supplements like fish oil, Vitamins, and Magnesium, others want a much faster and more effective result – something that goes straight into your veins, quite literally.

As part of the wellness trend and people’s constant pursuit of being the best version of themselves, IV infusion treatments have been on the rise since they first appeared on the scene a few years ago. While some doctors offer it as part of their medispa menu, IV infusion clinics that focus solely on the drip have popped up around the country.

Like a bar offering all kinds of drinks, IV clinics present an array of infusion cocktails to patients depending on their lifestyles, health, and desired effect. There are energising infusions, hydrating ones, antioxidant ones, and the classic that started it all, the so-called ‘Myers cocktail’, a nutrient-dense infusion pioneered by the late John Myers over 50 years ago.

So what’s the science behind IV drip infusions? Studies suggest that vitamins and minerals going directly into the bloodstream result in a higher level of nutrients than when taken orally.

Supplements taken orally have to pass the digestive tract and liver, 12 | CL INI CA L A EST H E T I CS

which causes many substances to be rendered inactive.

By foregoing those organs, higher than normal blood levels can be achieved.

Founder of Sydney based infusion clinic actIV, Max Petro hooks up over a dozen people to his IV drips most days, and loves the positive effects the infusions have on his clientele.

“We offer free consultations with our doctors who go through a patient’s health history and customise a package based on what they’re looking to achieve from an infusion (such as help with energy, skin conditions, or recovering from an illness). The consultations take about 15 minutes, and the infusions themselves take about 30-40 minutes,” he explains.

Petro opened his clinic in 2015 after working as a ski instructor in Australia, USA, and Japan.

“The ski patrollers (who were qualified paramedics) used to administer each other with intravenous infusions to help with recovery, and I tried it one day and was amazed by the benefits, so decided to bring these treatments to Australia.”

Since then, he’s seen a steady increase in demand for the pickme-up drips.

“Our most popular infusion is our ‘actIV Myers Cocktail.’ This includes IV Vitamin C (which gives your skin a lovely glow as

Vitamin C is used in collagen production), IV Vitamin B Complex (which is a great energy boost), and IV Magnesium (which is great for improving mood and easing stress). You can have each vitamin on its own, but when had as a combination they work very well. Our IV Glutathione infusion is also very popular - it’s a great antioxidant, used to mop-up the free radicals in the body.”

What works as a standalone treatment, has also become a great add-on for other medispa treatments such as lasers or facials. Cosmetic Nurse Practitioner and Owner of Duquessa Skin Sanctuary, Katherine Millar-Shannon, offers her so-called ‘VitaLite’ at her clinics, a combination of Omnilux LED Light Therapy and Vitamin IV infusions.

“After the VitaLite treatment you will be hydrated, with optimum vitamin levels. The Omnilux works its magic on your skin

such as Rihanna and Cara Delevingne. Images of the stars hooked up to IV drips posted online resulted in a lot of interest in the revitalising treatment, followed by many practitioners adding the service to their clinics.

As with any medical treatment, being in the care of a qualified doctor is crucial, as well as undergoing a detailed consultation and health check prior to treatment. Earlier this year, model and reality TV star Kendall Jenner was hospitalised after experiencing an allergic reaction to a Vitamin IV infusion.

While she recovered quickly, it goes to show that a seemingly harmless ‘wellness treatment’ needs to be taken as serious as any other medical treatment.

But the IV treatment trend isn’t just about curing hangovers and boosting our immune system. A relatively new treatment, NAD+,

by increasing circulation and collagen giving you a glow from the inside out,” her website explains.

“This marks the 4th year that I’ve been providing IV Vitamin therapies in my practice, and I find them an invaluable tool in rendering holistic care to my patients,” Millar-Shannon says.

“It takes a day or two for your body to digest nutrients. IV is direct. IV therapy is faster than any other method. It’s going into your blood stream. We need vitamins for metabolism, creating red blood cells and of course boosting the immune system.

The immediate effects are increased energy and hydration.

Other effects can include an improvement in mood and skin complexion.”

While both Millar-Shannon and Petro are convinced of the effectiveness of IV infusions, there are also critics, who argue there’s no need for IV drips as a healthy diet arguably provides us with all the nutrients we need.

“At actIV, we go so far as to say our treatments may work for you, or they may not, since everybody has a different metabolism.

If you eat a perfect diet, exercise every day, and live a stress free lifestyle, then of course our treatments aren’t going to work as well for you as most people in the ‘real world’ who perhaps skip the odd gym session or are fatigued due to kids or a hectic schedule,” Petro explains.

“To critics, I would say that we’ve been open for over two years and our membership base keeps growing, and our clients keep coming back, so if it didn’t work, how are we still in business!?”

As most wellness treatments, IV infusion cocktails started as a trend in the US and quickly became popular among celebrities,

has made it to Australia and promises to be a ‘brain-boosting’ substance that has shown incredible results in clinical trials.

Research on NAD+ infusions has shown a profound effect on balancing neuro-chemistry to help improve intra-cellular and inter-cellular communication. In simpler terms, signs of ageing in the tissue and muscles can be reversed, and people who have been taking NAD+ supplements have reported less cravings, more energy, and a general improvement of their overall wellbeing. A case study published in conjunction with the Springfield Wellness Center, has indicated a 90% success rate of NAD+ addiction therapy patient.

In Australia, the revolutionary treatment is offered by Dr Jeremy Cumpston from Ageless Clinic in Bondi.

“Infuse NAD+ and you will feel a profound neurological change that leads to better neuronal cell function. I have been humbled by our results so far,” he says.

Pre- and post-treatment care is of utmost importance for NAD+ patients.

“Our bespoke programs include appropriate communication with both GP’s, allied health professionals and specialists. We try where possible to include Neuro Linguistic programming support along with strict exercise and diet when dealing with patients fighting addiction. Each treatment is tailored to the patient’s goals and level of support they have to achieve them.”

This rise in the popularity of infusion treatments, and the development of neurological treatment could be the start of a new era in which regular IV infusions become part of our lifestyle to keep us healthy, happy, and ultimately help us live longer. All we can say is, watch this space.

CL INI CA L A EST H E T I CS | 13

Post-Treatment Wound Healing With

Manuka Honey

Dr. Ginni Mansberg shares her first aid advice on how to treat open wounds, scabs or inflammation from skin treatments.

M

icro-needling creates tiny punctures on the face, which your body responds to by initiating repair; therefore it’s common for skin to have a scabby texture around the area where the treatment is done.

On the other hand, Laser Hair Removal involves a lot of heat to burn the hair.

This can sometimes lead to symptoms such as skin burns for some users, swelling around the hair follicle, irritation, itch and inflammation of the skin, causing redness.

There are four important steps to treat open wounds post-treatment:

1) Clean the area Our skin is the largest organ in your immune system – so when there is an opening in the skin from treatments such as micro-needling or laser hair removal, one of the primary objectives is to prevent invasion from bacteria. Cleansing the skin is important to help prevent infection.

2) Keep it moist Wet or moist management of the skin has been shown to significantly reduce the time required for growth of new skin cells and also reduces the amount of inflammation, necrosis (or tissue death) and reduces scar formation. * Something like medical grade Manuka honey is an excellent healing agent, as it is a moisturising agent that not only has antioxidant, antibacterial and anti-inflammatory properties, but when it comes in to contact with ooze from a wound or skin breakage, it manages to generate bactericidal hydrogen peroxide without doing any tissue damage, which is quite extraordinary. Research also suggests that it 14 | CL INI CA L A EST H E T I CS

can be used as part of a dressing to promote rapid and improved healing when used on top of open wounds. It’s also been shown to help reduce the risk of infection and promote healing.

3) Keep the area covered A commonly overlooked step is to cover any open wound to protect it from bacteria as it heals. An open wound is like an open invite for bacteria, so keeping it covered and moist is the best way to help it heal and allows skin cells to heal more rapidly than if left to dry out.

If a scab does occur post treatment, they actually hinder the healing process by creating a barrier for new skin cells looking to heal the wound. A scab can be a sign that the wound is too dry to heal as fast as possible. Keeping the wound moist and covered helps allow skin cells to heal more rapidly than if left open to dry out.

If your skin shows no significant signs of improvement after about two weeks, consult a medical professional.

4) Soothe minor burns Alleviate any pain or blistering by applying a soothing cream, or dabbing gently on the

affected area with a clean cloth or towel with cool water or saline. Steer away from any iodine-containing liquids.

For more information on medical grade manuka honey and its assistance in wound healing, visit COMVITA.COM.AU Dr Ginni is a GP, medical & parenting expert with a special interest in women’s and family health, and six children of her own in a blended family. She is an authority on everything from sleep to beating stress, wellness, life balance and a range of general health and medical related topics; always packaged with a dose of reality, practical and helpful tips and delivered with her customary sense of humour. Aside from her practice in Sans Souci, Ginni is also an accomplished writer, having written 3 books and having worked extensively as a medical journalist and columnist. She is an experienced TV presenter working with Channel 7 as their resident GP for many years and as one of the hosts of Embarrassing Bodies Down Under. * https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC3941901/ https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC3609166/ https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC3842869/

SKINCARE BASED ON EVIDENCE Are you confused by the saturated skincare market? ESK skincare cuts to the chase with their no-fuss, evidence-based products.

W

e are constantly bombarded with marketing strategies, often without even realising it. This is especially true in the skincare industry, where endless shelves of creams, serums, and lotions promise us baby skin and throw around buzzwords, such as ‘superfood ingredients’, ‘age-reversing’, or ‘rejuvenating’.

When GP Dr Ginni Mansberg and her husband and business partner Daniel Rubinstein couldn’t find a skincare line that was based on actual scientific evidence, they simply created their own. ESK (Evidence Skin Care) uses only active ingredients in the forms, concentrations and formulations

supported by the strongest peer review evidence; and with NO harmful chemicals, preservatives or perfumes.

As much as evidence, integrity is important to the couple, meaning no testing on animals, avoiding all known and suspected harmful ingredients, using airless opaque bottles (increases shelf life and efficacy of the products) and trying to reduce their environmental footprint (e.g. recyclable outer bottles).

“Using evidence means that we can have confidence users will see results,” says Rubinstein.

“One of my biggest frustrations was, that every time I would do a segment on skincare

on TV, I would get hundreds of e-mails from viewers asking me what they should buy, and there was absolutely nothing I could recommend. Some of what is available is actually unethical,” Dr Mansberg explains, as skincare ingredients like Vitamin C or Vitamin A only work when used in specific formulations. Everything you find in ESK is based on independent peer reviews and scientific studies, and proven to make a difference to people’s skin. ”We don’t make any claims we can’t substantiate.”

ESK offers white-labelling for Dermatologists and Plastic Surgeons. For more information, visit ESKCARE.COM

Spring Spa Wear is a one stop shop for all your uniform & spa bed linen needs.

Shop online now www.springspawear.com.au

ULTRA

TRANSFORMATIONS

Anti-Ageing Before

Pigmentation Before

Anti-Ageing After

Pigmentation After

There is nothing better to prove the efficacy of a treatment or product than unaltered before and after photos of ‘real people’, i.e. regular patients.

So that’s exactly what Ultraceuticals have done in their latest campaign.

T

he skincare market is undoubtedly flooded with products promising to transform damaged skin into healthy, glowing skin. To say that most consumer brands don’t deliver, would be an understatement, which is why it’s so important for medispas and clinics to stock a brand that doesn’t just talk the talk, but walks the walk.

Ultraceuticals is one of them, proving their products’ efficacy with their RVR90™ campaign every year. Real Visible Results in 90 days, is a life changing campaign which runs across Australia and New Zealand with a vision to empower people and boost innerconfidence by achieving their best skin yet.

The program is designed to restore people’s faith in an industry with often over-hyped claims by experiencing a high-performing, cruelty-free, paraben-free and scientifically proven range.

The RVR90™ involves a simple 3-step process: Step 1: Skin technician identifies clients’ core skin concern and selects the treatment serum to treat this concern from four categories: Fine Lines and Wrinkles, Loss of Firmness, Acne and Congestion, Coarse Texture and Dull Skin tone.

Step 2: Skin technician then selects a pack to suit clients’ skin type. Each pack contains 3 full-size products.

Customers who take part in the program are given a promotional offer that involves a free bonus serum with their RVR90™ pack.

Step 3: Skin technician then prescribes a complete treatment and homecare plan to accelerate the client’s journey.

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

Clinics are provided with detailed booklets to document their customers’ skin journey over the 90 days including before and after pictures that showcases their progress throughout the program.

This year’s winners included three patients with different skin concerns from three different clinics.

PIGMENTATION “I’ve received so many compliments from girlfriends saying – My goodness Hayley your skin is amazing! - I’ve never had compliments like that in my life ever.”

36-year old Project Manager, Hayley Stevens says for the last nine years she had always found her pigmentation to be an eyesore. “It felt like it happened overnight, so suddenly”.

Her turning point to get help was last Christmas holidays whilst camping. Roughing it meant water skiing and sun replaced the daily makeup regime. “I remember looking in a mirror after skiing and realised how prominent my pigmentation was. I hated it.” Her sister in-law convinced her to do something about it – “Let 2017 be your year to get it sorted” she said.

Hayley previously thought only microdermabrasion could help, but when she walked into Renaissance, Art of Beauty in Christchurch, NZ, for her first consultation with Caroline, she was thrilled at what treatments were on offer.

Hayley quickly formed a close bond with Caroline. She was so informed about the Ultraceuticals product and explained exactly how the ingredients and treatments would work to fix her skin concern.

The whole team were so encouraging every time she came back.

“I’m very humbled by the fact they were able to show me with each visit the progress my skin was making with each photo. It was such an amazing reference to really see the difference. I’m a bit peeved I hadn’t done this sooner.”

Hayley had always worn makeup as a way to help cover up her pigmentation as opposed to wearing make-up just on social occasions to accentuate what she had. “Today I just put on sunblock and mascara and keep make-up for special occasions.”

Caroline has been with Renaissance for 16 months and feels a renewed passion for the industry especially after RVR90 and seeing how it can really change people’s lives.

ANTI-AGEING Grandmother of five grandkids, 61-year old Maxine Pigout said: “People have definitely commented on my skin since the RVR90 journey. I have a 16-year old granddaughter and people often mistake me for her mother.”

The 2017 RVR90 winner for the category of anti-ageing, Maxine says since her skin journey to help overcome the effects of ageing, her skin feels more radiant and has even noticed a big difference in capillaries which had started to surface.

“I really wanted to do something about my skin’s dullness, pigmentation and general ageing issues such as redness that had occurred over the years. I wanted my skin to look brighter. “ After getting her hair done regularly at Buoy Salon and Spa in Wellington, NZ, Maxine was presented with a chance to have her skin concerns improved through the RVR90 journey.

“I am still in shock that I won the campaign. It was such an enjoyable experience.”

“My therapist Kelly was fabulous. I learnt a lot about my skin and how to implement my daily routine. It was great to actually spend time with someone that was genuinely interested and cared about

Acne Before

Acne After

my skin. She really felt like a friend. I even noticed a big difference in my capillaries which is amazing.”

Kelly couldn’t agree more, saying Maxine’s skin changed dramatically. “Her skin was extremely healthier, much firmer and lifted as well as more even in colour.”

“Anyone can print [promises] on a product, but seeing results, is what matters the most. What I love about Ultraceuticals is the fact results are so quick! Within a month you can great results, and by the third month, amazing results!”

ACNE 16-year old Hayley Revell started getting acne at around 14 years.

“It came out of the blue and just got worse. I turned to wearing heavy makeup at school to try and hide my pimples. I would use as much foundation and concealer as possible and became addicted to layering my make-up throughout the day. It was hard to look people in the eyes as you could feel them looking at your skin as you were talking thinking you were dirty and to just wash your face.”

Hayley refused to take photos during her troubled years “You would not find one picture of me anywhere. But recently at my high school ball, I was able to feel comfortable for the first time having my photo taken and not having to worry about how it looks or using FaceTune. Now I love taking selfies.”

Hayley went to B Naturally You in Esperance, WA and met Skin Therapist Amy Thornton.

“Just to see the difference in Hayley is amazing. She’s a new person. When she first came in she was quiet and nervous and didn’t talk too much. Even after a month of doing treatments her skin had cleared and Hayley was much happier,” said Amy. “It was such a personal thing to share with someone, but she made me feel so comfortable and I became excited to start my journey,” Hayley explained.

The RVR90 journey has inspired Haley to pursue her own dream of becoming a skin therapist and studying at TAFE and doing her work experience at B Naturally You. “I’d always loved all things beauty, especially make-up with my past skin, but after experiencing my own journey I’ve realised how being a skin therapist can really help people be their best self.”

Hayley has a renewed self-confidence with her transformation and now walks out of the house without having to stress how her skin looks. “I’ve gone from an hour of doing my makeup to now a five-minute quick tinted moisturiser.”

Ultraceauticals invited the three winners and their therapists to Sydney, where they shot the 2018 RVR90™ campaign. For more information, visit ULTRACEUTICALS.COM CL INI CA L A EST H E T I CS | 17

Let’s Call It ‘Pro-Ageing’ He is an aesthetics pioneer from Canada and not afraid to say it like it is.

Plastic Surgeon Dr Stephen Mulholland sat down with Nadine Dilong to talk all things ‘pro-ageing’.

I

’m a Plastic Surgeon so my favourite thing to do is to operate, but nowadays there is a huge selection of non-surgical treatments we can offer, especially when it comes to ‘pro-ageing’ as I like to call it, which is how we want to grow old. ‘Antiageing’ is a bad term, it means we shouldn’t be growing old, but growing old is a requirement, however, looking old is now optional. You can decide what you want 18 | CL INI CA L A EST H E T I CS

to project and how you want to project it.

Looking smooth and bright, not overinjected or over-paralysed, has now become the norm.

While the number of people getting surgeries has stalled a little – though there is no substitute for a facelift or tummy tuck if you need one – non-surgical procedures have grown 1000% every ten years. Out of the 15 billion dollars spent on treatments

in North America, 80% of that was on non-surgical treatments, from skincare to lasers and fat destruction and injectables.

Back when I started in the early 1990s, it was 50/50.

The danger is over-promoting the nonsurgical and making people believe you’re going to see results as good as those from surgical procedures. Sometimes, there’s no replacement for surgery, it’s just a simpler

Clinical

option with a lesser outcome. If you think that Botox, filler, and photorejuvenation will give you the results of a facelift, they won’t, but they’re still a good option.

Especially if patients are afraid, or don’t want the downtime, or don’t have the resources for surgery, or they’re worried about the stigma attached to surgery, nonsurgical treatments are a great option.

Just like Toronto [editor’s note: where Dr Mulholland is based], Sydney is a conservative city where women don’t want to do things that their friends might find out about and don’t approve of. But no one’s going to say “wow, you’ve had laser hair removal” – it’s now become common.

TATTOO REMOVAL Another non-surgical treatment that has been growing steadily is tattoo-removal laser. In North America, 69% or all under 40-year olds have a tattoo. And now, for the first time in history, women outnumber men. So thank God for tattoo removal treatments, which are now better than ever.

What used to take 12 to 15 treatments for a 50% to 70% removal, now takes six to nine treatments to remove up to 90% of the tattoo with the PicoSure laser. We can remove all colours, not just black, which also makes it great for cosmetic tattoo removal.

“The average age of a first-time patient has gone down 10 years in 10 years.”

One of the most fascinating trends has been what we call ’10 in 10’: the average age of a first-time patient has gone down 10 years in 10 years. In the year 2000, the average age of a first-time Botox user was 41. It’s now 30, partly because millennial daughters saw what their mothers had to do to recover the damage that was already done, so they’re now starting much earlier with no guilt to prevent, and that includes fat-reduction treatments.

FAT REDUCTION The non-surgical fat-reduction industry started about 12 years ago with Ultrasound.

The results were modest and it never really took off. Then about seven to ten years ago, came sustained cooling, which worked much better, but the problem was and still is, it’s quite slow, and painful when it grabs and sucks in the fat. Moreover, there can be bruising and quite some sensitivity.

So while fat-freezing created a whole new market, as with most treatments, something better will come along, and in this case it’s Cynosure’s Sculpsure. Not only is it 3x faster, but it cools the skin while it heats the fat making it much more tolerable. The laser penetrates through the skin no matter what colour, and it heats the fat, which travels more efficiently than cold making it a more even distribution of fat-destruction. I usually do two treatments six weeks apart, which can cause about 20% to 30% of the fat cells to die. I even go so far as to promise my patients 1cm less pinchable fat, if not, I give them a free treatment.

I have a lot of women in their 70s who plucked all their eyebrow hairs in their 50s and then went to some Microblading girl who created a crazy brow up to her hairline, and I can remove that just as much as eyeliner or lipliner. By using lidocaine injections prior to the treatment, it is virtually painless.

WOMEN NOW HAVE OPTIONS I think women are fearless about exploring their options, but they’re still quite concerned about risks and recovery as they should be. They are more apt, the younger millennial particularly, to embrace technology and to celebrate what it can do without any guilt, any taboo, any sense of regret or remorse.

They live in a very competitive world where jobs are hard to come by and they do know that two women that show up for the same job and they have the same degrees, the same intelligent quota, but one's skin is classically prettier then they will generally get the job and it’s a sad fact and so I think they’re fearless about embracing what their mothers felt guilty about with the realisation that it’s a different world now.

You can look 10 years younger forever without a scalpel, and then one day when you do need scalpel based surgery there are a lot of mini things you can do now that don’t look done. I think we celebrate youth and health and vitality, but no one wants to look done.

MICRO NEEDLING

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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 A Professional’s Fractional Needling Therapy System, Medical Micro Needling System works with Stretch Marks, Acne Scar Removal, Pigment Stabilization, Wrinkles, Cellulite, Skin Texture, Surgical Scars, Large Pores.

COSMETIC TATTOOING SYSTEM Cosmetic Tattooing Plus Micro-Needling in one platform. The panel repulses the growth of bacteria. Suitable for Medical Aesthetic and Medi SPA Clinics.

1800 628 999 +617 3350 6898 ask@clinicalpro.com.au

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Our Holistic Responsibility As Practitioners The popularity of body sculpting is at an all-time high, but we need to treat patients holistically, says Body Catalyst founder Samantha Barakat Light.

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

M

edical, cosmetic and health treatments have been around for a long time. In more recent times, with the advancements in technology and the pressure to conform to the modern ideals of social media, we are seeing more people and professionals adopt new methods of treatments.

Essentially, while medical and cosmetic treatments result in a change in aesthetics, we are now discovering that the effects extend beyond the way we look to how we feel. There is a greater shift towards a holistic approach to cosmetics and medical with clinics such as Body Catalyst taking a firm stance on delivering a holistic offering with the understanding that it is more than just physical and the need to delve deeper -

not only providing treatments but treating the cause.

I founded Body Catalyst after I discovered that irrespective of how well people ate, or how much they exercised, they would still retain weight in certain areas. In fact, I observed that the harder people worked at keeping their bodies healthy and happy, the more frustrating it was to have pockets of fat that just wouldn’t budge. The disconnection wasn’t just a physical one; it impacted people’s motivation and confidence. I set out to make technology that was previously only available to the elite via cosmetic surgeons accessible and affordable to everyone needing a helping hand to achieve their body goals.

Ten years ago, we started to hone in on body treatments moving on from wraps and creams. In 2009 we saw the release of the first cryolipolysis (fat freezing) machine in the US, which set the gold standard for non-surgical treatments using proven technology to help people reach their body goals. Since then, we have seen huge advancements in the investment of technology. Everything in the cosmetic world originated from the medical world.

Cryo was originally used to kill cancer cells, and medical professionals transferred this into the cosmetic world.

However, what we have come to know is that as great as technology is, it has its limitations. For example with non-surgical fat freezing, firstly, it targets superficial fat only and secondly it is not suitable for everyone. It’s because of this that practitioners who perform non-surgical treatments need to have an understanding of health, how the body works and the impact people’s lifestyle choices have on results to ensure the best outcomes.

THE HOLISTIC APPROACH TO MEDICAL AND COSMETIC TREATMENTS There is a great need for practitioners to gain an understanding of why your clients want to undergo non-surgical treatments.

If we focus on fat loss, which often emulates an underlying cause, we as practitioners and clinic owners need to take a more holistic approach to our client’s overall health.

Irrespective of how well we can treat fat cells, 90% of our body’s makeup is what we put in our mouths. If we are not taught how to eat properly, how to exercise and what food affects our weight, then regardless of how great the technology is, your clients will not see results. In order for non-surgical fat freezing technology to work, it has to be incorporated with a healthy lifestyle.

If someone is looking for a quick fix, it is our responsibility as a practitioner to set realistic expectations for our clients and for them to understand how they can get the best results from the technology and maintain it.

Fat cells are expelled through the lymphatic system, however if this wastage and drainage system is clogged (generally due to poor lifestyle choices), the fat cannot travel through it. The lymphatic system needs to be cleaned, otherwise immobilising the fat to use as energy won’t occur through the lymphatic system.

I believe that it is our responsibility and standard practice that experts who perform these treatments must educate clients that this technology is not a substitute for a good diet and exercise regime, rather an enabler to stimulate and accelerate the body’s natural processes, leading to greater results.

SOCIAL MEDIA AND ITS INFLUENCE Cosmetic, and specifically non-surgical treatments are on the rise. We see this trend as a result of social media and the rise of social ‘influencers’ living their ‘best lives' through social media platforms. For this reason, anyone in the cosmetic world has a responsibility to make sure we are treating the cause – the issues around weight and the need for fat loss treatments by delving deeper into the why, avoiding only superficially treating someone. It is more important to learn about one’s mindset, about their stresses and not just about masking the underlying problems with technology.

Ideally men and women should be able to accept themselves as they are, however social media and other influences have created a world where men and women question themselves and their self-worth. As leaders in this industry and with some of the world’s most proven and leading technology we have a responsibility to empower people to be honest about the approach they take to achieve their best body.

If men and women are aspiring to look like the images they are exposed to on social media, and we accept that as the status quo, we are setting people up to fail.

We hear so many women and men talking about acceptance, yet this acceptance seems to be conditional. It is expected that men and women look a certain way and feel that they need to live up to these unrealistic and edited versions of reality without any help at all. For the majority of people these expectations are not achievable without the help of technology. There are many contributing factors that prevent people from reaching their body goals including genes, hormones, environment, medical and age, and non-surgical technologies enable people to make this shift. This should be celebrated!

THE CREDIBILITY OF TECHNOLOGY Not all technology is created equally, and because of this it is important that non-

surgical treatments are done by a qualified therapist. Safety standards for clinics have increased. Technology should all be on the ARTG list, clinic owners and therapists should do their research to ensure the technology and treatments offered are safe and effective.

The biggest trend in non-surgical and non-invasive treatment market is Fat Freezing. Fat loss is a big industry and non-surgical and non-invasive treatments growing in popularity. Leading the trend is Cryolipolysis - a non-surgical fat loss treatment using a controlled cooling to permanently eradicate subcutaneous fat in target areas. Now, whilst many of you may have heard of this technology, there are multiple brands, machines and techniques, which to the public eye, seem to do the ‘same’ thing. Unfortunately, though, not all technology is created equal. Clinic owners and practitioners should look out for mainly two things: safety and efficacy.

First and foremost, the safety of a procedure is of vital importance. The technology is just as important as the expertise as the therapist conducting the treatment. Ensure the equipment is medical-grade and registered on the Australian Register of Therapeutic Goods (ARTG). It’s astounding how many cheaper, non-medical grade fat freezing technologies are available. You cannot put a price on safety, so it is strongly encouraged that clinics do their homework and not take any risks.

Choosing high standard technologies that have been clinically proven to have high efficacy should be the first point of call. Look for real life testimonials, before and after photos and word of mouth as evidence of efficacy.

At Body Catalyst we make it our responsibility to help people make the shift to a healthier life. Not just a physical shift, but an emotional one – a shift in the way we feel about ourselves. We call this the ‘Body Catalyst Effect’.

Being one of the largest and most established Body Contouring & Sculpting Clinics in Australia means we have access to the very best technology partners globally. With the world’s most advanced technology comes the most superior training for our team, so not only are our clients getting the very best science has to offer, but they can rest assured they’re in the safest hands.

BODYCATALYST.COM.AU CL INI CA L A EST H E T I CS | 21

Why We

Need

Inflammation We all experience inflammation on a daily basis, but it’s a much more complex bodily function than many would realise.

I

nflammation is all around. As scary as that sounds, it’s completely normal and can actually be beneficial in the world of cosmetic treatments. When we think of inflammation, images of open wounds or infections come to mind, but inflammation is actually the body’s response to trauma, whether that trauma is as small as a pimple, or big like a fresh scar after surgery.

Former Chairperson of the Australian Society of Dermal Clinicians, Jennifer Byrne, held an educational sessions at this year’s Beauty Expo Melbourne on all things inflammation, the benefits to induce positive change in the skin, as well as the risks of over-treating skin.

According to Byrnes, many people don’t realise that the vast majority of facial treatments, such as lasers, Microneedling, peels, and even IPL photo rejuvenation induce inflammation in the skin.

This ‘controlled inflammation’ helps with repairing, regenerating, and replacing tissue and can therefore improve skin conditions such as rough texture, acne scarring, or fine lines. However, satisfactory results are only possible if the inflammation process is supervised and doesn’t turn from acute to chronic.

“Essentially, anything that alters the barrier function of the skin, causes injury to the skin or alters the environment that the skin/ body is comfortable in will cause inflammation,” explains Byrne.

“As Beauty and Dermal Therapists/Clinicians, we aim to harness these capabilities to regenerate and improve the condition of the skin. What is interesting and something that I’ve come across a lot in the industry is treatments or products that may be marketed as reducing inflammation are not. For example LLLT/LED, ultrasound, and electrotherapies are often recommended for inflammatory skin conditions (acne, eczema, wound/scar repair) and may be explained to clients as being anti-inflammatory. These therapies augment the inflammatory process and assist the tissue (skin) to move through the phases of inflammation in an optimal way (reduce any delays to healing, or ensure a robust inflammatory response). These therapies may actually be pro-inflammatory in many instances; however improvement in inflammatory skin conditions and healing occurs, modulating (biomodulation) the skin/body’s ability to heal.”

One of the problems that can occur when inducing inflammation, is that the full inflammatory and therefore healing cycle can’t be completed if the wrong post-op care is prescribed.

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

“We should recommend that clients limit what is put onto the skin until the barrier is repaired. The time that this is for will depend on how aggressively we have damaged the barrier. For example, a normal facial or waxing may be 24-48 hours, a chemical peel or microdermabrasion may be 3-7 days. We can recommend they use benign, barrier repair cosmetics, such as pH neutral/balanced non-foaming cleansers that respect the lipid protection of the skin and emollients with ceramides etc. These should be applied in a hygienic manner to limit potential for opportunistic microbes to enter or irritate the skin,” says Byrne.

The most important part of the cycle is the first three days.

As the Lymphatic system, which is responsible for removing extracellular fluid and the waste it contains, shuts down in the first three days, swelling and oedema can occur.

“It is believed this is to ensure that anything that may be harmful that entered the skin during the breach in skin integrity is walled

Non-Surgical Symposium

15-17 JUNE

15-17 JUNE

GOLD COAST CONVENTION CENTRE

GOLD COAST CONVENTION CE

ONE COLOUR - LANDSCAPE

15-17 JUNE

Non-Surg Symposi

FULL COLOUR REVERSED ON BLUE - LANDSCAP

Non-Surgical Symposium

15-17 JUNE

GOLD COAST CONVENTION CENTRE

Non-Surg Symposi

GOLD COAST CONVENTION CE

ONE COLOUR REVERSED ON BLACK - LANDSCA

Join us at the 2018 Non-Surgical Symposium on the Gold Coast | 15 - 17 June 2018

Non-Surg Symposi

Whilst it’s true that the health sector in Australia is a highly regulated sector, due to the unprecedented expansion of the cosmetic industry across a multitude of areas, the regulations have not kept up. Today’s cosmetic industry is vastly different to what it was 20 years ago.

The primary ingredient to the success of the NSS is 15-17 JUNE ensuring that those who attend are provided with an extraordinary learning experience from world-leading GOLD COAST CONVENTION CE experts, utilising the latest technologies and techniques available.

With so much recent attention on the cosmetic Nowadays, business is booming with Australians said surgery sector, patient safety and improvements to its to be spending more than $1 billion a year on nonsurety is at the very forefront of everything that ASAPS FULL COLOUR - PORTRAIT FULL COLOUR REVERSED FULL COLOUR REVERSE surgical procedures. stands for. ON BLACK Which is why in 2011, ASAPS sought to bring about a higher standard of practice in the non-surgical space by providing first-hand educational opportunities to those interested in aesthetic medicine through the invention of the Non-Surgical Symposium (NSS).

PORTRAIT It’s true that there has been a de-medicalization ofPORTRAIT

the non-surgical space with an influx of doctors preying on people’s vulnerabilities by offering cut-price procedures and slick marketing with offers that often sound too good to be true. This coupled with the fact that people are able to pick up their groceries and also Since that time the NSS has grown into the premier pop next door for a few shots of injectables or fillers annual event for plastic surgeons, dermatologists, 15-17 JUNE 15-17 JUNEhas caused a fundamental shift away from15-17 JUNE ensuring cosmetic physicians, nurse aestheticians, dermal patient safety is upheld in every facet of the cosmetic therapists and practice staff. The NSS has been a surgery arena. sell-out event since 2015. In 2016 it was awarded the Best Conference in Australasia, and in 2017 was This is why, at a minimum, people working in this named a finalist in the Australian Event Awards for Best space should attend the NSS to ensure they are GO LD COA S T G OLD C OAST G O L D CtoOA S T Conference. being steered onto the right path when it comes C ON VENT I O N C ENT R E C ONV E NTION C E NTREcosmetic procedures.

C ONV E NTI ON C E N performing The NSS is held by ASAPS in partnership with the Cosmetic Physicians College of Australasia (CPCA) and To find out more visit nonsurgical.org.au the Australasian Society of Cosmetic Dermatologists (ASCD), and is endorsed by the New Zealand Society of Cosmetic (NZSCM).

ONE COLOURMedicine - PORTRAIT ONE COLOUR REVERSED ON BLACK

Non-Surgical Symposium

Non-Surgical Symposium

PORTRAIT

15-17 UNE

15-17 JUNE

Non-Surgic Symposiu

off and trapped so that cells that remove debris and microbes can do their job. Oedema resolves because the lymphatics turn back on around day two to four and fluid is pumped out of the area.

Therapists may have even noticed this and explained to clients that procedures that cause significant inflammation, swelling will peak at 3 days and then it “starts to improve”. In some people, the turning back on of lymphatic pumping may not work well, or at all. Even in healthy people lymphatic pumping is quite slow.

Manual lymphatic drainage can stimulate the pumping mechanism and expedite the removal of inflammatory fluid ensuring that inflammation doesn’t prolong and cause problems.”

A full inflammatory cycle takes around 14 days, and inflammatory responses to a treatment can change with time as the body is smart enough to ‘remember’ certain traumas and acts accordingly, which is why Byrne stresses the importance of constantly and consistently monitoring clients’ skin, even if they’ve had a treatment before.

“Package deals for peels, skin needling, laser treatments, etc in my opinion may be unethical unless there is the ability to be flexible in how this is done and ensuring that the skin is being monitored closely. Particularly when managing conditions that experience altered inflammatory responses or healing. Serial treatments with increased frequency are based on chronic wound repair models whereby cells need stimulus to produce cytokines and growth factors to sufficient levels to achieve effective repair.

It’s also targeted at repairing or correcting a defective process or 24 | CL INI CA L A EST H E T I CS

condition rather than as an ongoing management strategy. If clients are buying packages for invasive therapies more than 3-4 times a year, this can potentially cause problems in the skin and increase the risk of adverse outcomes related to inflammation and immune function,” she explains.

“The main thing to remember and the biggest mistake that beauty therapists can make, which they may do unknowingly, is causing more damage through interfering with inflammation or through promoting damage (even controlled) to the skin over a prolonged period. Both of these things can have cumulative effects that result in issues over the long term, particularly in pre-disposed people. As an example, Lymphedema is a condition associated with failure of the lymphatic mechanisms within the skin and results in chronic and in some cases extreme swelling.

Research indicates that up to 25-40% of people may have some pre-disposition for lymphatic disorders. In these people, there is a link with the cumulative effects of trauma and inflammation in the skin culminating in a final event (the straw that breaks the camel’s back). Atopic Dermatitis and Psoriasis are other scenarios whereby the body may develop auto-immune issues and present with the condition in pre-disposed people after cumulative effects of the skin being stressed and vulnerable. Even skin ageing is now linked with micro-inflammatory responses. Therefore, the skin’s ability to heal and its role as the first line of defence should be respected. Inflammation should only be caused if there is a clinical need to do so.”

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Thread Lifts Deemed Unsatisfactory By Peers The debate about the ‘express facelift’ continues.

T

he suture or thread facelift has been around for over a decade now, and seems to have divided Plastic Surgeons’ opinions. While some swear by the non-surgical procedure that promises similar results of a facelift minus the downtime, others say its side effects such as inflammation or unwanted scar tissue make the risk outweigh the benefits, which are only temporary anyway.

Now, a new systematic review of thread lifts for facial rejuvenation revealed that there is still little evidence in the medical literature to support their efficacy and durability.

Dutch author and doctor Berend Van der Lei, MD, PhD, of the University Medical Center Groningen, The Netherlands, searched the PubMed database using the terms “facelift,” “facelifts,” “face lift,” “face lifts.” “platysmotomy,” “platysmotomies,”

“rhytidectomy,” “rhytidectomies,” “platysmaplasty,” “and “platysmaplasties” in combination with terms “barbed suture,” “thread lift,” “APTOS,” “suture suspension,” “percutaneous” and “silhouette suture.”

His findings concluded that the majority of studies and papers published about the suture facelift procedure had unsatisfactory findings, especially when it came to durability of the lift. In fact, only two papers were written in favour of thread lifts, and they just so happened to be sponsored by thread lift suture manufacturers.

The official conclusion published in the Plastic and Reconstructive Surgery Journal reads as follows: “The authors’ review demonstrated that, within the past decade, little or no substantial evidence has been added to the peer-reviewed literature to support

or sustain the promising statement about thread-lift sutures as made by Villa et al. in 2006 in terms of efficacy or safety. All included literature in the authors’ review, except two studies, demonstrated at best a very limited durability of the lifting effect.

The two positive studies were sponsored by the companies that manufacture the thread-lift sutures.”

The Latest Stats On Plastic Surgery Numbers don’t lie, so take a good look at these industry stats.

Top five cosmetic surgical procedures 1. B reast augmentation (300,378 procedures, up 3%) 2. L iposuction (246,354 procedures, up 5%) 3. N ose reshaping (218,924 procedures, down 2%) 4. Eyelid surgery (209,571 procedures, approximately the same as 2016) 5. Tummy tuck (129,753 procedures, up 2%)

T

he American Society of Plastic Surgeons have released a whole lot of statistics around plastic surgery and cosmetic procedures that are quite interesting – everything from the growth in treatment numbers since the year 2000, to the most popular treatments of last year.

Some results may surprise you, others, perhaps not so much (hint – the most popular non-surgical treatment, of course, hasn’t changed).

Either way, it’s always helpful to know how your clientele ‘ticks’ and where demand is growing and declining. Chances are, these stats mirror your own experience in your business, and if they don’t, the overall trend may sooner or later catch up with you.

• The overall number of cosmetic procedures from 2016 to 2017 increased by 2% •2 016 to 2017 saw an 11% increase in breast 26 | CL INI CA L A EST H E T I CS

reductions – comparatively, the previous year saw a decrease in the treatment • Of the 15.7 million minimally-invasive procedures in America last year, the most popular were Botox, soft tissue fillers and chemical peels • Of 1.8 million surgical procedures, breast augmentation, liposuction and nose reshaping made top of the list • M inimally invasive cosmetic procedures have now increased by almost 200% since 2000

Top five cosmetic minimally invasive procedures 1. B otulinum Toxin Type A (7.23 million procedures, up 2%) 2. Soft Tissue Fillers (2.69 million procedures, up 3%) 3. C hemical Peel (1.37 million procedures, up 1%) 4. L aser hair removal (1.1 million procedures, down 2%) 5. M icrodermabrasion (740,287 procedures, down 4%)

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Reference 1. Clinical Study HM Monteprincipe Hospital, Madrid, Spain, 2015 ©2018. All rights reserved. This marketing material may include registered trademarks, trade-names and brands in certain jurisdictions of Syneron Candela group of companies. SYNCAN0055

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