CN-OCT-2010b by webwax

The uk’S only fRee of ChARge MeDiCAl AeSTheTiCS TRADe MAgAZine

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

THE BIG QUESTION Why don’t IPL manufacturers suPPLy meters?

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SURGICAL VERSUS NON-SURGICAL

We Look at the most PoPuLar cosmetIc surgery Procedures and theIr non-surgIcaL aLternatIVes

ALSO In thIs Issue

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The on e stop a e sthetic s s ho p

EDITOR’S LETTER

WeLcome to the october Issue of cosmetIc neWs. The medical aesthetics industry has laid its foundations on the fact that it offers less invasive alternatives to surgery for patients seeking to improve their appearance. It has been widely accepted that, in most instances, non-surgical procedures are not a replacement for surgery as they could not yield as effective results, however, in recent years this has become less of the case with many non-surgical or less invasive options emerging onto the market that truly offer an alternative to surgery for those wanting to avoid the surgeon’s knife. As part of this months’ Special Feature we explore some of the most popular cosmetic surgery procedures and examine their non-surgical alternatives (p26-30). also in this issue, we find report on the industry’s reactions to the consumer launch of the Ihas cosmetic Injectables register, both good and bad (p12-14), and examine the results of a clinical study into the effectiveness of obagi clenziderm for acne skin (p35-36). Patrick treacy gives us his View on the development of cosmetic medicine at sea and consultant plastic surgeon Paul baguley and consulting room™ director martyn roes take the reins of this month’s Voice of the Industry column, giving their opinions on hard-sell cosmetic surgery and non-medics injecting respectively (p16). as well as this we report on the annual Iaafa conference and charity ball as well as the inaugural meeting of the british association of cosmetic nurses (p18-20).

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the medical aesthetics industry has laid its foundations on the fact that it offers less invasive alternatives to surgery for patients seeking to improve their appearance.

EDITOR’S CHOICE

CONTENTS 4 6 12

DEmILEC ACOUSTIC WAVE ThERAPy®

edItor’s choIce

Vicky Eldridge tries out the Demilec Acoustic Wave Therapy® treatment

Industry neWs

We round up the latest industry news

neWs sPecIaL rePort

The industry responds to the consumer launch of the IHAS Register

Like the majority of women, cellulite is one of my biggest body hangups. In my early 20s my thighs were smooth and bump free but in recent years the dreaded orange peel has began to make its mark.

VoIce of the Industry

Consultant plastic surgeon Paul Baguley on hard-sell cosmetic surgery and Consulting Room™ director Martyn Roe on non-medics injecting

Luckily for me I work in an industry where fixing imperfections is the name of the game, however working in the industry has also taught me that cellulite is notoriously difficult to treat and that many of the treatments out there can only improve, not get rid of, it.

18 22 24

on the scene

Out and about in the industry this month, from the IAAFA ball to the inaugural British Association of Cosmetic Nurses meeting

eXPo PreVIeW

The latest on what’s happening at the Cosmetic News Expo 2011

PeoPLe In ProfILe

We speak to Court House Clinic’s MD Paul Wilkinson about how he turned the company around and his plans for the future

so when I heard that madonna, the queen of the age-defying bod, had had demilec’s acoustic Wave therapy® system installed at her pad, I was intrigued to find out what made this so different from the other cellulite busters out there. aWt® works by stimulating the microcirculation in fat tissue and improving existing metabolic regulation disorders to reduce the visible signs of cellulite. Pioneered in switzerland, aWt® was originally used to treat ligament damage. the interesting side-effect of the treatment was a remarkable reduction in the cellulite of the patients. acoustic sound waves are generated in an application handpiece and gently introduced to the affected body regions. upon introduction into the body, the acoustic sound waves propagate over a large area and

26-30 surgIcaL Versus non-surgIcaL sPecIaL We look at the most popular cosmetic surgery procedures and their nonsurgical alternatives from liposuction and VASER to brow-lifts and Botox®

32 35 38

steP by steP

Our guide to combining Restylane® Vital and the Medki8 dermal roller

cLInIcaL study

We examine the results of a multi-centre, investigator-blind, randmonised study into the use of Obagi Clenziderm for acne skin

treatment sPotLIght

The Anteis Injection System

exert their stimulating and curative action in the skin layers. this results in skin smoothing and rejuvenation; breakdown of fat deposits; connective tissue tightening and improved retention of fat cells in the subcutis and reduced the circumference of affected body regions. the mechanical stimulus produced by aWt® is known to be converted into chemical activity. this phenomenon is referred to as ‘mechanotransduction’. the sheer force exerted by aWt® releases biologically active substances that lead to increased blood flow in all tissue layers, including the connective tissue. a course of eight to 10 treatments with maintenance every six months is recommended. I have recently started my course and have already noticed an improvement. by the time next summer comes around I am hoping my legs with be more delicious than dimply!

40 44 47 50 52 54

Product neWs

We round up the latest product news

best PractIce

Mike Murphy asks why don’t IPL manufacturers supply meters with their machines?

VIeW on

Dr Patrick Treacy gives his View On the development of cosmetic medicine at sea

busIness focus

In the latest of a series of articles on marketing, Zoe Davitt tells you how to market your ‘service’

dates for the dIary

Training course, conference and meeting dates

sponsored marketing of

the best standards of care.” TRACEy BELL, CliniC owneR

cosmetic treatments’.

“bupa is a strong advocate of the highest possible standards of patient care. We are proud to be members of the treatments you can trust

In OPPOSITION

scheme and our bupa centres in solihull and in mortimer street and bank

the british association of aesthetic Plastic surgeons is calling

in London were among the first to register their services. We hope that all

for the register to be put on hold pending guidance from the

eligible providers will take the opportunity to help encourage best practice

british (bsI) and eu standards agencies (cen), warning the

within the cosmetics industry by registering with the scheme.” DR BRIAN

public that it makes no distinction between practitioners who

FRANKS, Bupa HealtH and wellBeing uK, CliniCal diReCtoR, CosmetiCs

have trained for six or more years and those who simply took a

and dentistRy

weekend course. a recent poll among its members revealed that less than 4% of surgeons would even consider signing up to

“We welcome the launch of this register to enhance patient choice and

the scheme.

education. It’s really important to all professionals and potential customers that poor practice is stamped out to ensure patient safety and continued

according to consultant

confidence in the industry and that’s why we’re signing up for the

plastic surgeon and baaPs

treatments you can trust Quality assurance mark.” mEL BRAhAm, gRoup

president nigel mercer, “It is

CHaiRman, tHe HaRley mediCal gRoup

evident from the information circulated by the Ihas to

“We are pleased to have been involved in this scheme since its early days

the profession that the

and believe that for the first time, people seeking injectable treatments

scheme is being used as a

will easily be able to differentiate between the high-standard service

marketing tool, its regulation

providers that are registered under ‘treatments you can trust’ and the

appears rudimentary and

those that are not. It is a particular concern that the general public do not

their ‘Quality mark’ is not

generally understand the benefits and risks of these treatments and can

recognised by the british

be vulnerable to misinformation and mis-selling, so the scheme provides a

standards Institute or any other regulatory body.”

simple short-cut for confused consumers.” JO mARTIN fRom mappeRley Nigel Mercer, bAAPS president

paRK CliniC

many points of contention stem from the Ihas’ own press releases, which state “the Quality

“sk:n is completely committed to providing a safe and professional service

assurance mark will bring clear commercial advantage to

to its clients. unfortunately, there are many ‘rogue’ injectable practitioners

those who display it”, and their claims that the register has

who do not operate under the same strict medical qualifications, ethics

already brought increased amounts of business to those who

and safety policies as we do, which is harming the reputation of the

have signed up in the past few months.

industry. for this reason, we have been actively calling for a regulation scheme of this kind for some time and are delighted to be the first large

nigel mercer adds, “no regulation scheme should be set up in

clinic group in the country to achieve the Quality assurance mark.”

the interest of bringing in business. for example, clinics already

ANDy RANDALL, managing diReCtoR, sK:n CliniCs

have to register with the care Quality commission because it is the Law and it is the job of this agency to regulate the facilities

“the register is excellent for both the non-surgical industry and uk

where these treatments are performed. the Ihas scheme is not

consumers - it’s great to see this register launched and transform is fully

enforceable and has no teeth to stop poor practice. It seems to

supportive of the initiative the new register will allow consumers to make a

be sold to the profession on the basis of marketing rather than

better and more informed choice when it comes to injectible procedures

patient safety.”

and the provider they opt to have their treatments with.” mARK NORFOLK, CliniCal diReCtoR foR tRansfoRm CosmetiC suRgeRy

the process of european regulation of cosmetic procedures has started through cen, one of the recognised eu standards

“the bacd warmly welcomes the effort and work of the Ihas in respect

agencies, and the standards produced will have eu (ce mark)

this. nonetheless as doctors we feel this Quality mark doesn’t meet the

and national backing through the british standards Institute (bsI)

standards and regulations that the bacd had in place for it’s members.

in the united kingdom. the baaPs believe that these standards

We have for some years had our own certification and monitoring process

will have patient safety at their core and will have ‘teeth’

within the bacd. our members are of course all gmc registered and many

because they cannot be ignored by national governments.

are also registered with the care Quality commission. furthermore we have

mr mercer continues, “the baaPs urges the new government

appropriate for doctors then this quality mark. however I am sure it would

to wait until the eu standards are in place and to withdraw

be of value to members of the public wishing to have these procedures

support for the Ihas scheme as it stands.”

performed by nurses and dentists.” DR mIKE COmINS, CHaiRman BRitisH

introduced the first diploma in cosmetic medicine, which we feel is more

assoCiation of CosmetiC doCtoRs

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Voice of the Industry | Your Views

SURELy NOT IN THE Uk? Martyn Roe on

THE

hARDSELL

Consultant plastic surgeon Paul Baguley on hard-sell cosmetic surgery

Botox® Training For Non-Medics Well it was to be expected! hot on the heels of our recent government’s decision that it was okay for anyone in England who wants to have a go at burning your face off with a CO2 Laser or IPL machine to do so with impunity, along comes cosmetic injectables in the hands of non-medics! the former and current government’s failure to properly regulate the cosmetic injectable market means that coming to a high street near you soon could be the local barmaid offering ‘botox® with a beer’. how, you may ask, could this be possible? Well, during a round of internet searching I discovered the following site www.academyofcosmetics.co.uk offering botox® and dermal filler training to ‘non-medical personnel’.all that you need to do to attend one of their courses it to pass a Level 3 anatomy and physiology course. before injecting real people on the day you start off with empty syringes and dummies to practice on, so you can supposedly master the techniques. the good news folks is that they do not just give out certificates of competency to anyone, oh no, you actually have to inject four people on the day to prove that you are competent to inject (despite the fact the results of botulinum toxins take up to two weeks so adverse effects would not show on the day!!) If you inject less than four people you only get a certificate of attendance, but that’s okay, you can still inject people whilst you build up your portfolio of evidence to support your upgrade to a certificate of competence, all whilst not insured, but that’s alright as the consent form you will use states that! (Well that’s me totally reassured then!) they do state that they cannot supply you with botulinum toxin as you need to have a practitioner write a prescription, but they are able to supply you with practitioners that will do this so you can get the product and inject away! the really good news though, that will please the gmc, nmc, mhra and surely the new Ihas register for cosmetic Injectable Providers is that: “only doctors and nurses have the necessary skills to train you in basic medicine and drug interactions, which is included in our course agenda”. surely the reason that only doctors and nurses have the necessary skills to train you is because only doctors and nurses have the necessary skills to inject! In the testimonials section of their site, a tattoo artist explained how: “so far it has fitted in perfectly with my business of body piercing and tattooing. I use needles every day and it is a different technique to what I was used to but I soon got the hang of it.” Isn’t that great? this is the same ‘law’ that says it is illegal for her to inject a dog but a human is fine! do you think that as I once sewed a button on my shirt with a needle, they will let me have a go!? It’s a bit of a different technique but I am sure I will get the hang of it too!! Just to really worry you all though, 17 out of their next 18 courses, which all take place before the end of october 2010 in three locations across the country are fully booked – maybe after all, it really is the government’s way of lowering the dole queue!

Martyn Roe,

director The Consulting Room™ Read the full version of this article at www.theconsultingom.com under the ‘blogs’ section 16

cosmeticnewsuk.com

It is widely accepted that if you walk in to a car sales room or want to buy windows you will be hit by an all too keen sales person eager to hit their overly-inflated sales targets. Unfortunately it appears that these hard-sell tactics have infiltrated the cosmetic surgery industry. as I talk to chief executives and managers of cosmetic surgery companies, they tell you it’s a fact of life, and the hard-sell has become an all-too-familiar scene in the cosmetic surgery industry as it joins the much feared target driven set. I believe those of us who still operate independently would tell you we’re very much against these tactics, and I think this is true of the majority of members of recognised societies such as baaPs and baPras. the most important thing in any cosmetic surgical consultation is not how much it costs or when it can be done, but ensuring the client is offered the right operation at the right time, in the right way by a competently trained practitioner and/or surgeon who gives all the possible details to the patient. another point, which many of the larger companies overlook, is that surgery should be offered locally. at 2am what happens if you have a complication, a surgeon who the patient only met that day or the day before is not available, and they have to travel sometimes as far as 200 miles to get to the hospital where the surgery was done? there may be local arrangements these companies organise, but the patient will never see the surgeon that operated on them under those circumstances. follow up is always a problem too, whereas remaining local with a local surgeon in a local hospital, you can guarantee that you will see a member of their team or the surgeon themselves. I strongly disagree with the hard-sell for anything, but particularly with cosmetic surgery, which can be a life changing event for which people save up a lot of money, and once operated on it is nigh on impossible to correct problems. by no means am I saying recognised surgeons from baaPs and baPras don’t get complications, of course they do, but they’re on hand to sort out problems efficiently and professionally. so hard-sell? I don’t think so. I think that cosmetic surgery should be thought out, long and hard. It should be assessed by meeting the surgeon, meeting the team, discussing the fee, the venue, and when it can be done. all these things should be taken into consideration equally. at the end of the day the client should have the choice to walk away and should not be pushed into having surgery just because there is a deal that is available for the next 24/48 hours.

Paul Baguley

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ON N THE THE SCENE SCEN CENE

OUT AND ABOUT IN ThE INDUSTRy ThIS mONTh

IAAFA Conference and Charity Ball, London the International academy of advanced facial aesthetics (Iaafa) held its annual conference and charity ball in London last month. the two-day event took place at the royal society of medicine and kicked off on friday september 3 with a welcome by the association’s president dr bob khanna. the conference programme included a diverse range of lectures on topics including ‘problem solving with botulninum toxin and dermal fillers’, ‘cosmeceuticals and the part they play in any aesthetic clinic’, ‘how to set up a successful aesthetic practice’ and ‘effective strategies which will quickly increase your profits’. an exhibition also ran alongside the conference, supported by some of the industry’s leading manufacturers and suppliers. dr khanna said, “this years Iaafa conference was a huge success with more than 250 delegates and I have been overwhelmed by all

dr Lucy glancey with the showgirls

the finishing touches team glam it up

Vicky eldridge, Jazz dhariwal and karen sargeant

david beesley (skinbrands), karen sargeant, Vicky eldridge, tracey beesley (skinbrands), banu roe and dr Lucy glancey

Inaugural meeting of the British Association of Cosmetic Nurses, Royal College of Physicians, London the newly launched british association of cosmetic nurses (bacn) held its first members meeting at the royal college of Physicians in London last month. the association was formed in a bid to represent, serve and be the unified voice for cosmetic nurses, after the rcn cosmetic nurses forum was dissolved. as well as the 2010 agm, the programme included presentations on facial anatomy, ‘power politics and prejudice: the role of aesthetic nurses’, access to nurse prescribing, managing complications and the evolution of aesthetic nursing. chair emma davies said, “What a

constance campion, angela Porter and cathy Warwick

the positive feedback we have had. this years conference totally personified what Iaafa is all about which is to bring together all facets of aesthetic medicine from nurse practitioners and dentists to dermatologists and plastic surgeons.” the event finished with a charity ball held at the Portman radisson sas hotel. the glitzy event raised more than £15k for the make-a-Wish foundation, a charity that grants the wishes of dying children. dr khanna adds, “the ball is always a social feature that we look forward to because it heralds the end of the Iaafa conference and it is a chance for all those who have been involved to relax, unwind and enjoy a fantastic social occasion knowing that it is for a worthwhile cause. I am delighted as president to be involved with the make-a-Wish foundation which makes dreams a reality for lots of children with terminal illnesses.”

ben savigar-Jones (candela) and Jemma cooke (galderma)

the hamilton fraser team

cosmeticnewsuk.com

natalie mifsud and Vicky eldridge

great meeting – it truly exceeded our expectations! the presentations were all of a high standard though the pace left delegates hungry for more. We were able to cover a broad sweep of topics, including clinical, business, political and professional – something for everyone. We also had some world famous speakers alongside some new blood – no one could complain they had heard it all before! this meeting was truly more about the delegates though – nurses. We really demonstrated you can leave the nhs and still belong to the caring profession. We care about our patients, we care about standards, we care about quality and we are ready to drive change, starting with a good look at the issues that concern us and how we can work together to ensure excellence. this was a great beginning and I think we all felt privileged to be there, and fired up to maintain the momentum with great plans for the year ahead.”

gillian thornton, debbie bannister and heather Irvine

the bacn committee Jemma cooke and emma miller (galderma)

ben chenery, karen sargeant and dr Patrick treacy

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Environ Focus Frown Serum Wins Award

Q-med Practitioners meeting

environ's Ionzyme focus frown serum has achieved prestigious independent recognition and validation after it was named ‘Product of the year’ in a beauty industry competition. south african trade magazine Pharmaceutical & cosmetic greg hughes, ceo Infixion media, hazel kelly, review announced the environ and nick evans, manager, fragrances Iff winners of their new Product competition last month at an elegant lunch in Johannesburg. the competition was open to south african products launched during 2009. the products were all judged on four criteria being including: innovation of the product itself; packaging design appropriate to the product; marketing support and compliance with the cosmetic, toiletry and fragrance association (ctfa) regulations.

Q-med held its annual practitioners meeting at the royal college of Physicians in London last month. the popular event was over subscribed to with more than 250 people wanting to take part. the event has been running for six years and is a chance for users of Q-med’s products to get together and share information with their peers as well as listening to lectures from acclaimed speakers on the latest innovations and developments in both facial and body aesthetics, using Q-med’s unique and patented nasha™ technology. this year’s programme included dr stephanie Williams on new techniques and indications with restylane® Vital; marie duckett on lip hydration with restylane® Vital; dr toni Phillips on adding value to your patient offering with restylane skincare, dr bob khanna on new techniques in lip sculpting and dr dennis Wolf on body contouring with macrolane™. the event is chaired by consultant plastic surgeon rajiv grover and is free to attend however the company asks delegates to give a donation to a chosen charity. this year’s beneficiary was operation smile. the event closed with a champagne reception in the gardens of the college. Q-med’s James backhouse presents a cheque for £3,000 to alex talbot,

In action

steve and director/cameraman mike doxford on location

myFacemyBody Show on Location

myfacemybody presenter stpehen hanisides went medieval in his latest attempt to bust some of the myths surrounding cosmetic treatments. In a bid to prove whether or not botulinium toxin injections stop steve in full costume on the set of the underarm sweating steve went latest myfacemybody show jousting in a chain mail suit after being treated with botulinum toxin under one armpit. steve’s latest antics will appear on the newest episode of the myfacemybody show, the uk’s only tV chat show dedicated to cosmetic procedures, showing on Information tV (sky channel 166 and freesat 402). the show airs at 7.30pm on tuesdays and is repeated on thursdays at 3pm and sundays at 6.30pm as well as being re-shown every tuesday at the same time. Viewers can also catch the programme, see previous episodes and chat with the experts on www.myfacemybody.com

yvette newman and Jack cottle (Q-mmed)

the event has become so popular that the auditorium was packed

Q-med’s teresa simmonds chats to delegates at the champagne reception

John graham (Q-med), dr Verka beric and dr dennis Wolf

the champagne reception

cosmeticnewsuk.com

be a part of the aesthetic revolution

expo 2011 6th & 7th may 2011

business design centre, London, isLington register online now for free entry to the ukâ&#x20AC;&#x2122;s onLy free of charge aesthetics exhibition. bringing together the best manufacturers, distributors, retaiLers and educationaL seminars aLL under one roof. register onLine now for free trade entry

www.cosmeticnewsuk.com for exhibition space enquiries please contact hollie dunwell on 01268 754 897 or hollie.jane@creativemedialtd.co.uk

Cosmetic News Expo 2011 | Preview

BUILDING ON SUCCESS With plans well under way for the Cosmetic News Expo 2011, we keep you updated on what to expect from the event of the year...

In April 2010 Body media launched the UK’s largest free of charge conference and exhibition, the Cosmetic News Expo to great success and now plans are in full swing for our second event, which will take place once again at the Business Design Centre in Islington on may 6 and 7 2011. designed to be even bigger and better than our inaugural show, the 2011 expo will offer aesthetic professionals the chance to gain cPd accredited education at the same time as networking and exchanging information with their peers and finding out about the latest technologies and products on the market, all under one roof. educational workshops will once again be taking place throughout the two-day event with industry leading practitioners, manufacturers and suppliers educating you on how to improve your business and get the most out of your clinic by offering the best treatments and products. this year there will be a main programme in the conference auditorium upstairs, which has the capacity for 450 people, focusing on the three tiers of cosmetic dermatology on friday may 6 and beyond the face: body treatments anti-ageing medicine and Patient Psychology on saturday may 7. as well as this we will be running business workshops on the main exhibition floor. these proved to be hugely popular at this year’s expo so we will be packing even more into the programme for 2011. also on the exhibition floor will be live demonstrations and seminars hosted by the key manufacturers and suppliers in the industry who make up our exhibitors. We have already confimred some exciting speakers including leading skin cancer specialist and visiting harvard Professor, Paul banwell, injectables king dr bob khanna and PrP pioneer Ita murphy. In the next few months we will be finalising the programme and revealing who our renowned international speakers for 2011 will be. With preparations for this and the exhibition already well underway, the cosmetic news expo 2011 is shaping up to be an unmissable event, bringing together more aesthetic practitioners under one roof than any other meeting in the uk. the event will also be cPd accredited, making it one date on the training calendar you can’t afford to miss. although the event is free, is not open to the public and delegates/visitors will be asked to register in advance giving a small deposit of £50 (refundable on attendance) so they can reserve their place for the educational programmes. Whether you are a cosmetic doctor, aesthetic nurse, dermatologist, plastic surgeon, cosmetic dentist, aesthetician or practice manager, you won’t want to miss the cosmetic news expo 2011. to register for tickets visit wwwcosmeticnewsuk.com With over 40 exhibitors already booked the cosmetic news expo 2011 is well underway. With limited exhibiting space available it is imperitive you act fast!

Our Philosophy... the only free trade show and educational meeting in the uk, the philosophy behind the cosmetic news expo comes from body media’s extensive experience in running shows for other niche markets. We believe that education should be available to everyone, no matter what their budget, so we have designed an event that allows you to gather knowledge about the latest treatments and developments at the same time as attending hands on workshops and lectures, for free.

CONTACTS For further information regarding exhibition space please contact:

HOLLIE-JANE DUNWELL T: 01268 754 897 E: hollie.jane@creativemedialtd.co.uk

For event related sponsorship opportunities contact: Emilia Bronze T: 01268 754 897 E: emilia@creativemedialtd.co.uk 22 cosmeticnewsuk.com

“galderma were proud to be the Platinum sponsors of this exciting new event and are committed to the meeting in the future years! congratulations to all at body media and thank you for helping us raise the profile of galderma and azzalure® over recent LOGO-------------------------------------• monthsROLLER soBANNER successfully”

KEy maIn audItorIum eXhIbItIon fLoor break

FrIDAY MAY 6: tHe tHree tIerS oF coSMetIc DerMAtoLoGY

Your Your client’s client’s Skin Skin deserves deserves the the Best... Best...

Microdermabrasion Microdermabrasion

9am-10am registration and exhibition opening 10am-11am skin texture and tone aesthetic medicine is not just about filling lines and wrinkles, it is also about Improving the appearance of the skin. We look at the wide range of treatments designed to improve skin texture and tone from skin revitalisation to chemical peeling, fractional lasers and skincare. 10am- 11am business Workshops

Julian Popple - Galderma

11am-11.30am coffee break (main auditorium) 11am-1pm seminars and Live demos 11.30am-1.30pm skin texture and tone continued 1.30pm-3.30pm exhibition viewing and lunch

“We got a lot of quality leads to justify going and generate return for aestheticare. there was a good mix of new and existing clients, and overall it worked very well” roger bloxham – AesthetiCare

“the cosmetic news expo was a great success for Wealden Projects. We met lots of interesting people and recorded many positive leads, resulting in meeting regarding new projects. the end users we met were very entrepreneurial and clearly the decision makers within their respective organisations. the whole event exceeded all our expectations by far” kevin dewhurst – Wealden Projects

“attending the cosmetic news expo was highly beneficial for our company, and we will certainly be attending next years event” don maree – SkinGeeks

3pm-4pm business Workshops 3.30pm-4.30pm Lines and wrinkles botulinum toxin is one of the staple treatments of any aesthetics practice and one of the most successful ways of erasing lines and wrinkles. In this session we explore the latest advances, products and techniques with this wonder drug and hear from the key players in the toxins market. 4pm-6pm seminars and Live demos

Full Full Training... Training...

4.30pm-5pm coffee break (main auditorium) 5pm-6pm Volume and contouring In recent years facial aesthetics treatments have gone beyond chasing the line to placing more value on volume replacement and facial contouring. In this session we explore the dermal fillers and other treatments for this indication. 5pm-7pm exhibition viewing 7pm drinks party

SAtUrDAY MAY 7:

beYoND tHe FAce – boDY treAtMeNtS, ANtI-AGeING MeDIcINe AND PAIteNt PSYcHoLoGY

55 Year Year Warranty... Warranty...

9am-10am registration and exhibition opening 10am-11am Patient consultation and Psychology When it comes to aesthetics understanding patient psychology and giving a thorough consultation is an important factor. In this session we will explore issues such as body dysmorphic disorder and body image issues with leading health psychologist James Lampar as well as looking at the consultation process and how to manage patients’ expectations. 10am- 11am business Workshops 11am-11.30am coffee break (main auditorium) 11am-1pm seminars and Live demos 11.30am-1pm anti-ageing medicine medical aesthetics is becoming more and more integrated with the specialty of ant-ageing medicine. In this session we look at the internal factors that effect ageing from nutrition to hormones and tell you how understanding these can enhance your treatment results. 1pm-3pm exhibition viewing and lunch

Great Great Versatility Versatility Real Real Reliability Reliability Proven Proven Efficacy Efficacy High High Profitability Profitability UK UK manufacturer manufacturer 55 year year warranty warranty

3pm-4pm business Workshops 3pm-5pm body aesthetics body aesthetics has become big business in recent years. We explore a whole spectrum of body treatments from body needling to high definition Vaser and even some controversial new uses for lasers. 4pm-6pm seminars and Live demos 5pm exhibition viewing 6pm close

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

www.thecarltongroup.co.uk www.thecarltongroup.co.uk

People in Profile | Paul Wilkinson

HOLDING

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We chat to the managing director of Court house Clinics about his plans for the clinic chain

When Paul Wilkinson was approached about running a clinic chain he knew nothing about the world of medical aesthetics, however what the straight talking northerner did know about was turning businesses around.

aul originally trained as an

started to turn the business around. he explains,

already. although our volumes have increased

accountant for a leading jeans

“We have gone from the early months of last

we have tried to just increase doctor days at

brand and, after a short stint working

year which was still a struggle to within three

our various clinics with our existing doctors rather

as a supply chain manager, he

or four months really seeing sales take off. We

than bringing in too many outsiders.”

moved into the field of transport and logistics.

have reduced our costs massively and at the

for 14 years his job was to turn around struggling

same time we have increased our revenue by

and its not just the doctors, Paul is keen to

subsidiaries for both national and multinational

20% in 12 months. We are getting about 100

reduce staff turn over across the entire business.

freight and logistic companies and it was during

new clients a week now so we really are in the

he says, “the industry historically has a high

this time that he first worked with ron sullivan, co

growth phase – we are fairly confident now as

turn over of staff and that is not good for any

owner of court house clinics.

the diaries are booked pretty solid every day of

business. We are working hard to create an

the week.”

environment where people want to work – you have to look after your staff , train them

When the company Paul worked for was sold to one of its biggest competitors as part

hoLdIng COURT

and reward excellence. over the next six

of a multi-million euro deal, he was put on

court house clinics was founded by dr Patrick

months staff training will be a major project

gardening leave and started thinking about

bowler in 1998 and quickly became a leading

within our business. business is about people

which direction to go in next. It was then that he

centre for medically-led, technologically

and motivating them in trying to achieve

was approached by ron to take on the court

advanced products and treatments. however

the company’s goals, this is what has been

house clinic chain, which despite being a well-

what it was lacking was the business prowess to

successful for me in the past.”

established and previously successful business,

continue to grow and navigate its way through

had been hit hard by the tough economic times

the recession. this is where Paul was to come in.

and was struggling to advance its plan to roll out more clinics across the uk.

PAIRING doWn the next thing on Paul’s agenda was to look

Paul’s first strategy was to change the

at the treatment menu and to make it more

management structure at the company, at the

tailored and streamlined to make the clinics

Paul explains, “ron knew my background

same time as preserving one of its most unique

specialise in certain areas rather than try to be

in turning around struggling companies and

and valuable qualities, the fact that it was a

a ‘jack of all trades’. “We used to have over

asked me if I would be interested in court house

doctor founded and doctor led business. he

50 treatments and we used to spend a lot of

clinics. I had a look at the company and could

says, “the business had one or two excellent

time and marketing trying to promote all those

see that, whilst they were struggling business

managers, who have played a major part

treatments. now we have six main treatments

wise, clinically it was an excellent company that

in helping me turn the clinics around, but

and we focus on those six main treatments. yes

had just lost its way. I knew bugger all about the

just needed to be given more responsibility,

we still do other things but injectbales are about

industry but 85% of it is exactly the same as any

become more focused and guided a little

40% of our business and laser hair removal is

other business – it’s about people, marketing,

business wise. unfortunately some others had to

about 20% and growing rapidly. We want to be

controlling your costs and most importantly

be changed as they didn’t have the necessary

outstanding – we want to be the fastest growing

giving a better quality service than your

skills or drive. however, most of the excellent staff

non-surgical clinic chain in the uk – and we also

competitors for a good price.”

below the management team have stayed

want to be the best quality. We aim to give the

the same, which ensured that our high clinical

customer service of a five star hotel. our client

In may 2009 Paul came on board as a

standards did not slip during this transitional

retention rate and re-booking rate is fantastic.

shareholder and managing director of court

period. We have stayed very loyal to our existing

over 80% of our clients re-book there and then

house clinics and within four months he had

doctors because we had a fantastic team

for an appointment – I don’t think there are

cosmeticnewsuk.com

many chains of clinics that can say that.”

the quality of the clinics’ services, is what he believes

care of the business’ then that is what we are looking

one of the newest treatments introduced at

has driven the growth in the business. “We think we

for. two years ago everyone was making money and

the clinic has been alizonne therapy, a clinician

have got the marketing right now”, he says. “We

there was fast growth in the industry but now its not so

supervised weight loss and body contouring

have changed the whole focus of our marketing

easy. Lets face it most doctors are not businessmen,

programme, which has proved to be hugely

and that’s what has helped us bring in so many

they are not marketers and they are not finance

successful because of its dramatic results. Paul

new clients. We have cut back on a lot of the

people so lets help them do what they do best and

says, “We are now the biggest franchisee for

old traditional marketing methods but we have

we can run the business side because that’s what we

alizonne and have four clinics doing it. one of

trebled our marketing overall and at the expense of

are good at.”

the reasons I think it has been so successful is

profitability we will be spending more and more on

that if a person completes it the transformation

marketing in the coming year.”

so with all this rapid growth planned, how does Paul plan to distinguish court house clinics from other clinic

is massive both physically and psychologically.”

ExPANDING the BRAND

chains which have often been criticised in the industry

another treatment the clinic has been focusing

court house clinics now consists of seven sites across

for taking a ‘hard-sell’ approach to treatments and

on is pain free hair removal with the soprano.

the uk. the largest clinic is in Wimpole street, London,

being at the lower end of the market.

Paul says, “there are less expensive machines

with the second largest being the original clinic in

out there but again its about quality. Laser hair

brentwood, essex. other sites include maidenhead,

“95% of our injectables are done by doctors and

removal is a massive growth area for us and

haywards heath, sheffield stockport and

because of Patrick’s reputation we get fantastic

the fact the treatment is quick and pain free

birmingham and Paul is now keen to roll more clinics

quality doctors. that is one of our points of difference

is a big selling point. you want to make sure

out across the country and increase that number to

from other chains. I am sure there are some fantastic

the customers are happy and want to come

15. ambitious plans but Paul is confident that they

nurse injectors out there but we will always be doctor

back – today’s laser hair removal lady may be

can achieve it and has started looking for clinics that

led that’s why we are looking for more doctors

tomorrow’s botox® patient.” (see page 7)

would like to become part of the court house brand.

and clinics to join our group – that’s where we see

mARKETING Is key

“We are reaching capacity at our site in London

down one route but we are staying quality, quality,

While many of its competitors are pairing down

so the first thing we are looking to do is expand in

quality and doctor led. We don’t discount on doctors

their marketing to save on costs, Paul has been

London as well as around the m25”, he says. “Ideally

– I don’t believe in it. We don’t want to be the

doing the opposite and has upped court

if somebody has got a good quality clinic but is

cheapest, we want to be the best. We just want to

house clinics’ marketing game significantly

struggling on the marketing side and thinks ‘I just

replicate what we have got across the country and

which, combined with word of mouth about

want to be a doctor and have somebody else take

continue to stay at the top end of the market.”

our future. other similar clinic chains may be going

time for your

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Special Feature | Surgical v Non-Surgical

THE NEEDLE

v versus

THE KNIFE We look at some of the most popular cosmetic surgery procedures and examine their nonsurgical alternatives to find out who wins the battle of the needle versus the knife…

before the advent of non-surgical treatments, cosmetic surgery was the only alternative for patients seeking to enhance their looks beyond the realm of the beauty salon. What has made the medical aesthetics speciality grow so rapidly over the past two decades is the fact that it offers less invasive alternatives to some of the most popular cosmetic surgery treatments. While non-surgical procedures are not a replacement for surgery in most instances, they have opened up the door for a whole new generation of patients who may have considered undergoing some form of cosmetic enhancement but who didn’t want to take the risk of going under the knife or who want to prevent the need for surgery at a later date. In the past nonsurgical procedures were almost seen as the poor cousin of the scalpel because they could not yield as effective results, however, in recent years this has become less of the case with many non-surgical or less invasive options emerging onto the market that truly offer an alternative to surgery for those wanting to avoid the surgeon’s knife. On the following pages we explore some of the most popular cosmetic surgery procedures and examine their non-surgical alternatives to find out who wins the battle of the needle versus the knife…

FACIAL ImPLANTS Versus FILLERS one of the most successful ways in which a non-surgical procedure has replaced the need for surgery is in the area of facial implants. With the advent of soft tissue facial fillers designed to replace volume and facilitate facial contouring, the need for surgeons to use cheek and chin implants has declined. In recent years volume restoration has overtaken simply chasing the line as the main focus of anti-ageing treatments with dermal fillers. In fact even some of the uk’s leading cosmetic surgeons would advocate the use of dermal fillers over and above surgery when it comes to this indication. eminent consultant plastic surgeon rajiv grover says, “you can put physical implants in both the cheek and chin area but this would mean a general anaesthetic, it would mean coming to hospital and it would mean a recovery of about 10 days to two weeks. another problem with cheek and chin implants is that there is also a significant rate of infection, even with the use of antibiotics, because you have to go in through the mouth. also because these are quite mobile areas, a bit of movement in the implant is not uncommon. the greatest use of cheek and chin implants would probably have been in the late 80s early 90s but I would say that they have decreased in popularity since that time. “the non-surgical alternative using products like restylane® subQ doesn’t involve coming to hospital, can be done in about half an hour to 40 minutes and has very little downtime – you have got a bit of swelling for probably 48 hours but you can be back at work after a weekend. I wouldn’t say it’s a lunchtime procedure I would sell it more as something to do on a friday back to work on a monday. the other nice thing about it is you can truly sculpt in accordance to what the patient’s needs are. most of the implants come in a specific shape even though

cosmeticnewsuk.com

they come in different sizes. however the area of volume loss or area for

With these advanced indications, dr khanna stresses the need for

enhancement, particularly with the cheek, can be quite different between

understanding of the anatomy and appropriate training. he says, “treating

different people and the ability to inject subQ in different volumes and in a

these areas is very different to line filling, what we are talking about here is

different form means that you can be quite creative with it. another advantage

artistically sculpting someone’s face so clearly technique is very important.

is that if a cheek implant moves or gives you any trouble you have to take it out

the other thing that one has to be mindful of is adherence to a good sound

but if restlane® subQ gives you trouble – although I have never had to do this

understanding of the underlying anatomy its very very important when you are

– you could dissolve it with hyaluronidase so there is an easy remedy there for

placing needles or cannulas into these zones so you can achieve the results with

someone who doesn’t like it.”

minimal complications.”

dr bob khanna has been one of the pioneers of non-surgical cheek and chin sculpting in the uk and teaches the advanced indications on his training courses. he says, “the indications for chins are a retruded chin or a retrognathic or so called class II skeletal profiles. there are a number of indications for check augmentation, which can be anything from adding to the cheek volume that’s already there to give a more sculpted appearance, to replenishing volume where a significant amount has occurred due to ageing. you can achieve nice results in mild, moderate and quite extensive cases. the advantages are of course that you can pretty much have instantaneous results with very little downtime, minimal swelling and bruising and the procedure is relatively

the patient before cheek enhancement with restylane® subQ

after 2ml of restylane® subQ per side (Pictures courtesy of dr bob khanna)

a patient with a receding chin before treatment

after extensive chin remodeling with 6ml of restylane® subQ (Pictures courtesy of dr bob khanna)

a moderate chin case before treatment

after treatment with 3ml restylane® subQ and 1ml restylane® Perlane (Pictures courtesy of dr bob khanna)

pain free. the downside of course is longevity. I can’t really think of any other downside.” mr grover agrees however he is encouraged by his own experience and recent research which shows that restylane® may have a physiological effect, minimising the need for repeated treatments over time. he says, “the downside of course with a temporary treatment is that it will need to be repeated every year although that is certainly reflected in the cost. there is quite a bit of research now however that shows when you inject restylane® subQ it has a biological action on soft tissue that goes beyond the life span of the product itself. a good example of that is I treated a lady two years ago who had 2.2cc of restylane® subQ in her cheeks. I saw her at the beginning of the year and there was still some product there 18 months afterwards. I then saw her about 10 days ago. clearly there is no product left in her cheek because you can’t palpate it when you pinch the cheek, however there is more volume there than there was two years ago and in her own words she said there is some ‘springiness’ now in the cheek. there was some research done by Wang et al which was published in dermatologic surgery about three years ago which shows that the nasha™ gel, which is what restylane® is made from, stimulates collagen synthesis, so I don’t know that these people will necessarily need to keep having it done every year or every 18 months.”

BROW-LIFT Versus BOTULINUm TOxIN

because the procedure can now be performed

a brow-lift using botulinum toxin is ideally suited to

endoscopically, it has a very swift recovery process

younger patients and patients with mild brow ptosis.

Botulinum toxin is undoubtedly the most popular

and is a lot less invasive than other forms of facial

It works by relaxing the muscles, which depress the

non-surgical cosmetic procedure and the one

cosmetic surgery with results lasting up to 10 years.

brow, thereby allowing the elevator muscles to

that consumers are most aware of, so you would

work more freely. dr khanna says, “In non-surgical

have thought that its ability to lift the eye brows

mr grover believes that, unlike dermal fillers, which

brow-lift procedures you have a premeditated

and erase lines and wrinkles on the forehead

have largely replaced the need for facial implants,

requirement to lift the outer third of the brow so this

would have meant a decline in brow-lift surgery,

botulinum toxin patients and brow-lift patients are

relies on understanding the dynamic action of the

however on the contrary the popularity of brow-

two distinctly separate groups. he explains, “here

upper facial musculature and carefully immobilising

lift surgery has grown significantly in recent

you are actually treating two different categories

the right muscles.”

years. Figures released by the British Association

of people. the person who would have a brow-lift

of Aesthetic Plastic Surgeons this year showed

with botox® is different to the person who would

mr grover adds, “by treating preferentially high

that male brow-lifts rose quite considerably (up

need a surgical brow-lift. you have to graduate

up in the forehead and maybe centrally you are

51%) with brow-lifts for men and women rising by

from one to the other – I wouldn’t treat a patient

preserving the muscle lower down and at the outer

43% overall.

who could happily be treated with botox® with an

edge of the forehead. to try and compensate the

unnecessary brow-lift.”

muscles work a little harder and therefore that lifts

cosmeticnewsuk.com

Special Feature | Surgical v Non-Surgical the brow. that’s fine for somebody whose brow is not too heavy, however it is

that if you use botox® for about eight to nine years it actually reduces the effect

not going to work for someone who does have a heavy brow, those are the

of ageing and the development brow ptosis because you are not constantly

people that would benefit from a brow-lift.”

getting those muscles to move the eye brow. your brow height is a little higher and you haven’t loosened the ligaments as much, so you may prevent the

research has also shown that by having a non-surgical brow-lift with botulinum

need for a brow-lift by having botox® for a long period of time.”

toxin can reduce the need for surgery long term. mr grover explains, “I did publish some research which was presented at Imcas about three years ago

LIPOSUCTION Versus VASER Liposuction has traditionally been one of the most popular cosmetic surgery procedures, however last year the popularity of the procedure saw a massive decline. In the uk there was a 29% reduction in liposuction procedures being performed and, across the atlantic in the usa, the procedure was knocked off the top spot for the first time in the american society for aesthetic Plastic surgery’s (asaPs) history. could this reflect the impact the recent influx of non-surgical liposuction techniques had an impact on the market?

a patient with a slightly droopy brow before treatment

after a botulinum toxin brow-lift (Pictures courtesy of dr bob khanna)

Liposuction has been used to remove stubborn areas of fat from the body in order to enhance aesthetic liposuction techniques have developed and many surgeons now routinely perform liposuction under local

RhINOPLASTy Versus NONSURGICAL NOSE REShAPING

anaesthetic.

Rhinoplasty has always been one of

appearance since the 1970s however the early techniques used carried high risks. over the years

the top cosmetic surgery procedures, In recent years the introduction of so-called ‘non-surgical’ alternatives to liposuction has undoubtedly

particularly with men where it has

seen the fat reduction market change direction. most recently it has been Vaser, a treatment that uses

ranked top in The British Association of

ultrasound to break up fat cells, that has been causing a stir in the liposuction arena.

Aesthetic Plastic Surgeons’ (BAAPS) stats for a number of years.

the Vaser technique differs from traditional ultrasound – assisted Lipoplasty (uaL) procedures as it uses

there are two main techniques employed

a patented probe, which delivers ultrasound energy from all sides, as well as from the tip, allowing the

for carrying out surgical rhinoplasty: closed

practitioner to sculpt more precisely. this means there is less risk of damaging the surrounding structures

rhinoplasty and open rhinoplasty. cosmetic

such as blood vessels or nerves, as with traditional uaL. the treatment can be done in a minor surgery

surgeon Paul banwell explains, “as a

environment and is proving popular with physicians and patients alike.

plastic surgeon I do a lot of rhinoplasties. they can be performed as either a closed

dr ravi Jain said, “Vaser offers patients all of the benefits of liposuction with much less downtime and

or endonasal procedure, or as an open

increased skin tightening and it provides great results for patients thighs, tummies and love handles - pretty

procedure. closed rhinoplasty involves

much all over.”

making a small cut inside the nostril that you then work through. this is how rhinoplasty was traditionally always done, however the results with this technique can be variable because you haven’t got very good access. there are some very skilled surgeons who get fantastic results with this method. the technique itself is straight forward, however the results are unpredictable because you don’t know how the skin is going to re-drape. this is a

before Vaser treatment to the thighs (courtesy of dr ravi Jain, riverbanks clinic)

side profile of an abdomen before Vaser treatment (courtesy of dr ravi Jain, riverbanks clinic)

before Vaser contouring on the stomach area (courtesy of dr ravi Jain, riverbanks clinic)

disadvantage because you can get a high level of patient dissatisfaction. “the open technique really revolutionised rhinoplasty procedures when it was introduced 10-15 years ago. It involves making an incision in the columella and pulling the skin back, which gives you a complete view of the anatomical structure of the nose. the advantage is obviously that the surgeon can see what he is doing and can be more accurate, especially with

after Vaser (courtesy of dr ravi Jain, riverbanks clinic)

after Vaser treatment to the abdomen (courtesy of dr ravi Jain, riverbanks clinic)

after Vaser (courtesy of dr ravi Jain, riverbanks clinic)

bone work, however the disadvantage is the risk of scarring, a longer recovery and more swelling. I have never had any problems with scarring using the open

cosmeticnewsuk.com

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Special Feature | Surgical v Non-Surgical

approach but there is a risk.” although mr banwell

lifted an re-sited using dermal fillers to essentially

of something rather than addition of something –

has carried out extensive rhinoplasty surgery he

create a new tip in an elevated position. you can

they are having a reductive rhinoplasty. the most

believes non-surgical rhinoplasty also has its place.

also correct slight deviations and asymmetries

common problems would be a slightly bulbous tip,

he says, “recently I have started using dermal

very nicely. the combination of reshaping of the

which you can’t correct by adding something,

fillers for non-surgical rhinoplasty with great success.

dorsal hump and re-siting of the nasal tip means

or a bump on the bridge. now the way in which

about five or six years ago I was speaking at a

that we can essentially mimic the effect of a

most people non-surgically transform a bump

conference and had this misfortune to have to go

surgical rhinoplasty. In severe cases where you

on the bridge is by filling the bit above that, the

on after an american facial plastic surgeon called

have severe hump in the dorsum of the nose or

root of the nose, so you get the illusion that the

michal cain who gave a fantastic presentation

quite considerable deviations of the septum and

bump is flatter. In my view that just gives them a

and really opened my eyes to what could be

nasal bones, that would be better treated with

roman nose, which comes right down from the

done non-surgically. non-surgical rhinoplasty is

surgery. the benefits of course with a non-surgical

forehead. If you look at someone from the side

a very good treatment and has a number of

procedure are that there are no scars whatsoever

and there is no difference between the forehead

uses within my practice. firstly it is very good as a

and there is very little downtime if any at all. It is also

and the nose, it is just one line, I don’t think looks

corrective procedure post surgery. Quite often after

relatively pain free with the advent now of new

as attractive as when you take the bump away,

rhinoplasty you can have some lumps or bumps or

generation fillers such as restylane® Perlane with

so I am not a fan of thinking you can treat people

asymmetries that the patient is not happy with and

lidociane, which makes it a lot more comfortable.”

with that. If someone came to me with just a

fillers can be used in this instance to correct any

subtle bump that didn’t need surgery maybe they

post-surgical deformities. they can also be used for

both dr khanna and mr banwell agree that this

are the right people to treat non-surgically but

a percentage of patients as a primary rhinoplasty

procedure is very specialist and technique is key.

in most cases I would think they are going to be

procedure. If they have got subtle dorsal deformity

mr banwell says, “non-surgical rhinoplasty has got

better off having surgery.”

or a problem with the tip or asymmetry, non-surgical

to be done in the right hands as there is definitely

rhinoplasty is fantastic as the downtime is virtually

an artistic element. I’m not saying whether or

dr khanna actually agrees with some aspects

zero.

not that should be a surgeon a doctor or a nurse

of this and says that patient selection and

practitioner, however you should not just enter into

maintaining the aesthetic appearance of

it lightly.”

the profile is key. he says, “With non-surgical

“I have a patient at the moment, a pretty young girl who was in a serious rta and has a scar across

rhinoplasty it is important to maintain the nasal

her nose which has left her with a big divert, a bit

dr khanna adds, “as with most of these things it

frontal angle. there needs to be a slight concavity

like a boxers nose. I used a little bit of Juvederm

is very much technique driven because putting

at the root of the nose. If that is totally obliterated

in her nose and she is delighted with the result. to

dermal filler just anywhere is not the answer, its

and it’s a straight line then that will look very

be able to treat her without having to do surgery

about knowing where to put it precisely to create

peculiar and unaesthetic. With a very extensive

is very rewarding. “noses are also one of the

the right line angles and the correct contour.”

dorsal hump the temptation would be to totally

most common focuses for patients suffering from

obliterate that area to minimise the appearance

bdd. many patients who come in for rhinoplasty

however mr grover is not convinced. he says, “I

of the bump, however that would give rise to a

procedures have an abnormal perception of

have got a slightly different opinion. 95% of the

very unaesthetic appearance. that’s why case

how their nose actually looks. Whereas I might not

people I treat for nose correction need removal

selection is very important.”

think it is that bad it has a major impact on their life. to be able to resolve that quickly and easily with no downtime and without doing surgery has huge advantages and there is a high level of patient satisfaction with the procedure. the only disadvantage is that they have to come back repeatedly for treatment. “as a surgeon you would think I would be biased towards surgery, however I think as a good surgeon you have to consider the non-surgical solutions and make the decision on whether or not to perform surgery based on the patient’s best interests. If they can be treated

a patient with mild nasal deformities before treatment

the patient in profile before treatment

a patient with a nasal deformity following an rta

after non-surgical nose reshaping (Pictures courtesy of dr bob khanna)

the patient in profile after non-surgical after a non-surgical rhinoplasty nose reshaping (Pictures courtesy of dr (pictures courtesy of Paul banwell) bob khanna)

without having to undergo surgery then I think we have a responsibility to do that.” dr bob khanna adds, “a typical presentation for non-surgical rhinoplasty would be a patient who has what is known as a dorsal hump. as long as this is mild to moderate this can be very nicely and easily rectified using dermal fillers placed in precise areas to minimse the appearance of this natural bump. the other application is where the nasal tip has dropped. this can be

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Call 0845 310 6300

Quote code: ADCN02 (lines open Mon-Fri. 9.00 to 5.30)

or visit us at: www.hamiltonfraser.co.uk

Hamilton Fraser Insurance Kingmaker House, Station Rd, New Barnet, Herts, EN5 1NZ. Hamilton Fraser Insurance is a trading name of HFIS plc. HFIS plc are authorised & regulated by the FSA.

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Step-by-Step | Skin Revitalisation and Dermal Rollering

PERFECT PERFECT PAIRING We take a step-by-step look at combining restylane® Vital skin revitalisation treatment with the medik8 roller for optimal skin boosting good skin quality and skin appearance is of particular importance as it is an indicator of youth. Whilst restylane® Vital and the medik8 dermal roller skin needling technique each encourage the production of healthy new skin in their own right, used in combination they optimise skin health and produce glowing, radiant skin. restylane® Vital provides deep dermal hydration in the skin where it is needed and the skin needling encourages the production of new collagen, making them the perfect pairing.

Restylane® Vital

restylane® Vital provides deep dermal hydration and moisturises from

an important part in the skin’s hydration system and in the production of

within to improve skin elasticity and skin smoothness. restylane® Vital keeps

healthy looking skin. restylane® Vital improves skin surface smoothness

the skin looking plump and hydrated and so diminishes the appearance

and elasticity, which results in smoother and firmer skin and enhances the

of fine crêpey lines caused by sun damage. a recent ground breaking

skin’s light reflecting qualities. skin glow and lustre are restored.

study demonstrates that restylane® Vital changes the skin’s biophysical

* (stefanie Williams, md, slobodanka tamburic, Phd, henriette stensvik,

properties towards that of younger skin*. restylane® Vital is a smooth,

bsc (hons). changes in skin physiology and clinical appearance after

pure crystal clear hyaluronic acid (ha) gel and is injected into the skin to

microdroplet placement of hyaluronic acid in ageing hands. Journal of

replenish the skin’s own ha, which attracts water in the skin and plays

cosmetic dermatology 2009, 8: 216-225)

cosmeticnewsuk.com

medik8 Dermal Roller

collagen with impressive results on common skin conditions such as fine lines

skin needling using the medik8 titanium dermal roller results in the formation

and wrinkles, indented scars, enlarged pores and hyperpigmentation. skin

of thousands of miniscule pin prick wounds to the targeted skin tissue, which

needling allows for controlled induction of the skin’s self repair mechanism

in turn triggers the onset of the normal healing process to occur in the

by creating micro injuries in the skin, which trigger new collagen synthesis,

broken skin and the production of new collagen in the upper dermal layer

yet does not pose the risk of permanent scarring. the result is smoother, firmer

of the skin. consecutive skin needling sessions continue to promote new

and younger looking skin.

Treatment protocol Step 1

Step 2

Step 1: first the patient has a topical anaesthetic

Step 2: restylane® Vital, containing non animal stabilised

cream applied for a minimum of 45 minutes to

hyaluronic acid, is injected into the skin using the restylane®

numb the area. then the skin is cleaned with an

injector, in a series of micro injections across all areas of the

antiseptic wash.

face, upper from the brow, mid face to lower face and chin.

Step 3

Step 4

Step 3: a cooling ice pack is

Step 4 : the skin needling technique with the dermal

applied.

roller commences with the practitioner making sweeping movements across all areas of the face with the roller.

Step 5

Step 5: Immediately afterwards you can see the very many tiny marks made by the needling and micro-injections and a cooling face mask containing calendula and arnica is applied to the skin.

Step 6

Step 6: the skin still looks quite pink immediately afterwards – like sunburn. but with a light application of mineral make up, the redness can be covered and patients can leave the clinic without feeling too self-conscious. the treatment regimen comprises two or three treatment sessions about six weeks apart. benefits of the treatment are not immediate but a marked improvement in skin quality and texture is noticeable around three weeks after the second treatment session.

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P Ex R C ten a s m iv p e a ig n

Genuine Dermaroller™ Therapy™ Natural Skin Regeneration & Scar Repair Genuine Dermaroller™ Therapy™ significantly improves the appearance of:

• Acne scars

• Facial and décolleté lines and wrinkles

• Sun damaged skin & pigmentation

• Stretch marks

Genuine Dermaroller™ CE marked sterile single-use medical devices guarantee quality - accept no substitutes

Before and after Genuine Dermaroller™ Therapy™

GENUINE TM

Dermaroller

Acne scars After two Genuine Dermaroller™ procedures

Aged and sun damaged skin/ facial lines & wrinkles Improvement 3 months after one Genuine Dermaroller™ procedure

O TH

R IS E D CL I

IC OR

ISE D C L

0800 0195 322 www.genuinedermaroller.co.uk

The Professional Choice Advanced dermo-cosmetic and dermatological research-based products

www.aestheticare.co.uk

w C w w l C .ge ini c a ll nui a 0 ne l t 8 0 der ra 0 m i 0 ar nin o 19 l g 5 ler. c 3 2 o.u k 2

To find out how to become an authorised Dermaroller™ clinic, call us now on

Genuine Dermaroller™ Therapy™ is only available from trained medical practitioners and authorised Dermaroller™ clinics.

Clinical Study | Obagi Clenziderm

SPOT

ChECKED

We examine the results of a multi-centre, investigator-blind, randomised study comparing a novel solubilised benzoyl peroxide gel (obagi clenziderm) with benzoyl peroxide/clindamycin

INTRODUCTION

novel solubilised 5% benzoyl peroxide (bPo) gel (obagi clenziderm) has recently become available as a treatment for acne vulgaris—both as a stand-alone product1 and as part of a 3-step acne system2 (in conjunction with a proprietary cleanser and toner containing 2% salicylic acid). In other formulations of bPo, the bioavailability and follicular penetration of bPo can be suboptimal because the molecule is only poorly soluble and can exist as macrocrystals whose diameters may exceed those of hair follicles. In contrast, the solubilised bPo formulation aims to maintain the bPo in solution in order to promote greater bPo bioavailability and greater penetration of bPo into the follicles. this study compares the efficacy and tolerability of the solubilised 5% bPo formulation with those of a leading 5% bPo/ clindamycin prescription product in a multi-centre investigator-blinded study. an initial set of four-week data from this study has been presented previously.3 additional patients were subsequently been enrolled into the study and the period of treatment has been extended to 12 weeks. overall results from both parts of the study are reported here.

METHODS

Washout periods

Study design

• One week for medicated facial cleansers

• Multicenter, investigator-blind, randomised,

• Two weeks for topical alpha-hydroxy acids, anti-

split-face study

acne medications, topical retinoids, topical and systemic antibiotics, topical and systemic steroids

Key inclusion criteria

• Three months for estrogens/birth control pills

• Moderate facial acne vulgaris (25-100 non-

(unless use had been stable for at least three

inflammatory lesions, 25-100 inflammatory lesions,

months)

up to two nodulocystic lesions)

• Six months for systemic retinoids

• 11-45 years of age • Willing to refrain from excessive exposure to the

Treatment regimen

sun and the use of tanning booths

• Patients were randomly assigned to apply one

• Willing to refrain from facial use of non-study

of the following to one side of their face and the

acne medications, moisturisers, sunscreens,

other to the contralateral side of their face, twice

fragrances, aftershaves, and make-up (however,

daily for four or 12 weeks:

oil-free non-comedogenic make-up, mascara,

– solubilised 5% bPo gel

(eyeshadow, and lipstick were allowed)

– 5% bPo/1% clindamycin combination product (gel product packaged in a pump)

Key exclusion criteria

• Before applying either product, patients

• Allergy to benzoyl peroxide, clindamycin,

were required to wash their face using a gentle

lincomycin, salicylic acid, sunscreens or other

cleanser (provided).

ingredients in the study products

• Patients were instructed to avoid applying the

• Facial cosmetic procedure in the preceding six

test products around the lips and eyes and were

months

allowed to use a non-comedogenic moisturizer

• Papulopustular rosacea and other skin diseases

with sunscreen (of at least sPf 15) as necessary

on the face (other than acne) that could interfere

during the study.

with study evaluations • Facial sunburn at the baseline visit

Outcome measures

• Males with a beard or sideburn that could

• Non-inflammatory lesion count (open

interfere with study evaluations

comedones plus closed comedones)

• Uncontrolled systemic disease or infection with

• Inflammatory lesion count (papules plus pustules

human immunodeficiency virus

plus nodules)

• History of regional enteritis, ulcerative colitis, or

• Patient satisfaction with the improvement in their

antibiotic-associated colitis

acne (rated as very satisfied, satisfied, somewhat

• Concurrent facial use of other medicated

satisfied, indifferent, or dissatisfied)

products

• Erythema, dryness, peeling, stinging/burning,

• Participation in an investigational study in

and itching (table 1)

preceding 30 days

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Clinical Study | Obagi Clenziderm TABLE 1: Scales used to evaluate tolerability parameters Scale

Erythema

Dryness

Peeling

Stinging/burning

Itching

None – no erythema present (may be minor discoloration)

None – no dryness present

None – no peeling present

None – no stinging/ burning

None – no itching

mild – light pink, noticeable

mild – slight but definite roughness

mild – slight peeling

mild – light warm, tingling sensation, not really bothersome

mild – occasional, slight itching

moderate – pink-red, easily noticeable

moderate – moderate roughness

moderate – definitely noticeable peeling

moderate – definite warmth, tingling/ stinging sensation that is somewhat bothersome

moderate – constant or intermittent itching that is somewhat bothersome

Severe – deep or bright red, may be warm to the touch

Severe – marked roughness

Severe – extensive peeling

Severe – hot tingling/ stinging sensation, which is disturbing normal activity

Severe – bothersome itching, which is disturbing normal activity

Statistical analyses • Between-group differences in lesion count and mean scores for erythema, dryness, peeling,

Tolerability

stinging/burning, and itching were compared using

• Mean levels of erythema, dryness, peeling,

a paired t-test or Wilcoxon signed rank test.

stinging/burning, and itching were less than mild in

• A P value of ≤05 was considered statistically

both groups at all time points.

significant.

• Although the mean levels of these parameters

RESULTS

were significantly higher with the solubilised bPo gel than with bPo/clindamycin in the first three or

Patients

four weeks of treatment, these differences were

• A total of 65 patients enrolled:

transient and were likely not clinically significant

– 23 to receive four weeks of treatment (of whom,

in the majority of patients—as evidenced by the

100% completed)

fact that there was no significant between-group

– 42 to receive 12 weeks of treatment (of whom, 37

difference in mean patient satisfaction score at any

(88%) completed).

timepoint.

• Premature discontinuations from the study were

• One patient discontinued prematurely due to

due to non-compliance (2), burning sensation and

adverse events (burning on the side of the face

erythema (1), voluntary withdrawal (1), and loss to

treated with the bPo/clindamycin product, and

follow-up (1).

erythema on both sides of the face).

• The patients had a mean age of 19 years and

• In addition, another patient discontinued applying

54% were female.

the solubilised 5% bPo gel to one side of their face

• They were predominantly:

(due to a burning sensation on their temple) but

– caucasian (71% caucasian, 6% caucasian

continued applying bPo/clindamycin to the other

hispanic/Latino, 14% black, 3% asian, 6% other)

side of their face.

– fitzpatrick skin type III (13% I, 25% II, 39% III, 8% IV, 5%

clinical improvement attained with the threestep acne system

V, 10% VI).

Efficacy • The solubilised BPO gel resulted in a significantly greater reduction in non-inflammatory lesion count than bPo/clindamycin at weeks 1, 2, 3, 4, and 12 (P≤05) • At week 12, the non-inflammatory lesion count was reduced by a mean of: – 57% with the solubilised bPo gel (P≤05 versus bPo/clindamycin) – 46% with bPo/clindamycin. • Both groups showed comparable reductions in the inflammatory lesion count at all timepoints

CONCLUSIONS In this study, twice-daily monotherapy with the solubilised 5% bPo gel resulted in significantly greater reductions in non-inflammatory lesion count compared with twice-daily therapy with a 5% bPo/clindamycin combination product. Levels of patient satisfaction, and reductions in inflammatory lesion count, were comparable in both groups. the significantly greater reduction in non-inflammatory lesion count with the solubilised bPo gel is likely attributable to enhanced follicular penetration of bPo. It is also possible that the unique solvent technology used in the bPo formulation could play a role. the solubilised bPo gel has two advantages of considerable clinical importance. first, significantly greater reductions in non-inflammatory lesion count may be evident after only one week of treatment (and speed of improvement is very important to patients). second, the clinical advantages of the solubilised 5% bPo gel in achieving a comparable reduction in inflammatory lesion count and a significantly greater reduction in non-inflammatory lesion count are achieved in the absence of an antibiotic.

• At week 12, the inflammatory lesion count was reduced by a mean of: – 63% with the solubilised bPo gel 64% with bPo/clindamycin.

Patient satisfaction • Patient satisfaction with the improvement in their acne was comparable in both groups at all timepoints.

[REFERENCES] 1. Introducing solucLenZ rx geltm. obagi medical Products website. http://www.obagi.com/article/ forpatients/obagisoluclenzrx/ soluclenz.html. accessed december 2, 2008. 2. cLenZIderm m.d. - Product detail. obagi medical Products website. http://www.obagi.com/article/ forpatients/obagiclenzidermmd/products/products.html. accessed december 1, 2008. 3. tanghetti e, kircik L, Wilson d, dhawan s. comparison of a novel solubilised benzoyl peroxide gel with benzoyl peroxide/clindamycin: a multicenter, investigator-blind, randomized study. Poster #123 presented at the 66th annual meeting of the american academy of dermatology, february 1-5, 2008, san antonio, tX. http://www.obagi.com/documents/n0a%20010a%20Poster%20fInaL.pdf. accessed december 5, 2008.

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Treatment Spotlight | Anteis Injection System

INJECTION LOADED w

e take a look at the results of a clinical trial into the use of the anteis Injection system for rejuvenation and filler injections

Introduction Existing techniques for the aesthetic treatment of facial wrinkles and folds by injection include the use of hyaluronic acid, Botox®, collagen and various other materials. Injection techniques are all associated with some degree of side effects, include hematomas, swelling and pain, which can dissuade patients from undergoing treatment. manual injections can also cause papules to remain visible on the skin surface for two or three days following treatment, mainly due to the non-homogeneous volumes of the drops produced. The speed of injection is hard to control, and the more quickly the injection is performed, the more pain the patient feels. The repetitiveness of manual techniques and the viscosity of the products also lead to the practitioners experiencing muscle fatigue, further reducing the accuracy of the volume administered and the control of speed and depth. the anteis Injection system is a new, automated electronic injection system for fillers and rejuvenation products, designed as a modern alternative to traditional injection procedures that provides increased accuracy, comfort, ease of use and safety. It is intended for local injection with anteis aesthetic product lines, which include esthélis soft and basic for superficial to mid-dermis injections, fortélis for mid- or deep dermis injections of face skin tissues, and mesolis and mesolis+ for rejuvenation with superficial dermis injections of face or body skin tissues. It can be used in flow mode (only one movement is required, injection is regulated) and/or in drop mode (volume of papule is homogeneous and standardised, using a drop dosage). this article reports the results of a recently completed preliminary clinical evaluation of the anteis Injection system.

Clinical trial objectives

Methods

the objective of the clinical trial was to provide clinical evidence for the

a total of 193 patients in eight centres were involved in

safety and efficacy of the anteis Injection system for the treatment of

this assessment. 130 patients were injected with mesolis or

different facial wrinkles and folds with fillers and rejuvenation treatments,

mesolis+ products for rejuvenation treatment, with all eight

and to assess the strengths, limits, ease and mode of use of this device.

practitioners participating. 63 patients were injected with

the trial allowed the accumulation of data on how the Injection system is

the fillers esthélis soft, esthélis basic and/or fortélis, with six

used by practitioners for different techniques, and on both practitioner and

practitioners participating. a total of 267 indications were

patient satisfaction.

treated with the Injection system in these patients: 92 with fillers and 175 for rejuvenation. In some cases the two treatments were combined. 64% of rejuvenation patients and 63% of filler patients had previously been injected manually. outcomes were recorded and assessed through questionnaires and evaluation forms filled in by patients and practitioners.

cosmeticnewsuk.com

Results

In practitioners’ global assessment, 100% found

the main adverse events were redness (44%)

Use of Anteis Injection System for

the Injection system easy to install and handle

and pain (27%), followed by itching (15%). other

rejuvenation treatment

and comfortable for injection, and 100% were

adverse events each affected no more than

the three main indications treated were facial

satisfied with the results. 80% found the injections

4% of patients. 68% of patients declared that

hydration (65%), crow’s feet (12%) and neck

more precise than with manual injection. the main

the injection itself was not painful, and 86% of

(7%). the mode used most frequently for these

inconvenience mentioned was the time to install

patients did not feel any pain after the injection.

indications was the drop mode (57% drop

(40%), while the main advantage was the lack of

72% of patients did not report any side effects.

alone, 31% drop and flow). the lowest speed

pain for the patient (80%).

89% of patients were satisfied with the treatment. among patients who had previously been

was selected for 69% of drop usages, facilitating the creation of homogeneous papules. 30g

the following is a summary of the key

injected manually, most said that the use of the

needles were used for 52% of the injections, while

characteristics observed for the anteis Injection

Injection system was painless, and none felt more

for another 46% of injections 32g needles were

system used for rejuvenation treatment:

pain than with manual injection. In practitioners’

used, despite the fact that only 30g needles are

•

global assessment, 100% stated they were satisfied

provided in the anteis boxes. With 32g needles, pain during treatment could be significantly

•

reduced, the use of an anaesthetic before treatment could be avoided and fewer side effects were observed.

•

for the main indication performed in rejuvenation treatments, face hydration, an average of 1.2 ml of product were

•

Injection with high precision and better control of speed and papule volume.

with the results. 60% found the anteis Injection

the application of both micro-papular and

system more comfortable for injection, and 60%

nappage techniques by using the distinct

said it was less painful for the patient and easier

drop and flow injection modes.

to inject than manually. 40% found the injection

reduced downtime, as papules disappear

more precise and the depth of injection easier

faster due to the homogenous volume of

to control, while 60% found the speed easier to

drop delivery.

control. the main inconveniences mentioned

a significantly less painful injection for the

were the time to install (40%) and loss of product

patient with fewer side effects.

(40%), while the main advantages were the lack of pain for the patient (80%), lack of adverse

used for the whole face, drop mode with low speed and 32g needles

Use of Anteis Injection System with fillers

were the most used parameters, and

the main indications treated were nasolabial

no anaesthesia was used in 74% of

folds (47%) and bitter folds (11%), followed by

the following is a summary of the key

cases. 67% of patients stated that the

cheeks (7%), lips (7%) and around the eyes (7%).

characteristics observed for the anteis Injection

injection was not painful and 88%

fortélis was the most used filler with the Injection

system used for fillers:

did not feel any pain after injection.

system with 47% of injections, followed closely by

75% of patients reported no side

esthélis basic with 45% of injections. fortélis was

effects, and those reported were

used mainly in flow mode (62%), using a 27g

only slight redness immediately

needle for 85% of these injections. When used

after the injection. 87% of patients

in drop mode a 27g needle was also used for

were satisfied with the treatment.

all injections. esthélis basic and esthélis soft were

among patients who had

used almost exclusively in flow mode, with a 30g

previously been injected manually,

needle used for 78% of these injections. overall,

66% claimed that the Injection

the flow mode was used for 81% of the indications.

system procedure is less painful.

75% of fillers were injected under anaesthesia.

events (40%) and better control of injection (40%).

•

Injection with better control of speed and volume

•

reduced pain, with a procedure that is faster and more comfortable, with few adverse events

•

easier injection of fortélis, especially for deep wrinkles

•

a better result due to better integration of the filler into the dermis.

Discussion the anteis Injection system was designed for ease of use with all injection techniques, providing highly predictable doses of product. freed from the need to control flow rate or drop volume and able to apply softer pressure, the physician is able to focus on the

Conclusion altogether, these results demonstrate the safety and efficacy of the anteis Injection

placement of the product, leading to greater precision and a more

system for rejuvenation and filler injections. It

homogeneous application of the product within the desired plane,

presented no safety concerns and provided better

whether superficial, mid- or deep dermis. the Injection system also allows the use of smaller-diameter needles, and anaesthesia can be avoided altogether in the case of rejuvenation treatments. these properties provide greater comfort for the practitioner and lead to

control of depth, speed and volume than manual injections. as a consequence, patients experienced less pain and fewer other side effects and a singularly reduced downtime after rejuvenation treatment.

significantly reduced pain for the patient. the consistent results at

these positive results were underscored by a

all injection sites and enhanced integration into the dermis yield a

global practitioner satisfaction rate of

better result and minimise bruising, redness and swelling. the anteis

100%.

Injection system therefore represents a superior means of applying fillers and rejuvenation products compared to traditional manual injection techniques.

cosmeticnewsuk.com

Product News | Round Up

News

PRODUCT

EUROSURGICAL INTRODUCES IGUIDE® Eurosurgical has introduced iGuide®, a surgical suture system which uses minimallyinvasive technology to allow brow and neck-lift procedures to be performed without general anesthesia and without incisions. created by dr gregory mueller, the iguide® can be used to oversew the muscles of the neck, or elevate the brow using the patented instrument system, without making any incisions. featuring five tools, the iguide® allows for the placement of a suture support system through a series of needle punctures. Instead of cutting and repositioning the muscles and other structures, the surgeon weaves the suture underneath the jaw line with one continuous thread. this provides immediate neck rejuvenation results that equal the results from traditional methods – without the swelling, bruising and scarring. the devices include: iguide® mark, which creates transparent stencil marks puncture sites along the sides of the jaw line; iguide® Pierce, a puncture device that creates access to the

AESTHETICARE ExPANDS PRODUCT OffERING AesthetiCare is proud to announce the

sites to allow for the percutaneous building of the suture trampoline®; iguide® clear which

addition of Endocare to its repertoire of anti-

clears dermal attachments around each puncture and allows easy passage of the suturod®

ageing and appearance-enhancing devices.

in and out of puncture sites, without piercing the deep dermis; iguide® suturod®, disposable,

the endocare skincare range uses sca

fiber optic, polymer-coated, stainless steel lighted rod, with attached suture, guides the

biorepair technology to provide scientifically

passage and placement of the suture over the muscles and

advanced regeneration of ageing and photo-

iguide® Light

damaged skin.

a docking device/handle for the iguide® suturod® which

the patented technology utilises a natural

illuminates the tip of suturod® through its fiber optic core

secretion of the mollusc crytomphallus

and aids safe placement of the surgical trampoline®.

aspersa, containing powerful growthfactor mechanisms. It stimulates natural skin regeneration mechanisms, increases the numbers and activity of fibroblasts, which generate collagen, elastin and hyaluronic acid, builds the underlying architecture of the skin, and provides anti-oxidant activity against skin damaging free radicals. the endocare skincare range uses differing concentrations of sca biorepair technology to target specific areas and treatment needs so that regular use will regenerate the skin and reduce visible signs of ageing and photo-damage.

PRODUCT NEwS IN BRIEF mED-Fx ExPANDS SKINCARE RANGES TO mEDICAL AESThETIC mARKET

SUPERmODEL ERIN O’CONNOR IS ImAGE SKINCARE’S BIGGEST FAN

med-fx is pleased to announce two new additions to its skincare range:

Image skincare has a new celebrity fan in the form of supermodel erin o’connor.

onLy yourx skincare and Image skincare.onLy yourx skincare is a

the catwalk queen has been raving about the line’s Vital c range. she said, " I have

customised skincare programme which offers practitioners a substantial

been using Image skincare, in particular the Vital c range, and find the products

mark up and is also a great range to increase customer retention, as the

to be fantastic for the rigorous routine my skin endures being a fashion model. after

client must return for their unique formula. Image skincare is the latest

using the Vital c hydrating facial cleanser to remove excess heavy duty make up, I

range to hit the uk by storm. the pharmaceutical grade range works at

use the hydrating enzyme masque to rejuvenate and balance my skin, restoring my

cellular level to diminish fine lines and wrinkles, fade sun damage, increase

natural skin tone. It leaves my skin feeling brilliantly refreshed and hydrated. I love this

hydration and stimulate cell turnover for more youthful looking skin.

line and to boot the smell is addictive – I am a fan."

cosmeticnewsuk.com

For more information or to receive your instructional DVD contact Eurosurgical on T: +44 (0)1483 456007.

FOR FURTHER INFORMATION CONTACT: Merrow Business Centre, Guildford, Surrey GU4 7WA T: +44 (0)1483 456007 F: +44 (0)1483 456008 E: sales@eurosurgical.co.uk W: www.eurosurgical.co.uk

Product News | Round Up

News

PRODUCT

ENvIRON LAUNCHES AvST BODy OIL environ has unveiled the latest addition to its aVst range, aVst body oil. a very fine oil, containing high doses of vitamins a, c and e, aVst body oil also contains ingredients that fight the signs of sun damage and ageing and improve firmness and hydration. the nourishing, moisturising oil is formulated to improve the elasticity of the skin, reduce body scars and tighten lax body skin. It is ideal for smoothing a crepey décolletage, to tightening slack ‘bingo’ wings, and minimising the appearance of stretch marks commonly caused by weight gain or pregnancy. It is also good for dry skin conditions and is particularly recommended for sundamaged areas of the body. this is no superficial, short-term moisturising product, it uses the known effects of the vitamins to stimulate the body’s own natural moisturising factors and promote firmer skin. the oil stimulates the production of healthy collagen and elastin and improves the blood supply to the layers of the skin, increasing the growth of the basal layer of the skin. this in turn thickens the epidermis while compacting the skin’s surface.

mENE&mOy® LAUNChES NEW PRODUCTS mene&moy® has introduced facial masque c10 and c silk touch. facial masque c10 is a peel off mask with a face-lift effect which rapidly releases anti-radicals. It is applied to

JANE IREDALE SUPPORTS BREAST CANCER ChARITy

cleansed skin over the face and neck and left to take effect

mineral make-up brand jane iredale has created a lip plumper and exfoliator to

vitamins a, e, phytic acid, bisabolol and zinc the masque

raise awareness of breast cancer, not just during Breast Cancer Awareness month,

has an immediate and long lasting firming effect, removes

but throughout the year.

dead skin cells, provides intense hydration and brightens your

the mythical Phoenix represents resiliency and renewal, and is the name chosen for

complexion. after the facial masque c10 the c silk touch

a special new version of jane iredale’s popular sugar and butter lip plumper and

is applied to the face neck and décolleté for a rich night

exfoliator, an uplifting pink featuring ingredients that honour women’s health.

time treat. the silky texture comes from silicone polymers and

from now through to august 2011, £1 per Phoenix product sold will be donated by the

cyclomethicone which helps to lock in hydration, smoothing

distributor of jane iredale in the uk and Ireland, to the charity against breast cancer,

and soothing the skin. this gentle triple protection antioxidant

in support of their research at university college London. against breast cancer is

night treatment also contains a high concentration of vitamins

funding unique research to increase survival after diagnosis and ultimately to discover a

a, e and c for the ultimate protection against free radicals.

for approximately 20 minutes or until the mask is completely dry. the film is then detached and gently lifted off in an even movement. containing Vitamin c and antioxidants

vaccine against breast cancer.

PRODUCT NEwS IN BRIEF CACI AmINO LIFT IS A WINNER

KUSh SUPPORTS BREAST CANCER AWARENESS

cacI amino Lift has won the prestigious ‘best Ingredients’ category

the company behind an innovative breast support device is pledging £2 per sale of

in the Prudence beauty awards. the annual awards are made up of

their pink-coloured version to support breast cancer awareness month. aimed at

16 categories and will be featured in the september/october issue

women who are a c cup or above, the kush is a cylindrical breast support device

of Ireland’s Prudence magazine, a glossy, bi-monthly. reviewing

made from an extremely lightweight Pet plastic. the device is placed between the

cacI amino Lift, acclaimed dermatologist and guest judge dr

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clare cushen commented, “good science, good ingredients like

the company will donate £2 for every pink kush purchased through its website

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Best Practice | IPL Efficiency

RUNNING

ON EMPTy? mike murphy asks, why don’t manufacturers supply energy meters with their IPL systems? measurements do not tell you how much energy is

Mike Murphy, b.Sc., M.Sc.(bioengineering) has been involved with lasers and iPl systems

many clinics and salons throughout the uK now offer ipl systems as part of their daily service whether for hair removal or the treatment of thread veins, brown skin marks or facial rejuvenation. they are now as routine as facials, aromatherapy and nail treatments even though they have only been in the market for less than 10 years.

since 1986 when he worked with plastic surgeons in the Plastic and Reconstructive Surgery unit, Canniesburn hospital, glasgow. he is a physicist and was involved in clinical research into the removal of vascular and

out, an IPL’s electrical and optical system may also become less efficient over time. this will also affect the power output. the upshot of all this is that you may be under-treating your clients. have you noticed that some clients appear to take much longer than others to achieve a good result? this may be due to differences between individual clients, but it may also be due to your IPL system delivering lower than expected

But, how do you know if your system is operating

powers. In some cases your unit might be generating

at its best? If you don’t have an energy meter to

a power that is simply too low to destroy the germ

check it from time to time, you won’t! however,

cells in hair follicles.

pigmented lesions and tattoos using lasers and

many manufacturers do not supply such meters

was also the laser safety officer in the hospital’s

with their products – why not? Can you imagine

simply put, this means that some clients are going

driving your car without a speedometer to tell

to need too many treatments while others may

you how fast you were going? Of course not!

never achieve good results. either way, this is bad for

So why are we expected to use a hi-tech piece

business and your reputation.

laser unit. he has published a number of clinical reports in peer-reviewed journals across the world in both clinical and theoretical aspects of laser/iPl treatments in skin. in the last few years he has worked as an independent consultant in both lasers and iPls around the world.

of equipment without being able to check it is working properly?

cosmeticnewsuk.com

What can we do about this? I have recently come across a company based in sweden

every IPL system uses a flashlamp (or two) – this is

(www.photonova.com), which has just launched

where the light is generated. essentially flashlamps are

an energy meter specifically designed to

highly engineered light bulbs. as with your domestic

measure the output of almost any IPL system. It

light bulb they wear out over time. the more you use

is called the efm meter and this device can tell

it the less light it generates. so, after 5,000 shots the

you the energy density and the length of the

Can you imagine driving your car without a speedometer to tell you how fast you were going? Of course not!

reaching the skin!) In addition to the lamp wearing

lamp will likely not produce

pulse from your IPL unit. It is critical to know each

as much light as when it is

of these parameters to ensure safe and effective

new. after 10,000 shots it

treatments and to generate good, consistent

might be generating only

results ultimately.

50% of its original power, or less. this means that you

as far as I know it is the only device on the market,

should increase the power

which can measure all IPL systems’ output. If

to your clients as the lamp

you want to be sure you are delivering the best

ages. but who does this? as

service to your clients, then I suggest you look into

far as I am aware, nobody. that’s because there is no

checking your system. Which brings me back to

way to measure the energy output of an IPL system

my original question – why don’t manufacturers

without using an energy meter. Ideally you need to

supply energy meters with their products? It seems

measure the power at the point of delivery – that is, at

obvious to me that they should. or, are they trying

the part, which is in contact with the client. (Internal

to hide something?

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9/15/10 8:44 AM

View On | Cosmetic Medicine Sea View On/ Cosmetic Medicine at atSea

sAIL

SETTING Dr Patrick treacy gives his View on the potential for developing cosmetic medicine at sea

Although cosmetic medicine clinics have been around for at least 10 years, familiarity with the concept in the cruise line market has yet to occur. In a recent survey of major cruise liners, only two had considered the possibility of placing this exciting and developing branch of medicine on board. Dr Patrick Treacy, medical director of the Ailesbury Clinic

was recently keynote speaker at a major cruise line conference in Venice (European medical Travel Conference 2010). The conference focused on many aspects of the industry, including the interaction of emergency and recuperative medicine aboard cruise liners. Dr Treacy spoke about the introduction of this emerging field of medicine into this novel jurisdiction.

Dr Treacy is well suited to develop this new marine specialty having previously been ship’s surgeon with Carnival Cruise Lines (1993-1994). he also served as Surgical Lieutenant Comm. Royal New zealand Naval Reserve (1987) and was assist Port medical Officer in Gibraltar (1991). here his gives us his View On the subject…

“the practice of cosmetic medicine at sea has the potential to emerge as a dynamic force, which has the power to positively change the healthcare landscape globally. In the united states, cosmetic medical spas are presently a $30 billion industry. over the past five years, in this jurisdiction alone they have

“The practice of cosmetic medicine at sea has the potential to emerge as a dynamic force, which has the power to positively change the healthcare landscape”

grown at 150% making it the fasting growing sector of this market. this phenomenon is largely considered to be driven by the ‘baby boomer’ generation who presently comprise nearly 30% of the american population. a ‘baby boomer’ is defined as someone who was born during the period of increased birth rates when economic prosperity rose in many countries following World War II. It is important for future strategists of the cruise line industry to remember this is an iconic term widely used to refer to the american population in particular and post WW II and demographics in europe did not necessarily mirror this effect until later. despite this, we normally say whatever happens in america will happen in europe also, so be prepared for what I feel is the next stage of the healthcare industry – the cosmetic medical spa! there are other influences driving this market. recent statistics from the cruise Lines International association (the industry’s largest trade group) show europe is a rapidly growing market where cruising presently generates $32 billion annually. this compares very favourably with annual revenue in the united states of $40 billion. of equal importance is the fact that the cruise line industry itself has experienced an average of 7% annual growth in passengers since 1980, even during recent recessionary times.

cosmeticnewsuk.com

View On | Cosmetic Medicine at Sea

“I predict most cruise liners will in the near future have medical spas and these will fit into two categories: aesthetic/cosmetic and preventive/ wellness”

and alternative medicine. this

location for the introduction of more novel ideas

means there would be two skill

such as IPL lasers, especially on the longer three to

sets of doctors with the latter

four month world cruises where hair removal over

approach, favouring the term

five to six courses becomes technically feasible.

wellness centre, while spas with a

there probably will not be an immediate market

cosmetic specialty will be happier

for skin resurfacing due to the risk of skin cancers

to incorporate the word medical

from uV light in this environment, however I did

into their names.

this in australia with similar conditions and we should possibly consider some of the ships sailing

this means medical spas with an aesthetic/cosmetic orientation will utilise lasers and intense pulsed light technology as well as botox®

closer to antarctica or alaska. anything is possible, depending on our imagination. With an optimistic outlook for 2011, this is the perfect time to introduce cosmetic medicine into this jurisdiction.

and restylane® injections, medical microdermabrasions, photofacials, medical

In my experience, we also have to be vigilant

peels and other medical beauty procedures.

to what happened to the type of doctor was

With such a portfolio of services, cruise line spas

initially involved with the medi-spa industry in the

during the 90s, I used to work on the ms fascination

could combine standard skincare treatments with

united states. We know that many doctors were

porting in Port canaveral, florida. this port was

medical procedures.

initially attracted to this industry because they get

home to ships from royal caribbean, disney cruise Line and carnival cruise Lines. Little did I realise

It takes six years to plan a new ship and we can

back in 1993, as I faced another lonely night at sea,

certainly sit with the ship designers of the future

hundreds of miles from shore with a sick patient, that

in order to plan the ships of the next decade but

I would be standing here many years later in the

this is something that can be done now with little

presence of such eminent company as Professor

extra investment. It would probably just entail

eilif dahl from the university of bergen and trying to

modification of some of the procedure rooms

bestow upon him the benefit of bringing the most

already available in the spa areas. We have got to

toxic substance on the planet on board cruise ships

realise that the total ethics of marketing, will possibly

to remove the wrinkles of the elderly passengers!

also change while one is in the no man’s land of

Little did I also realise, as I injected an Italian staff

the marine environment. We realise that most liners

captain’s osteoarthritic knee with hyaluronic acid

are flagged under flags of convenience to ports in

in 1994 that I would be speaking about the benefits

monrovia or Liberia where standards are often lower

of now putting the same substance into a patient’s

than the united states or europe. however, where

face in order to make them look younger.

this may benefit marketing of products, I would

“the cosmetic market at sea is ready to be established if clients could trust the cruise line industry having a premier level of patient care”

urge people not to make the mistake of lowering so, what would be the infrastructure required and

standards in terms of medical personnel, sterilisation

paid right away and there was little paperwork

what procedures could safely be considered

procedures or some other protocol as you have to

or overheads compared to running their own

for a marine environment? firstly, I would intend

remember our clients are first world although our

business. this unfortunately, also led to a type

the cosmetic medical spa to be run under the

badges of reference may not.

of doctor who worked administering botox®

supervision of a trained cosmetic doctor and to be

who often had little previous experience of laser

totally separate from the normal medical personnel

the cruise world is also changing with most of the

treatments. the american industry quickly learned

of the ship’s hospital. there are many reasons for

newer ships rolled out in the last few years have

that consistency of service and continuation of

this including the difference in skill sets and the

4,000 passengers+ and many with 20,000 sq. foot

care were the primary requisites to provide the

inability of the cruise ship’s doctor to deal with

spas. the optimism for this year's economic outlook

proper level of aesthetic care. In this regard, we

the specific complications of cosmetic medicine.

means we should be considering increasing our

must learn from this experience and not make

secondly, I would consider two different types

amenities on board and what better place to

the same mistakes. I have been medical advisor

of medical personnel emerging from this model.

recuperate and return refreshed looking than a

to the onboard spa company for the past three

I predict most cruise liners will in the near future

holiday at sea. recent data from the canaveral

years and they have led the european industry by

have medical spas and these will fit into one of two

Port authority Port shows revenue is up 43.8%

providing specialised dedicated onshore training

categories: aesthetic/cosmetic and preventive/

compared with the same period a year ago. even

schools for all their healthcare professionals who

wellness. this will occur as a consequence of the

in recessionary times, their year-to-date cruise

remain onboard for many months. this scheme

owners of the cruise line companies and attitudes

passenger counts were up 19.4% and multi-day

was enacted in order to provide their onboard

will be driven by factors such as insurance risks

cruise revenue was up 23.4%. We are encouraged

clients with that consistency of service by those

and operators happier to take a ‘wait and

that the number of passengers passing through the

who work on board their ships, which was initially

see’ approach. medical spas with a cosmetic

port was 2.5 million in 2008 and 3.5 million in 2009.

lacking in the american model. I envisage setting

orientation would have a primary purpose of using

up training positions for new staff within dublin. I

medical procedures to improve appearance.

facts show cruise line passengers also tend to

have already trained over three hundred doctors,

this type of facility will employ high-tech devices,

spend twice as much in port as normal tourists. I

dentists and nurses in the practice of cosmetic

prescription medications and lean towards future

consider that the cosmetic market at sea is ready

medicine in hamilton fraser approved courses. I

surgical interventions. the other type of operation

to be established if clients could trust the cruise line

have been invited on board the Queen Victoria

would focus on wellness, the emphasis being on

industry having a premier level of patient care with

in a few weeks to enact the model and I look

maintaining health, well-being, and appearance,

only the best fda approved products and highly

forward to establishing another expansion to this

most probably with the help of complementary

trained cosmetic staff on board. this is the perfect

industry – cosmetic medicine at sea!

cosmeticnewsuk.com

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Business Focus | Clinic Marketing

E C I v R E A E S Th yL I W

T S

As part of a series of articles on marketing, Zoe Davitt tells you how best to market a service In our previous articles we have in turn looked at each of the traditional four P’s of the marketing mix: Product, Place, Price and Promotion. three additional Ps have since been added to the traditional marketing mix – Physical evidence, People, and Process. nowadays, marketing is far more customer-orientated than before and so this extended mix takes into account the different elements of the service you offer, as opposed to a physical product. before looking in more detail at these additional three Ps (which we shall be addressing in future articles), we will first look at the five main characteristics of a service and the consequent marketing implications. Zoe Davitt is managing director of 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.

Characteristic

1: Intangibility

If you are offering a service as opposed to a product – which in the aesthetic medical sector you are – then the benefits of that service are often seen as being intangible. In other words, there is no physical substance in service delivery. Clearly, this creates difficulties for the customer. They are not sure exactly what they will be receiving (and in terms of the treatment you offer how successful it will be), and so they feel there is a higher proportion of risk involved. This can inhibit their inclination to buy or ‘consume’ the service. to cut down on the perceived element of risk, the consumer needs information to form some grounds for judgement. this means that when you are marketing your services, you need to make the choice of the product safer and make consumers feel more comfortable about paying for something that might not have a physical form. The intangibility may be counter-acted in two ways: • By the consumer seeking opinions from other consumers • By the service supplier offering the consumer something tangible to represent the purchase

cosmeticnewsuk.com

marketing implications (a) Increasing the level of tangibility. When dealing with the customer, staff

can use demonstrations, videos or illustrations to make the customer feel

potential customers why they should choose you rather than other service

more confident about what the service is delivering.

supplies. this can be achieved by enhancing their perceptions of service

(b) focusing the attention of the customer on the principal benefits of

and value. differentiating factors such as quality, service reliability and

consumption. this can often take the form of communicating the benefits of

value for money will help add tangible elements to your service. branding

purchasing your services in such a way that the customer can easily see how

has become all-important; attaching specific values to your brand and

it will benefit them – they can visualise the difference it will make to them. a

communicating these to your customers secures and enhances your

great way of doing this is by using testimonials from previous customers.

market position and builds your company’s reputation.

Characteristic

2: Inseparability

A service often cannot be separated from the provider of the service,

Characteristic

4: Perishability

services cannot be stored like a can of baked beans. they are innately

because the performance of a service often occurs at the same time as its

perishable. this is because they are time based. that appointment slot from

consumption.

9-10am on monday september 1 is only available once. so you can only

think of a client having dermal fillers or a veneer fitted to a front tooth - neither

‘sell’ it once, and once it has gone you can’t re-use it.

exists until actually ‘consumed’ by the purchaser. marketing implications marketing implications

this presents specific marketing problems. meeting customer needs in

because the service and the provider are often inseparable in the minds of the

these operations depends on your staff being available when they are

consumer, increasing importance is attached to values of quality and reliability,

needed. this must be balanced against the need to minimise unnecessary

together with a strong customer service ethic. everything that you do must be

expenditure on staff wages. anticipating and responding to levels of

orientated around the customer – what they want, what they need and what

demand is, therefore, a key planning

they expect.

priority. there are two risks:

all staff, not just the clinician/surgeon, must be of a high calibre, well trained and customer-service orientated.

Characteristic

• An inadequate level of demand from customers is accompanied by

3: Heterogeneity

the substantial fixed cost of staff wages. too high a level of demand from customer smay result in lost custom because you don’t have sufficient staff to offer adequate service provision.

many services face a problem in maintaining consistency in their standard of

• You can try to match demand with supply by using price variations and

output. Variability of quality in delivery is inevitable, because of the number

promotions to stimulate off-peak demand. for example, if mondays are

of factors, which may influence it. this can create problems of operations

traditionally your quietest day, you could offer 25% off your services every

management.

monday.

the quality of the service can depend heavily on who delivers the service. marketing implications (a) Precise standardisation of the service offered. the quality of the service

Characteristic

5: Ownership

When you purchase a product, you become the owner of that item. services

can depend heavily on who delivers the service and when it takes place.

do not result in the transfer of any property and thus marketing a service

most of us have had bad experiences with rude receptionists, who may

becomes more challenging.

have been the fly in the ointment in an otherwise high quality establishment, or who may have just been having a particularly bad day. even if you use

marketing implications

standard procedures, the customer’s experience can differ dramatically

this lack of ‘ownership’ may very well lessen the perceived customer value

according to who they deal with and when.

of a service, and consequently make for unfavourable comparisons with tangible alternatives.

(b) Influence or control over perceptions of what is good or bad customer service. from the customer's perspective, it is very difficult to obtain an idea

many potential customers may well be comparing your service offering with

of the quality of service in advance of purchase. as a result, you need

other tangible items – a new flat-screen television, a new suit or a new watch.

to constantly monitor customer reactions, and maintain an attitude and

this is particularly applicable in the current economic environment, when

organisational culture which emphasises three things:

people may prefer to spend on ‘something that lasts’.

• Consistency of quality control • Consistency of customer service

to help overcome this issue, you need to provide symbolic tangible items,

• Effective staff selection, training and motivation

which can be taken away and kept. high quality brochures and marketing literature are a prime example of this. even though they are not of a

It is also important to ensure that there are clear and objective quality

high economic value to your customer, they can, strangely, make a big

measures in place and, where possible, there are standards set within the

difference to their perceived value of the service you are offering.

service. (cambridge marketing Press, 2005)

Conclusion

(adverts, brochures, website) providing customers with the information that

When a customer cannot touch or feel a product, they have to trust that

they need – reassuring them and communicating the benefits?

the service will be performed as promised. think about how you can help

giving thought to, and addressing, all these issues, may take some time, but

your customers compare you to other providers. What makes you different?

it is an investment that should reap rewards for your practice.

how can you exceed their expectations? are all the people involved in

In our next article we will be looking at the additional 3 Ps of the marketing

your service offering adding value? are your marketing communications

mix – People, Physical evidence and Process.

cosmeticnewsuk.com

DATES fOR THE DIARy OCTOBER

1 Epionce® Users Meeting, Royal Society Medicine, London lucy@episcienceseurope.co.uk 1 Dr Bob Khanna Training Institute, Beginners Dermal Fillers, www.drbobkhanna.com 1 SkinBrands Training: SkinMedica, Scotland, www.SkinBrands.co.uk 1-5 Plastic Surgery, Canada 2 Boston Medical Group Revanesse and Redexis Dermal Fillers Training, www.boston-medical-group.co.uk 2 Wigmore Medical Training Microsclerotherapy, London, www.wigmoremedical.com 2 Aesthetox Academy Training Courses, Birmingham, www.aesthetox.co.uk 4 The Obagi Masterclass and Designer Blue Peel with Dr Fred Coville, Dublin, www.healthxchange.com/obagi-training 3 Finishing Touches One Day Colour Workshop, Haywards Heath, www.finishingtouchesgroup.com 4 Finishing Touches One Day Brow Workshop, Haywards Heath, www.finishingtouchesgroup.com 4 Wigmore Medical Training Sculptra, London, www.wigmoremedical.com 4-7 Finishing Touches Five Days Cosmetic Tattooing Diploma Course, Canterbury, www.finishingtouchesgroup.com 4-8 Dr Grant Hamlet VASER® Training, www.granthamlet.co.uk 5 The Obagi Masterclass and Designer Blue Peel with Dr Fred Coville, Manchester, www.healthxchange.com/obagi-training 5 Wigmore Medical Training Introduction to Skincare Peels, London, www.wigmoremedical.com 5 LCS Academy Contraindications for Light Based Therapies, www.lcsacademy.co.uk 6 LCS Academy Laser/IPL Protection Supervisor Course, www.lcsacademy.co.uk 6 Dr Bob Khanna Training Institute, Peel Training, www.drbobkhanna.com 6 The Obagi Masterclass and Designer Blue Peel with Dr Fred Coville, Birmingham, www.healthxchange.com/obagi-training 6-10 19th Congress of the EADV, Gothenburg, Sweden, www.eadvgothenburg2010.org/index.php 7 Mapperley Park Core of Knowledge, Nottingham, www.mapperleypark.co.uk 7 The Obagi Masterclass and Designer Blue Peel with Dr Fred Coville, London, www.healthxchange.com/obagi-training 9-10 Foundation Botox and Dermal Fillers, Birmingham, www.medicsdirect.com 10-11 Professional Beauty Manchester, www.professionalbeautymanchester.com 11-14 Mapperley Park Btec Laser and Light Based Hair Removal and Photorejuvenation, www.mapperleypark.co.uk 11 Wigmore Medical Training CPR and Anaphylaxis - Update, London, www.wigmoremedical.com 11 Wigmore Medical Training Conceal and Camouflage Post Treatment, London, www.wigmoremedical.com 12 Introduction to Obagi with Shannon Lister, London, www.healthxchange.com/obagi-training 12 Wigmore Medical Training Introduction to Skincare Peels, London, www.wigmoremedical.com 12-13 LCS Academy BTEC Medical Laser/IPL Therapies, www.lcsacademy.co.uk 13 Obagi Blue Peel Half Day with Shannon Lister, London, www.healthxchange.com/obagi-training 13 Intraderm Basic Botulinum Toxin Course, Leicester, www.intraderm.com 14 Wigmore Medical Training Introduction to Botulinum Toxin Type A and Dermal Roller London, www.wigmoremedical.com 14 Intraderm Basic Dermal Filler Course, Leicester, www.intraderm.com 15 Wigmore Medical Training Introduction to Fillers, London, www.wigmoremedical.com 15-17 EMAA, Paris, www.euromedicom.com 16 British Association of Cosmetic Doctors Autumn Meeting, The Four Pillars Hotel, Cotswold Water Park, Gloucestershire www.cosmeticdoctors.co.uk

cosmeticnewsuk.com

We round up upcoming events, training courses and meetings

16 Foundation Botulinum Toxin and Dermal Filler Training, Cosmetic Courses National Training Centre, Buckinghamshire, www.cosmeticcourses.co.uk 16 Wigmore Medical Training Microsclerotherapy, London, www.wigmoremedical.com 16 Genuine Dermaroller™ Training, London, elizabeth@aestheticare.co.uk 16-17 Foundation Botox and Dermal Fillers, Manchester, www.medicsdirect.com 17 Finishing Touches One Day Lip Workshop, Haywards Heath, www.finishingtouchesgroup.com 18 Advanced Skincare Seminars with GMT TEC and Sally Durrant, Bristol TBA, www.sallydurant.com 18 Finishing Touches One Day Eyes Workshop, Haywards Heath, www.finishingtouchesgroup.com 19 Obagi Intermediate Course with Shannon Lister, Manchester, www.healthxchange.com/obagi-training 20 Introduction to Obagi with Shannon Lister, Birmingham, www.healthxchange.com/obagi-training 20 Dr Bob Khanna Training Institute, Beginners Botulinum Toxin, www.drbobkhanna.com 20 Introduction to Skin and Laser Applications in conjunction with Manchester University, Lynton Clinic, Cheadle, www.lynton.co.uk 21 Dr Bob Khanna Training Institute, Advanced Botulinum Toxin, www.drbobkhanna.com 21-22 Finishing Touches Two Days Skin Rejuvenation (Micro Needling), Cheshire, www.finishingtouchesgroup.com 22 Dr Bob Khanna Training Institute, Beginners Dermal Fillers, www.drbobkhanna.com 23 Innomed Training Chemical Peeling Systems - New Users, London, www.innomedtraining.co.uk 24 Innomed Training Mesotherapy for Fat, Cellulite and Skin Rejuvenation, New Users, London, www.innomedtraining.co.uk 24 Advanced Botox and Dermal Fillers, Manchester, www.medicsdirect.com 25-27 LCS Academy, BTEC Medical Laser/IPL Therapies, www.lcsacademy.co.uk 25-28 Finishing Touches Five Days Cosmetic Tattooing Diploma Course, Haywards Heath, www.finishingtouchesgroup.com 25-29 Nouveau Contour All Round Training in Permanent Cosmetics, Yorkshire, www.nouveaubeautygroup.com 26-27 SkinBrands Training: SkinCeuticals, London, www.SkinBrands.co.uk 27 Wigmore Medical Training Advanced Toxins and Fillers, London, www.wigmoremedical.com 27-28 Sterex Electrolysis Advanced Cosmetic Procedures, Manchester, training@sterex.com

NOvEmBER

1 Advanced Skincare Seminars with GMT TEC and Sally Durrant, North TBA, www.sallydurant.com 1-4 Five Days Cosmetic Tattooing Diploma Course, Newry, www.finishingtouchesgroup.com 2 Obagi Overview with Shannon Lister, Dublin, www.healthxchange.com/obagi-training 3 Obagi Intermediate Course with Shannon Lister. Glasgow, www.healthxchange.com/obagi-training 6 Innomed Training Botulinum Toxin in Facial Aesthetics – New Users, Southampton, www.innomedtraining.co.uk 6 Boston Medical Group Introduction to Mesotherapy, www.boston-medical-group.co.uk 6 Wigmore Medical Training Microsclerotherapy, London, www.wigmoremedical.com 6-7 Foundation Botox and Dermal Fillers, London, www.medicsdirect.com 7 Innomed Training Dermal Fillers – New Users, Southampton, www.innomedtraining.co.uk 7 Wigmore Medical Training Conceal and Camouflage Post Treatment, London, www.wigmoremedical.com 8 LCS Academy, CQC Compliance Workshop, www.lcsacademy.co.uk 8-9 Two Days Pigment Removal Training, Liverpool, www.finishingtouchesgroup.com

9 LCS Academy, Laser/IPL Core of Knowledge, www.lcsacademy.co.uk 10 Mapperley Park Core of Knowledge, Nottingham, www.mapperleypark.co.uk 10 Core of Knowledge in conjunction with Manchester University, Lynton Clinic Cheadle, www.lynton.co.uk 10 Eden Aesthetics Business Development Seminar and Demonstrations, The Macdonald Hotel and Spa, Manchester, lucy@edenaesthetics.com 11 Eden Aesthetics Introductory Agera and Microdermabrasion Training and Advanced/Refresher Agera and Microdermabrasion Training , The Macdonald Hotel and Spa, Manchester, lucy@edenaesthetics.com 11 Wigmore Medical Training Introduction to Botulinum Toxin Type A and Dermal Roller, London, www.wigmoremedical.com 12 Wigmore Medical Training Introduction to Fillers, London, www.wigmoremedical.com 14 Advanced Botox and Dermal Fillers, Newcastle, www.medicsdirect.com 15-18 Five Days Cosmetic Tattooing Diploma Course, Haywards Heath, www.finishingtouchesgroup.com 16 November – Manchester – Introduction to Obagi with Shannon Lister 17 Obagi Intermediate Course with Shannon Lister, London, www.healthxchange.com/obagi-training 17 Intraderm Basic Botulinum Toxin Course, Leicester, www.intraderm.com 18 Intraderm Basic Dermal Filler Course, Leicester, www.intraderm.com 18-20 Dr Grant Hamlet VASER® Training, www.granthamlet.co.uk 19 Wigmore Medical Training CPR and Anaphylaxis - Update, London, www.wigmoremedical.com 20 Foundation Botulinum Toxin and Dermal Filler Training, Cosmetic Courses National Training Centre, Buckinghamshire, www.cosmeticcourses.co.uk 20 Aesthetox Academy Training Courses, Birmingham, www.aesthetox.co.uk 22-23 Sterex Electrolysis Advanced Cosmetic Procedures, Birmingham, training@sterex.com 22-26 Mapperley Park Btec Laser, Light and Associated Aesthetic Therapies, www.mapperleypark.co.uk 22-26 Nouveau Contour All Round Training in Permanent Cosmetics, London, www.nouveaubeautygroup.com 27 Innomed Training Chemical Peeling Systems - New Users, London, www.innomedtraining.co.uk 27-28 Foundation Botox and Dermal Fillers, Birmingham, www.medicsdirect.com 28 Innomed Training Mesotherapy for Fat, Cellulite and Skin Rejuvenation, New Users, London, www.innomedtraining.co.uk 29 LCS Academy, Contraindications for Light Based Therapies, www.lcsacademy.co.uk 30-1 (Dec) LCS Academy, BTEC Medical Laser/IPL Therapies, www.lcsacademy.co.uk

DECEmBER

1-3 Four Days Scalp and Brow Masterclass, Haywards Heath, www.finishingtouchesgroup.com 2 Advanced Skin and Laser Applications in conjunction with Manchester University, Lynton Clinic Cheadle, www.lynton.co.uk 4 Wigmore Medical Training Microsclerotherapy, London, www.wigmoremedical.com 4-5 Foundation Botox and Dermal Fillers, Glasgow, www.medicsdirect.com 6-9 Five Days Cosmetic Tattooing Diploma Course, Liverpool, www.finishingtouchesgroup.com 6-10 LCS Academy, BTEC Aesthetic Laser/IPL Therapies, www.lcsacademy.co.uk

• If you have any dates you would like to add to our Dates for the Diary section please e-mail vicky@ creativemedialtd.co.uk •

8145 Cosmetic News:Layout 1 16/09/2010 11:51 Page 1

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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

Stotland MA, Kowalski JW, Ray BB, Plastic and Reconstructive Surgery, Volume 120, October 2007; 5: 1386-1393. 2 UK launch April 2006. 3 Data on file, Allergan, Inc.; Safety Analysis. UK/0596/2010 and Date of preparation: July 2010