Cosmetic News July 2010 by webwax

the uk’s only free of charge medical aesthetics trade MAGAZINE

THE VOICE OF YOUR INDUSTRY www.cosmeticnewsuk.com JULY 2010

VEIN SPECIAL We examine the best treatments for veins

IN THE BLOOD

Dr Roberto Viel on facial rejuvenation using platelet rich plasma

1 ANNIVERSARY ISSUE st

We celebrate Cosmetic News’ first birthday

ALSO IN THIS ISSUE MICRO MANAGEMENT Using microsites as part of your web strategy

LOCATION, LOCATION The importance of ‘place’ in marketing

THE LAST WORD The NMC on remote prescribing

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The on e stop a e sthetic s s ho p

EDITOR’S LETTER Welcome to the July issue of Cosmetic News. This is a particularly special issue for us, as it marks the first anniversary of the magazine’s publication. It is hard to believe that it has been a year since our first issue went to print and I would like to thank everyone for their support over the last 12 months, from our advertisers to our contributors and obviously you, our readers. To celebrate our first year in print we are making some exciting new changes to our editorial content including our new Voice of the Industry column, which gives people a chance to air their views on the issues shaping the industry, as well as more features dedicated to the latest products and treatments to keep you up to date on what’s happening in the industry. Check out our new Product News on pages 34-35, our Special Feature on veins (p22-27) and our in depth feature on remote prescribing, including a Q&A with Rebecca Cheatle from the NMC, on pages 12-17. We are also going to be launching a bi-monthly e-newsletter to keep you posted on the latest news and developments in between your monthly delivery of Cosmetic News. If you would be interested in receiving this please let us know. In last month’s Editor’s Letter I told you I was heading over to the States to visit The Aesthetics Show in Las Vegas. I was hoping to be able to report back to you on what went on in this month’s issue, however the organisers of the show would not let us in as they felt our magazine was in competition to a publication they are associated with (see Voice of the Industry p9 for more on what happened) so instead there are some pictures of my publisher, Charlotte Body, and I enjoying a well earned break in the sun! (see On the Scene p10). I hope you like what we have done with this issue and as always would welcome your feedback. Get in touch by e-mailing vicky@creativemedialtd.co.uk

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Editor’s choice

CONTENTS 6

INDUSTRY NEWS We round up the latest industry news

VOICE OF THE INDUSTRY Vicky Eldridge asks what ever happened to a bit of healthy competition?

ON THE SCENE Out and about in the industry this month

BIG DEBATE We speak report on the ‘Chatham House Rules’ meeting on remote prescribing and speak to the NMC about their stance

VIEW ON Mike Murphy gives his View On tattoo removal in beauty salons

PEOPLE IN PROFILE

JET-M HYDROJET VITAMIN INFUSION FACIAL By their very nature most medical aesthetics treatments have an element of discomfort about them, even those that bridge the gap between the beauty salon and the clinic and have minimal downtime, however most people are prepared to put up with a little bit of discomfort to get the kind of results they deliver. So when I heard that the Jet-M Hydrojet Infusion Facial was a treatment that promised instant results, as well as clinically proven effects over a course of treatment, I was expecting it to be at least a little bit uncomfortable – luckily I as very pleasantly surprised.

The Jet-M hydrodermabrasion treatment has to be the most pampering medical aesthetics treatment I have ever tried. Not only did it not hurt at all but it was incredibly relaxing and incredibly enjoyable. Having trekked across central London on a very humid summer’s day to get to the Skin Oasis clinic in George Street, I was feeling very hot and bothered but within a few minutes of the treatment beginning I was in heaven.

We talk to the founder of Q-Med, Bengt Agerup

SPECIAL FEATURE: VEINS We examine the most effective treatments for veins, from laser to microsclerotherapy and Veinwave™

TREATMENT FOCUS Dr Roberto Viel on platelet rich plasma rejuvenation

Q&A We speak to Dr Carl Thornfeldt about hyperpigmentation and the latest launch from Epionce®, the Melano Corrective System

PRODUCT FOCUS How Renew Medica boosted its business by taking on a new skincare line

PRODUCT NEWS We round up the latest product news

business?

WEB MANAGEMENT Ron Myers on using microsites as part of your web strategy

BUSINESS FOCUS Zoe Davitt on why finding the right location is so important for your business

DATES FOR THE DIARY Training course, conference and meeting dates

DIRECTORY Our guide to the manufacturers, suppliers and business services featured in this month’s issue

To finish Sarah applied some luxurious Jan Marini products with smells including green papaya adding to the pampering feel of the treatment. My skin looked glowing and radiant afterwards and felt really soft and hydrated - absolute bliss on a hot summer’s day.

BEST PRACTICE How will the new Government’s emergency budget affect your

The treatment literally feels like having very cold, refreshing air blown in your face and, although it tickled slightly at first, it was a very pleasurable sensation. The first stage of the treatment is designed to aid lymphatic drainage. My therapist, Sarah Shaban, started by passing the handpiece, which is fitted with several jet nozzles containing concentrated water, over my skin in a downward movement towards the base of the neck and the lymph nodes. Then, working closer to my skin, she infused a concentrated oxygen and saline solution, working in sections to exfoliate the dead skin cells and get rid of any dry skin or debris. Once the hydrodermabrasion was complete she started the vitamin infusion, applying the appropriate vitamins into the skin via the jet nozzles. The vitamins used can be tailored to each individual clients’ needs, with a choice of vitamins A and E, B5, C and hyaluronic acid.

Charlotte Body Publisher 01268 754 897 charlotte@creativemedialtd.co.uk Vicky Eldridge Editor 01268 754 897 M: 07931 924 322 vicky@creativemedialtd.co.uk Emilia Bronze Associate Publisher 01268 754 897 emilia@creativemedialtd.co.uk Peter Johnson, Art Director 01268 754 897 peter.johnson@creativemedialtd.co.uk Charlie Crocker Designer 01268 754 897 design@creativemedialtd.co.uk Hollie-Jane Dunwell Account Manager 01268 754 897 hollie.jane@creativemedialtd.co.uk Shauna Peters Production Assistant 01268 754 897 shauna.peters@creativemedialtd.co.uk

DISCLAIMER The editor and the publishers do not necessarily agree with the views expressed by contributors nor do they accept responsibility for any errors in the transmission of the subject matter in this publication. In all matters the editor’s decision is final.

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Indsutry News | Round Up

BAAPS called on to help the FBI capture one of America’s Most Wanted Britain’s plastic surgeons have been asked by the FBI to help them capture one of America’s Most Wanted criminals. They have been asked if they have treated Catherine Elizabeth Greig, the girlfriend of ‘Whitey’ Bulger, a US mobster wanted for 19 murders, as well as racketeering, money laundering and drug dealing. Greig is said to be addicted to cosmetic surgery and it is believed that a faulty breast implant could well lead to her arrest, thanks to a recently issued FBI wanted poster. Bulger has been on the FBI’s Ten Most Wanted list since 1999 - a list that

Top UK surgeons are to provide key input at a new committee in Brussels, so that Europe-wide standards can be introduced in the cosmetic surgery sector. BAAPS president Nigel Mercer, attended the EASAPS (European Association of Societies of Aesthetic Plastic Surgery) meeting in Germany last month where a vote was held in favour of establishing standards. The CEN – the European Committee for Standardisation – has recently accepted

today also includes the likes of Osama bin Laden and the $2million

a proposal from the Austrian Standards

reward for information that leads to his capture is second in value only

Institute (ASI) to create a new Project

to the bounty for the al-Qaeda terrorist. The mobster is thought to have

Committee for Aesthetic Surgery Services to

had extensive cosmetic surgery to alter his looks since he went on the

elaborate European standards for aesthetic

run. Greig, who is wanted for harbouring Bulger after he went on the

surgery services.

run in 1995, has had extensive plastic surgery in the past. The FBI believe she may have found the habit hard to break. With the last confirmed sighting of the couple in London in 2002, agents have asked British and Irish plastic surgeons for their help. Douglas McGeorge, consultant plastic surgeon and former president of the British Association for Aesthetic Plastic

Mr Mercer said, “The UK has so far failed to put in place adequate regulations or standards to protect the public from

Surgeons, said, “The FBI have been looking for or this couple for a very long time and so are exploring all avenues.

unscrupulous providers. Therefore I will

It may be that Greig has seen a plastic surgeon in recent times. If she has, the FBI may be able to find out which

be delighted to join the new Project

part of the world they are in and where in that particular country they are. We do get some pretty unusual

Committee for Aesthetic Surgery Services

requests but being approached by the FBI is one of the most unusual.”

and help design a solid Europe-wide

Both Bulger and Greig are known to be extremely dangerous. The FBI states: “James J Bulger is being sought for

framework, which will ensure patients

his role in numerous murders committed from the early 1970s through to the mid-1980s with his leadership of an organised crime group that allegedly controlled extortion, drug deals and other illegal activities in the Boston, Massachusetts area. He has a violent temper and is known to carry a knife at all times.”

seminar is a Smart Idea for the consulting room™ More than 35 doctors, nurses and clinic managers from across the UK came to London on the hottest day of the year so far for the Smart Ideas seminar, organised by The Consulting Room™. The free event was designed to help clinicians give their aesthetic businesses a competitive edge with practical business strategies as well as access to a number of exhibitors offering products and services aimed at increasing profits.

can rely on safe treatment and facilities wherever they might be.”

MED+DBASE WELCOMES chris adams Med+DBase has welcomed Chris Adams as its new head of business development. Adams brings significant healthcare experience to the company, including 12 years at BUPA in a variety of senior positions and two

Presentations were given by Ron Myers and Martyn Roe, directors of The Consulting Room™ on everything

years at the international division of

from how to maximise the return on your marketing budget, to effectively using online marketing and social

Hospital Corporation of America as

media strategies, plus the critical importance of receptionist training and how to invest wisely in equipment for your business. The Consulting Room™ web designer, Dan Huxley, was also on hand offering free website reviews with design and Search Engine Optimisation advice for clinic businesses.

Chris said, “I am looking forward to working with our existing high-calibre aesthetics customer-base to develop increased

Dr Kate Goldie, was held on the new alginate facial shaping agent

functionality to assist the industry in key

from Merz Aesthetics, Novabel®. This included an intimate practical

areas such as patient communication and

demonstration towards the end of the day where attendees could

billing management, thereby driving growth

get first hand product knowledge and technique tips. The day also

for our customers.”

ABC Lasers, the latest development in ‘pain free’ laser hair removal from Alma Lasers. The launch included a presentation on the new machine from Ohad Mandelbaum, European sales director for

cosmeticnewsuk.com

commercial director.

In addition a two-hour workshop, featuring Professor Syed Haq and

included the official UK launch of the Soprano Blue device from

A Brussels face-lift

Medical Management Systems’ MD, David Temple added, “Everyone at MMS is excited about the dynamic Chris will

Alma Lasers. Commenting on the day, Ron said, “We had excellent

bring to the company and we are proud

feedback from delegates attending again this year, who liked the

of the obvious endorsement it gives to the

mixture of business and product related topics and we will definitely

product that someone of Chris’s standing

be running more meetings under the Smart Ideas format in the

and calibre has chosen to invest in and

future.”

work with the Med+DBase system.”

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I am happy to confirm that the Soprano XL Hair Removal system has been very well received by our patients and that they have all been truly amazed that it is a pain free treatment. The staff have found the laser system very easy and safe to use and we have been very pleased with the service and support we have received from ABC Lasers. dr rita rakus mBBs Founder member of the BaCd, Clinic in Knightsbridge. Known as the London Lip Queen.

“Soprano painless hair removal has transformed the laser hair removal experience for our clients. Working with other Lasers too, the Soprano hits all the right notes.” dr patrick Bowler. Founder & medical director of Court House chain of 10 Clinics and co founder of the British association of Cosmetic doctors BaCd.

“We offer a wide range of treatment modalities for clients seeking to remove unwanted hair using technology supplied by ABC lasers. The Soprano XL has enabled us to provide previously unavailable pain-free treatment and successfully include darker skin types in our patient pool. We recommend the Soprano XL without reservation.” dr. peter ilori is the founder of ‘the Beauty society’ - a premier provider of medical spa, aesthetic, dental and specialist orthodontic services.

When opening my new clinic I was looking for a system which stood above the rest. The painless technology from the Soprano XL has opened up a new and increasing market for my business in both Laser Hair Removal and Skin Tightening. One year on, results are excellent and many of our new clients come by word-of-mouth recommendations from our happy client. dr ravi Jain, BaCd, owner riverbanks Clinic, winner Best new clinic award 2008-2009.

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Industry News | Round Up

Study Examines Factors A Brussels facelift: European That May Helpfor Predict Patient regulations cosmetic satisfaction Surgery surgery to bewith introduced A study of patients undergoing elective facial plastic surgery has suggested that older patients and those currently being treated for depression may be more likely to be satisfied with the results of their procedures, whereas overall optimism and pessimism do not appear related to satisfaction with surgical outcomes. According to the report in Archives of Facial Plastic Surgery, patients who were older than the average age of 53 were more satisfied with their surgical results than patients younger than the average age. This may reflect more realistic expectations among older patients, the authors noted. In addition, those currently being treated for depression were more satisfied than those who were not being treated for depression. No correlation was identified between a patient’s optimism or pessimism at the beginning of the study and later satisfaction, nor did any other demographic factor assessed predict later satisfaction. Patients and physicians generally agreed with regard to satisfaction, although surgeons tended to be less positive in their assessment of outcomes than were patients. “The ability to preoperatively identify patient characteristics (psychological, social or demographic) that might impact the subjective perception of surgical outcome and predict dissatisfaction with facial plastic surgery could be highly useful to surgeons,” the authors concluded. “Although preliminary, our observations provide insight into these relationships and identify potential associations, which establish a basis upon which future studies can be built. In particular, it will be interesting to design larger scale studies to examine the potential associations between perceived surgical outcomes and sex, education, marital status, depression and/or inclination toward optimism/pessimism.”

new GUIDANce ON IMPLANTS

BAAPS has welcomed clarification provided by a detailed study into France’s controversial PIP implants by the French Society of Plastic, Reconstructive and Aesthetic Surgery (SOFCPRE) and issued new safety recommendations to the UK public such as a call for all women who have PIP implants to undergo an ultrasound scan in the next six months, to determine whether there is any rupture or weakening.   The study by SOFCPRE found that the company making PIP implants, which has now gone into administration, not only dispensed with the protective barrier since 2005 but was also using a gel (within the implant) which had not been the one tested originally for its CE mark. To determine how the altered version might react with the human body, SOFCPRE contacted the gel manufacturers for any studies - however, these were unavailable, as they had understood the substance to be intended for use in mattresses. BAAPS president Nigel Mercer said, “This comprehensive study concludes this situation is clearly not the fault of the surgeon, who acted in good faith - it would be similar to blaming a dealership for a faulty car. There was no way of knowing the gel was untested or that the protective envelope, which adds strength and restricts the gel from travelling into the body, had been dispensed with.”

mr veinwave Veinwave™ creator Dr Brian Newman has been sharing his medical skills with surgeons from around the world at an LA conference. Dr Newman demonstrated the Veinwave™ technique he pioneered to treat thread veins to more than 70 medical experts from across the globe in Marina Del Rey. Medical Innovations was granted 510(k) approval from the Food and Drug Administration in 2009 to distribute and sell Veinwave™ machines in the US. Since then, Dr Newman has delivered training to doctors at Harvard and John Hopkins universities and the Veinwave™ technique is now being praised at Harvard’s dedicated medical clinic. Dr Newman, who has trained more than 500 consultant surgeons in the UK, Europe, the US, Canada and Asia in techniques for cosmetic vein removal and rosacea, said, “I carried out live demonstrations on case studies in front of an audience of doctors, specialists and practice nurses and explained what Veinwave™ does in terms of veins and facial aesthetics. US buyers are investing in the machines on the strength of what they have seen, which is very encouraging. The US market is completely different to the UK, it is much bigger and they have a greater interest in facial aesthetics.”

cosmeticnewsuk.com

News In Brief warning after fitness to practice hearing for nurse who forged Botox® prescrption A nurse has been given an offical warning by the NMC after being found guilty of fraudulently changing the number of vials on a signed Botox® script. Louise Elizabeth Whiteman from Lichfield, Staffordshire, was brought before the Nursing and Midwifery Council after dishonestly making fraudulent representations to obtain Botox®. The nurse pleaded guilty at Stafford Crown Court in June 2008 and was sentenced to 26 weeks’ jail, suspended for 12 months, plus 150 hours of unpaid work by the courts. At a fitness to practice hearing the NMC panel ruled the ‘serious offence’ and conviction warranted a five-year caution order to her nursing record. But they also said that the nurse had shown regret and ‘acknowledged her shame’ for the offence. This is a stark warning to nurses about making sure they follow the laws around the prescribing of licensed medicines such as Botox®. Last month saw a meeting with the NMC to discuss the topic of remote prescribing. Turn to pages 12-17 for more on this.

AIMA holds advanced skin workshop in Birmingham The American Institute of Medical Aesthetics (AIMA) will be hosting an Advanced Skin Rejuvenation and Cellular Health day at the NEC in Birmingham this month. The event will tackle all common cosmetic problems including blemishes, discoloured, lined and saggy skin and will take place on Monday July 5 at the Birmingham NEC. The event costs £195+VAT. AIMA vice president Constance Campion and distinguished Harvard specialist Professor Syed Haq will be hosting the seminar. Both speakers received an overwhelming reception at the Cosmetic News Expo 2010 following their presentations on advanced pathways of knowledge, treatments and essential products for intrinsic and extrinsic rejuvenation, drawn from their combined work at Plastic Surgery Associates UK and The London Wellness Centre. To register e-mail order@medicobeauty.com.

Wrinkles scare indoor tanners more than skin cancer Young women are more likely to stay away from indoor tanning salons if they are warned that the practice could increase their risk of getting leathery, wrinkled skin, than being warned about risk of melanoma, the deadliest form of skin cancer, a study found. The study, published in Archives of Dermatology, found a 75% reduction in indoor tanning visits if girls were warned of skin deterioration and turning unattractive. “They’re not worried about skin cancer, but they are worried about getting wrinkled and being unattractive,” said June Robinson, a professor of dermatology at Northwestern University Feinberg School of Medicine and senior author of the study. The study examined the best strategy to wean college-age women who are considered addicted or pathological tanners from tanning salons. “The fear of looking horrible trumped everything else. It was the most persuasive intervention, regardless of why they were going to tan,” said Robinson. The research showed warning them about the effects on their appearance caused a 35% drop in their indoor tanning visits, which were measured at intervals up to six months after the intervention.

Honor for Dr Treacy Dr Patrick Treacy has been nominated as Honorary Lecturer of the 1st Annual Antalya Congress in Cosmetic Surgery and Medicine. The event will take place at the Papillon Hotel, Antalya, Turkey on October 29-November 2 2010. Dr Treacy will be co-chairman of the congress and will be presented with a trophy during the event.

eden joins forces with LCBT Eden Aesthetics is collaborating with the London College of Beauty Therapy in supplying DermaGenesis M1 mcrodermabrasion machines for their training facility in central London. Microdermabrasion is a core part of the curriculum for students studying at the college. Rochelle Saneria, programme manager at the LCBT comments, “It is important that we train and develop our students to the highest standards possible before graduating. Microdermabrasion is leading the way in terms of advanced beauty treatments and we feel it is important that our college sends highly skilled and knowledgeable graduates out into the industry. We have chosen to work with Eden Aesthetics as the DermaGenesis microdermabrasion machines have a reputation second to none for reliability and performance”.

SkinMedica Founder Receives Top Honors SkinMedica founder Dr Richard Fitzpatrick has been recognised by his peers with a Presidential Citation honoring his major impact in the field of laser medicine at the recently held 30th Annual Scientific Conference of the American Society for Laser Medicine and Surgery (ASLMS). ASLMS president, Dr Rox Anderson,

Voice OF THE Industry First refusal

Editor Vicky Eldridge starts off our new monthly column by asking whatever happened to a bit of healthy market competition? In last month’s issue of Cosmetic News I promised to bring you news about some of the latest developments from across the pond after my publisher, Charlotte Body, and I flew to the States for The Aesthetics Show, Las Vegas. However to our astonishment the organisers of the event would not only not issue us with press passes but wouldn’t even let us pay the $700 delegate fee to get in as they felt that Cosmetic News was a competitor publication to the magazine they are associated with, The Aesthetics Guide.

presented Dr Fitzpatrick with the award, noting him as a master clinician, pioneer, inventor, teacher, entrepreneur, visionary and friend. “I’m overwhelmed with gratitude upon receipt of this accolade. It’s especially meaningful to have received it from Dr Rox Anderson – I consider Rox my mentor, friend, and the greatest mind in laser medicine,” Dr Fitzpatrick said following the event. Additional recent honors for Dr Fitzpatrick include the 2005 Sturge-Weber Society ‘Physician of the Year’ award, recognition by Allure magazine as the ‘Physician Who Has Most Influenced Beauty’ and the EnvisiON Award for lifetime achievement from the American Society of Cosmetic Dermatology and Aesthetic Surgery. The SkinMedica range is distributed in the UK by SkinBrands. One of the brand’s signature products is TNS Recovery Complex, containing NouriCelMD, an unparalleled physiologic combination of elements that are found naturally in the skin. The gel enhances skin texture, reduces the appearance of age spots and blotchiness, and improves skin elasticity.

myfacemybody tackles weighty issue The MyFaceMyBody Show, the UK’s only TV chat show dedicated to cosmetic surgery and aesthetic treatments, has unveiled its latest stats as part of a new episode dedicated to the topic of weightloss. The new show aired on Sky Information Chanell 166 and Freesat 402 on Tuesday June 29 and featured results of a survery of 500 members of the public, which showed that nine out of 10 (89%) women are unhappy with their weight and two out of five would consider weight loss surgery. The survey also revealed the public’s lack of faith in celebrity diets, with the majority of respondents saying they don’t work, and over half already having tried them. The show is repeated every Tuesday at 7.30pm, Thursday at 3pm and Sunday at 6.30pm, with a new episode every month. As well as appearing on Sky TV, the programme will also be available to watch on demand on www.MyFaceMyBody.com

increase in foot fillers

In my six years as an editor in this industry (formerly for Aesthetic Medicine) I have never been refused access to a trade event – either here or abroad – and am absolutely dumfounded that the chairman of the show felt that this was an appropriate way to treat international journalists. We had planned to do a four-page spread on the event, reporting on what the exhibitors had been showcasing and had set up meetings with physicians who were presenting at the show to speak to them about the new innovations they were lecturing on. Instead we were told not to waste our time and that we could purchase a DVD afterwards! Having never had any issues with press access to events before we had already booked our flights and accommodation so we went anyway. Of course having five days in Las Veags and not having to work was fantastic and gave Charlotte and I a well-earned break, but I was actually really looking forward to attending my first US trade show and was disappointed that we received such a frosty reception. Although this is the first time I have been refused access to a show it is not the first time in recent months that I have seen unhealthy competition in this market. Whether it is between clinic chains reporting each other at every opportunity to the ASA or suppliers ‘slagging off’ their rival brands, the hard economic times seem to have brought out a competitive side to some people that is not healthy for the industry. There are a number of different events and magazine titles that could be seen as being in competition to Cosmetic News and the Cosmetic News Expo, but each brings their own value to the table. We promote and report on all other events in the industry in the magazine and are confident enough in the strength of our own title to let anyone from competitor magazines attend our show, as are the majority of our competitors. Competition is healthy in any market and I think we should work with our competitors rather than against them. Driving a wedge between you and them by refusing them access to an event, being rude or unhelpful (as the women we spoke to was) or bad mouthing them will never get you anywhere. What is most amusing about this is that we don’t even target the American or European markets, where the aforementioned magazine has its main distribution! So unfortunately I won’t be spending four pages telling you how fabulous The Aesthetics Show was and how I would recommend making a trip to the States to attend next year, instead the only coverage they will be getting is this rather negative tirade! What a shame…

Vicky

If you have something you would like to get off your chest please e-mail Vicky at vicky@cretaivemedialtd. co.uk and you could be our next Voice of the Industry.

Transform Cosmetic Surgery Group has reported an increase in the number of patients undergoing dermal filler injections in their feet to end high heel pain. The increase in foot filler patients equates to 49% from 2009 to 2010 alone. “With fashion icons like Cheryl Cole wearing pairs of six-inch pumps during the day and throughout the evening, other women are doing the same. And even though they cause pain, women find high heels make them feel taller, thinner, sexier, and boost their confidence, so they’re not too interested in giving them up,” says Gwen Davies, the non-surgical group manager for Transform.

cosmeticnewsuk.com

On The ScenE EF MEDISPA Chelsea Launch Party EF Medispa owner Esther Fairgrass celebrated the opening of her plush new premises on the Kings Road in

Tracey Beesley’s charity walk SkinBrands’ managing director Tracey Beesley has completed a 13-mile walk sponsored walk on the Chilterns in aid of Sue Ryder Care. Tracey completed the walk in four hours. The charity cares for people with challenging conditions and terminal illnesses such as cancer, stroke, brain injury, Parkinson’s, dementia and multiple sclerosis. Tracey said, “It was pretty tough, especially as I got a bit lost and walked for about 20 minutes more than I should have done uphill but Sue Ryder Care is a fabulous charity so it was all worthwhile.”

Chelsea with a glamorous party last month. Guests enjoyed drinks and canapés as well as having a chance to sample the latest aesthetic and rejuvenating treatments the spa has to offer. Created by award winning designers Campaign, EF Medispa Chelsea is symbolic of Esther’s concept of water and energy flow. The

For more information on the charity visit www.suerydercare.org

elegant venue’s reception area also features a stunning George Singer art installation of a crystal waterfall. CLOCKWISE FROM TOP RIGHT During the party guests could sample 20 minute treatments such as party eyelashes by eye-lash and permanent make-up artist Annie Park From left to right: Rudi Fieldgrass manager of EF Medispa Kensington, Esther Fieldgrass EF Medispa’s creative director, Victor Fieldgrass business development manager, Theo Fieldgrass manager of EF Medispa Chelsea, Max Fieldgrass operations manager of EF Medispa From left right: TV personality and ‘Diet Doctor’ Dr Wendy Denning, EF Medispa’s creative director Esther Fieldgrass and acclaimed female hormone specialist and author of It Must Be My Hormones Dr Marion Gluck

Flautist Heather Hoyle

From left to right: Dr Charakida and Dr Katerina Charakida

Colonic hydrotherapist Victoria Cooper

Viva Las Vegas Cosmetic News’ publisher Charlotte Body and editor Vicky Eldridge jetted off to the States for five days to visit The Aesthetics Show in Las Vegas. Unfortunately the organisers felt Cosmetic News was in competition to The Aesthetics Guide and wouldn’t let them into the show so they enjoyed a well earned break at the amazing Caesar’s Palace and celebrated the first year publishing Cosmetic News with a few cocktails by the pool.

On the gondolas at the Venetian hotel

cosmeticnewsuk.com

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Big Debate | Remote Prescribing

The final say

Mai Bentley gives us a summary of the meeting with the Nursing and Midwifery Council at De Montfort University, Leicester to discuss the controversial issue of remote prescribing

On May 20 a meeting was held at De Montfort University, Leicester to give nurses and other interested parties a chance to speak with the NMC about the subject of remote assessment, consultation, prescribing and administration of injectable cosmetic medicines. The meeting took place under ‘Chatham House Rules’ to enable a frank and open discussion of current practice to be undertaken between the attendees and Rebecca Cheatle from the NMC. Mai Bentley is a registered nurse and an Independent Nurse Prescriber. She is one of the directors of Intraderm Ltd and runs aesthetic training courses in London and Leicester. Intraderm are also offering the Independent and Supplementary Prescribing Course for Nurses (V300) in association with De Montfort University. It is currently the only prescribing course with specific aesthetic input.

Important points were highlighted in the NMC document

that although many of our medical colleagues are highly

Standards for Medicines Management, which clarified

regarded, nurses should not accept information from them

previously unclear areas of practice. The most important point

without questioning it. Many nurses were shocked to find that

concerns the administration of a drug by a nurse without a

information given to them by some doctors has been incorrect

written and signed direction in front of him/her. A direction to

and that they are actually working unlawfully. The advice from

administer must be a patient specific direction that contains

the NMC was to stop unlawful practice with immediate effect.

the name of the drug, strength, dose, frequency, route,

Under Chatham House Rules, nurses confided to the NMC that

start and end time/date etc. To take a verbal direction from

they could not simply stop working overnight and that they

the prescriber on the telephone is not sufficient and breaks

would continue to work illegally. Although sympathetic, the

the NMC standards. To administer a drug without all this

NMC gave the stark warning that if nurses were reported to

information in a written and signed document is not only

them, even those currently undertaking a prescribing course

breaking the NMC standards, it is unlawful. The current NMC

would be brought to a fitness to practice hearing and could

Standards for Medicines Management were issued in 2007.

lose their nurse registration. To break any NMC Standard is

They are not new. Nurses may feel that they are new because

unlawful and will lead to a fitness to practice hearing.

they are not familiar with the Standards. The NMC Code of Conduct Standard 6 states:

Each individual case may lead to four conclusions: 1. A caution

“You must maintain your professional knowledge and competence”

2. A restriction to practice 3. Suspension with immediate effect pending an investigation 4. Removal of the nurse from the NMC register

It is each individual nurse’s responsibility to keep up to date with professional matters. All 660,000 NMC registrants receive

The NMC confirmed that there does not need to be patient

a circular each year with details of updates but this is often

harm to bring a nurse to a fitness to practice hearing. Anyone

discarded as junk mail. The NMC pointed out that they can

can report a nurse – a patient, relative or indeed a nurse or

only send information – they cannot force nurses to read it.

doctor colleague. The NMC do not go in search of nurses

The NMC reminded nurses that their governing body is the

breaking Standards – that is not their role – but they do have to

NMC and that they should be aware that there are currently

act on information given to them in order to protect the public.

differences between the guidance offered by the NMC, the

With patients being more informed about treatment and

GMC and the MHRA. However, nurses cannot choose to

standards, it may simply be a matter of time before patients

adhere to others’guidance instead of, or over and above that

report nurses. It may also be that other colleagues within the

of the NMC because it suits them better. Standard 1.3 in the

industry may feel that it is their duty to report unlawful practice.

Code of Conduct states:

This will now be a huge ethical dilemma for many. Personally, I am entrusted with the careers of many nurses. I know that

“You are personally accountable for your practice. This means that you are answerable for your actions and omissions, regardless of advice or directions from another professional”

they are working illegally but I do not feel that it is my place to ‘whistle blow’. It has been and will always remain my role to educate aesthetic nurses - not to destroy them. The meeting also exposed confusion over terms such as NMC

cosmeticnewsuk.com

Nurses must also not rely on other professionals to keep

advice, guidance and Standards. NMC guidance supports

them updated. The NMC stated very clearly at the meeting

NMC Standards. NMC advice seeks to further clarify specific

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Big Debate | Remote Prescribing “Personally, I am entrusted with the careers of many nurses. I know that they are working illegally but I do not feel that it is my place to ‘whistle blow’. It has been and will always remain my role to educate aesthetic nurses - not to destroy them”

they are not involved in helping to supply persons who are involved in the illegal supply of drugs to nurses and therapists. During the meeting it was disclosed that it is not only individual, self-employed nurses who work outside of the NMC Standards. Some large organisations expect their nurses to work outside of the law. In these cases, if nurses question the way in which they are expected to work, they are simply removed from their jobs – a shocking insight into the workings of some large companies. The CQC and IHAS should be aware of this. It is possible that on-line assessments and electronically signed

areas and is also in direct support of NMC Standards for Medicines

prescriptions may become a possibility, as in use in some areas of the NHS.

Management. Therefore it is not possible to ignore NMC advice and

However, the NMC made it clear that such a situation within aesthetic

guidance as these support the law and are therefore part of it. The main

medicine has not been thought of prior to this meeting and would require

thing to remember is that NMC Standards are law. To go against NMC

careful consideration and legislation before any such idea could be

Standards is to break the law.

approved or used.

The NMC confirmed that the most common form of ‘remote

It is also possible that a course of treatment could be prescribed at one

consultation’ used in aesthetic nursing is not a remote consultation by

consultation between a patient and prescriber that could cover a set

the NMC definition as an assessment of the patient by the doctor usually

period of time. From the NMC perspective the nurse would need to

does takes place albeit by telephone. In a true remote consultation, it

have in place all the requirements from the 26 Standards for Medicines

does not. This confusion around the term ‘remote prescribing’ has led to

Management. This would not be seen as supplementary prescribing

different interpretations of what is allowed and not allowed to happen

because a ‘course’ of treatment would be prescribed. A direction to

when prescribing and administering cosmetic injectable medications. A

administer would need to be in place for each and every treatment

real remote consultation is not allowed in cosmetic treatments. It is only allowed in exceptional circumstances e.g. in palliative care. This has led many nurses to believe that because an assessment of their patients does take place, they are working safely. However, what nurses have failed to do is to look at the whole transaction that takes place when using a prescribing service and to apply their NMC Code of Conduct and Standards for Medicines Management to that transaction. Supply of products to nurses was also highlighted. Some nurses rely on retrospective prescriptions for products in order to treat patients immediately after telephone consultation. In this case, the product used may have another patient’s name on it. The NMC confirmed that the nurse is breaking the Standards for Medicines Management and the Code of Conduct and the law by doing this. It is regarded as theft.

“On-line assessments and electronically signed prescriptions may become a possibility, as in use in some areas of the NHS. However, the NMC made it clear that such a situation within aesthetic medicine has not been thought of and would require careful consideration and legislation before it could be approved or used”

Other companies do issue patient specific prescriptions and patients return at a later date when their product has been dispensed, for their

(with all the requirements attached). As for how long a direction

treatment. However, if there is no written and signed direction in front of

to administer/prescription lasts would be down to local policy and

the nurse at the moment of administration then it is still unlawful. Stocks

professional judgment. The NMC would advise that nurses have in place

of drugs can be forwarded to nurses belonging to the same legal entity

local polices for how frequently the prescriber needs to assess the client.

as a prescribing doctor. This enables drugs to be administered without

That said this would all need to be checked legislatively with the MHRA

delay. However, there is quite some difference between a nurse being

before proceeding.

employed by a company, clinic or hospital and a self-employed nurse adopting paperwork and a website logo of a company in order to take

The future for some aesthetic nurses may look difficult at this time. The

delivery of stocks of drugs. The following is taken from the MHRA website:

V300 prescribing course for nurses is offered at most universities throughout the UK and is probably the best way forward. That said, many universities

Question to the MHRA:

do not accept privately funded nurses. Also, for the next five years it is

“What about the situation where stocks are provided to nurses/therapists

not mandatory for universities to offer teaching on aesthetic medicine

who are self-employed - i.e. separate legal entities from the organisation

subjects. Websites such as www.nurseprescribingcourse.com can

or company sending the stocks?”

provide information to help nurses to overcome some of the difficulties in accessing a V300 course.

Answer from the MHRA:

“In these circumstances the organisation or company sending the

We can help you if you need advice about courses or simply need to

stocks would be wholesale dealing. Such nurses or therapists do not

talk in confidence about how the NMC Standards affect you and your

fall into a category of persons entitled to be sold POMs by way of

current practice. I currently sit on the NMC expert panel for Revalidation

wholesale dealing.”

and also for Independent Non-Medical Prescribing.

This issue does affect some nurses currently. These nurses need to seek

Call in confidence on 0116 2416898 to discuss any concerns that you may

legal advice. Pharmacies and drug companies need to ensure that

have on this subject.

cosmeticnewsuk.com

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Big Debate | NMC Interview

Position statement

Rebecca Cheatle has been the professional

We speak to the NMC’s professional advisor for advanced nursing practice and non-medical prescribing, Rebecca Cheatle, about the remote prescribing of botulinum toxin

advisor for advanced nursing practice and

Cosmetic News: Can you explain to anyone who wasn’t there what the ‘Chatham House Rules’ meeting on May 20 at De Montfort University was all about?

clinical practice – the Standards for Medicines

experience in these areas. Her role involves

Management are the minimum Standard that nurses and midwifes must be applying.

setting standards and guidance relating to

CN:

non-medical prescribing at the Nursing and Midwifery Council since 2008 and has extensive professional knowledge, skills and

non-medical prescribing, providing advice and guidance to nurses, midwives, employers

What should nurses who have set up

and other stakeholders which helps support

Rebecca Cheatle: It was an opportunity for

a business model in aesthetic medicine

nurses who are involved in cosmetic injectables

around cosmetic injectables, but are not

to discuss the Standards for Medicines

Independent Nurse Prescribers or do not

Management, which are written by the NMC and to ask questions about practice with regards to those Standards.

work in a practice with a prescribing doctor,

prescribing of botulinum toxin following the

do now?

meeting held at De Montfort University under

safe and effective practice. Here she talks to us about the NMC’s position on the remote

Chatham House Rules at the end of May…

RC:

The advice that we give to all nurses who

CN: What is the NMC’s stance on the remote

are supplying and administering medicines

prescribing of boutlinum toxin?

is that they need to apply the Standards

RC:

practice. There are about 26 Standards in

for Medicines Management to their clinical We have written a very clear Standard

on remote prescribing which is in our Standards

there that cover everything from assessment to

for Medicines Management that says remote prescribing should only occur in exceptional circumstances where medicine has been previously prescribed but the prescriber is unable to issue a new prescription but where maybe changes to the dose are needed that’s our definition of our Standard for when nurses or midwifes can administer from a remote prescription. What we say is that it should be

storage and transportation as well as supplying and administering and we want them to look through that document and ensure that all of the Standards are adhered to in order for them to continue to practice clinically.

CN:

So if their business model is not within

those Standards they need to change their business model?

In exceptional circumstances, where medication (not including controlled drugs) has been previously prescribed and the prescriber is unable to issue a new prescription, but where changes to the dose are considered necessary, the use of information technology (such as fax, text message or e-mail) may be used but must confirm any change to the original prescription.” NMC ‘Standards for Medicines Management’ followed up within 24 hours by fax or e-mail concerning the changes. What that makes

RC:

clear is that remote prescriptions or directions to

Standards. Under the NMC we have several

administer should only be used in exceptional

levels of documentation. We publish Standards

circumstances and not as a routine means to

and we also do publish guidance and

administer cosmetic injectable products such as

advise. For nurses and midwifes Standards

botulinum toxins.

must be adhered to – there is no guidance

CN: Why is this the Standard across nursing? RC:

or interpretation there they are the top level rules. We would want nurses to ensure they are following the Standards in all areas of clinical

The reason that this is the Standard is that

practice be that cosmetic aesthetic injectables

we are about maintaining and safeguarding

or accident and emergency or in general

the patient, public and women and their

practice settings.

families and through extensive investigations

Yes. They are not guidelines they are

when we were writing the Standards this

CN: Has this always been the NMCs position

was the safest way to ensure that patients

on remote prescribing and are you just having

received the best clinical care. It is about

to reiterate your position because of the way

applying the minimum Standard to nursing led

practice within cosmetic medicine has evolved?

cosmeticnewsuk.com

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RC:

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29/10/2008 13:56:17 29/10/2008 13:56:17 13:56:17 â&#x20AC;&#x2DC;Cosmetic Injectable Treatmentsâ&#x20AC;&#x2122; and that will give them 29/10/2008 an overview of

The Standards have been there for about three years

now and the issues around remote prescribing havenâ&#x20AC;&#x2122;t changed in

the regulatory side for nurses and midwifes around cosmetic injectable

that time. I think it is perhaps come to light now as the profession has

treatments. If they wanted additional advice we provide a confidential

developed and more and more nurses and more nurses and midwives

advice service at the NMC where nurses, midwives, employers, clients

are engaging in the clinical practice of cosmetic medicine. It is about

or patients can ring to receive professional advice and that number is

ensuring that they adhere to the Standards and getting that message

An independent firmour offering one to one We meetings anywhere in the UK giving advice and help with: also available on website. would be more than happy to support

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actually guide them to ensure that they are achieving the Standards. We

CN:

t how to start in private practice

t computer software

t how to maximise private practice income

t tax and financial advice re: car purchases

t how to start in private practice t computer software are here to ensure but also give advice to t how to maximisethe privateStandards practice income aret followed tax and financial advice re: carto purchases

What would happen to a nurse if they carried on using remote prescribing in this arena and were reported to you?

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RC: We are duty bound as an organisation, once a nurse is reported to us, to investigate all cases. It is impossible to give a definitive answer as to what would happen because each case is different and separate and is investigated on its own merits, however by not following the Standards nurses could be jeopardising their registration and putting their livelihoods at risk. The ultimate sanction that we are able to apply to any

setting up in Chambers/Groups how toup maximise private practice income setting in Chambers/Groups limited companies and LLPâ&#x20AC;&#x2122;s ways tocompanies reduce taxand payments limited LLPâ&#x20AC;&#x2122;s financial planning setting up in Chambers/Groups financial planning record keeping limitedkeeping companies and LLPâ&#x20AC;&#x2122;s record financial planning record keeping

schemes t schemes tax and financial advice re: car purchases t purchase of consulting rooms and surgeries tt purchase consulting and surgeries pensions:of NHS, personalrooms and employee t schemes inheritance tax and capital gains tax planning t inheritance tax and capital gains tax planning VAT ttt VAT purchase of consulting rooms and surgeries tForinheritance tax and capital gainsustax more information please contact by:planning For more information please contact us by: t VAT Wilmslow Harley Street Wilmslow Harley Street For more information Phone: 01625 527351 please contact Phone: us 020by:7307 8759 Phone: 01625 527351 Phone: 020 7307 8759 Wilmslow Harley Street Fax: 01625 539315 Fax: 01625 539315 Fax: 01625 539315 Fax: 01625 539315 Phone: 01625 527351 Phone: Â 020 7307 8759 Email: info@sandisoneasson.co.uk Email: info@sandisoneasson.co.uk Fax: 01625 539315 Fax: 01625 539315 Website: www.sandisoneasson.co.uk advice@nmc-uk.org Website: www.sandisoneasson.co.uk Email: info@sandisoneasson.co.uk Website: www.sandisoneasson.co.uk

Useful resources

NMC professional advice service

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â&#x20AC;&#x153;The safe, safe, definitive definitive solution solution â&#x20AC;&#x153;The our register, which will disable them from being able to practice as a for permanent permanent lip enhancementâ&#x20AC;? enhancementâ&#x20AC;? nurse or midwife.for â&#x20AC;&#x153;The safe, definitive solution lip for permanent lip enhancementâ&#x20AC;? CN: Where can nurses who are worried about this issue go nurse or midwife is a striking off order and that is a removal of them from

Designed exclusively exclusively for for lips lips â&#x20AC;˘â&#x20AC;˘ Designed to for advice? â&#x20AC;˘ Is not an injectable filler â&#x20AC;˘ Is not exclusively an injectableforfiller â&#x20AC;˘ Designed lips â&#x20AC;˘â&#x20AC;˘ IsIs permanent, permanent, yet can be easily removed RC: In the first instance I would say order yourself a copy of the yet removed â&#x20AC;˘ Is can not be an easily injectable filler Standards for Medicines , they the are free to anybody who contoured to match match shape of your your lips lips â&#x20AC;˘â&#x20AC;˘ IsIs contoured to the shape of â&#x20AC;˘ Is Management permanent, yet can be easily removed wants a copy. They can go onto the NMC website and order a copy Available in various various sizes â&#x20AC;˘â&#x20AC;˘address Available in sizes contoured match theofshape of yourWe lips and we will post â&#x20AC;˘it Is free of charge to to an their choice. Available various sizes would recommend them reading that. â&#x20AC;˘We have alsoinproduced quite a helpfulTel: advice which augments or supports the Standards and 020sheet 8441 6500 Tel: 020 8441 6500 that can also be found on our website and the advice sheet title is www.surgisol.com www.surgisol.com Tel: 020 8441 6500 www.surgisol.com

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Past Lecturer and Examiner in Headguidelines & Neck If so, do you realise that changes toEdinburgh NMC mean that you are risking your registration doingand to attract attract new new patients patients Royal College of Surgeons Anatomy (Newcastle Medical School) doing to Anatomy (Newcastle Medical School) From September 2009 the NMC have stated â&#x20AC;&#x153;that remote prescriptions or directions to administer From September theand NMC haveinstated possibly your client base? Find out what otherbypractices are Past2009 Lecturer Examiner Head &â&#x20AC;&#x153;that Neck remote prescriptions or directions to administer Increase Revenue targeting Increase Revenue by targeting should only only be be used (Newcastle in exceptional exceptional circumstances, and not not as as aa routine routine means means to to administer administer doing to attract new patients Anatomy Medical circumstances, School) the correct correct demographic should used in and the demographic 2'0-$3 From September 2009 the NMC have stated â&#x20AC;&#x153;that remote prescriptions or directions to administer 2'0-$3 â&#x20AC;&#x153;Dentalâ&#x20AC;? Blocks for Dermal Dermal Fillers 2'0-$3 2'0-$3 â&#x20AC;&#x153;Dentalâ&#x20AC;? Blocks for Fillers injectable cosmetic cosmetic medicinal products.â&#x20AC;? Increase targeting injectable products.â&#x20AC;? Train and Revenue motivate by your staff to to 52/3 Train and motivate your staff should only be usedmedicinal in exceptional circumstances, and not 52/3 as a routine means to administer 52/3 the correct demographic 52/3 promote cosmetic procedures on on 2'0-$3 (and other Cosmetic Procedures) 2'0-$3 â&#x20AC;&#x153;Dentalâ&#x20AC;? Blocks for Dermal Fillers promote cosmetic procedures %$23 (and other Cosmetic %$23 injectable cosmetic medicinalProcedures) products.â&#x20AC;? %$23 the telephone telephone andyour in person person %$23 Train and motivate staff to the and in 52/3 NMC Meeting 20th May 2010 52/3 $.059$)' $.059$)' NMC Meeting 20th May 2010 +/+3*+/) !05%*'3 $.059$)' promote cosmetic procedures on +/+3*+/) !05%*'3 $.059$)'

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View On | Tattoo Removal

tats all folks

Mike Murphy has spent many years in the medical laser industry. His first company, Derma-Lase Limited, was borne out of clinical research in Canniesburn Hospital, Glasgow, Scotland into the removal of tattoos and benign pigment lesions using the Q-switched ruby laser. He was involved in the original research program from 1986, and also studied the effects of the pulsed dye laser on vascular lesions (such as port wine stains). While working in the hospital Mike became the Laser Safety Officer responsible for the safe use of all the lasers within the Canniesburn Laser Suite. At the same time he had to implement the recently formed COSH regulations where they applied to lasers. In 1989 Mike and his colleagues formed Derma-Lase Ltd to sell the DLR1 ruby laser across the world with many sales in America and in South East Asia. They opened the world’s first tattoo removal clinic in Glasgow using Q-switched lasers. Two years later they launched the world’s first commercial Q-switched Nd:YAG laser for dermatological applications, the MultiLine. In 2002 Mike started working with PhotoNova of Sweden as a consultant. He is currently working on a report on the thermal effects of IPL pulses on tissue, in particular blood vessels. This area has not been fully explained in the literature and has led to a poor understanding of the best way to treat various skin problems using IPL systems. He plans to publish this report later in the year. He has also recently begun a new spectroscopic study of tattoo inks and their response to Q-switched laser energy.

Mike Murphy gives his View On why tattoo removal lasers are a potential danger in our beauty salons Recently salon owners in the UK have begun to look at offering tattoo removal services as part of their overall package. While this is a good move, generally, there are a number of issues, which should be understood by all therapists before launching into this area. Firstly, the only technique that has been clinically proven to remove tattoos without seriously damaging the skin is the Q-switched laser. A Q-switch is a device that essentially ‘squeezes’ all the laser energy into an extremely short pulse duration, typically, billionths of a second. Such short pulses do not generate thermal (heat) reactions in tissues, unlike many other lasers and all IPL systems. Instead, a different type of reaction known as the ‘photo-acoustic effect’ is induced. This reaction generates a shock wave, which causes the brittle tattoo ink particles to fracture into smaller fragments, which macrophages within the skin will remove over time. Secondly, IPL systems cannot produce nearly enough power to break down tattoo ink in the same fashion as with Q-switched lasers. Indeed, IPL systems cannot induce the photo-acoustic effect at all. They can only generate thermal reactions, which can lead to scar formation if used on tattoos due to damage to the adjacent collagen. The power density is absolutely critical when attempting to treat tattoos. Below a certain threshold the photo-acoustic effect will not occur and the tattoo pigment will not fragment. The graph on the opposite page shows the differences in the power density generated by various systems. IPL systems can generate power densities between 50 watts/cm2 and 2000

watts/cm2 typically. If we represent 50 watt/cm2 as a 1cm high point on the graph, then many lasers used in cosmetic treatments today will generate equivalent power densities of 5000 watts/cm2 – a height of 100cm on this graph. However, Q-switched lasers can easily generate power densities of hundreds of millions of watts/ cm2 – on the graph opposite this would be represented by a point more than 150 kilometres high.

cosmeticnewsuk.com

CosmetNews95x265.qx8_Layout 1 22/06/2010 14:46 Page 1

To be absolutely clear on this, each Q-switched laser pulse generates a power density 150,000 times greater than typical lasers and 15,000,000 times greater than IPL systems! It is clearly obvious how much more powerful Q-switched lasers are when compared with ‘standard’ lasers and IPL systems. This point must be understood by all Q-switched laser users. It is absolutely imperative that anyone using this kind of technology appreciates the power of the laser they are using. I cannot stress this enough. This is particularly important when considering the potential hazard of such lasers to the eyes – this is covered in my next point. Thirdly, the correct safety goggles or glasses MUST be used when utilising Q-switched lasers. This is a legal requirement in the UK and

The world leaders in laser safety

is enforceable. I have become aware that some suppliers do not supply the proper eye protection. This is doubly dangerous because not only do they not provide the proper level of eye protection, but they also allow the wearer to believe that they are protected! Every pair of safety eyewear MUST indicate the level of protection and

Quality laser safety equipment and compliance services based on over 100 years of collective experience.

must be CE marked. These are both legally required otherwise the eyewear cannot be used within the EU countries. Current regulations, known as the EN60825/207 standard, state that both the frame and the filter must be chosen according to the laser wavelengths and output power density. For pulsed lasers this means that they must offer full protection for at least 100 pulses (or 10 seconds for a continuous laser) – this applies to both the frame and the filter. The old regulations specified the optical density (OD) of the filter alone. The OD is a measure of how much light can get through the filter to the eye. It is a logarithmic scale so an OD of 1 represents a

Protection Products

10% transmittance while and OD of 2 is only a 1% transmittance. However, the newer European Standards incorporate a required protection level for the frames too – this is now law for all EU states. Laser safety goggles are specifically designed for particular lasers. They are not transferable. The goggles must take into account both the wavelength(s) and the output power of the laser. If you use a Q-switched Nd:YAG laser for tattoo removal then your goggles must be able to protect you from the 1064nm and 532nm wavelengths (which

Installations

most Nd:YAG lasers will output) and the huge powers they generate. However, these goggles will only protect you from this type of laser. They are useless if you use a different laser. I know of a case where a very well known laser researcher damaged both of her eyes because she accidentally put on the wrong safety goggles before working with a Q-switched laser. That damage is permanent – it cannot be repaired! Q-switched lasers generate both visible and invisible laser light of immense power (as above). Even a fraction of a percentage of this power is capable of permanently damaging the eye’s retina.

UKAS Accredited Testing

Hence, if the wrong safety glasses/goggles are used and an errant reflection enters eye damage is almost guaranteed. All of the above must be clearly understood before even switching on a Q-switched laser. Comprehensive training must be provided to all users by authorised personnel only. Secondary training by new users should absolutely not be allowed – this is imperative to ensure safe and effective use of such lasers.

Expert Advice & Training

Tel +44 (0)1202 770740 sales@lasermet.com www.lasermet.com cosmeticnewsuk.com

People In Profile | Bengt Ågerup

The Swede smell of

success We speak to the founder and CEO of Q-Med Bengt Ågerup

When it comes to the aesthetics industry Q-Med is considered to be one of the major players with its flagship brand Restylane® remaining one of the market leading dermal fillers. What makes Q-Med different to its big pharmaceutical rivals, however is the fact that it is still a relatively small, family run business.

Man of Science

Growing the business

at the test tubes now and then and quite suddenly

Q-Med was founded by Bengt Ågerup in 1987

The inspiration behind the name Q-Med came

at about half past 11 I could see that everything

and, despite being in his late 60s, he remains very

from the simple fact that there are not many

had become a gel, which meant that the synthesis

much hands on with the company. Swedish born

companies in the telephone book that begin

had worked. When I saw that lump of gel I was

Bengt was always passionate about science – a

with a ‘Q’.

so infinitely happy, because so many months of

passion he still has today.

In the early days of the business, the company was

unsuccessful attempts had suddenly found a

“My belief is that our children’s children will no

actually not the main focus for Bengt however.

solution. Furthermore, I realised of course the value

longer worship God they will workshop science”, he

Between 1985 and 1995 he was the managing

of this, the vast implications of having access to a

says. “It’s a big statement but I think our knowledge

director of Biomatrix Sv. AB (today Genzyme) where

natural hyaluronic acid.”

will move so fast and become so advanced that

he took part in developing another HA-based

In 1995 the patent for the NASHA™ technology

we can have most of our questions answered by

product for the treatment of osteoarthritis in the

was submitted. At this time Q-Med had only three

science.”

joints: Synvisc.

employees and it was not until now that Bengt

Having gained a Master of Science (Mathematics,

With a passion for hyaluronic acid and its

employed himself at the company.

Physics, Chemistry and Biomedicine) and a PhD

applications in the human body, Bengt began

“I was 52 and a father of four children and I could

in Physiology at the Medical Faculty of Uppsala

to search for a formula for the production of a

have made myself a nice life in the South of

University in Sweden, Bengt was recruited by

biocompatible substance with a long duration in

France”, he says. “Q-Med was making money and

Pharmacia and in 1975 became the manager of

the body. Bengt performed his research in his free

that was enough for me but then I saw this life of

clinical research for eye surgery. The focus was on

time at home in the kitchen or in the small house

playing golf and drinking wine and I thought ‘no’ so

replacing lenses in the eyes of patients suffering

known as ‘The Hut’ where Q-Med had its offices at

I told my wife, come and join me at Q-Med and lets

from cataracts and in the course of his work Bengt

this time.

do this properly.”

realised that the results from this type of surgery were

As time went on Bengt spent more and more time

It was not within the aesthetics market that

improved if hyaluronic acid was used as part of the

on his research. As a physiologist he approached

NASHA™ made its debut. Q-Med used the

treatment. The product Healon (based on hyaluronic

the task with the intention of keeping the idea

technology to develop an alternative for the

acid of animal origin) was developed and became

simple. “Since I am a physiologist, I am a poor

treatment of vesicoureteral reflux in children:

the first HA product to be launched in USA.

chemist”, he says. “My ambition when I started was

Deflux™, which remains a successful niche product

In 1977 Bengt became the director of explorative

to use as few chemical ingredients as possible - and

and has improved the lives of thousands of children

research at Pharmacia and in 1980 he was

still develop a material with long-lasting properties. It

all over the world. In fact it became the first of

appointed managing director of R&D at the

was to be minimally modified.”

Q-Med’s products to be approved by the FDA (US

Ophthalmics Division of Pharmacia. After more than

After persistent work Bengt found the formulation

Food and Drug Administration) for sales in the USA in

10 years at the company Bengt decided to start his

that laid the foundation for NASHA™ (Non-Animal

2001. So what first made Bengt realise the potentials

own business and Q-Med was born.

Stabilised Hyaluronic Acid) technology. “I looked

of his invention in facial aesthetics?

cosmeticnewsuk.com

Small beginnings: The Q-Med headquarters affectionately know as ‘The Hut’ in 1991

The Q-Med head office in Uppsala, Sweden today

“When we first developed NASHA™ I didn’t have any

The Restylane® years

applications in mind. I was thinking of creating the

In 1996 Restylane® received CE approval and could begin to be sold in Europe. Bengt

material to begin with. I wanted to capture the secret of

explains, “At that time there were only about seven people in the company and we were

the material and make a highly biocompatible very pure

supposed to start selling Restylane® so we moved to France and we hired an apartment and

and stable form of HA and then there are hundreds of

had our aupair calling all the clinics asking them if they did treatments. We had a good map

potential applications. I was highly confident that I had

of Paris and we started there. Then I got a distributor in Italy and then in Germany and they

something that was innovative and could be adapted

started to order a lot of products so the company needed to expand in Sweden.”

into various products.”

In the autumn of 1996 Q-Med moved 10 or so employees to new premises, a former sheet-metal

Bengt used NASHA™ in a number of trials for different

workshop of 900m2 at Seminariegatan 21. By then Q-Med already had revenues of 13 million

applications but it was the results and the potential it

Swedish Kroner (MSEK). Even so there were not so many people who believed Bengt when he

offered in facial aesthetics that grabbed his attention as

declared his ambitions in a TV interview saying: “Q-Med will become a billion kronor company!”

the market was still relatively young and the only product

Things began to really take off for the company in 1998 after Restylane® obtained registration

practitioners had at their disposal at the time was

approval in Canada and Brazil. 15 different distributors around the world were contracted and the

collagen, which had potential side effects and a short

number of employees at the company also increased to 77.

mode of action and so Restylane® was created.

In 1999 Q-Med was listed on the Stockholm Stock Exchange and new premises with a larger production facility, a warehouse and offices were built in Uppsala. In 2001 Bengt was given the award of ‘Entrepreneur of the Year’ in Sweden and by the following year Restylane® had been used in one million treatments worldwide. In 2003 Restylane® was approved for sales in the USA and three

All of my life I have strived to produce the best products. I am not interested in anything else. I don’t want to repeat something that someone else could equally well do

years later, Q-Med had revenues of far above a billion kronor. Today more than 11 million Restylane® treatments have been successfully performed in more than 70 countries across the globe. The range has been expanded to include Restylane Vital™ and Restylane Vital™ Light, the company’s hydro balance product as well as a recently launched skincare range (see this month’s Product News). In 2007 the company also launched Macrolane™ VRF as the first product on the market for body shaping. Q-Med now has more than 650 co-workers in 20 countries, with 385 at the company's head office and production. Bengt has retained control of the majority of the company and is still involved in every major decision made today. As such research and development has remained a top priority. “We reinvest about 25% of our turnover in R&D”, he says. “I did not start Q-Med for me to have fun I wanted to start business and to use the technology that we have in the best way to serve people. If it is only for the money it will not last long you have to have other vision about what you doing. I had a president a few years ago who felt that I was too aggressive on product development and research. He thought we should focus on what we have and make more of that commercially and discontinue the medical side as aesthetics had become the core business, but I said ‘we will focus in on aesthetics when we have developed the medical products to a stage where we can safely go to another company and say this is the product, this is the way you should sell it’. A year ago we sold our Deflux™ for 50 million so in the end it paid off! I think for a company to develop in a safe way is not to put all your eggs in one basket. Our strength is our technology, so why not establish that technology in more aspects because you never know one day it may not be fashionable to look younger – you don’t know! Its good to have more legs than one on the chair!” Listening to Bengt talk it is very clear that he is not only a passionate scientist but an entrepreneur with ability to combine good business sense with an innovative spirit, a very rare trait indeed.

cosmeticnewsuk.com

Special Feature | Veins

Thread work

We take a look at the most successful treatments for thread veins

Thread veins are largely considered to be a cosmetic problem and as such many medical aesthetics clinics have branched into treating them as part of their clinic’s offering. However unlike other treatments, which sit firmly within the specialty of aesthetic medicine, the treatment of veins is an industry in its own right and there are boundaries between what cosmetic clinics should and shouldn’t be treating that can be quite difficult to distinguish. Mark Whiteley founder of the Whiteley Clinic, and leading UK vascular surgeon says, “There are few medical conditions that are so widely spread as varicose veins and thread veins and yet are misunderstood by so many and treated so badly.”

wide to about 2mm wide. You get the tiny tiny little ones that look almost like bits of cotton right the way up to the flares, which can be straight or start shaped and they are the ones you usually see on the skin. They don’t usually bulge although sometimes the very big ones can feel a bit rough when you touch them.”

Types of Veins

Vein diagnosis

There are two main types of problem veins that people seek treatment for:

Although thread veins can be treated by non-vascular specialists, Mr

varicose veins and thread veins.

Whiteley warns that, in many cases, there may be an underlying problem of varicose veins, which needs to be addressed first and recommends

Varicose veins are dilated veins, which you can often see bulging on the

sending the patient to a vascular surgeon for diagnosis and treatment of

surface of the legs. They are a sign of leg pump failure and are caused

the varicose veins before you tackle the thread veins. He says. “The trouble

when the valves in the veins fail, allowing blood to flow the wrong way

with veins is, and this is where cosmetic doctors, nurses and therapists are

down the leg and cause the vein to start dilating. This in turn causes the

getting into problems, that we used to think that thread veins were totally

vein wall to stretch in both directions and, as the condition worsens, large

different from varicose veins but the research over the last 10 years has

sacs form at the bends of the vein. The vein can sometimes thrombose

shown that 89% of people with thread veins have actually got underlying

leading to inflammation called superficial thrombophlebitis. Varicose veins

varicose veins causing them. Now what that means is that not all varicose

are usually deeper beneath the skin than thread veins and are more than

veins can be seen on the surface. So for everyone that has got a lumpy

2mm in diameter.

one that you can see, there is someone else who has got the same problem, a valve that’s not working, but its not near enough to the surface

“If you are looking at the outside of the leg, which is what people are

to see, its deep inside so its hidden away. The first time we know about it is

actually seeing, varicose veins are usually lumpy and quite often look skin

when it causes a complication like a leg ulcer, swelling of the leg, itching of

coloured because they are deep enough that you can’t see the vein itself”,

the skin or skin damage.”

explains Mr Whiteley. “Sometimes however varicose veins are closer to the surface so they can look bluish green.” Varicose veins are more serious than thread veins and although some people get no other problems apart from the cosmetic appearance, there are many who complain of pain

Type of Vein

Thread Veins

Varicose Veins

Where are they?

Very near the surface

Deeper under the skin

What colour are they?

Red, blue or purple

Skin coloured or bluish/ green

What size are they?

Usually less than 1-2mm

Usually larger than 2mm

Medical importance?

Cosmetic only BUT-may be a sign of underlying leg pump failure

Sign of underlying leg pump failure

and aching particularly towards the end of the day. Varicose veins are a problem that very few medical aesthetics clinics provide treatment for and is a condition usually best left for vascular surgeons and experts in the field of veins to tackle. Thread veins or spider veins as they are sometimes known are different to varicose veins and are the most common type of vein treated in aesthetics clinics. Thread veins are usually very near the surface of the skin and are red, blue, or purple in colour. They are not regarded as a serious medical condition but they can occasionally ache. “Thread veins can be anything from about half a millimetre

cosmeticnewsuk.com

Source: The Whiteley Clinic

Mr Whiteley uses the Duplex Ultrasound system and believes no patient should be treated for veins without first being examined using one of these machines or, at the very least, a Doppler. Using the Doppler theory, a Duplex Ultrasound can show blood moving on an Ultrasound picture. It not only shows the direction of flow but also the speed of flow. Mr Whiteley explains, “For vein surgery, we need to know which way blood is flowing. In normal veins, blood flows upwards towards the heart. If a vein is blocked, there is no flow. If the vein isn’t working (i.e. the valves aren’t working) blood flows back the wrong way, giving all of the problems that varicose veins and venous reflux can cause. All of these abnormalities are best picked up by Duplex Ultrasound. What’s happening in

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the cosmetic world is that practitioners are seeing people with thread veins but they are not getting a Duplex Ultrasound Scan to check whether there is an underlying problem – they are just treating the thread veins on the surface by trying to destroy them using injections or laser. With 11% of people of course, if you do it right, it will get better, but with the other 89% if you haven’t treated the underlying problem its going to come back. “With the majority of people who come and see us for thread veins when we scan them we find they have got underlying varicose veins that need treatment first. If you are treating thread veins then, at the minimum, you should go on a course and learn how to use a hand-held Doppler to check for the underlying varicose veins. The reality is however that, if you have got any sense and you really want to provide the best treatment, then you really need to have a high resolution Duplex Ultrasound scan.” Mr Whiteley recommends setting up a referral system with a local vascular surgeon. He says, “Clinics should strike up a relationship with a vascular surgeon local to them who will be able to fix the underlying varicose veins and then send them back to them to treat the thread veins afterwards. Its not losing the patients if you have a good relationship because a lot of surgeons don’t want to do thread veins themselves so they start sending thread vein cases along in any case. If you do that everybody wins because the vascular surgeon treats the underlying veins properly and the cosmetic clinic gets a better result from their treatment as a result.”

Vein treatments There are a variety of different options for treating thread veins including microsclerotherapy, Veinwave™, laser and electrolysis. Microsclerotherapy is considered the gold standard for treatments on the legs while

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laser treatment, IPL (Intense Pulsed Light), Veinwave™ and electro-coagulation or electrolysis are best for thread veins on the face. On the following pages we take a look at some of these treatments...

Microsclerotherapy Microsclerotherapy involves using tiny needles to inject problem veins with a substance known as a ‘sclerosant’ (usually a chemical). This destroys the vein making the walls of the veins fibrose (or stick) together. Microsclerotherapy is normally used for the treatment of leg veins rather than facial veins where the vessels are usually too small to get a needle into. The treatment can be uncomfortable and patients can experience some stinging or burning during injection. “The treatment that works best for thread veins by far is microsclerotherapy”, says Mrs Whitely. “This is the

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injection of a ‘poison’ or detergent,usually polidocanol or STD. Some people inject saline or glycerine, which may or may not work as well, but the industry standard is the detergents. However you have to get the right dosage in the right vein because if you miss the vein it is possible to damage the skin or get a brown stain or an ulcer.” As microsclerotherapy closes the veins by inflammation of the wall, most patients get a patch of inflamed skin over the site of the injection, which lasts for up to two weeks. This inflammation is actually very good – it is the body’s way of removing the dead vein. The area then settles down but the full benefit can take up to 12 weeks to be seen. Depending on the number of thread veins on the legs, several sessions may be need to get the required results. Compared with other treatments, microsclerotherapy gives the best results with 95% of patients seeing an improvement and 80% getting a good or very good result, according to the Whiteley Clinic. As with any medical procedure, there are some risks involved, but complications with microsclerotherapy are very rare and are generally of a very minor nature. Some 4-5% of people can get brown marks – usually very mild and usually fading over several weeks or months. Very occasionally the brown stains can be dark. Approximately 1% (1 in 100) people can get a little break down of the skin – called a chemical ulcer. This can be very tender for a few weeks and then usually heals with a small scar. This scar can be permanent, but such a small scar is usually better then the thread veins that were there before the

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treatment. Allergies are often quoted as a problem but are exceptionally rare. Before and after microscelrotherapy (Pictures courtesy of Mr Mark Whiteley, The Whiteley Clinic)

FOR MORE INFO: 01903 768 380 Commerce Way, Lancing, BN15 8TA Email:info@thecarltongroup.co.uk

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Special Feature | Veins Veinwave™

a place for Veinwave™ in

Introduced into the UK by Medical Innovations in 2001, Veinwave™

your practice.”

uses the process of thermo-coagulation, which involves using microwaves to heat fine blood vessels. The energy is transferred to the

In the legs Mr Newman uses

affected area via an ultra-fine insulated needle to ensure accurate

Veinwave™ in combination

application without affecting

with microsclerotherapy to

the surrounding skin and tissue.

get the best results.“When

When the high frequency

treating veins in the legs

energy (4Mhz) is passed

you have to have more

through the vein it causes

than one bit of armament,”

it to collapse and instantly

he explains. “I have been

disappear. As thermo-

lecturing a lot in the States

coagulation uses a selective

recently and they have taken this treatment on at Harvard and at the

controlled energy, which

New York Vein Centre for

preserves the epidermis, there

treatment of leg veins in combination

are no risks of burns or necrosis.

with microscelrotherapy and I think that

One treatment session usually

combination is now the gold standard for

lasts around 10-15 minutes,

treating leg veins.

representing approximately 200-250 pulses, and the results

“For veins up to 0.3 of a millimeter we

can be seem immediately. Now

use Veinwave™ first of all. People who

used by some of the top vascular clinics in the country, and recently

have got complex venous flares (like

given FDA approval, the treatment can be used to treat cosmetic

bruises on their legs) we use Veinwave™

veins on any skin type with virtually no downtime.

to slow the flow down then six weeks or so later follow them up with a course

Brian Newman, a vascular surgeon and the creator of Veinwave™,

of microsclerotherapy either using

says, “Veinwave™ was developed originally to deal with fine thread

polidocanol or saline. For the very fine

veins or all types of fine telangiectasia. It uses radio-frequency from an

veins you can’t get a needle in but with

external source rather than using RF inside of blood vessels, which you

Veinwave™ you can always deal with

can do to close bigger blood vessels. In fact one of the things that has

the very fine veins. The other thing is with

happened over the years is that we have actually developed within

scelrotherapy alone if you just inject

the Veinwave™ range a method of dealing with the larger reticular

veins one of the problems is that about 20% of people develop pink

veins on legs. But Veinwave™ itself has developed dramatically in

discoloration in the legs which can look worse than the fine veins they

that it is not only being used for dealing with veins on legs, it’s now the

had to start with one of the things we have developed is a technique

number one treatment for dealing with facial telangiectasia and for

using cross polarised light to identify prior to injection whether they

large veins on and around the nose.”

have this likelihood of developing this and then we Veinwave™ them first. If you Veinwave™ them first then inject them six to eight weeks later

Mr Newman is a strong believer however that a surgeon should

you dramatically reduce the incidence of this.”

have more than one tool at his disposal and this has continued to be his philosophy since he developed Veinwave™. “If you go for

More than 350 consultant surgeons in Europe have successfully trained

an operation you don’t expect the surgeon to have one piece of

in Veinwave™ techniques and the product has recently been taken on

equipment,” he says. “If you are doing scelrotherapy or laser there is

by Harvard Medical School.

The Fotona laser systems have proved popular in the vascular field

Laser and IPL

company’s spectrum of Nd: YAG, Q-Swtiched Nd:YAG

Lasers can be used to treat a variety of vascular or

and KTP Nd:YAG laser sources are perfectly suited to

pigmented legions on the face and body. In the area

treat veins. The Nd:YAG wavelength is strongly absorbed

of veins however, general opinion is that laser treatment

in hemoglobin yet can penetrate deeply enough to

is more effective for broken veins and capillaries on

treat even the deepest and largest of unsightly veins.

the face, rather than for larger leg veins.Lasers work

The versatility of parameter settings ensures maximum

by targeting a specific tissue in the skin. In the case of

treatment efficiency and speed as well as minimal

thread veins, the target is the blood filled vessel that is

patient discomfort.

precisely heated and destroyed by the laser without harming surrounding areas.

Candela’s Vbeam laser technology will successfully treat

Lasers can be used to treat telangiectasias and Spider

a wide range of skin conditions, including acne, rosacea,

Naevus (both forms of thread veins) and can also be

scars and stretch marks, benign gynaecological vascular

used to treat varicose veins in some cases.

lesions, other benign cutaneous vascular lesions, leg and facial veins, sun spots, freckles, angiomas, hemangiomas,

Fotona’s systems are widely used in the vascular field before and after treatment with the Fotona

cosmeticnewsuk.com

port wine stains, psoriasis and pigmentation. As with all

at they can be used

lasers under the Candela umbrella, the Vbeam laser

for Endovascular Laser

is effective in deleting the evidence of skin defects by

Ablation (EVLA), a popular

delivering a gentle burst of light on to targeted areas of

method for dealing

the skin. The light is absorbed by specific blood vessels or

with varicose veins. The

melanin pigmented areas in the dermis. The Candela

Special Feature | Veins Vbeam procedure is

and short term erythema and oedema is usually observed but typically

non-invasive and without

persists for only a few hours post treatment. The Lumina is not only capable

significant downtime.

of successfully addressing facial vascular lesion but offers a long-pulsed Nd:YAG laser to treat leg veins. Telangiectasias of the legs occur in 40%

Before and after treatment with the Candela VBeam system

Lumenis’ new multi-application

of women and 15% of men and are often of great cosmetic concern.

platform, the M22, is another

Nd:YAG lasers emit a wavelength of 1064nm. At this wavelength there is

system, which offers impressive

a broad peak (approximately 800 to 1100nm) in the absorption spectrum

results for veins. Featuring its

of blood. Skin penetration depths are relatively high (approximately 1mm)

proprietary Optimal Pulse

as there is little absorption by melanin at these wavelengths, enabling

Technology (OPT™) and Multiple-

safe treatment of darker skin types. These lasers have proved particularly

Sequential Pulsing, the M22 has

effective in the treatment leg veins and treatment of larger and deeper

the broadest range of energy

facial veins, such as those that occur frequently around the nose.

for its size and application. OPT, unique to Lumenis IPL, delivers the right pulse and

Compression

fluence for each application.

In no other area of cosmetic medicine is post-procedure compression

Physicians can safely and

so vital as following vein treatments. In the vascular field the benefit of

efficiently treat a variety of

compression has been well documented with studies demonstrating

skin types by controlling each

a significant decrease in the incidence of post-sclerotherapy

pulse shape. The M22 offers

complications where graduated compression hosiery is worn.

the Nd:YAG upgrade module, Mr Whiteley says, “With microsclerotherapy you are injecting a poison into the vein that kills the vein wall. The poison instantly gets absorbed and washed away but, as with all tissue, it takes 14 days for the vein to completely reabsorb. So you have now got a dead tube and if you don’t compress it straight away blood is going to flow back in to it. The Lumenis M22 system Broken facial capillaries before treatment with the Lumenis system

Broken facial capillaries after treatment with the Lumenis system

Blood in a dead tube will clot and you will end up with thrombus and of course that is not only tender and itchy but it also stains. If you do

proven for vascular lesions, leg veins,

microsclerotherapy on thread veins and you don’t compress you will

and non-ablative facial wrinkle

almost definitely

treatment. The treatment head is

get brown stains.

equipped with two spot sizes (2 x 4mm

If you compress

and 6mm) for precision treatment,

by getting the

complete with computer-enabled

patient to wear

recognition and SapphireCool Light

good compression

Guides for optimal patient comfort.

stockings for 14 days and nights

Cynosure’s Cynergy™ laser

then you keep

combines two optimal vascular wavelengths, the Pulse Dye Laser

the blood out

and a high powered 1064nm Nd:YAG laser in one unit. In addition

of the vein, the

to these two lasers, the Cynergy offers a third option, the innovative

vein is dead so

MultiPlex™ feature, which allows the sequential delivery of these

it gets eaten away by the white blood

two wavelengths, enhancing its multifunctional capability.

cells and you get a really good result.”

Sigvaris is a market leader in postvein treatment compression

MultiPlex provides a new concept for the treatment of vascular lesions. Using one laser wavelength to alter the absorption

Sigvaris is one of the most well known brands when it comes to post vein

characteristics for a second, sequential wavelength, allows

procedure compression. A market-leader across the globe, Sigvaris are

reduction in the treatment fluence of each while maintaining or

experts in medical compression stockings for treatment of venous and

improving outcomes and side effects profiles. Multiplex provides

lymphatic diseases. The Sigvaris range is incredibly diverse and includes

better, non-purpuric, single treatment efficacy for telangiectasia

five lines of medical compression stockings: Magic, Comfort, Traditional

and provides improvement to previously resistant vascular lesions.

and Custom Made. Their stockings are designed to be elegant and stylish as well as comfortable and casual to meet every requirement.

Recently, intense pulsed light (IPL) treatment has proven highly successful

The Magic range is designed to be convincingly natural - thanks to

in the treatment of vascular lesions on the face, neck and decollette. IPL

its discreet transparency – and is for all indications of compression

systems operate on the principle of selective photothermolysis in which

classes I and II. Garments are available in

target vessels are selectively damaged with minimal risk of injury to the

standard sizes and made-to-measure. The

surrounding healthy tissue. The Lumina, developed by Lynton Lasers Ltd,

Comfort range is designed to be universal so

effectively and efficiently treats facial vascular lesions with minimal risk of

it’s suitable for both men and women and to

side effect. The Lumina vascular application covers a wavelength range

be comfortably soft and smooth. Garments

from 585 to 1100nm which targets absorption peaks in haemoglobin and

are available in up to 24 different sizes and

oxy-haemoglobin. In addition, the Lumina comprises a multiple pulsing

for all indications of compression class II.

facility with variable interpulse spacing, allowing the operator to select

The Traditional range provides a constant

appropriate parameters to treat vessels of different sizes and at different

level of compression throughout the day and

depths. In this way, the Lumina system predominantly targets blood

has high medical effectiveness for safe and

vessels by delivering sufficient energy to thermocoagulate the entire

successful therapy and can be combined

vessel while causing minimal damage to the surrounding skin. Following

perfectly with any fine stockings for all

treatment, the damaged vessels are absorbed by the body and little or

indications of compression classes II, III and IV.

no trace of the initial lesion remains. Treatment is mildly uncomfortable

Its available in standard sizes and made-to-

cosmeticnewsuk.com

The VENOSAN® 4000

REFERENCES 1.

measure - for women and men. The company also does made-to-measure compression stockings.

Another leading brand of compression designed

for post vein treatments is the VENOSAN® 4000 and Legline products. VENOSAN® 4000 ‘s luxury support

stockings include Tactel climate effect technology ensuring breathability in wear, a sheer appearance

and velvety touch whilst perfectly hugging the 6. 7. 8.

contours of the leg. Available in EU compression class 1, 18-21mmHg and class 2 23-32mmHg. The advanced technology used in the manufacture of this range has been proved to increase

elasticity to aid ease of application to the leg.

10.

VENOSAN® Legline is knitted with an extremely fine

11.

mesh offering sheer looking compression socks, stockings and tights. This compression helps prevent and relieve mild oedema and slight varicose

12.

veins and is frequently worn post procedures

13.

such as sclerotherapy and laser treatments. Legline 20 has a compression of 20mmHg and

14.

Legline 30 has a compression of 30mmHg. This is the range favoured by Mr Whiteley

MACOM offers a wide range of compression garments including stockings for use post-vein procedures

he says, “You must have compression that is going to hold the vein shut for 14 days and nights and be comfortable for the patient because it is a long time to ask people to wear it. You need a graduated compression stocking, which is maximum pressure down by the ankle and foot and least at top so you are encouraging the blood to flow back upwards. The second thing

15. 16. 17. 18.

you need is that it has to be tight enough so grade II or more and the third thing it comes down to is the material and how its made and that’s why we use the VENOSAN® because our patients find them very comfortable.”

19.

Conrad P, Malouf GM, Stacey MC. The Australian polidocanol (aethoxysklerol) study. Results at 2 years. Dermatol Surg. 1995 Apr;21(4):334-6; discussion 337-8. Corazza M, Zampino MR, Lauriola MM, Vecchiati G, Virgili A. An unusual local reaction after microsclerotherapy with chromated glycerin. Dermatitis. 2006 Dec;17(4):198-200. Goldman MP, Bennett RG. Treatment of telangiectasia: a review. J Am Acad Dermatol. 1987 Aug;17(2 Pt 1):167-82. Goldman MP, Sadick NS, Weiss RA. Cutaneous necrosis, telangiectatic matting, and hyperpigmentation following sclerotherapy. Etiology, prevention, and treatment. Dermatol Surg. 1995 Jan;21(1):19-29; quiz 31-2. Goldman MP, Kaplan RP, Duffy DM. Postsclerotherapy hyperpigmentation: a histologic evaluation.J Dermatol Surg Oncol. 1987 May;13(5):547-50. Green AR, Morgan BD. Sclerotherapy for venous flare. Br J Plast Surg. 1985 Apr;38(2):241-2. Guex JJ. Microsclerotherapy. Semin Dermatol. 1993 Jun;12(2):129-34. Kono T; Yamaki T; Erçöçen AR; Fujiwara O; Nozaki M “Treatment of leg veins with the long pulse dye laser using variable pulse durations and energy fluences” Lasers Surg Med. 2004; 35(1):62-7 Lupton JR; Alster TS; Romero P “Clinical comparison of sclerotherapy versus long-pulsed Nd:YAG laser treatment for lower extremity telangiectases” Dermatol Surg 2002; 28(8):694-7 McDonagh B. Comments of the use of post-sclerotherapy compression. Dermatol Surg. 1999 Jun;25(6):519-21. No abstract available. Nootheti PK, Cadag KM, Magpantay A, Goldman MP.Efficacy of graduated compression stockings for an additional 3 weeks after sclerotherapy treatment of reticular and telangiectatic leg veins. Dermatol Surg. 2009 Jan;35(1):53-7; discussion 57-8. Epub 2008 Nov 21. Omura NE; Dover JS; Arndt KA; Kauvar AN “Treatment of reticular leg veins with a 1064 nm longpulsed Nd:YAG laser” J Am Acad Dermatol 2003; 48(1):76-81 Rabe E, Pannier-Fischer F, Bromen K, et al. Bonn Vein Study by the German Society of Phlebology. Epidemiological study to investigate the prevalence and severity of chronic venous disorders in the urban and rural residential populations. Phlebologie. 2003;32:1-14. Rabe E, Schliephake D, Otto J, Breu FX, Pannier F. Sclerotherapy of telangiectases and reticular veins: a double-blind, randomized, comparative clinical trial of polidocanol, sodium tetradecyl sulphate and isotonic saline (EASI study). Phlebology. 2010;25(3):124-31. Tanghetti EA “Multiplex 595 nm, 1064 nm Laser Treatment for Blebbed Port Wine Birthmarks and Telangiectasia” Lasers in Surgery and Medicine 2006 38; S18, 21 Tanghetti E; Sherr E “Treatment of telangiectasia using the multi-pass technique with the extended pulse width, pulsed dye laser (Cynosure V-Star)” J Cosmet Laser Ther 2003; 5(2):71-5 Thibault PK. Copper vapor laser and microsclerotherapy of facial telangiectases. A patient questionnaire. J Dermatol Surg Oncol. 1994 Jan;20(1):48-54. Weiss RA, Sadick NS, Goldman MP, Weiss MA. Post-sclerotherapy compression: controlled comparative study of duration of compression and its effects on clinical outcome. Dermatol Surg. 1999 Feb;25(2):105-8. West TB, Alster TS. Comparison of the long-pulse dye (590-595 nm) and KTP (532 nm) lasers in the treatment of facial and leg telangiectasias. Dermatol Surg. 1998 Feb;24(2):221-6.

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Treatment Focus | PRP Rejuvenation

In the

blood

We chat to Dr Roberto Viel about his experience with Platelet Rich Plasma rejuvenation

It may have been dubbed the ‘vampire face-lift’ by the tabloids but Platelet Rich Plasma rejuvenation or PRP is a far less scary procedure than it sounds so much so that it is proving incredibly popular with patients at the Harley Street clinic of Dr Roberto Viel. Half of the infamous Viel brothers, Roberto was one of the first practitioners in the UK to perform the technique using the GPS III System from Biomet Biologics. Dr Roberto Viel and his brother Maurizio have been practising cosmetic surgery for more than 20 years. Born in Rome, the brothers studied for 11 years in Milan to become specialists in facial surgery. For the first six years they practised in their homeland and in 1990 they established their Harley Street clinic, The London Centre for Aesthetic Surgery, and opened their second clinic in the prestigious Dubai Health Care City in January 2008, providing the same range of surgical and non-surgical procedures available at their London clinic.

“With dermal fillers you are giving volume, with this you are helping the skin to improve by itself. When you give volume you don’t do anything to actually improve the complexion”

The brothers famously pioneered the technique known as penoplasty and are always ahead of the game when it comes to taking on the latest and most innovative treatments. It’s no surprise therefore that they are pushing the boundaries once again with PRP rejuvenation. Having now performed the procedure on around 50 patients Roberto talks to

Cosmetic News about why he thinks it complements rather than replaces dermal fillers and other injectable treatments…

Cosmetic News: How new is this treatment? Dr Roberto Viel: The use of Platelet Rich Plasma itself is not particularly new. It has been used in the past, in the recent past mainly, in orthopaedic surgery and in cardiac surgery for the obvious reason that it gives better healing and a quicker recovery. It has been used also in athletes to help them recover from injuries. Also in the States it has been used a lot in top race horses – they are athletes too and they need the quicker recovery to perform at their best in races. What is new however is the application within our field in plastic and cosmetic surgery. When you look at the properties of platelets you can see why they can be used for rejuvenation purposes. When there is an injury in the body it is the platelets that arrive first at the site of trauma. These are rich in growth factors and different chemicals, which help to repair the trauma. We can use these properties in our field for skin rejuvenation and for facial rejuvenation and we can use them also to enhance fat grafting techniques. So this technique has been taken from other fields of medicine but has been adapted in our specific field.

CN: How does the treatment work? By injecting platelets that are rich in growth factors, with the technique of mesotherapy, you will stimulate more production of collagen and elastin. The other advantage is that these growth factors and other components of the platelets that we use will activate the stem cells in the skin, which causes rejuvenation.

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CN: What kind of results can you get with this treatment?

RV: I am using the technique now quite often because I see good results. What I see in the patient after two or three weeks of treatment is a better skin glow – they will look younger with a better tone and firmer looking skin. There is also a good reduction of fine lines and especially the fine lines around the eyes, which is a difficult area to treat. Basically the skin looks younger because you are giving it what it needs to rejuvenate itself.

CN:

“The blood is processed in the GPS III System where the Platelet Rich Plasma is separated from the platelet-poor plasma and the red blood cells. When the blood is ready we have 3mls of platelets from 30mls of blood. The concentration of platelets is nine times more than in normal blood”

What is the difference between this

CN: How is the treatment performed? RV: The patient comes in first for a consultation

are very fine superficial vessels. The next day

dermal fillers?

RV: With dermal fillers you are giving volume,

then they come back here for the treatment.

needle but then its back to normal. If there

with this you are not giving volume you are

Before the treatment we first apply an

is bruising it will usually take about a week to go.

helping the skin to improve by itself. When you

anaesthetic cream to the skin on the face

give volume you fill up the lines and wrinkles but

because of course they will be having lots

CN:

you don’t do anything to actually improve the

of small injections. This makes the treatment

get the best results?

skin complexion, improve the glow, improve

more comfortable for them otherwise there

RV: I would recommend to do the treatment

the younger look of the skin. Other treatments

can be a little bit of discomfort. In the time it

every six months.

that claim to trigger more collagen and elastin

takes for the anaesthetic to work the blood

production are yet to prove that. With this

with be processed. The patient gives 10ccs of

CN:

there is good research to show that platelets

their blood. The blood is processed in the GPS

grafting techniques?

really trigger that. I like to work with an honest

III System where the Platelet Rich Plasma is

RV: If a patient also needs volume

reliable company that will provide me with the

separated from the platelet-poor plasma and

replacement then we can use fat injections

scientific research so that I know that I am using

the red blood cells. That process takes about 20

to the face using the platelets. By mixing the

a technique that has been well researched and

minutes. When the blood is ready we will have

platelets with the fat, the fat will have a better

am giving the patient what I have promised, and

3mls of platelets from 30mls of blood. With this

survival. The problem with fat transfer has

that it is something that is safe. The patient needs

system the concentration of platelets is nine

always been inconsistent results because of

to understand that this is a good technique, it

times more than what you get in normal blood.

absorption, which can be up to as much as

is a safe technique, it will give skin rejuvenation

So what we inject is highly concentrated. We

50%. The platelets can be injected directly into

treatment and other injectable treatments like

you may still see a few little marks from the

How many treatments do you need to

How can it be used to enhance fat

the harvested fat tissue and the fat tissue is

“If a patient also needs volume replacement then we can use fat injections to the face using the platelets. By mixing the platelets with the fat, the fat will have a better survival”

then re-injected into the patient’s face. The fat can last up to five times longer than any other form of fat transfer and the absorption rate is only between 10% and 20%, depending on each individual patient. Fat harvest is a great technique I have personally been doing it since the early 90s and I am still doing it because I have always seen a good result, however it is a technique that is very dependent on the operator, it depends how you handle the fat. If

but its not a substitute to Botox® or a face-lift.

use a small syringe with a very small needle

you do the technique in the right way then you

Everything has its own indication. The key is

specifically made for the application of

will see the results.

to work together – one treatment is good for

mesotherapy and then we inject all over the

one indication, another treatment is good for

face of the patient. We use the mesotherapy

another indication. There is no one treatment

technique of injecting because we want to

for everything. A good doctor will use different

deliver the platelets very superficially.

treatments to deliver the best result.

[REFERENCES] 1) Du Toit DF et al, State of the Art Rejuvenation and Wound Healing With Platelet Rich Plasma Growth Factor. The Specialist Forum 2007, 7: 36-42

CN: Is one of the main advantages that

CN: What are the side effects? RV: After treatment the patient will have

patients like to use something that has come

a little bit of redness or pinkness because of

Adhesives on Dermal Fat Graft Resorption Following

from their own body?

erythema and moderate to medial swelling.

Reconstruction of a Superficial Parotidectomy

RV: Definitely that is really appealing to the

Sometimes it is possible to see some bruising,

Defect: a Double-Blinded Prospective Trial, Head

patient.

especially in the periorbital area where there

Neck 2009 Apr; 31 (4): 521-30

2) Chandarana S et al, Effect of Autologous Platelet

cosmeticnewsuk.com

Q&A | Hyperpigmentation

the mark Cosmetic News chats to Dr Carl Thornfeldt about Epionce’s newly launched products for hypergimentation – Melano Corrective System

Dr Carl Thornfeldt is a practicing dermatologist with 25 years of skin research experience, 21 US patents granted and more than 20 scientific publications in the area of treatment of skin. He is also the president, CEO, and chief scientific officer of Episciences, Inc. In 2003 and 2005 he was selected as one of the top 50 doctors in the US by The Sinatra Health Report. The only dermatologist on the list, Dr Thornfeldt has spent over a decade researching the skin barrier and cutaneous inflammatory conditions. He developed the Epionce® skincare range, based on his research that linked the effects of two damaging biological processes in the skin: chronic inflammation and disruption of the skin's natural protective barrier. By providing a highly effective skin wellness line that works at the cause of these conditions, he believes Epionce® products are changing the way skin professionals can help their patients improve the performance and health of their skin.

Cosmetic News: What causes hyperpigmentation? Dr Carl Thornfeldt: Hyperpigmentation is activated by a number of things, including: • UV and X radiation • Elevated Estrogens • Heat • Autoimmune Disease • Proinflammatory Injury • Chronic Inflammation • Chronic Atrophic or Disrupted Skin Barrier • Medications (estrogen, amiodarone, minocycline) • Herbal Photosensitizers (i.e. St. John’s Wort, lime) • Pregnancy • Liver disease • Addison’s disease • Hemochromatosis • Pituitary tumors These activators then start a complicated process made up of 14 different steps: Three occur outside the melanocyte, 11 occur within the melanocyte and 10 of the steps that occur can be pharmacologically affected by topical product application. The remaining four steps are too transient.

CN: How common is it? CT: This is the third most common skin condition in darker races with incidence of 9-13%. Incidence in caucasians is 2-4%.

product containing Hydroquinone 4%, Tretinoin 0.05% and fluocinolone and 2) a system containing the first two plus ascorbic acid, soy and other herbs. Other leading treatments can include laser. Their primary mechanism of action for all leading products tends to be inhibition of tyrosinase, which is the rate limiting step of the 14 steps. The problems are that these products have a lot of irritation rates, which increasing inflammation in the skin, ultimately leading to more long term damage including Post Inflammatory Hyperpigmentation (PIH) and rapid recurrence of the original lesions.

CN: Tell us about the new Epionce® Melano Corrective System CT: The Melano Corrective System is comprised of two products that work synergistically to help the complicated process leading to visible hyperpigmentation. It is made up of a combination of herbal and algae extracts with multiple mechanisms of action that were previously evaluated in human skin in vivo trials. They are also able to deliver these active ingredients without destroying the stratum corneum barrier and activating inflammation response. The MelanoLyte Tx is for daily at-home use, that can be used year-round, and the MelanoLyte Pro is a very active mask for in-office application.

CN: What treatments are available? CT: The ‘mainstay’ is hydroquinone 4%

CN: What makes these products different to other products for hyperpigmentation? CT: Neither product contains hydroquinone,

prescription, but also tretinoin, azelaic, glycolic, salicylic and/or ascorbic acids , and others like arbutin, kojic acid, soy, niacinamide are standard therapies. Most of the ‘botanical’ hyperpigmentation products still include some combination of hydroquinone, arbutin or kojic acid. The current gold standards for treating hyperpigmentation are: 1) a single prescription

tretinoin, ascorbic acid, glycolic acid, soy, tea, kojic acid or niacinamide. We also had little to no irritation in the clinical study, showing tremendous safety that none of the other products can claim. Obagi Nu Derm regimen produced varying degrees of irritation in all panelists. Because they do not cause photosensitivity, the products can be used year-round.

cosmeticnewsuk.com

CN: A study was carried out comparing the Epionce® Melano Corrective System to Obagi Nu Derm, what were the results? CT: It was an 18-week prospective randomised parallel trial conducted and assessed by dermatologist researchers at Stephens and Associates, Colorado Springs. Both groups given MCS regimens were highly statistically superior (p<0.001) in lower incidence of erythema, scaling/ dryness and peeling when compared to the OND at all time points. The group with both MCS products was statistically superior (p<0.05) to a OND regimen in diminishing lentigines at eight and 12 weeks, and highly statistically significant (p<0.001) at 18 weeks since the OND treated lentigines worsened. The two MCS groups were statistically significantly superior (p<0.05) in reducing appearance of melasma on forehead and cheeks at four weeks, with 19.3% and 19.1% in both BF2 and BF1 groups. At 12 weeks the BF2 group reduced melasma by 51.8% vs. 26.8% for OND. MCS was comparable in efficacy to OND in all remaining hyperpigmentation parameters including mottled hyperpigmentation, dyschromia – but with superior safety.

CN: Anything else you want to add about the products or the Epionce® range? CT: It is important to use an Epionce® Renewal Facial product and sunscreen when using the Melano Corrective System for optimal results. Since inflammation plays such a crucial role in hyperpigmentation it is imperative to use other complimentary anti-inflammatory products. The Epionce® Renewal facial products help repair the damaged skin barrier and help stop inflammatory factors. The Epionce® sunscreens are the only sunscreens on the market that contain anti-inflammatory/anti-oxidant ingredients. It is important to remember that not all anti-oxidants are necessarily anti-inflammatory, so just because a sunscreen has anti-oxidants in it, does not mean it has anti-inflammatory properties.

Redefine over time Sculptra速 has been successfully redefining the way your patients look for quite some time. Sculptra速 replenishes lost collagen for a more natural-looking, gradual effect that can last up to 25 months. Popular with patients, this aesthetic result has got to be good for your business over time. In partnership with Succeev速 it can also successfully widen your Medical Aesthetics opportunity. For more information visit www.sculptra.co.uk or talk to your sanofi-aventis Medical Aesthetics Account Manager.

M E D I C A L

A E S T H E T I C S

C O N F I D E N C E

T H A T

S H O W S

sanofi-aventis, One Onslow Street, Guildford, Surrey GU1 4YS. Date of preparation: May 2010. GB.POL.10.05.03a.

Product Focus | Image Skincare

Image is

everything We find out why Image Skincare’s range has been such a big hit with one of the countries leading clinic chains and doubled their retail takings in just eight weeks

Retailing skincare is an important part of running a successful aesthetics business, yet many practitioners still struggle with the concept of selling products to clients. While selling product is second nature to many beauty therapists or hairdressers, medical professionals are often not used to working in such a commercial environment and, in some cases, are not making the most of the opportunities that retailing skincare affords their business. The advantages of selling skincare within your practice are plentiful. Not merely is it another revenue stream but it is also a way of enhancing the results your clients get from treatments and getting them to come back more regularly to purchase their favorite products. Choosing a skincare range can be hard however, with so many professional cosmeceutical brands on the market. Renew Medica is one of the UK’s largest and most successful clinic chains and carries a number of key cosmeceutical ranges, the latest of which is Image Skincare. Image Skincare was introduced to the UK market by SkinGeeks earlier this year. Founded by Janna Ronert in 2003, the brand is one of America’s most popular professional skincare ranges. The brand harnesses scientifically advanced formulas to create pharmaceutical grade skincare products that give therapists, physicians and aestheticians the ability to offer professional treatments and products that yield unparalleled results. The range is also formulated without the use of parabens, petrochemicals and synthetic fragrances. There are no chemical preservatives and the use of essential oils makes this cosmeceutical range a real pleasure to use. This may sound like spiel from the company’s PR brochure but according to Renew Medica’s senior clinic manager, Wilma Bird, it doesn’t even slightly begin to explain how phenomenal her and her team thinks the brand is.

doubled their retail takings in just eight weeks of carrying the line.

“We have had the Image Skincare line for eight weeks now and our retail sales percentage has doubled” In the past staff have struggled to sell retail products but the Image products are flying off the shelves. So why does Wilma think this is? She explains, “We do still have quite a price conscious clientele so price does come into it and most aesthetics ranges are not cheap. If you want to get results you have got to invest in it but persuading people to make that investment in their skin has been one of the hurdles in the past. Our clients are looking for results and that doesn’t just come from the treatments they have, that also comes from the aftercare. So the products that we give them have to be seen to be getting results, which is very much the case with Image – we have got a very happy client base at the moment. Once they are on it they are all coming back saying ‘that is fantastic, I have to get that for my friend or my sister’ or ‘now I want to get this and I want to get that’ – they are expanding themselves on the range without our girls having to do anything!”

Rave Renew

Another factor that has really made Image a hit with the staff at Renew Medica is the fact they can give their clients everything from one range. Wilma explains, “What appealed to us about the range was the combination of the glycolic and the Retinol – we new we could get results for our clients with that all from one range. One of the things we have struggled with in the past is that we have had to cross between two different ranges, which is fine, but technically, from a chemistry point of view, you don’t know what those products will do together. To be able to tailor make a program from one range is fantastic as far the girls are concerned because we know what’s in there will complement each other.”

Renew Medica was one of the first clinics in the UK to take on the brand, and the decision proved to be a good one as astonishingly they have

She continues, “It just caters for everything, which makes it very easy for us – every client we get in

cosmeticnewsuk.com

from the most sensitive to the most congested to the most sun damaged we can prescribe something from this range and adapt it as their skin changes. If somebody is on the Ageless™ range but has had a peel and can’t use Retinol they can use something from the OrMedic™ range or from the Vital C™ range, they don’t have to stop using the product range, which is what was happened before with Cosmedix and SkinCeuticals – they had to stop using their skincare for a few days after treatment. Also the products can be used on a wide range of skin types from Afro Caribbean to your pale English Rose skin, we are able to cater to all our clientele with this skin range.” The fact that that the products smell nice is another bonus, according to Wilma. “The Image products are scented – almost aromatherapy based – which is a bonus”, she says. “An awful lot of the cosmetics ranges you have got now are very clinical. This isn’t just clinical, it is a range that will adapt.” The staff have all been using the range themselves and this has made it even easier for them to rave about its benefits to clients. Wilma says, “Our aestheticians have been here for nine years and have got an awful lot of expertise in the business. They have been using Cosmedix and SkinCeuticals for years so it was going to take an awful lot of convincing to move them over to a new range, but they transferred over to Image fantastically well. They believe in it, and have been using it themselves which helps. They can sell these products because of that. The girls couldn’t be happier because they have got happy clients, they are getting results and its very simple for them to use - what more could you want?”

The Image range in a nutshell The Image Range incorporates six different lines: Ageless™, Vital C™, OrMedic™, Clear Cell™, Sun™, Body Spa™. Image also has seven Professional I Peel Treatments – ranging from an organic Passion Peptide Peel to RXonly TCA and Jessners treatments.

Product Focus | Image Skincare Line Description Ageless™

Products

An effective product line for preventing and treating the signs of ageing and environmental exposures. Diminish fine lines and wrinkles and reverses the effect of cellular damage. Promotes skin rejuvenation and leaves skin fresh and youthful

• • • • • • • •

Total Facial Cleanser, Total Anti-Ageing Serum, Total Repair Creme, Total Eye Lift Creme and Total Resurfacing Masque Ageless Lashes Total Pure Hyaluronic Acid Total Retinol A Creme Total Skin Bleaching Serum Total Skin Lightening Serum Total Rejuvenating Hand Creme SPF15 Ageless The Max and Ageless The Max Creme

A daily hydrating product line for sensitive, dehydrated and rosacea prone skin. Soothes skin irritation and nourishes tired and dry, dull looking skin. High in anti-oxidants for ultimate protection and nutrition

• • • • •

Hydrating Facial Cleanser Hydrating Anti-Ageing Serum Hydrating Repair Crème Hydrating Enzyme Masque Hydrating Eye Recovery Gel and Hydrating ACE Serum

OrMedic™

Ormedic™ combines highly potent anti-oxidants with organic ingredients. It is designed for all skin types, including post-treatment skin and irritated skin injured by aggressive treatment regimes as well as post operative wound healing phases

• • • • • •

Balancing Facial Cleanser Balancing Anti-Oxidant Serum Balancing Bio Peptide Creme Balancing Eye Lift Gel Soothing Gel Masque Lip Enhancement Complex

Clear Cell™

A highly effective line to fight acne, reduce inflammation, eliminate excess oil and purify skin

• • •

Salicylic Gel Cleanser Salicylic Clarifying Tonic and Clarifing Pads Medicated Acne Lotion,Medicated Masque and Medicated Scrub

Sun™ offers a range of moisturisers catered to different skin types. These outstanding moisturizers also offer UVA/UVB environmental protection.

• • • •

Solar Defense Oil Free Spf 15 and 30 Solar Defense Creme Spf 30 Tinted Solar Defense Organic Spf 30 Solar Defense Organic Spf 30

A line consisting of products developed for promoting a healthy overall well-being. Bronzers for a natural beautiful tan, exfoliating body scrubs to promote skin regeneration and a body firming creme to promote a smooth, tighter looking skin.

• • • • •

Cell-U-Lift Body Firming Creme Body Lightening Lotion Exfoliating Body Scrub Facial Bronzing Creme Body Bronzing Creme

Vital C™

Sun™ Body Spa™

time for your

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PRODUCT ws

Restylane® goes beyond fillers Leading dermal filler brand Restylane® has launched a range of skincare products designed to complement its dermal filler treatments. Restylane® Skincare has been developed to improve the skin’s physiology and function. The products are based on Q-Med’s patented NASHA™ technology and include scientifically proven active ingredients. The range comprises six products for patients’ own daily use to promote healthy, glowing skin. The products also strengthen the skin’s protective barrier and help the healing process, which means they are perfect for use in combination with all aesthetic procedures.

Aestheticare launches DermastamPTM AesthetiCare is pleased to announce the launch of Genuine Dermaroller™ Dermastamp™. The new micromedical skin-needle device is designed to complement Genuine Dermaroller™ Therapy and is used for the treatment of isolated and deeper atrophic scars and lines. The Dermastamp™ is a sterile single use medical device created to repeatedly puncture deep scarring and lines with maximum precision and minimum pressure. Using high quality 2mm micro-medical skin-needles in a 5mm diameter circular arrangement, the Dermastamp™ is perfect for skin regeneration and scar repair for these previously difficult to treat areas. The multiple medical-needle-columns stimulate the regeneration of skin cells, blood vessels and collagen and also helps release tissue tethering the scar and lines. The Dermastamp™ is available individually or in a combination sterile pack with the Genuine Dermaroller™ MF8 1.5mm for the treatment of larger areas of skin that also features deeper scars and lines.

hat trick for carlton The Carlton Group has launched a new product as part of the Carlton Professional range. DermaVisage includes both diamond and crystal microdermabrasion as well as Colour Therapy all in one compact machine. Diamond Microdermabrasion uses two, treatment specific, variable speeds and choice of two diamond tipped heads, which allow the treatment to be tailored for any skin type, from sensitive to oily. Furthermore, there are no consumables, making it a hugely cost effective treatment. Crystal Microdermabrasion uses a controlled flow of ultra clean Aluminium Oxide crystals, which are set in motion using vacuum. DermaVisage works using a ‘closed system’. This means that the crystals only flow when the hand piece is placed on the skin. The Colour Therapy treatment stimulates the skin’s cells to facilitate change. The inclusion of four colours (red, green, blue and yellow) using LED lights and set at varying wavelengths offers a wide range of benefits. Green cools and reduces redness, blue reduces swelling and offers antibacterial effects for the treatment of acne, red rejuvenates and stimulates the lymphatic system, whilst yellow tones and smoothes the skin, as well as promoting the production of collagen. Four pulsed modes are also included which allow the wavelengths to penetrate the skin at different levels providing stimulation for the epidermis, dermis, subcutaneous tissue and deep into the circulatory system.

New Look for SkinMedica SkinMedica has updated its packaging. The beautiful new design features sleek oval tubes, convenient pumps and tamper resistant seals, creating a more uniform look that complements the existing packaging to ensure a seamless transition for each range. The new packaging offers improved functionality and features including a new spray application for toners. SkinMedica’s two signature products; TNS Recovery Complex® and TNS Essential Serum™ are now packaged in luxury metallic gray airless pumps encased in illuminating charcoal cello-wrapped cartons. Each product is labelled with Skin Type and AM/PM to make them more consumer friendly and a moisturisation scale indicates the level of hydration provided. In addition six key products are now available in travel sizes.

cosmeticnewsuk.com

NEWS IN BRIEF Succeev® with new treatment from sanofi sanofi aventis medical aesthetics has launched Succeev®, a new mono-phasic hyaluronic acid filler available to treat fine to deep wrinkles and increase lip volume. Succeev® is available in three simple formulations with different applications for different facial areas and depth of wrinkles. Succeev® One is suitable for fine wrinkles; Succeev® Two is suitable for medium and deep wrinkles and Succeev® Three is suitable for deep wrinkles and to increase lip volume. The treatment can last up to 12 months. Cathy Erwin, sanofi aventis medical aesthetics brand manager said, “The launch of Succeev® has expanded our aesthetic portfolio and will allow us to offer clinics a range of treatments for patients seeking a non-surgical anti-ageing procedure. Succeev® is ideal for patients seeking an instant result to smooth lines and wrinkles, while our existing collagen replenishment treatment Sculptra® offers patients a more gradual and natural approach for refining their appearance.”

New Skin Camouflage Cream from Varama Varama has launched a new skin camouflage that contains its own setting agent and offers variants for black and Asian skin tones.

The product is easy to apply and involves simply blending two base colours with a drop of concentrated pigment to match each individual skin tone. This also allows patients to adjust the tone of the camouflage cream to take account of changes in skin colour throughout the year. The company has also launched Varama. co.uk, a comprehensive online information resource which tells people everything they need to know about the conditions the cream can be used on, how to select the right products and easy step-by-step guides on how to blend and apply the creams.

UK press launch of Novabel®

Merz Aesthetics held the UK press launch of its new facial shaper, Novabel®, in London last month. The media were invited to a champagne breakfast at LifeSmart at the Albany to find out more about the new product, which was launched to the trade at IMCAS in Paris in January. Novabel® is designed not just to treat localised facial laxity, wrinkles or folds, but also to reshape facial features. Novabel® is a natural and biocompatible polysaccharide extracted from marine algae. Through a patented process, extracted alginate is purified, stabilised and then sculpted nto 3-dimensional, flexible microspheres called Geleons™. According to consultant physician Professor Syed Haq of Plastic Surgery Associates UK and the London Wellness Centre, “Novabel’s flexibility and versatility is remarkable, as is the way that it harmonises so completely with facial tissue. As a physician, it provides a way for me to look not just at specific areas but at the whole face and consider how to restore overall volume and provide facial enhancement.” Dr Michael Prager added, “The patients I injected went straight to photography after treatment. You wouldn’t dare try something like that with an HA filler. I also don’t have to work out which presentations and types of product to use on specific areas. Novabel® can work wherever I need it to.”

INDUSTRY’S ONLY 4-HEAD 3D SCANNER FOR FACE and BREAST PROCEDURES introduced The Aesthetics Show in Las Vegas saw the launch of Axis Three’s new XS-400 scanner, a turnkey system designed to address face, breast, and body procedures. The only 4-position 3D scanner on the market, the XS400 captures anatomically-accurate, 3D images of a patient’s face or body. The hardware and software package enables surgeons and their staff to show patients how they will look post-surgery, using 3D simulation to dramatically enhance the aesthetic consultation experience. Designed to support Axis Three’s current software modules and future development application roadmap, the XS-400 features Color Coded Triangulation (CCT™), a patented capture technology developed in conjunction with Siemens that delivers the industry’s only spatially aware 3D images. “Our team of 3D experts is constantly innovating as demand for preoperative simulations grows,” said Paul Moffett, co-founder and technical director for Axis Three. “We know surgeons need incredibly sophisticated technology that is simple and intuitive to use and this is exactly why we’re introducing the XS-400. With streamlined features, sleek aesthetics, and highly accurate image capture, the system complements the consultation process and brings a new dimension to the patient experience.”

Another dimension

Chromogenex has launched Fusion 3D Lift, an advanced system for non-invasive facial rejuvenation which combines three technologies of laser, acoustic wave and diamond exfoliation to achieve instant face-lift and skin rejuvenation for a natural, more youthful appearance. The treatment is safe, painless and needle free, delivering instant results and long-term facial rejuvenation. A course of six treatments is recommended at one per week, and then once a month as maintenance. Following skin preparation with a powerful diamond tip exfoliator, acoustic wave technology is used to creates channels in the skin to allow deep penetration of a pure hyaluronic gel. Finally a visible infrared laser is used to activate the hyaluron and tighten the skin.

No reaction to Avene

Avene Skincare has launched two new products for allergic and hypersensitive skin. The range includes a cleanser, Tolérance Extrême Cleansing Lotion, and a moisturiser, Tolérance Extrême Anti-irritating Soothing Cream. The products are both suitable in the cases of acute irritation including redness, tightness and stinging following procedures such as laser resurfacing or peeling or when the skin has become intolerant to standard cosmetic products or in the case of skin allergic reactions. Manufactured in a sterile environment, according to a patented procedure, they are free from fragrances, preservatives and irritants. The products are distributed by Pierre-Fabre DermoCosmetique UK.

RevitaLash® Mini

RevitaLash® has introduced a mini version of the much acclaimed product. At half the size of the original 4.10ml version and costing £66, the minime version is the perfect way to introduce yourself and clients to the brand. Utilising the power of peptides and botanicals, RevitaLash® harnesses the TDE Growth Complex, which nourishes lashes back to health.Fruit Extracts are naturally stimulating and rich in fatty acids and provide an excellent source of moisture to feed lashes.

Combination of RF and soya-based creams rejuvenates the skin

Belgian cosmeceutical company NANNIC has introduced the NBE500 – a device it claims is a ‘groundbreaking advance in radiofrequency heat technology’. “It is not the application of radiofrequency in itself but the right size frequency for the skin in combination with specially developed products that make our beauty device different from others” explains Rene Nagels, founder of NANNIC International and creator of the NBE500. “It has already become a celeb favourite in Holland and Sweden and looks set to be equally successful in the UK. Discerning customers are already enjoying rapid results.”

Name change for LaserAid

LaserAid, the well-established brand of cooling hydrogel pads for laser and IPL treatments has been given the new name of HydroPad. Hydropad is well known for its use during laser/ IPL treatments providing pain relief, reducing the effects of heat build up and preventing laser splatter/plume. In addition Hydropad is a sterile, transparent and cooling hydrogel cushion that can be used before and after operations such as face-lifts injections with botox, fillers, hyaluronic acid, etc. or dermabrasions. As a sterile product it may be applied directly on freshly operated skin. It cools the skin, relieves pain, calms the patient and absorbs exudate where necessary. The products are distributed by Laser Physics.

cosmeticnewsuk.com

Best Practice | Finance

Ontheup

Chartered accountant and tax expert Shen Yap on what the coalition Government’s emergency budget could mean for you and your business

Shen Yap is a partner of Barnes Roffe LLP, a ‘Top 50’ firm of chartered accountants, with particular expertise in tax. Having joined the firm as a trainee in 1998, Shen qualified as a Chartered Accountant in 2001. Shen has extensive experience in advising clients on maximising their returns, through business consultancy, and tax saving strategies. More recently, Shen has been advising clients in the healthcare industry, who he feels have been starved of specialist tax advice.

As I write this article, I am staring at a crystal ball trying to predict what the new Coalition Government will announce in their Emergency Budget on June 22. As you read this though, all shall have been revealed by our new Chancellor George Osborne. One thing is for sure – the tax burden on every taxpayer is going just one way – yes, you guessed it – up, up and up! What, where, how and when is anyone’s guess (at the time of writing that is). It is easy to understand why. For 2009, the country’s budget deficit stood at over £159 billion or around 11.4% of the gross domestic product (“GDP”) of the country. At the end of 2009, our debt was at £950 billion, or around 68% of our GDP. Compare this to Greece and its problems – deficit of around 13% and debt approaching 120% of GDP. Indeed, our debt is at a level which is still manageable (phew!) but the fact is, such a large deficit is unsustainable and must be tackled as soon as possible to prevent a downgrade of the country’s sovereign debt status – itself a cause of more problems. Recently, the two leading credit ratings agency, Standard and Poor’s and Fitch, indicated that there is a serious risk that the UK might lose its AAA rating unless the deficit is reduced more aggressively. So what can the Government do to reduce the deficit, which is forecast to exceed £160 billion in 2010? There is not much that can be done about the cyclical deficit, which is estimated to make up around half the overall deficit – this ‘naturally’ occurs in a recession and as the economy comes out of recession and grows, then this generally reverses itself. However, the Government is expected to tackle the structural deficit, the other half of our overall deficit of £160 billion. Economists are expecting a reduction of around £30 billion (of the £80 billion), which should mean that if and when the cyclical deficit reverses itself, this would leave us with an overall deficit of around £50 billion (or around 3% of GDP) – seen as a sustainable level. This conveniently leads me back to my surety above – that taxes are only going to go higher. Why? Because there are principally only two ways for the Government to reduce the structural deficit – cut spending and increase taxes. We have already heard about the £6 billion cut in spending and a full spending review. Now we have the increase in taxes... Here are my predictions. If you would rather not assess how accurate (or indeed how wild) my predictions have turned out to be, skip straight to my tax planning tips – otherwise read on!

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HIGH TECHNOLOGY • GREATER SAFETY GREATER PURITY • GUARANTEED RESULTS

Renew beauty naturally and safely... RENNOVA® Fill is a sterile gel, monophasic cross BDDE linked (1,4 - butanediol diglycidyl ether) with a hyaluronic acid, obtained through bacterial bio-fermentation. It is completely viscoelastic, biocompatible, homogeneous, transparent and resorbable. It has results with long-lasting effects. Easier application, greater lifting effect and greater security. Thanks to its high-tech manufacturing, RENNOVA® offers more visible and longer lasting results. RENNOVA® was developed and is manufactured by one of the largest pharmaceutical companies in Europe, which has been operating in the pharmaceutical market for more than 30 years, specifically with hyaluronic acid based products for use in ophthalmology, orthopedics and dermatology. It has a history of more than 15 million treatments sold around the world. Thanks to the new XPM Tech® technology, RENNOVA® is submitted to processes that make the gel’s tridimensional molecular structure even more even, stabilized and elastic, with new definite molecular “bridges”, extremely important characteristics for providing a greater lifting effect, greater duration and greater aesthetic results. New technology

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www.magroup.co.uk For further information about RENNOVA® call Medical Aesthetic Group on 02380 676733 or visit www.magroup.co.uk

Best Practice | Finance

Likely scenario Personal tax rates – 20%, 40% and 50% (marginal rate of 60%(!!!) due to loss of

lives only to find their estate subject to further [inheritance] tax!;

personal allowance for taxpayers earning more than £100,000);

Pension contributions tax relief restricted to basic rate for taxpayers earning

Personal allowance – £6,475 for now; from April 2011, probably around £7,500

more than £150,000 – threshold likely to be reduced to a lower amount such

to £8,000, increasing to £10,000 over time;

that the restriction will apply to more taxpayers;

Income Tax bands – some tampering of the tax bands more than likely so

Corporation tax – small company tax rates at 21% and large company tax

that more people become higher rate taxpayers faster!;

rates at 28%; from April 2011, small company rates to reduce to 20% and large

National Insurance rates and thresholds – increase for employers, but

company tax rates to reduce to 25%;

no increase for employees (unsurprisingly, this will be championed as the

Allowances and reliefs for companies – simpler system, but less generous;

elimination of the ‘jobs tax’); thresholds likely to be changed such that more NI

the reduction in the headline rates (21% to 20% and 28% to 25%) seen to be

is collected overall; this could generate around £5 billion

enough of an incentive;

Capital gains tax – a return to the taper relief regime, which means generous

Value Added Tax – an increase to 20% from 1 January 2011, but with a re-

reliefs and low effective rates of tax for business assets, but higher rates for non-

defined basket of goods ‘enjoying’ lower rates of VAT (these will most likely be

business assets; this means that if you sell your business, you may still qualify for

the basic necessities); this can potentially generate around £12 billion!

the low rates of 10% or 18% on the gain, but if you sell a second house, it may be taxed at 40% or 50%; this is likely to generate around £4 billion

The ‘elephant in the room’ is VAT. At the time of writing, there is noted silence

Inheritance tax – no changes to existing rate of 40% and Nil Rate Band of

from the Coalition Government on whether VAT rates will increase. However,

£325,000; this is obviously bad news for taxpayers who have paid taxes all their

most, including yours truly, see this as inevitable...

SOME TAX PLANNING POINTS

Remuneration planning

Even if my predictions are not spot on, it will

Along the same principle as above, observe

Capital gains and Estate planning

become undeniable that higher taxes are here

the disparity between the application of

You have accumulated wealth and invested

and they are here to stay for a few years yet.

National Insurance to different types of

it wisely. With the change in capital gains tax

income. Salary attracts National Insurance

rules and the stagnation in Inheritance Tax

Another undeniable fact is that the income

contributions. Dividends do not. It therefore

‘tax free’ bands, be prepared to re-visit the tax

tax rates (at up to 50%!), are much higher than

follows that dividends are typically more

profile of your investment assets.

corporation tax rates (at up to 28%), which leads

efficient in an environment where NI rates are

me to the first tax planning point.

going only one way.

Incorporate or not

Remember also that every taxpayer has their own

benign vehicle like a company! It will only ever

Do you operate under a corporate veil?

personal allowances and tax bands. If possible, it

be taxed at corporate tax rates, which we have

Whatever your reasons for not operating your

certainly makes sense to spread income around

already established is much lower! Consider trusts

business under a corporate veil, you now have

more than one taxpayer such that exposure to the

for estate planning.

another factor to consider – taxes. The potential

higher rates of tax are minimised.

tax savings under a corporate structure has

Rates are likely to reach 40% for capital gains, so do consider housing your assets in a more tax

Stay compliant – perform health checks

difference between personal tax rates and

Corporate and business structure

corporation tax rates. Believe you me, the

Do consider the efficiency of your business or

million business, prevention is better than

maths show savings in the thousands. Add this

group structure. I have seen a variety of cases

cure or rather, in dealings with HM Revenue &

to the possibility of gaining access to funds at

where inefficient structures have resulted in

Customs (HMRC), ‘compliance is better than

10%. Add to that the benefit of having limited

extra tax being paid unnecessarily.

penalties’.

the compliance cost of running a company is

If you have a group of companies, has the

HMRC, in their quest for additional revenues, will

paled in significance.

overall group tax profile been considered to

no doubt seek to impose heavier penalties where

establish if reliefs and claims are made to the

there is evidence of non-compliance. Understand

If you are still keen on keeping your existing business

benefit of the group as a whole? Are assets

the rules and implement controls to ensure that

structure, have you considered a corporate

and business structured in the most appropriate

compliance is met, be it PAYE and NIC, VAT,

member in a partnership?

company? Does the structure lend itself to the

corporation tax or income taxes.

become increasingly attractive due to the

Finally, whether you are a £100,000 or a £100

liability protection. It soon become clear that

easy (and tax efficient) disposal of any part?

whether you are a £100,000 or a £100 million business, prevention is better than cure, or rather, in dealings with the HMRC, compliance is better than penalties 38

cosmeticnewsuk.com

SUMMARY Higher taxes are here to stay. Lower post tax net income is therefore more than likely. How much of an impact this will have on your business is an unknown for now, but ignore it at your peril. For the tax conscious of you, tax planning will never be more important. My final gaze into the crystal ball revealed another prediction: a clamour for the phone to speak to your accountant and tax advisor!

New e-clinic launches this month 20% off pre-orders! Includes all the features you know and love, plus: • Postcode lookups for faster addresses • Online credit card processing • Stock control with barcode support • Drag and drop photos and scans • Targeted marketing by text and email • Reports with visual graphs

Call 01274 530505 for your free demo CD or email sara@e-clinic.uk.com

Web Management | Microsites

micro management

Ron Myers on using microsites as part of your web marketing strategy

As the home pages of websites become more cluttered with menu bars, banners and images it can become confusing for a consumer with a specific requirement to quickly get to the information that they require. This is becoming increasingly evident with full service medical aesthetic clinics who are marketing treatment solutions for multiple problems ranging from excessive hair to age spots, acne scarring to wrinkles, cellulite reduction, fat loss etc. etc.!

Ron Myers has more than 13 years experience in the pharmaceutical industry in a variety of sales and marketing, sales management and business development roles working for Smith Kline Beecham, Novartis, and Allergan Pharmaceuticals. Ron was involved in the launch of Botox® and M.D. Forté® glycolic peels into the UK market place in 1994. He set up a specialist consultancy service in 2002 with business partner Martyn Roe. Since then they have been busy working on a variety of high profile projects in the aesthetics industry, including the development of Wigmore Medical’s concept as a specialist aesthetic distributor; the launch of the Facial Aesthetic Conference and Exhibition (F.A.C.E.); business development projects with individual medical aesthetic clinics and website design and development – including e-commerce sites and the launch and management of MediZen – a non-surgical medical aesthetic clinic - in conjunction with Dr David Eccleston. In addition Ron and Martyn developed www.consultingroom. com – launched in 2003, and now the largest specialist aesthetic information website in the UK, and winner of “Best Aesthetic Patient Information Website” at the 2008 Aesthetic Medicine Awards.

If a potential customer types ‘laser hair removal clinic’ into a search engine – the link that they click on to reach your website should direct them straight to the relevant page for the solution they are seeking. Does this page just give generic information on how laser hair removal works? – Or does it have compelling copy as to why they should do business with you, rather than a local competitor, alongside a ‘call to action’ telling them what do to if they’re interested? Microsites can help to address the problem of too much information on your main website and provide a route to deliver a more compelling and focussed message.

A cluttered site can frustrate some consumers and cause them to leave

What is a microsite? The world of web marketing is littered with confusing jargon – but a microsite is a simple concept to grasp as it is a small website ranging from a single page, to several linked pages focusing on a specific service or product that you offer. The features of a microsite are that it focuses on the benefits of the specific product or service, outlines a few key points about why you might be different from your local competition and has a very visible “call to action” with a telephone number and web enquiry form. In

cosmeticnewsuk.com

A complete range of Medical Systems from Lynton essence, it’s more akin to a single page advertisement that you might use in a magazine to sell a specific service – and a great example of this is currently being used by sk:n, one of the largest and most successful groups of clinics in our industry.

Lynton has been a leading UK manufacturer and supplier of light-based aesthetic and medical treatment systems since 1994, with products and services widely adopted into private hospitals, cosmetic clinics and aesthetic centres for a range of treatments including hair and tattoo removal, leg veins and the treatment of a wide range of other vascular and pigmented lesions.

Are there any other advantages to owning a microsite?

LUMINA-Q The flexible dermatological tool-box with Intense Pulsed Light, Laser and Q-Switched Laser technology • Deep & superficial vascular lesions • Permanent hair reduction • Superficial & dermal pigmentation • Photorejuvenation and active acne treatments • Tattoo removal using active Q-Switched laser • Interchangeable Lightguide (ILG) Technology • Fast and east control via Touchscreen Interface • Optional Patient Database

Probably the main other advantage of a properly constructed and optimised microsite is that they can give you additional separate presence in search engine results alongside your existing website. The more separate listings you can get in search engines, the more likely it is that a consumer will click on your link and discover your clinic. We recently built a microsite for a Dentist in Ireland focussing on the different teeth whitening procedures that she used. Built around the domain name – www.teethwhiteningdublin.co.uk , this site now comes higher in search engine listings for keywords such as ‘teeth whitening

LIGHT SERIES

Dublin’ and ‘Zoom laser teeth whitening Dublin’ than her main website.

The latest multifunctional Alexandrite, KTP and Nd:YAG Laser Platforms • Long Pulse Laser Platform System • YAG/Alex for ultimate hair removal on all skin types • YAG/KTP for complete vascular solution • Port Wine Stains • Leg Veins, Rosacea • Pigmented Lesions • Spot sizes up to 16mm • Integrated Contact Cooling (optional)

The site is very focussed on different teeth whitening options and does not contain information on other services such as veneers, implants, crowns etc. Some people build microsites with a number of pages that are content rich on a very specific niche area – www.thread-veins.co.uk is an example used by a surgeon who is clearly using this to show that he is a specialist and has specific expertise in this area.

Summary Microsites are a flexible, simple, cost-effective and powerful concept in

LUMINETTE ADVANCE

terms of maximising calls to your business. As the aesthetic market has

Desk-top medical aesthetic Intense Pulsed Light System • Compact and portable • Ideal first IPL System • Multiple IPL Treatments • Hair Removal and Acne Treatments • Skin Rejuvenation Treatments • Pigmented and Vascular Lesion Treatments • Interchangeable Lightguide (ILG) Technology • Optional printer for instant patient records

matured, it has become increasingly competitive, and the Internet, more than any other marketing tool, has become the “battle ground” where new clients are won – or lost! Put yourself in the shoes of your customers and type in the words that people will use to find your service – see how much competition there is. Are you on the first page of the search engine? Do you stand out from the crowd? Is your message concise and compelling? The plethora of different web marketing techniques is growing at an exponential rate, and it can be difficult to know how and where to invest your time and money in this confusing field. A properly constructed microsite can be built and launched in a matter of days, is normally easier to amend and test different marketing messages and offers than your main website and can really “give you the edge” over your local competition in attracting new customers.

www.lynton.co.uk

For more information on web marketing and costs of microsites,

For further information or to book a demonstration please call 0845 612 1545 or email info@lynton.co.uk

please visit www.consultingroomservices.com

lynton-halfCNjuly10.indd 1

28/05/2010 16:10:06

Business Focus | Marketing

In the second part of our series on the four Ps of marketing Zoe Davitt explains the importance of ‘place’

In our last article, we looked at the first of the classic 4 P’s of marketing, price. We gave some advice on feesetting, and explained how you could use pricing to influence purchase behaviour – for example by running special offers on non-surgical treatments or offering payment plans. This month, we are looking at the second of the classic 4P’s – place. For the purposes of this article, we are defining this as your premises – namely the location of your clinic, and how it is presented to your patients. You may think this has little to do with the quality of your treatments, and of course you would be right, but to patients it is important – it plays a significant role in their perception of you and your clinic and it is this perception that influences their decision on whether to have treatment with you or elsewhere. It can also determine how much they are prepared to pay. If you need convincing, consider what the customers of up-market stores such as Harvey Nichols and Selfridges are paying for. It’s not just the latest fashion item they want, it’s the ambience of the store and Zoe Davitt is marketing director at Blue Horizons. She has a strong background in marketing and customer service, giving her a perfect combination of skills and expertise. Her many business-orientated qualifications include ones from the CIM (Chartered Institute of Marketing), and she has a wealth of experience across many sectors including medicine, dentistry, recruitment, tourism, hotel management and facilities management.

the whole shopping experience.

Location In the aesthetic medical sector, location is not always something you get to choose. Many surgeons hold consultations and carry out procedures in private hospitals such as those run by BUPA and Nuffield. But while treating patients in such establishments makes perfect sense, holding your consultations there is not always the best way forward. The facilities at private hospitals are usually fantastic, but the consultation rooms, while adequate, are pretty impersonal. They are usually shared by a number of consultants in a number of specialities, and, to a lay person, are not that different from a GP’s surgery. We’re not saying there is anything wrong with this set-up - if this is how you currently work, and you are happy with the amount of patients you attract and the fees they pay, then clearly you don’t need to change anything. However, if you would prefer to be able to attract a higher class of patient and to be able to charge more for your services, then you may want to consider holding your consultations in a higher prestige environment.

cosmeticnewsuk.com

“As you can see, the key is to find a location that appeals to the clients you want to attract. Being near to other places they might regularly visit offers the advantage that you may attract their attention as they pass by, plus they will feel more comfortable in environs with which they are familiar.”

For London-based surgeons, this often means Harley Street and its environs. For those outside the capital, you need to look for areas that attract the high-spenders – leafy squares with fantastic architecture, the sort of place you would find the very best solicitors and accountants. Conversely, if you would prefer to attract younger patients, you may find that a more popular, fashion-conscious environment would work well. Somewhere in a city centre, perhaps, where the trendier, more expensive boutiques and cafes are located. As you can see, the key is to find a location that appeals to the clients you want to attract. Being near to other places they might regularly visit offers the advantage that you may attract their attention as they pass by, plus they will feel more comfortable in environs with which they are familiar.

Dècor Just as the location of your clinic and/or consulting rooms should appeal to your target patient, so should the exterior and interior decor. It is pointless, for example, having a clinic in a hip and trendy part of town in the hopes of attracting young, image-conscious patients, if you then make the inside look like a gentlemen’s club or a page from a Laura Ashley catalogue. It goes without saying that your premises need to be fresh and clean – anything less is, to put it bluntly, quite unacceptable in the medical aesthetic sector. So no chipped paint or peeling wallpaper, no stained chairs or carpets – everything needs to look well cared for. Outside, ensure that, again, the property looks well cared for, and that any decorative items are in keeping with the architecture and environment. Keep fixtures and fittings polished, windows sparkling, and the front area litter free. We know that these are obvious, but unfortunately there are a lot of people, in all sectors, who pay absolutely no attention to these and then wonder why they are not attracting their wished-for clientele.

The finishing touches Adding a few well-thought-out finishing touches can give your practice a real ‘wow’ factor, and has the potential to boost both your enquiry-treatment conversion rate, and your word-of-mouth referrals. The aim is to create an environment that not only satisfies your patients, but surprises and delights them. This makes your practice memorable, and therefore more likely to become a patient’s practice of choice. It also means that those patients who are happy to admit they have used your services are more likely to talk about you and recommend you to their friends. These finishing touches don’t need to cost a fortune, they simply need to help set your practice apart from all the others.

Hopefully the days of old dog-eared

have a real feel-good factor about them.

magazines are well and truly gone by now,

As well as having them in your reception

but if you are guilty of not replenishing

area, consider putting them in less obvious

the reception area reading material as

places – it may sound silly, but we are

regularly as you could, do something

always impressed when we find fresh flowers

about it. You can save time, money and

in a bathroom.

effort by subscribing to monthly magazine packs if you wish. Make sure the magazines

Don’t forget to do all you can to make

you choose are those that your clients

your patients feel comfortable and valued.

would choose. Those aimed at people in

Expensive toiletries in the bathroom always

their early 20s will not appeal to clients who

go down well (some clinics even offer a

are somewhat older!

choice of top perfumes!). Hot and cold beverages are a must – consider how

Art always gives a good impression –

you serve them as well – fine china for

again, ensure it is appropriate for your

discerning older patients, funky designer

patients and of course your environment.

labels for younger ones. In short, your goal is

You may wish to consider giving local

to create a highly favourable impression of

artists the opportunity to use your practice

your practice in the minds of the right type

walls as an informal gallery to add extra,

of actual and prospective patients, so that

ongoing interest.

they choose you and your practice over and above anyone else’s.

Fresh flowers can make a big difference –

Next month we turn to the third of the

they are attractive and welcoming, and

classic 4 P’s, Product.

Dates for the Diary July 1-2 Two Days Skin Rejuvenation (Micro Needling) Canterbury, www.finishingtouchesgroup.com 2-4 FACE, Royal College of Physicians, www.faceconference.com 3 The Aesthetic Industry Summer Ball, Natural History Museum, info@face-ltd.com 3-4 Foundation Botox and Dermal Fillers, Birmingham, www.medicsdirect.com 5 Advanced Skin Rejuvenation and Cellular Health - Level One, NEC Birmingham, order@medicobeauty.com 5 Innomed Training Advanced Aesthetics (Botulinum Toxin and Dermal Fillers) – New Users, Southampton, www.innomedtraining.co.uk 5-6 July Two Days Pigment Removal Training Haywards Heath, www.finishingtouchesgroup.com 5-8 Five Days Cosmetic Tattooing Diploma Course Manchester, www.finishingtouchesgroup.com 5-10 Aesthetox Academy Bespoke Training Week (at your own clinic), www.aesthetox.co.uk 6 Introduction to Obagi with Shannon Lister, London, www.healthxchange.com/obagi-training 6 Wigmore Medical Training NeoStrata Peels, London, www.wigmoremedical.com 7 Intraderm Basic Botulinum Toxin Course, Leicester, www.intraderm.com 7 Obagi Intermediate Course with Shannon Lister, Manchester, www.healthxchange.com/obagi-training 8 Intraderm Basic Dermal Filler Course, Leicester, www.intraderm.com 8 Wigmore Medical Training Sculptra, London, www.wigmoremedical.com 10 Boston Medical Group Revanesse & Redexis Dermal Fillers Training, www.boston-medical-group.co.uk 10-11 Breast Aesthetics and Reconstruction, University Hosptial, Coventry, www.plasticsurgeryuhcw.org.uk 10-12 International Master Course on Aging Skin, Hong Kong, www.imcas.com

We round up upcoming events, training courses and meetings

12-15 Five Days Cosmetic Tattooing Diploma Course Droitwich, www.finishingtouchesgroup.com 12-16 Mapperley Park Btec Award Laser, Light and Associated Aesthetic Therapies, www.mapperleypark.co.uk/training 13 SkinBrands Training: Medik8, Ireland, www.SkinBrands.co.uk 14 Mapperley Park Master Class Tattoo Removal, Nottingham, www.mapperleypark.co.uk/training 14 Wigmore Medical Training Introduction to Skincare Peels and Derma Roller, London, www.wigmoremedical.com 14 Skin Geeks: Introduction to Clinical Skincare, London, www.skingeeks.co.uk 14-15 SkinBrands Training: SkinCeuticals, Ireland, www.SkinBrands.co.uk 15 SkinBrands Training: Susan Posnick and Revitalash, Ireland, www.SkinBrands.co.uk 15 Wigmore Medical Training Introduction to Botulinum Toxin Type A, London, www.wigmoremedical.com 16 SkinBrands Training: SkinMedica, Ireland, www.SkinBrands.co.uk 16 Wigmore Medical Training Introduction to Fillers, London, www.wigmoremedical.com 17-18 Foundation Botox and Dermal Fillers, Belfast, www.medicsdirect.com 19 Dr Bob Khanna Training Institute, Beginners Botulinum Toxin, www.drbobkhanna.com 19 The Obagi Masterclass and Designer Blue Peel with Dr Fred Coville, Manchester, www.healthxchange.com/obagi-training 19-20 CosMedix Corrective Skin Peels Level One and Two, Kensington, London, order@medicobeauty.com 19-21 Three Days Medical Masterclass Haywards Heath, www.finishingtouchesgroup.com 20 The Obagi Masterclass and Designer Blue Peel with Dr Fred Coville, Birmingham, www.healthxchange.com/obagi-training 20 Dr Bob Khanna Training Institute, Advanced Botulinum Toxin, www.drbobkhanna.com 21 Dr Bob Khanna Training Institute, Beginners Dermal Filler, www.drbobkhanna.com

21 Skin Geeks: Product Knowledge, London, www.skingeeks.co.uk 21 The Obagi Masterclass and Designer Blue Peel with Dr Fred Coville, London, www.healthxchange.com/obagi-training 22 The Obagi Masterclass and Designer Blue Peel with Dr Fred Coville, London, www.healthxchange.com/obagi-training 24 Innomed Training Chemical Peeling Systems – New Users, London, www.innomedtraining.co.uk 25 Innomed Training Mesotherapy for Fat, Cellulite and Skin Rejuvenation – New Users, London, www.innomedtraining.co.uk 25-26 Advanced Botox and Dermal Fillers, Belfast, www.medicsdirect.com 26 Skin Peels, Belfast, www.medicsdirect.com 26-30 VASER® Training, www.granthamlet.co.uk 27-28 SkinBrands Training: SkinCeuticals, London, www.SkinBrands.co.uk 28 Skin Geeks: Introduction to Clinical Skincare, Oxford, www.skingeeks.co.uk

August 2 Genuine Dermaroller™ Training, Manchester, elizabeth@aestheticare.co.uk 2-5 Five Days Cosmetic Tattooing Diploma Course Canterbury, www.finishingtouchesgroup.com 4-8 AAD, Chicago, www.aad.org 7 Innomed Training Botulinum Toxin in Facial Aesthetics – New Users, Southampton, www.innomedtraining.co.uk 8 Innomed Training Dermal Fillers – New Users, Southampton, www.innomedtraining.co.uk 9-12 Five Days Cosmetic Tattooing Diploma Course Newry, www.finishingtouchesgroup.com 14-15 Foundation Botox and Dermal Fillers, Manchester, www.medicsdirect.com 16-19 Five Days Cosmetic Tattooing Diploma Course Yorkshire, www.finishingtouchesgroup.com

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DIRECTORY ABC Laser Contact: Guy Gouldsmit T: 08451 707 788 E: info@a-b-c-uk.com W: www.abclasers.co.uk

Eden Aesthetics Contact: Anna Perry T: 01245 227 752 E: info@edenaesthetics.com W: www.edenaesthetics.com

Morning Star Surgical S.A. (Pty) Ltd Contact: Brian Nielsen T: +27 (82) 667 2506 E: brian@morningstar-medical.com W: www.morningstarsurgical.co.za

ABME Tech Contact: David Leahy T: 01843 297110 E: david.leahy@abmetech.com W: www.abmetech.com

Energist Contact: Andrew Snoddon T: 01792 798768 E: enquiries@energist-international.com W: www.energist-international.com

My Cells/Scandinavian UST Ltd Contact: John Tucker T: +35361 312979 E: info@mycells.ie W: www.my-cells.net

Allergan Contact: Customer Service T: 01628 494444 W: www.juvedermultra.co.uk

Ericson Laboratoire Contact: Mike Filapiuak T: +44 02076296269 E: mike@ericson-laboratoire.co.uk W: www.ericson-laboratoire.com

Barnes Roffe LLP Service: Chartered Accountants, Business and Tax Advisors Contact: Shen Yap T: 020 8988 6100 E: s.yap@barnesroffe.com W: www.barnesroffe.com

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Blue Horizons Marketing T: 01242 236600 E: info@bluehorizonsmarketing.co.uk W: www.bluehorizonsmarketing.co.uk Services: Websites, patient literature, referral literature, brand image, advertising, e-marketing and more. Boston Medical Group LTD Contact: Iveta Vinklerova T: 0207 727 1110 E: info@boston-medical-group.co.uk W: www.bostonaestheticsclinic.co.uk Candela UK Ltd Contact: Ben Savigar-Jones T: +44 08455210698 E: alex@alexsilver.co.uk W: www.candelalaser.co.uk Cordcourt Limited Service: Uniform Supplier Contact: Gina Unsworth T: 0161 724 6009 E: sales@cordcourt.co.uk W: www.cordcourt.co.uk Cosmedix Contact: Aysha Capion-Awward T: 0844 855 2499 E: info@cosmedix.com W: www.cosmedix.com Cosmetic Courses Contact: Morag Hague T: 0845 230 4110 E: info@cosmeticcourses.co.uk W: www.cosmeticcourses.co.uk Cutera (Europe) Contact: Deborah Mechaneck T: 07711954740 E: dmechaneck@curtera.com W: www.cutera.com

Hamilton Fraser Contact: Wai Chan T: 0845 3106 300 E: cosmetic@hamiltonfraser.co.uk W: www.hamiltonfraser.co.uk Health xchange Contact: Customer Service T: +44 1481 736832 E: orders@healthxchange.com W: www.healthxchange.com LCS Academy Contact: Dr Elizabeth Raymond Brown T: 0845 0037315 E: admin@lcsacademy.co.uk W: www.lcsacademy.co.uk Lynton Contact: Customer Services T: 0845 6121545 E: info@lynton.co.uk W: www.lynton.co.uk Lifestyle Aesthetics Contact: Sue Wales T: 0845 0701 782 E: info@lifestyleaestheics.com W: www.lifestyleaesthetics.com

Polaris Lasers Contact: Neil Calder T: 01234841536 E: njc@polaris-laser.com W: www.polaris-laser.com Q-MED Contact: Customer Service T: 02079 763240 E: info.uk@q-med.com W: www.q-medpractitioner.com.uk RECOVA COMPRESSION GARMENTS Contact: Eva Sanchez-Smith E: eva.sanchez@recovapostsurgery.com W: www.recovapostsurgery.com T: 0207 000 1044 Sanofi Aventis Contact: Customer Service T: 01483 554 809 W: www.sanofi-aventis.co.uk Skin brands Contact: Tracey Beesley T: +44 (0) 2089978541 E: tracey@skinbrands.co.uk W: www.skinbrands.co.uk Skin Geeks Ltd Contact: Trishna Shah T: +44 (0)1865 338046 E: trishna@skingeeks.co.uk W: www.skingeeks.co.uk Specialist Make-Up Services Ltd Contact: Mike Lawrence T: 0845 2302021 E: enquiries@permanent-makeup.com W: www.permanent-makeup.com Services: Permanent Make-Up

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Medical Aesthetic Group Contact: David Gower T: 02380 676733 E: info@magroup.co.uk W: www.magroup.co.uk

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For less than ÂŁ25 per month, you can list your company details here. For more information contact Hollie Dunwell 01268 754897/ hollie@creativemedialtd.co.uk 46

cosmeticnewsuk.com

Think you can’t have it all? Now you can… Inspired by nature, perfected by science – Novabel® heralds a new era in non-permanent facial aesthetics. Purified from marine algae, Novabel’s unique GeleonTM technology has given rise to a dermal shaper that is ultra-gentle, yet has the power to shape, contour and define skin across all facial indications – an exceptionally versatile solution. Who says you can’t have it all? Please contact info@merzaesthetics.co.uk to find out more about Novabel –

the gentle, powerful, versatile dermal shaper

Date of preparation: February 2010 NOV002/0210/KV

Merz Pharma UK Ltd 260, Centennial Park, Elstree Hill South, Elstree, Hertfordshire, WD6 3SR Customer Services: +44 (0)333 200 4140 Fax: +44 (0)208 236 3526 Email: info@merzaesthetics.co.uk

You know where to inject. You know how much to inject. You’re conﬁdent she’ll be happy. • • • •

Provides precise1 and predictable2 treatment results A unique formulation you can trust High levels of patient satisfaction3 Four years4 experience in the UK with 900,000 treatments and 11 million procedures worldwide

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Vistabel® (botulinum toxin type A) Abbreviated Prescribing Information Presentation: Botulinum toxin type A (from clostridium botulinum), 50 Allergan Units/vial. Temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at frown, in adults <65 years, when the severity of these lines has an important psychological impact for the patient. Dosage and Administration: See Summary of Product Characteristics for full information. Do not inject into blood vessels. Doses of botulinum toxin are not interchangeable between products. Not recommended for patients <18 or >65 years. Use for one patient treatment only during a single session. Reconstitute vial with 1.25ml of 0.9% preservative free sodium chloride for injection (4U/0.1ml). The recommended injection volume per muscle site is 0.1ml (4U). Five injection sites: 2 in each corrugator muscle and 1 in the procerus muscle: Total dose 20U. Contra-indications: Known hypersensitivity to any constituent. Myasthenia gravis, Eaton Lambert syndrome. Infection at proposed injection sites. Pregnancy or lactation. Warnings/Precautions: Use for one patient treatment only during a single session. Relevant anatomy and changes due to prior surgical procedures must be understood prior to administration. Product contains less than 1mmol sodium (23mg) per dose. Do not exceed recommended dosages and frequency of administration. Epinephrine (adrenaline) or any other anti-anaphylactic measures should be available. Very rare reports of adverse reactions possibly related to spread of toxin distant from site of injection. Therapeutic doses may cause exaggerated muscle weakness. Caution in patients with history of dysphagia and aspiration. Patients or caregivers should seek immediate medical care if swallowing, speech or respiratory disorders arise. Too frequent or excessive dosing can result in risk of antibody formation, which may lead to treatment failure. Caution in the presence of inflammation at the proposed injection site(s) or when excessive muscle weakness or atrophy is present. Caution when used in patients with amyotrophic lateral sclerosis or with peripheral neuromuscular disorders. Effects of administering different botulinum toxin stereotypes simultaneously, or within several months of each other, is unknown and may cause exacerbation of

excessive neuromuscular weakness. Interactions: Theoretically, the effect may be potentiated by aminoglycoside antibiotics or other drugs that interfere with neuromuscular transmission. Adverse Effects: See Summary of Product Characteristics for full information on side effects. Based on controlled clinical trial data, the proportion of patients that would be expected to experience an adverse reaction after treatment is 23.5% (placebo: 19.2%). These adverse reactions may be related to treatment, injection technique or both. In general, reactions occur within the first few days following injection and are transient and of mild to moderate severity. Pain/burning/stinging, oedema and/or bruising may be associated with the injection. Frequency By Indication: Defined as follows: Very Common (≥1/10), Common (≥1/100, <1/10), Uncommon (≥1/1,000, <1/100), Rare (≥1/10,000, <1/1,000), Very Rare (<1/10,000). Infections and infestations. Uncommon: Infection. Psychiatric disorders. Uncommon: Anxiety. Nervous system disorders. Common: Headache. Uncommon: Paresthesia, dizziness. Eye disorders. Common: Eyelid ptosis. Uncommon: Blepharitis, eye pain, visual disturbance. Gastrointestinal disorders. Uncommon: Nausea, oral dryness. Skin and subcutaneous tissue disorders. Common: Erythema, Uncommon: Skin tightness, oedema (face, eyelid, periorbital), photosensitivity reaction, pruritus, dry skin. Musculoskeletal and connective tissue disorders. Common: Localised muscle weakness, Uncommon: Muscle twitching. General disorders and administration site conditions. Common: Face pain, Uncommon: Flu syndrome, asthenia, fever. The following have been reported rarely for glabellar lines and other indications: Rash, urticaria, pruritus, erythema multiforme, psoriasiform eruption, anaphylactic reaction (angiodema, bronchospasm), alopecia, madarosis, tinnitus and hypoacousia. Adverse reactions possibly related to spread of toxin distant from injection site have been reported very rarely (muscle weakness, dysphagia, or aspiration pneumonia which can be fatal). Price: £85.00 per vial. Marketing Authorization Number: PL 05179/0010 Marketing Authorization Holder: Allergan Pharmaceuticals (Ireland) Ltd., Westport, Co. Mayo, Ireland. Legal Category: POM. Date of preparation: December 2008.

Adverse events should be reported. Reporting forms and information can be found at www.yellowcard.gov.uk Adverse events should also be reported to Allergan Ltd. UK_Medinfo@allergan.com or 01628 494026 1 De Almeida A et al; Dermatol Surg 2007 Jan; 33 (Suppl1); S37-43 2. De Maio M, Expert Approaches to Using Botulinum Toxins, Issue 5, Nov 2006 * Botulinum Toxin from Galderma is identical in formulation to botulinum toxin from Ipsen. 2 Carruthers A, Carruthers J, Lowe NJ et al, Journal of Clinical Research, 2004; 7: 1-20. 3 Stotland MA, Kowalski JW, Ray BB, Plastic and Reconstructive Surgery, Volume 120, October 2007; 5: 1386-1393.4 First EU launched 2004. 5 Data on file, Allergan, Inc.; Safety Analysis. Date of preparation: April 2010, UK/0334/2010