Cosmetic news july 2013

FAT

CHANCE FAT FOR FACIAL SCULPTING

PA I N S P E A K I NG

PAIN MANAGEMENT

ON THE

SURFACE OF IT

THE AESTHETIC AWARDS 2013-14, 7 DECEMBER 2013. ENTER TODAY

COSMETIC NEWS THE UK’S LEADING TRADE TITLE FOR MEDICAL AESTHETIC PROFESSIONALS

LASER RESURFACING SPECIAL ALSO IN THE JULY ISSUE OF COSMETIC NEWS...

CANNULAS

WEIGHT LOSS

LATEX ALLERGIES

Bocouture® 50 Abbreviated Prescribing Information Please refer to the Summary of Product Characteristics (SmPC). Presentation 50 LD50 units of Botulinum toxin type A (150 kD), free from complexing proteins as a powder for solution for injection.

Indications Temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at frown (glabellar frown lines) in adults under 65 years of age when the severity of these lines has an important psychological impact for the patient. Dosage and administration Unit doses recommended for Bocouture are not interchangeable with those for other preparations of Botulinum toxin. Reconstitute with 0.9% sodium chloride. Intramuscular injection (50 units/1.25 ml). Standard dosing is 20 units; 0.1 ml (4 units): 2 injections in each corrugator muscle and 1x procerus muscle.

May be increased to up to 30 units. Not recommended for use in patients over 65 years or under 18 years. Injections near the levator palpebrae superioris and into the cranial portion of the orbicularis oculi should be avoided. Contraindications Hypersensitivity to Botulinum neurotoxin type A or to any of the excipients. Generalised disorders of muscle activity (e.g. myasthenia gravis, Lambert-Eaton syndrome). Presence of infection or inflammation at the proposed injection site. Special warnings and precautions Should not be injected into a blood vessel. Not recommended for patients with a history of dysphagia and aspiration. Adrenaline and other medical aids for treating anaphylaxis should be available. Caution in patients receiving anticoagulant therapy or taking other substances in anticoagulant doses. Caution in patients suffering from amyotrophic lateral sclerosis or other diseases which result in peripheral neuromuscular dysfunction.

Too frequent or too high dosing of Botulinum toxin type A may increase the risk of antibodies forming. Should not be used during pregnancy unless clearly necessary.

Interactions Concomitant use with aminoglycosides or spectinomycin requires special care. Peripheral muscle relaxants should be used with caution. 4-aminoquinolines may reduce the effect. Undesirable effects Usually observed within the first week after treatment. Localised muscle weakness, blepharoptosis, localised pain, tenderness, itching, swelling and/or haematoma can occur in conjunction with the injection.

Temporary vasovagal reactions associated with pre-injection anxiety, such as syncope, circulatory problems, nausea or tinnitus, may occur. Frequency defined as follows: very common (≥ 1/10); common (≥ 1/100, < 1/10); uncommon (≥ 1/1000, < 1/100); rare

(≥ 1/10,000, < 1/1000); very rare (< 1/10,000). Infections and infestations; Uncommon: bronchitis, nasopharyngitis, influenza infection. Psychiatric disorders; Uncommon: depression, insomnia. Nervous system disorders; Common: headache; Uncommon: facial paresis (brow ptosis), vasovagal syncope, paraesthesia, dizziness. Eye disorders; Uncommon: eyelid oedema, eyelid ptosis, blurred vision, eye disorder, blepharitis, eye pain. Ear and Labyrinth disorders; Uncommon: tinnitus. Gastrointestinal disorders; Uncommon: nausea, dry mouth. Skin and subcutaneous tissue disorders; Uncommon: pruritus, skin nodule, photosensitivity, dry skin. Musculoskeletal and connective tissue disorders; Common: muscle disorders (elevation of eyebrow), sensation of heaviness; Uncommon: muscle twitching, muscle cramps. General disorders and administration site conditions; Uncommon: injection site reactions (bruising, pruritis), tenderness, Influenza like illness, fatigue (tiredness). General; In rare cases, localised allergic reactions; such as swelling, oedema, erythema, pruritus or rash, have been reported after treating vertical lines between the eyebrows (glabellar frown lines) and other indications. Overdose May result in pronounced neuromuscular paralysis distant from the injection site. Symptoms are not immediately apparent post-injection. Bocouture ® may only be used by physicians with suitable qualifications and proven experience in the application of Botulinum toxin.

Legal Category POM. List Price 50 U/vial £72.00. Product Licence Number PL 29978/0002. Marketing Authorisation Holder Merz Pharmaceuticals GmbH, Eckenheimer Landstraße 100, 60318 Frankfurt/Main, Germany. Date of revision of text FEB 2012. Full prescribing information and further information is available from Merz Pharma UK Ltd., 260 Centennial Park, Elstree Hill South, Elstree, Hertfordshire WD6 3SR. Tel: +44 (0) 333 200 4143 Adverse events should be reported. Reporting forms and information can be found at yellowcard.mhra.gov.uk. Adverse events should also be reported to Merz Pharma UK Ltd at the address above or by email to medical.information@merz.com or on +44 (0) 333 200 4143.

1086/BOC/JUN/2012/JH

Date of preparation July 2012

Bocouture® is a registered trademark of Merz Pharma GmbH & Co, KGaA.

Editor’s Letter Welcome to the July issue of Cosmetic News.

Last month we announced that we would be launching the Aesthetics Conference Ireland.

In order to make sure the programme for the inaugural event is as cutting edge as possible we have changed the date to May 17, 2014. I am really excited about moving into the Irish market and look forward to developing this concept with our events team. Another event I am excited about is the Aesthetic Awards. Online entry closes on Auust 1 so make sure you enter today (see pages 20-21 for how). On to this month’s issue…

Laser has always been an integral part of aesthetic practice. In the area of skin rejuvenation however it has really come into its own as new techniques and technologies offering less invasive treatments and lower downtime have been developed. As part of this month’s special feature we will be looking at this dynamic area of aesthetic medicine with contributions from two leading doctors in this field – Dr Patrick Treacy and Dr Sean Lanigan (pages 23-27). We will also be looking at the use of fat for facial sculpting (p29-30) and reporting on a number of new and exciting products launched last month (see our FACE report on pages 12-13; On the Scene on pages 14-15 and Product News on pages 54-55).

I would also like to take this opportunity to thank the gorgeous Antonia Mariconda for helping out with this month’s issue so I could take a well-earned break. In her role as The Cosmedic Coach, Antonia has become the go-to expert for consumers interested in aesthetic treatments and we are delighted to have her as part of our editorial team. She is also now the star of her own TV show The Coach on Sky 282 where she will be sharing celebrity beauty secrets so make sure you check it out.

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Contents INDUSTRY INSIDER 4 EDITOR’S CHOICE

Vicky Eldridge on Collagen Shots by Rejuvenated Ltd 6 INDUSTRY NEWS

We round up the latest industry news

protecting your patients against life threatening latex allergies 39 PAIN MANAGEMENT

We chat to Dr Matteo Tretti about Galderma’s FDA approved selfoccluding topical local anesthetic cream, Pliaglis 42 CLINICAL STUDY

12 NEW SPECIAL REPORT: FACE

Find out what happened at this year’s FACE meeting and Aesthetic Industry Summer Ball 14 ON THE SCENE

We report on the what has been going on in the industry this month from press launches to the annual Fotona meeting in Slovenia 18 ANTI-AGEING CONFERENCE

Antonia Mariconda reports on the Anti-Ageing Conference in London 20 AESTHETIC AWARDS

As the closing date for entries approaches, we tell you everything you need to know about entering The Aesthetic Awards 2013-14

We examine the data on Ellanse Hands 44 Q&A

We speak to Dr Sam Robson from Temple Medical Aesthetics about why Stylage is her lip product of choice 46 PRODUCT FOCUS

We find out about the Regenlite laser treatment from Chromogenex 50 INTERVIEW

Antonia Mariconda speaks to LoveLite’s Debra Robson about Lipoglaze®

52 TREATMENT SPOTLIGHT

We find out about Highgate Hospital’s obesity management treatment programme

CLINICAL PRACTICE 23-27 [SPECIAL FEATURE] LASER REJUVENATION

We look at facial rejuvenation techniques using laser 23 Dr Patrick Treacy on fractionalised laser skin resurfacing 26 Dr Sean Lanigan on laser resurfacing 29 FAT TRANSFER

We speak to Dr Roberto Viel about his use of fat in facial sculpting 32 INJECTABLES

Holly House Hospital on the use of botulinum toxin injections for migraine sufferers

54 PRODUCT NEWS

We round up the latest product news

35 CANNULAS

58 A DAY IN THE LIFE OF…

How you can make sure you are

COLLAGEN SHOTS

by Rejuvenated Ltd

They say ‘you are what you eat’ and by the same token we all know that what you drink can have just as much of an effect on your internal and external health.

The secret to truly healthy skin comes from a combination of what we put in our bodies as well as what we apply topically. Anyone who has been to the Cosmetic News Expo may have already sampled Collagen Shots, an exciting concept in improving skin health, which has gained much attention in the press and on social media since its launch to the UK market.

The brainchild of beauty specialist Kathryn Danzey, who has been in the industry for 38 years, Collagen Shots are wholly British manufactured and contain 10,000mgs of marine extract collagen per serving as well as the super fruit Acai berry and vitamins B and C to create a synergistic blend for maximum benefits. They now also contain hyaluronic acid for greater hydration. This unique combination of ingredients works to synthesise more collagen, strengthen connective tissue and arterial walls. After the age of 25 collagen synthesis reduces at a rate of 1.5% a year and by the age of 45 collagen levels can have fallen by as much as 30%. Studies have shown that supplementing collagen levels with Collagen Shot per day, can stimulate collagen synthesis and skin hydration slowing down the signs of ageing. The results are reduced fine lines and wrinkles, an improvement in skin elasticity and softer skin texture.

Collagen Shots cost £39.95 for a 30-day supply making them an affordable option for clients keen to improve the health and appearance of their skin. I have never been a fan of taking supplements in tablet form as I always forget to take them and some of them are too bag and difficult to swallow, however Collagen Shots are easy to take and as you only need one a day, I find taking it first thing in the morning easy to remember to do. With all the fantastic products I get to try on my skin, it is nice to be tackling my skin health from the inside too!

56 BUSINESS FOCUS

PRODUCT REVIEWS

36 BEST PRACTICE

choice

IN BUSINESS

Karen Fewster MSc on the shake up to cosmetic regulations due to take place this month

Mr Dalvi Humzah on why the TSK STERiGLIDE: Hybrid Technology represents the next generation in cannulas

Editor’s

Antonia Mariconda finds out what a typical Day in the Life has in store for Mr Mario Russo 60 TRAINING NEWS AND DATES FOR THE DIARY

The latest dates for your diary

CONTACT THE COSMETIC NEWS TEAM ON 01268 754 897

Charlotte Body Publisher | M: 07903 944 666 | charlotte@cosmeticnewsuk.com Vicky Eldridge Editor | M: 07880 812 582 | vicky@cosmeticnewsuk.com Hollie Dunwell Sales Manager | M: 07557 359 257 | hollie@cosmeticnewsuk.com Kathryn Kingsmore Events/Production | 01268 754 897 | kathryn@cosmeticnewsuk.com Peter Johnson Art Director | 01268 754 897 | peter@cosmeticnewsuk.com DISCLAIMER

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

Belotero® now approved by the FDA • One of only 3 HA approved by the FDA currently promoted in the US • Optimal integration1 for superior evenness2 • Minimal local for sustained patient satisfaction4

voted as The Best by our customers in 2011 and 2012

Call Merz Aesthetics Customer Services now to find out more or place your orders: Tel: +44(0) 333 200 4140 Fax: +44(0) 208 236 3526 Email: customerservices@merz.com 1 Histological examination of human skin (eyelid dermis layer). Courtesy Dr. J. Reinmüller, Wiesbaden, Germany 2 Prager W, Steinkraus V. A prospective, rater-blind, randomized comparison of the effectiveness and tolerability of Belotero Basic versus Restylane for correction of nasolabial folds. Eur J Dermatol 2010;20 (6):748-52.

3 Taufig A, et al. A new strategy to detect intradermal reactions after injection of resorbable dermal fillers. J Ästhetische Chirurgie 2009; 2: 29-36 4 Reinmüller J et al. Poster presented at the 21 World Congress of Dermatology, Buenos Aires, Argentina, Sept 30 – Oct 5, 2007. Thereafter published as a supplement to Dermatology News: Kammerer S. Dermatology News 2007; 11: 2-3.

www.belotero.uk.com Merz Pharma Uk Ltd 260 Centennial Park, Elstree Hill South Elstree, Hertfordshire, WD6 3SR Tel: +44(0) 333 200 4140

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3

SAVE THE DATE FOR THE AESTHETIC AWARDS 2013-14 - DECEMBER 7, 2013

NANONEEDLE

SPF BEAUTY PRODUCTS

New nanoneedle helps scientists uncover secrets under the skin

SPF is the ‘magic ingredient’ for UK’s beauty market

Researchers at the University of Bath are using a pioneering technique to study the properties and characteristics of our skin, in tests that could pave the way for new treatments for dermatitis, and for an improved understanding of the skin ageing process.

Research from The NPD Group Inc has shown that sales of beauty products containing an SPF were up +11% vs. last year as more women take preventative action to combat the damage the sun’s rays can do to their skin.

Using a minute ‘nanoneedle’ in conjunction with atomic force microscopy (AFM), scientists are studying the structure of the stratum corneum. Until this research, published in The Journal of Investigative Dermatology, it was only possible to examine the surface of the corneocyte with AFM. Now, thanks to the novel nanoneedle technology, researchers can shine a light on the cell structure deep below the surface.

The nanoneedle enables a mechanical scan (so-called tomography) of the skin cell to be performed, offering the potential to detect structural and biomechanical changes caused, for example, by environmental factors, ageing or skin disease.

Professor Richard Guy, from the Department of Pharmacy and Pharmacology, commented, “A deeper understanding of the biomechanics of skin barrier function and the relationships between this role and the physical properties of human skin cells, may lead to the development of new therapeutic or cosmetic products to restore or reinforce the skin.

“This would benefit, for example, individuals with dry or eczema-prone skin and, perhaps, the ever-increasing ageing population whose skin becomes progressively fragile over time”.

TEKNO SURGICAL

Mary-Kay Sheehy joins Tekno Surgical Tekno Surgical is pleased to welcome Mary-Kay Sheehy as its new aesthetic sales manager for Ireland and the UK. Mary-Kay has been working in the medical devices and pharmaceutical industry for almost a decade and has spent the last seven years in the aesthetics market. Tekno Surgical is the sole distributor for Ulthera, Thermavein and Motiva breast implants in the UK and Ireland. In Ireland, they also distribute Syneron-Candela, Dermaceutics, Galderma, Lynton and Teoysal.

Mary-Kay said, “Our aesthetic division has been growing steadily over the last 18 months with the UK being an important area for us. I am excited about my new role and look forward to all the challenges it brings with it!”

G

Prestige beauty products with SPF 25 are performing especially well, seeing a 19% growth year on year in total skincare and a 21% growth in make-up. In the four months to April 2013, women’s facial sun creams grew +4.4%, driven by creams with SPF30 and above which grew +8% compared to last year. In the same period, 25% of all women’s prestige face moisturising cream sold included SPF, and value sales increased 6.5%. By comparison, products without SPF saw only 1% growth in value sales. It is not just moisturisers that are benefitting from the surge in demand for sun protection. Sales of prestige cosmetics including foundations and lipsticks with SPF also increased in the year ending April 2013. Almost 80% of all foundations sold in the UK contained a sun protection factor ranging from five to 50.

The report said: “Women know that sun damage is a major cause of premature ageing – something many want to address through their skincare regime. Taking preventative action whether with a moisturiser, a foundation or lipstick with SPF removes the effort from protecting the skin on a daily basis. As more British women choose prestige beauty products with SPF, we expect the manufacturers to respond by incorporating SPF into their ranges in more innovative ways this year and beyond.”

PRGF

Leading cosmetic surgeon backs natural alternative to fillers Leading cosmetic surgeon Mr Dalvi Humzah has become the first practitioner in the West Midlands to offer the Plasma Rich in Growth Factors (PRGF) filler treatment.

The procedure uses a patient’s own blood to create a natural alternative filler using growth factors to rejuvenate the face. Mr Humzah completed his training at the Biotechnology Institute (BTI) training centre in Vitoria-Gasteiz, Spain. He said, “The science behind PRGF is very interesting. It contains growth factors, which are necessary for wound healing, repair and Mr Dalvi Humzah, medical director of Plastic inflammation. These processes are important and Dermatological Surgery (PDS) for tissue regeneration. By injecting PRGF back into the skin, we can utilise the body’s natural regenerative powers and important ‘growth factor’ to rejuvenate and boost the skin. It’s ideal for patients looking for an alternative treatment to plump up and heal tired and ageing skin. Unlike using other manufactured fillers, no patient can have an allergic reaction because it’s their own tissue matter.”

Smooth texture for a natural look and feel1 ive them a lift with

LaSting volume – up to 18 months1 SatiSfaction – 96% of patients would recommend Juvéderm® vOLumA® with Lidocaine to a friend 2

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References: 1. Raspaldo H. J Cosmetic and Laser Therapy, 2008;10:134–142. 2. Fischer TC. Poster presented at EMAA, 1–3 October 2009, Paris. 3. Allergan Data on File (DoF), 2011.

4. Allergan Data on File (DoF) Marketing overview, 2011. Instructions and directions for use of JUvéDeRm® vOLUmA® with Lidocaine are available on request. Lidocaine does not affect the intrinsic performances of JuvéDERM® vOLuMA® and its safety profile, therefore, JuvéDERM® vOLuMA® data is representative of JuvéDERM® vOLuMA® with Lidocaine3

Date of Preparation: January 2013 UK/0008/2013a

INDUSTRY NEWS

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Contact us on: Tel: 0845 1707788 info@a-b-c-uk.com, www.abclasers.co.uk © 2013 Alma Lasers, Ltd. All rights reserved. Alma Lasers Ltd., its logos and Soprano, are trademarks or registered trademarks of Alma Lasers, Ltd. Product specifications are subject to change without notice.

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SAVE THE DATE FOR THE AESTHETIC AWARDS 2013-14 - DECEMBER 7, 2013

RESEARCH

SOPRANO

High molecular weight hyaluronan found in skin of naked mole-rat could hold key to cancer cures

Soprano ICE launches in to MYA Alma Lasers has launched its new Soprano ICE technology in to Courthouse Clinics @ MYA. Soprano is Alma’s flagship laser hair removal system based on the company’s patented Super Hair Removal (SHR) technology – a clinically proven method of effective and virtually pain free hair removal. In multiple clinical studies, Soprano has been proven as safer, equally or more effective and resulting in considerably less pain than other laser hair removal technologies. It can also be used all year round on all hair and skin types.

A rodent that never gets cancer could hold the key to preventing or treating malignant tumours, say scientists.

Lab studies show the skin cells of the naked mole-rat are rich in high molecular weight hyaluronan (HMW-HA) which they believe stops tumours developing. The findings, published in Nature journal could lead to new human cancer therapies in the long term.

A team of researchers from the University of Rochester, New York, US, led by Andrei Seluanov and Vera Gorbunova, investigated the anti-cancer properties of the naked mole-rat and cultured skin cells from the rodent in the laboratory. Experiments showed that when HMW-HA is removed from naked mole-rat cells, they become susceptible to cancer, suggesting it plays a role in making the rodent ‘cancer-proof’.

Dr Seluanov said, “There’s indirect evidence that HMW-HA would work in people. It’s used in anti-wrinkle injections and to relieve pain from arthritis in knee joints, without any adverse effects. Our hope is that it can also induce an anti-cancer response.”

AURORA CLINICS

The Soprano ICE system takes this one step further. The high fluency delivery system provides an even more comfortable and faster treatment with improved results for light coloured and thin hair and all skin types, including tanned skins making it a year round treatment. It also cools the skin with an encircled sapphire tip, preventing burns on the skin surface while maintaining heat within the dermis. A lighter and improved ergonomic design also means Soprano ICE is now even easier to use and can be used to treat small and difficult to target areas like the eyebrows, nose and ears making it the ideal treatment for men.

Courthouse Clinics aesthetician Shelley Masser with the Soprano Ice

Guy Goudsmitt, managing director of ABC Lasers said, “We are delighted to be working with Courthouse Clinics and MYA, the UK’s leading providers of surgical and non-surgical cosmetic treatments. Alma Lasers’ technology is constantly evolving and we are committed to delivering the most advanced, efficacious solutions that enhance clinical outcomes and promote positive patient experience.”

Surgeon opens sixth UK clinic Plastic surgeon Adrian Richards has opened his sixth branch of Aurora Clinics at Chelmsford Private Day Hospital with Mr Garrick Georgeu.

Mr Richards claims that small, ethical clinics using local NHS-trained plastic surgeons and no hard selling by salespeople is the way forward to clean up the plastic surgery industry. He said, “Sadly the plastic surgery industry has been tainted by scandals like the widespread use of PIP implants and companies using hard selling sales techniques. These companies have put profits before patients. We surgeons are now taking control and giving people back the confidence in our industry. UK surgeons are among the best-trained in the world, but companies using poorly trained surgeons from abroad and cheap, sub-standard products have tainted the industry throughout the UK.”

WEBSITE LAUNCH

ARC launches new website ARC Aesthetic Professionals has launched a new website – www.aestheticprofessionals.co.uk.

Established in 2008, ARC is the only recruitment consultancy in the UK dedicated solely to helping the aesthetic medicine and cosmetic surgery sectors. The company helps individuals looking for positions and businesses looking for new members of staff in all types of positions including clinical, sales, managerial and administrative roles.

8

www.cosmeticnewsuk.com

BAAPS CALLS FOR IMPLANT ACTION

UK surgeons demand similar testing of removed devices following implant action in Sweden In the wake of Sweden’s announcement that all PIP implants in their country should be removed as a preventative measure, the British Association of Aesthetic Plastic Surgeons (BAAPS) has reiterated its own calls for similar analysis to take place in the UK as a matter of urgency.

The new recommendations from the Swedish Medical Products Agency and the National Board of Health and Welfare are based on a “changed state of knowledge”, resulting from analysis of explanted products rather than off-the-shelf ones. Their document states: “The examination of a number of removed PIP implants with large ruptures shows that the silicone gel within the coating has changed its character”.

According to consultant plastic surgeon and BAAPS president Mr Rajiv Grover, “At the BAAPS we have long been warning that a major loophole in safety regarding these defective implants relates to the lack of in vivo testing of PIPs. The Swedish findings, which have been undertaken in this manner, show that when inside the body the silicone alters in such a way that doesn’t ‘stick together’ as well, allowing it to disperse more easily. It is known that there is a subgroup of PIP implants in which the concentration of an irritant compound (known as D4) is higher than in others, but there is no way of knowing which ones are affected. This is why the Swedish government has made the decision to remove all PIPs as a preventative measure.

The combination of higher concentrations of D4 and the changes in the silicone which happen when the implant is within the body, finally explain the issues that surgeons and patients have been seeing and experiencing around the country. We urge the government, who we know have collected in vivo specimens, to perform similar analyses - as a matter of urgency.”

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SAVE THE DATE FOR THE AESTHETIC AWARDS 2013-14 - DECEMBER 7, 2013

BUSINESS TOUR

VITAMIN A BENEFITS

Cosmeceuticals completes business tour

Vitamin A supplementation could cut skin cancer risk

Cosmeceuticals has completed a successful nationwide business tour. The business days which took place in London, Wakefield and Glasgow were hosted by managing director Tracy Parkin and education and brand manager Sharon Cas. The informative events saw a series of lectures designed to help salon owners and their staff understand how to successfully implement PRIORI® and Vitage® products into their businesses.Tracy explained, “A key focus for the professionals attending was to understand the ‘hero products’ that drive sales and how they can compete with the high street brands by offering a solution-driven product focus.”

The business days also had a practical aspect to highlight some basic business information and to demonstrate how easy it is to mix and match retail products to give best skincare results. The Skin Therapy Centre’s Shelia Godfrey said, “I came back to the clinic with renewed enthusiasm and motivation after my session with the girls.”

Popping a daily vitamin A pill not only helps skin to look beautiful, it could also give it vital protection. Research published in the Journal of Investigative Dermatology suggests that taking vitamin A supplements may reduce the risk of skin cancer by up to 40% in women.

While the study found that supplementation was strongly associated with a reduction in skin cancer, the scientists said there was no association with consumption of the vitamin in food, nor with beta-carotene, a pro-vitamin precursor to vitamin A.This preliminary study points the way to vitamin A supplements becoming more widely recommended to augment our diet. This is particularly significant in light of a marked rise in people being treated for basal cell carcinoma (BCC), the most common form of skin cancer. According to UK researchers in another study due for publication in June, the incidence of BCC is estimated to be twice as high as previously thought. Skin cancer is nearly as common as all other cancers in the body combined.

“Vitamin A has been shown to contribute to the maintenance of normal and healthy skin when applied both orally and topically”, comments iiaa nutritional consultant Lorraine Perretta. “Taking nutrients orally is the normal way your body is used to getting vitamin A and this study indicates that supplementation rather than diet had the most important protective effect.”

NEW CLINIC OPENING

VITAMIN A BENEFITS

TOP OF THE SCOTS

New treatment will help GPs tackle sun-damage that can lead to skin cancer

Top Scottish plastic surgeon Taimur Shoaib has opened a cosmetic surgery clinic in Harley Street. Mr Shoaib, whose clinic, La Belle Forme, has branches in Edinburgh and Glasgow, opened the new clinic in June. He will continue his NHS work with the Royal Infirmary in Glasgow. He said, “There has been a move away from the large cosmetic chains and people now want small, ethical clinics, run by plastic surgeons themselves. I saw that there was an opportunity for me in London as I already have quite a lot of London patients who fly to Glasgow for their consultations and surgery. This way, my London patients will still have surgical operations in Glasgow, but consultations and cosmetic treatments that do not require hospitalisation will be carried out at my new clinic in Harley Street.”

Mr Shoaib lectures and trains other plastic surgeons all over the world on facial plastic surgery, however, he believes that the industry will see a gradual move away from invasive surgery to less invasive procedures. He said: “There will always be a place for surgery, but these non-invasive treatments are the future because as technology improves, so do the results. This latest laser and ultrasound technology for instance is so advanced that people can get on with their everyday lives while it is working way below the surface of the face. It is simply amazing what these non-invasive techniques can do compared to just a few years ago.”

HARLEY FACIAL AESTHETICS LAUNCH

Harley Street Dental Group launches a new Facial Aesthetics Division The Harley Street Dental Group has launched a new Facial Aesthetics Division.

The group recently opened a new practice at 52 Harley Street with a whole upper floor dedicated to facial rejuvenation. The new multi-disciplinary centre of excellence is entirely dedicated to the health and well-being of the mouth and face.

The group has brought in Jilla Malek-Mohammadi to extend the range of facial rejuvenation techniques, which are designed to complement the dental procedures and further improve the appearance.

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A new treatment for sun-damaged skin that can lead to skin cancer has been launched by LEO Pharma. Picato® gel is a topical treatment licensed for the cutaneous treatment of non-hyperkeratotic, non-hypertrophic actinic keratosis (AK) in adults, a type of skin damage caused by long-term sun, or UV exposure, that has the potential to progress to the nonmelanoma skin cancer, squamous cell carcinoma (SCC).

Current topical, patient-applied therapies have treatment durations from three weeks up to three months, longer treatment durations can lead to levels of patient adherence as low as 37%. Picato® effectively manages actinic keratosis with a once-daily treatment, which is applied over two or three days and demonstrates high patient adherence in clinical trials of over 98%. It is indicated for the treatment of non-hyperkeratotic, non-hypertrophic actinic keratosis in adults. An extensive phase III clinical trial programme has demonstrated that, three days’ treatment application with Picato® 150mcg/g on the face or scalp led to an 83% median reduction in the number of AK lesions compared to baseline, when measured at Day 57. Following two days’ treatment application on the trunk or extremities with Picato® 500mcg/g, there was a 75% median reduction in the number of AK lesions compared to baseline, when measured at Day 57.

Commenting on the launch, Dr Tony Downs, consultant dermatologist at the Royal Devon and Exeter Hospital, said, “The launch of Picato® in the UK is a very positive step forward for both patients living with actinic keratosis, and GPs and dermatologists treating the condition. As it is impossible to predict which actinic keratosis lesions will advance to non-melanoma skin cancer, early detection and effective treatment is very important.”

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SPECIAL REPORT

FACE

On the FACE of it We report on the annual FACE conference and Aesthetic Industry Summer Ball

A change of venue to the QE2 Conference Centre in Westminster, after a decade at the Royal College of Physicians, saw FACE Ltd host its largest event to date.

Now in its 11th year, FACE brings together aesthetic practitioners from around the globe to share information about the latest treatments and innovations in aesthetics.

With a packed scientific programme, as well as an exhibition spread across three halls, this year’s meeting was sponsored by Syneron Candela, Merz Aesthetics, Wigmore Medical, Galderma, Solta Medical, SkinCeuticals and La Roche-Posay.

As well as a three-day facial cosmetic injectables agenda, the conference also saw a one day facial surgery programme; two-day skin forum, exploring cosmeceuticals and the treatment of ageing skin; three-day business agenda and two day equipment agenda. Exhibitor workshops were also held throughout the event.

PRP, botulinum toxin alternatives, skincare myths and the Keogh Review. In the afternoon Cosmetic News editor Vicky Eldridge sat down with Medik8 founder Elliot Isaacs to find out about his latest innovation Dermadart, the prototype of which was being showcased on the SkinBrands stand. The invention looks set to revolutionise micro needling techniques by moving away from motorised mechanisms. (See next month’s Cosmetic News for Vicky’s full interview with Elliot).

For Cosmetic News it was a busy few days, starting on Friday morning with a walk round the exhibition to find out what the latest launches were from the manufacturers and suppliers exhibiting. First stop was the Clinogen stand where Sujata and Sapna Jolly told us about their advanced wound repair therapy, Youki, which serves to dramatically reduce the healing time following advanced skin procedures.

During the morning coffee break we caught up with the charismatic John Castro from Cosmetic Websites who has recently launched into the aesthetic arena and was speaking as part of the business agenda about SEO. Lunchtime saw the press conference with an esteemed panel of experts including Wendy Lewis, who chaired the session, Dr Tim Flynn, Dr Stephen Mulholland, Dr Nick Lowe, Dr Kate Goldie, Dr Zein Obagi and Dr Beth Briden.This was a fantastic opportunity for the media to hear from some of the leading lights in aesthetics from around the globe together in one room and some heated debates arose during the session. Topics covered included

Debate was also stirred in the Westminster Suite as the Equipment agenda focused on treating vascular lesions and the problems that can be encountered.

Dr Brian Newman presented his results using thermo coagulation while Professor John Harper and Dr Neil Walker explored the latest clinical data on the use of laser and IPL as well as asking the audience to share their experiences. There were mixed views on how successful laser was in this arena, which made for an interesting session and active discussions.

Saturday also gave us a chance to catch up with Dr Andre Steps and Dr Daniel Cassuto (below centre) about the new Asclepion QuadroStarPro being

L to R : Vicky Eldridge tries out Pliaglis; Dr Daniel Cassuto and Andre Steps; Luminary showcase the Proshock Ice; the Aesthetic Source team with ‘Professor Jolly’

Friday evening saw ‘An Evening With Dr Nick Lowe’, undoubtedly one of the most well-known and influential practitioners in the industry. The consultant dermatologist shed some light on his views of the industry as well as his philosophy as a dedicated clinician, researcher and highly successful businessman. This was a rare opportunity to hear from one of the aesthetic industry’s greats and a fitting end to the first day of the meeting.

Saturday’s agenda was no less jam-packed with a chance to sit in on some of the lectures before interviewing Dr Matteo Tretti about pain management following his morning lecture (see page 39-40).

One of the most talked about sessions of the second morning was the open panel discussion on the implications of the Keogh Review and CEN European Standards for Cosmetic Surgery. With much still unknown about how the review will impact the

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industry it seemed as if there was still a long way to go before the industry sees any form of concrete change and concerns were raised that if nothing is done before the next election we will be going back to square one with a new government.

displayed on the Carleton Medical Stand. The system is the first yellow table top laser in dermatology and the doctors spoke to us about the advantages of using its 577nm wavelength compared to 532nm KTP and 585/595nm pulsed dye for vascular treatments. (See next month’s Cosmetic News for full interview).

The Aesthetic Source stand attracted attention, not merely because of the beautiful guide dog called Jolly who was on the stand, but also because of its new anti-ageing breakthrough from NeoStrata - Skin Active Line Lift Duo. The patented two-step product system includes AminoFil Activator and Finishing Complex to synergistically build the skin’s natural volume and visibly reduce the appearance of deep lines and wrinkles. The Cosmetic News team also took away samples of the fantastic Problem Dry Skin Cream to soothe their sore and tired feet after the second day of the exhibition! With cryotherapy being one of the hot

topics of the moment we stopped by the Luminary stand to find out about the Proshock Ice from Promoitalia, which it has taken on the distribution for. The system uses ice-lipolysis and acoustic shock therapy for effective destruction of fat and cellulite with instant measurable results. Saturday also saw the added drama of the austerity cuts protest going on outside the venue, which is adjacent to Westminster Abbey and the Houses of Parliament. While many of the protestors were peaceful, a group dressed in V for Vendetta style masks became rowdy and clashed with members of the EDL during the afternoon.

study they had done in conjunction with each other to show that combining the Clear and Brilliant Treatment and C E Ferulic accelerates product penetration for reduced downtime and enhanced results.

SkinCeuticals has also launched a new physician only Retinol 1.0 product, which is perfect for problematic and photo-damaged skin and contains 1% pure retinol. It was then time for an interview with leading skincare pioneer and innovator Joe Lewis who was over from the US to give three talks at the meeting. Joe gave us an insight into his latest cutting edge development - PRIORI® Cellular Recovery Serum

The final day of the meeting started with a visit to both the SkinCeuticals and Solta stands to find out about a

with DNA Enzyme Complex™ - which mimics the skin’s own repair enzymes to normalise and repair the cell. See next month’s Cosmetic News for the full interview.

The final interview of the day was with Belgian plastic surgeon Dr Fabrice Rogge who was there to give a seminar on ‘Advances in Skin Regeneration Using a Unique Nitrogen Plasma Device’, followed by a workshop incorporating treatment demonstrations. The device in question is the NeoGen Plasma system from Energist which delivers pulses of Nitrogen Plasma energy onto the skin, initiating the generation of a brand new skin layer, which grows beneath the intact treated layer, which then peels four to five days later (see next month’s Cosmetic News for full interview).

The 2014 FACE meeting will be held on June 20-22.

AESTHETIC INDUSTRY SUMMER BALL The Brewery in the heart of the city was the glamorous setting for this year’s Aesthetic Industry Summer Ball.

The black tie event is a chance for exhibitors, delegates and speakers to let their hair down after an intensive few days at the FACE conference and has become the social event of the summer calendar.

The weather held off for an outside drinks and canapé reception in the courtyard before guests took their seats for the start of the evening. Following a welcome by Raffi Eghiayan of FACE Ltd and the sponsors of the evening, Syneron Candela and Image Box PR, the mic was handed to Simon Allen from Commando Spirit which the proceeds of the evening’s silent auction were in aid of. As has become tradition the tables were pitted against each other in a fun challenge. This year it was to see who came up with the best cocktail. The winning table – AesthetiCare - named their concoction ‘Off your FACE’ and won a case of champagne.

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ON THE SCENE |

ON T HE SC E N E Out and about in the industry this month

PRESS LAUNCH OF LUSTRE PURE LIGHT PRO AND THE LUSTRE CLINIC, ONE ALDWYCH, LONDON

SYNERON CANDELA SKINHIBITIONS PRESS EVENT, THE ROYAL SOCIETY, LONDON To coincide with the release of its UK wide survey into women’s ‘Skinhibitions’, Syneron Candela invited members of the press to The Royal Society to enjoy afternoon tea while listening to presentations from some of the leading female voices in UK aesthetics.

To open the event, global aesthetic consultant Wendy Lewis gave an overview of the survey of 1,340 women, which gave an eye-opening insight into how they feel about their skin.

The survey showed that nearly half (47%) of women said bad skin made them feel less confident while 20% were actually depressed over their bad skin. Nearly a third admitted that ageing and growing old ranked in their top five life fears. A third of those surveyed even said they would cancel a first date if they woke up with bad skin while nearly a quarter (24%), voted lines and wrinkles as their top skin dislike. 16% of women cited their pigmentation and uneven skin colour as their top skin dislike and surprisingly this was highest amongst 24-35 year olds than all age groups.

Other speakers on the expert panel included Dr Anu Arasu, a GP specialising in bio-identical hormone therapy who spoke about the role hormones had to play in skin health; Dr Ines Verner a specialist in cosmetic dermatology from Tel Aviv who spoke about subablative skin rejuvenation with eTwo; Dr Sabika Karim, medical director of Revere Clinics, who shared her personal experiences in dealing with women with problem skin and dermatologist Dr Maria Gonzalez who spoke about the patient journey and shared her case studies and insights.

Acne affects 650 million people globally, with one in five women in the UK afraid to leave the house because of the poor state of their skin, yet the condition has always been notoriously difficult to treat.

The Ambicare Health team and Flipside PR invited members of the press to London’s trendy One Aldwych Hotel to hear about two new tools in the fight against acne: Lustre Pure Light Pro and www.thelustreclinic.co.uk, a fantastic new online resource for acne sufferers.

After an overview of adult acne and its impact by Wendy Lewis, Gary Conroy from Ambicare Health introduced the new website and device. www.thelustreclinic.co.uk will offer free advice and support for people suffering from acne. Lustre Pure Light Pro has been developed to provide an at-home solution to acne with daily use for as little as 20 minutes. The product harnesses the safe, natural part of the visible light spectrum – blue light – using clinically proven technology to eliminate spot-causing bacteria. Revolutionising acne maintenance, clinical trials with blue light at 415 nm prove acne sufferers can achieve a 60% improvement in inflammatory acne, and a 50% improvement in comedone counts after 12 weeks of regular application.

The device is a small, rechargeable product with slim, flexible pads that directly target problem areas with no pain or downtime. Lustre Pure Light Pro is portable and the blue light is delivered while the product is worn, giving users the freedom to get on with everyday tasks.

Dr Johanna Ward from The Skin Clinic presented her impressive results with the system and answered questions from the floor. Dr Sam Robson from Temple Aesthetics was also on hand to answer questions as one of the first practitioners in the UK to take on Lustre in her Aberdeen clinic.

A video testimonial was also shown from MBE Gold Medalist Paralympian Hannah Cockcroft who has struggled with acne since her teens. She tried everything from creams and prescription drugs to face washes and make-up but Lustre was the first product to improve her skin. She said, “Lustre worked and that made me happy. I found it very useful. I could incorporate it with whatever else I was doing. It’s little; I could carry it around, take it to hotels and track meets. I live on the track but I’m a girl and I like to look nice, especially now when I get to go out and people recognise me. It made me confident and happy with how I look and my acne has almost completely disappeared.”

Watch Hannah’s story at http://thelustreclinic.com/site/hannah-cockroft/

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CYNOSURE PICOSURE™ LASER LAUNCH, CHANDROS HOUSE, LONDON Members of the press joined aesthetic practitioners for champagne and canapés at London’s Chandros House to find out about the latest innovation from Cynosure – the PicoSure™ Laser.

Being touted as ‘the most advanced technology for tattoo removal’, the PicoSure™ is the world’s first picosecond aesthetic laser, which delivers ultra-short pulse bursts of energy to the skin in trillionths of a second.

Picosecond pulse widths are 100 times faster than nanosecond technology, enabling unmatched photomechanical impact for better clearance with fewer treatments. The system is even effective on dark, stubborn blue and green inks as well as previously treated recalcitrant tattoos.

This means patients can now receive a more effective treatment and in a shorter timespan, with some tattoos just needing one session. Other tattoos can be removed in half the sessions usually needed when using regular tattoo removal.

Presentations were given by Cynosure’s Neil Wolfenden and Dr Tapan Patel who is one of the first practitioners in the UK to trial the system.

I-LIPOXCELL LAUNCH, THE ROYAL SOCIETY OF MEDICINE

Cosmetic News was delighted to get an exclusive invite to the UK launch of Chromogenex’s new system, i-LipoXcell, at The Royal Society of Medicine.

Following a drinks reception with canapés, guests took their seats to hear about the latest innovation in non-surgical fat reduction and body shaping from a panel of experts.

An introduction was given by Chromogenex’s CEO, Peter McGuiness, before the technical director, Kevin Williams, gave a short presentation about the i-LipoXcell technology.

Clinical presentations and impressive case studies were then showcased by Dr Donna Freeman and Dr Clara Santos who shared their experiences with using the system and gave an overview of the clinical evidence. Marketing manager Justin Richards then spoke about the marketing opportunities offered to practitioners who invest in the system before a Q&A session and closing by Kevin Williams.

The i-LipoXcell is FDA cleared for circumferential reduction and improvement in cellulite. It incorporates four technologies for intelligent body fat analysis and measurement, laser diode fat reduction, IR vacuum massage and radio-frequency skin tightening. The treatment results in the biostimulation of metabolic pathways resulting in the release of fatty acids and glycerol, shrinking fat cells, without destroying them. Results are seen immediately with an average of 3cm (1 inch) per 30 minute treatment.

Laser treatment is followed by combination laser/vacuum massage to enhance lymphatic drainage, improve circulation and achieve deeper penetration of laser into fat cells for improvement in cellulite.

Using multi-polar radio-frequency i-LipoXcell can also tighten up loose skin to further enhance results and achieve a firmer skin texture and appearance. The application of RF heat can stimulate metabolic activity and smooth out cellulite. It also incorporates patented technology to instantly measure body fat and provide detailed analysis including basal metabolic rate, body fat percentage and records in a patient data base reduction in body fat and overall improvement in patient health.

‘A BREAK THROUGH IN ANTI-AGEING’ PRESS EVENT WITH JOE LEWIS, THE HOSPITAL CLUB, LONDON Members of the UK press were given an exclusive opportunity to have a one on one chat with PRIORI® skincare founder and leading chemist of anti-ageing skincare technologies, Joe Lewis, at The Hospital Club last month at an event organised by Flipside PR. Joe was over in the UK to speak at the FACE conference where he presented on ‘New Advances in Topical Skin Protection: The Role of Sunscreen, Antioxidants and DNA Repair Enzymes’. A leader in his field, Joe is the man behind top anti-ageing sciences including AHA’s, CoffeeBerry® and Idebenone. His latest innovation in topical skincare, combining DNA repair enzymes with sunscreen and anti-oxidants for the ultimate protection and correction, looks set to change the way we treat the ageing process in the years to come.

Cosmetic News editor Vicky Eldridge managed to catch up with him in between lectures at FACE. See next month’s Cosmetic News for her interview.

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ON THE SCENE | FOTONA

LASER DAYS Vicky Eldridge reports on the annual Fotona laser meeting in Slovenia

Innovations in laser technology and techniques were the focus of the three-day Fotona lasers meeting in Slovenia. The annual event sees Fotona distributors and users from around the globe come together to share clinical experience, ideas and information about new products and treatment protocols.

With its manufacturing heritage in Slovenia, the picturesque country has played host to the educational and social gathering for the last few years. This year’s location was the stunning 5* Bohinj Park Hotel Eco Resort and Spa. Bohinj Park is the first ecological hotel in Slovenia sitting on the edge of Triglav National Park and just 6.5 km from Lake Bohinj with breathtaking views of the Julian Alps.

I joined UK distributors David Leahy and Craig Smith from ABMETech along with Debbie Thomas and Richard Weare from Debbie Thomas Advanced Skin Treatments and Steve Goddard from Beautonics Aesthetics and Lasers.

The intensive agenda revolved around three key cosmetic applications for laser: aesthetics/dermatology; dentistry and gynaecology.

Day 1 saw an overview of the dental, aesthetic and surgery and gynaecology programs with hands on product training in the afternoon for each specialty.

Day 2 saw five hours dedicated to aesthetics, dermatology and surgery with lectures on Nd:YAG skin tightening with PIANO; FRAC3 Skin Tightening; onychomycosis; combination wavelength treatments for tattoos and the treatment of veins.

Day 3 was the distributors day with global distributors of the lasers sharing their successes and experiences from their country.

David Leahy spoke on behalf of ABMETech for the UK talking about an educational event they had hosted for their customers.

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W H AT ’ S N E W ?

FRAC3® SKIN REJUVENATION Fotona lasers include an Accelera Nd:YAG laser that generates extremely short pulses to provide FRAC3® skin rejuvenation and many other popular non-ablative aesthetic treatments, such as hair removal and vascular treatments. A revolution in skin rejuvenation and anti-ageing–FRAC3® produces a unique, self-induced skin rejuvenation effect as it seeks out minuscule, age-related skin imperfections in the skin. Thanks to its three-dimensional treatment pattern, more surrounding tissue remains unaffected to provide faster healing than in conventional fractional treatments.

PIANO Fotona systems feature a new treatment possibility with Fotona‘s Nd:YAG PIANO modality. This new super-long PIANO pulse is much longer than the thermal relaxation time of the epidermis or any other skin structures. As a result, it does not cause high initial temperature peaks in the epidermis. It is therefore preferable to use super-long PIANO pulses that achieve approximately the same overall heat shock effect on the dermis, while sparing the epidermis from the unnecessary thermal damage.

The PIANO modality is perfectly indicated for treatments where overall homogeneous, bulk heating of the dermis is desired: skin collagen remodeling, PIANO skin tightening, wound healing and scar prevention. It also improves the end result in treatments that combine the non-ablative Nd:YAG laser skin remodelling with the Er:YAG laser fractional skin resurfacing.

THE LASER POUT Being pioneered by Steve Goddard in the UK The Laser Pout is a revolutionary new method for temporarily plumping lips.

Using Fotona’s SMOOTH mode the Er:YAG treatment modality delivers laser energy onto the skin in a fast sequence of low-fluence laser pulses inside an overall super-long pulse of 200-350 msec.

Because SMOOTH pulses are longer than the epidermal TRT, the effect of SMOOTH mode is gentle coagulate heating of the skin without any significant ablation of the epidermis. The technology enables gentle precise laser energy, to be applied to the outer and inner lip area, thus plumping the lips. Additionally, because The Laser Pout is non-invasive and painless and results are immediate lasting up to 60 days.

SOCIAL NETWORKING As well as a full on and informative lecture programme the meeting gave members of the international Fotona family a chance to network and socialise with each other. A fantastic social programme was put on by the company with a decadent dinner and entertainment by Slovenian singer Manca Spik on the first night, an evening of bowling at the hotel’s on-site bowling alley on the second evening, a wet-weather day of in-door games including giant Jenga, Connect Four, golf and table football on the third day and a pool party on the final night. There was also a chance to enjoy some time in the hotel’s pool, complete with waterslides. As everyone got ready to depart, the UK contingency joined a few of their Slovenian colleagues to take a boat trip and walk around the stunning nearby Lake Bohinj, a fitting and relaxing end to what was an inspirational, enjoyable and jam packed few days.

“Meeting up with our distributors from other countries is a great opportunity to learn about new procedures and clinical developments that have taken place with our laser systems internationally. Every year so much clinical research is presented about existing and new procedures. It still amazes me just how much the laser is implicated in new therapies each and every year!” David Leahy, ABMETech www.cosmeticnewsuk.com 17

THE ANTI-AGEING SHOW

A S H OW O F ST RE NG T H Antonia Mariconda takes us on a whistle stop tour of the UK’s first anti-ageing show at Olympia, in May.

and as an advocate of safe beauty I was pleased to see the consumer take ‘spending power’ into their own hands to research, test and try some of the latest developments in anti-ageing at this unique event. There were all sorts of genius state of the art developments on display, ranging from fat freezing (CoolSculpting via the Cosmetic Skin Clinic) to EndyMed 3 Deep face-lift treatments, all the way through to the more traditional heavyweight players of time defiance such as Thermage.

“We’re delighted with the overwhelming consumer response”, said Shelley Williams, one half of the dynamic duo and brains behind the first ever UK based Anti-Ageing Health and Beauty Show, held at Olympia on May 11-12.

Newspapers reported how “thousands flocked to hold back the ravages of time” (Financial Times 11/5/13).

The hustle and bustle of the grand exhibition halls was testimony to the fact that the antiageing industry is serious business, valued to be worth more than 3.6 billion pounds by the year 2015. People take pride in their appearance and image now more than ever,

In the wake of the Keogh review, educating consumers and enhancing awareness about the positive side of aesthetic medicine is even more essential. Antonia Mariconda reports on an event that aims to do just that...

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I was particularly impressed by these great treatments and also by new devices and treatments such as Clear and Brilliant by Solta Medical. If time is of the essence then Philips have mastered the art of ‘at home’ anti-ageing solutions with their fantastic hand held devices such as RéAura and also VisaPure delivering clearer, radiant, young looking skin, I thought this was a welcome addition for time pushed parents, and professionals, struggling to find that all important “me time”.

In between pitstops with refreshing Collagen drinks from Dermacoll, and some skin smoothing from Nubo Skincare, I tried to focus on filming for a TV show on Sky, which aired on Sky 282 this month called The Anti-Ageing Special which I was delighted to present.

There were lot’s of lovely faces from the press and media world, as well as some celebrity appearances, none more notable than the lovely Dr Dawn Harper from Channel 4’s Embarrassing Bodies TV Show.

It was a fascinating and unique event that I was very proud to be part of both as a speaker and as an exhibitor presenting safe, smart and successful solutions in beauty via my sponsor partners The Revere Clinic, Aestheticare, Irwin Mitchell and Contactspod, all to whom I extend my sincere thanks. If you visited the event I hope you had a great time, and for those of you that didn’t, I am sure you will have read or heard some great positive feedback in the national news and press, I hope to see you there next year for an even bigger and brighter event.

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AESTHETIC AWARDS

CLOSING TIME

With just one month left until entries for the Aesthetic Awards 2013-2014 close, we tell you why you should enter and be a part of the most glamorous event in the aesthetics calendar

A

s an industry that is all

about looking good it is no surprise that we all like donning our glad rags and attending a glamorous shindig. The Aesthetic Awards is the premier awards event for the aesthetics industry and is not only a chance to get dressed up and enjoy a good party but is also a chance to celebrate the achievements of the practitioners, clinics, products and treatments that represent the gold standard in cosmetic medicine.

This year’s Awards dinner will take place on Saturday December 7 at The Grange Tower Bridge Hotel, London and will have a Winter Wonderland theme. Online entries are still open and will close on August 1, 2013. Entering could not be simpler. Just go to www.cosmeticnewsuk.com and fill out our online entry form.

You can enter as many categories as you like as well as nominating other people, products, companies and associations who you think are worthy winners.

If you have never entered before then why not give it a try? Winning an aesthetic award or even being a shortlisted finalist has proved to be a fantastic marketing tool for those who have entered, enabling them to show their clients that they stand out from the crowd and have gone that extra mile. If you are proud of what you do or know someone you think deserves recognition then make sure you enter or nominate before August 1.

Once all the entries have been received and the short lists have been compiled voting will be opened. The voting process 20 www.cosmeticnewsuk.com

will be between August 15 and October 15 1. Shortlisted clinics will also be mystery shopped during this time.

A NOTE ON VOTING

Each person can only vote once. Multiple votes under the same name or from the same email address will be discounted.

Multiple voting from within the short listed finalist’s organizations will also be monitored. Voting is IP address monitored.

Voting will open on August 15, 2013.

A N O T E O N M Y S T E RY SHOPPING

Please note that mystery shoppers will not be booking in for any surgical or invasive procedures. They are instructed to book in for a consultation and/or non-invasive treatment, where appropriate, and will be examining the clinic facilities; the telephone and in person customer service; the staff/ practitioners; the range of treatments available and the consultation process. You are not obliged to give away any treatments if you do not wish to however it does help if the mystery shopper is able to try out a suitable treatment to enable them to get the full experience of your clinic. We also ask that you waive the cost of the consultation/ treatment. The mystery shopper will present you with a voucher once they come to pay. If you do not agree to giving away a free consultation/treatment you will need to let us know as soon as the short lists

come out. This will not affect your place in the final short list, however it may affect your score as the mystery shopper will not be able to mark you on certain areas. You will not be marked down in any way for refusing treatment following consultation if it is not appropriate for that patient.

For more information visit www.cosmeticnewsuk.com or call our events team on 01268 754 897.

THE CATEGORIES FOR THE 2013-2014 AESTHETIC AWARDS ARE… AWA R D S F O R M A N U FA C T URE RS A N D S U P P L IER S • Best Product Innovation • Best Newcomer (Product or Treatment) • Cosmeceutical of the Year • Injectable Product of the Year • Treatment of the Year (Face) • Treatment of the Year (Body) • Best Selling Retail Product • Equipment Brand of the Year • Best Weight Loss/Diet Programme • The Janeé Parsons Award for Sales Representative of the Year • Best Customer Service by a Manufacturer/Supplier • Best Advertising Campaign by a Manufacturer/Supplier • Distributor of the Year • Training Provider of the Year * NEW AWARD • Training Course of the Year * NEW AWARD

AWA R D S F O R C L IN IC S / P R A C T I TI O N E RS • Rising Star • Best New Clinic • Best Clinic Chain • Best Clinic (three rooms or less) • Hospital Group of the Year * NEW AWARD • Best Mobile Practitioner • Aesthetic Nurse Practitioner of the Year • Aesthetic Practitioner of the Year • Best Clinic Customer Service • Best Clinic Website • Speaker of the Year • Clinic Receptionist of the Year • Association of the Year

S P EC IA L AWA R D S • Services to the Industry • Lifetime Achievement Award

BOOK YOUR TICKETS NOW! The Aesthetics Awards is always a sell out event so, to make sure you don’t miss out, on what promises to be a night to remember, book your tickets today by contacting our events team on 01268 754 897.

Tables cost £1,750. Individual tickets are £180.

early bird offer

10% off

book before september 30th enter code eb123 online

You are invited to the Ultimate Christmas party DeCemBer 7 th the aesthetiC awarDs, taking place at the prestigious grange hotel london be transported through a winter wonderland of festive entertainment. take part in the most glamorous event of the season.

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Post 3 Sublative Treatments RE Treatments Post 3 CO Before info@syneron-candela.co.uk | Tel: 0845 521 0698 | www.syneron-candela.co.uk 2

info@syneron-candela.co.uk | Tel: 0845 521 0698 | www.syneron-candela.co.uk info@syneron-candela.co.uk | Tel: 0845 521 0698 | www.syneron-candela.co.uk Not for use in the U.S. market. © 2013. All rights reserved. eTwo, Sublative and CO2RE are trademarks of Syneron Medical, Ltd. Syneron and the Syneron logo, Candela and the Candela logo are registered trademarks. PB81281EN

Not for use in the U.S. market. © 2013. All rights reserved. eTwo, Sublative and CO2RE are trademarks of Syneron Medical, Ltd. Syneron and the Syneron logo, Candela and the Candela logo are registered trademarks. PB81281EN Not for use in the U.S. market. © 2013. All rights reserved. eTwo, Sublative and CO2RE are trademarks of Syneron Medical, Ltd. Syneron and the Syneron logo, Candela and the Candela logo are registered trademarks. PB81281EN

FLSR

THE EVOLUTION OF FLSR F R A C T I O N A L I S E D L A S E R S K I N R E S U R FA C I N G

Dr Patrick Treacy Dr Patrick Treacy is Medical Director of Ailesbury Clinics Ltd and Ailesbury Hair Clinics Ltd. He is Chairman of the Irish Association of Cosmetic Doctors and is Irish Regional Representative of the British Association of Cosmetic Doctors. Dr Treacy is a renowned international guest speaker and features regularly on Irish breakfast television (TV3), RTE and as an expert panelist with the BBC World Service. He had a series on Discovery Health and the Discovery Channel (New York) recently filmed a programme about his work. He is an active member of many international medical societies and is a Fellow of The Royal Society of Medicine.

Fractionalised laser skin resurfacing (FLSR) has become an important component of facial rejuvenation surgery as patients continue the trend of seeking less invasive procedures with low downtime and low risks. This behavioural change in attitude has also been prompted by a realisation of both doctors and patients that the recent much hyped non-ablative methods are not comparable with ablative skin resurfacing and were often subject to extravagant claims in terms of efficacy.

During the nineties, CO2 laser resurfacing was considered the â&#x20AC;&#x2DC;gold standardâ&#x20AC;&#x2122; for the treatment of acne scarring, deep rhytids and photodamaged facial skin. It was one of the earliest gas lasers to be developed (invented by Kumar Patel of Bell Labs in 1964). The CO2 laser produces a beam of infrared light with a wavelength around 10, 600 nm. Because CO2 lasers operate in the infrared, special silvered mirrors and windows made of either germanium or zinc selenide are necessary for their construction.

In 1995, some physicians, including Prof Nick Lowe went further and stated the ultrapulsed CO2 laser was the most effective modality for repairing photo-damaged skin.

Although it quickly became the best option for treatment of this type of photo-aged facial skin, it also had considerable post-procedural problems, including prolonged postoperative recovery, pigmentary changes and a high incidence of adverse side effects. The infections included acne flares, fungus and herpes simplex virus (HSV) infection. Many patients also complained of oedema, burning, and erythema that sometimes lasted for many months. The delayed healing, the implied risks and long downtime made many patients reluctant to accept this method.

For a period during the early part of this century some physicians, including Prof David Goldberg favoured the use of Erbium YAG devices to minimise these side effects. These new lasers were solid-state lasers whose lasing medium was erbium doped yttrium aluminium garnet (Er:Y3Al5O12). Er:YAG lasers typically emit light with a wavelength of 2940nm, which is

Fractionalised laser skin resurfacing (FLSR) has become an important component of facial rejuvenation surgery as patients continue the trend of seeking less invasive procedures with low downtime and low risks www.cosmeticnewsuk.com 23

FLSR

Fractionalised C02 lasers are extremely versatile, in that they can be used for the treatment of facial rhytides, acne scars, surgical scars, melasma and photodamaged skin infrared light. Unlike similar Nd-YAG lasers, the output of an Er:YAG laser is strongly absorbed by water. This fact limits the use of this laser in surgery, and in many other laser applications where water is present. They were mostly used for acne scarring, deep rythides and melasma.

In addition to being absorbed by water, the output of Er:YAG lasers is also absorbed by hydroxyapatite, makes it a good laser for cutting bone as well as soft tissue.

Radio-frequency devices such as Polaris ® and Thermage® arrived in 2004, promising noninvasive treatments that delivered tighter skin, renewed facial contours and healthier collagen after a single treatment.

One year later, the Fraxel laser made by Reliant Technologies arrived on the market.

It took its name from the fact that it worked on only a fraction of the skin’s surface. The device created a pattern of pinpoint burns (microzones) of injury in the skin, surrounded by normal intervening skin that rapidly healed the injured tissue. Only about 15 to 20% of the skin was affected and the relatively light burn healed within a few days, eliminating the prolonged downtime of the resurfacing lasers.

The technique was called fractional thermolysis.

Non-sequential fractionalised technology had arrived with its benefits of faster recovery time, more precise control of ablation depth, and reduced risk of post procedural problems.

In 2006, Lumenis released the ActiveFx as an upgrade of the Ultrapulse Encore with smaller spot size and a new CPG giving a random pattern reducing the possibility of having several adjacent spots with resultant heat accumulation. This was followed by the Deka 30W SmartXide DOT. The newer SmartXide DOT adopts lightweight titanium articulated arm in conjunction with a user friendly colour Touch-screen control panel to display the settings. The SmartXide DOT requires 24 www.cosmeticnewsuk.com

an external plume device. The obvious benefits of these lasers led to many new fractional resurfacing lasers reaching the market at the same time. These new fractionalised CO2 lasers substantially reduced the high level of nonresponders seen with quite expensive non-ablative RF type treatments that in reality often required multiple painful sessions.

The adoption of the newer fractionalised C02 lasers by many physicians also reduced the morbidity associated with this type of laser treatment. Damage to the epithelium is less apparent because unlike in conventional ablation some of the stratum corneum remains intact during treatment and acts as a natural bandage. This allows the skin to heal much faster than if the whole area was treated, as the ‘healthy’ untreated tissue surrounding the treated zones helps to fill in the damaged area with new cells. Downtime is also reduced and erythema is moderate, permitting patients to apply cosmetics five days after treatment.

Fractionalised C02 lasers are extremely versatile, in that they can be used for the treatment of facial rhytides, acne scars, surgical scars, melasma and photo-damaged skin. This photoageing effect is demonstrated clinically as a gradual deterioration of cutaneous structure and function. It manifests itself in the epidermis and upper papillary dermis by giving skin a roughened surface texture as well as laxity, telangiectasias, wrinkles and variable degrees of skin pigmentation.

There are presently several high-energy, fractionalised carbon dioxide (CO2) lasers currently available for cutaneous resurfacing.

Although each laser system adheres to the same basic principles there are significant differences between lasers with respect to tissue dwell time, energy output, and laser beam profile. These differences may result in variable clinical and histological tissue effects.

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LASER RESURFACING

On the surface of it Dr Sean Lanigan on laser resurfacing Dr Sean Lanigan MD FRCP DCH Dr Sean Lanigan is a consultant dermatologist and chairman of the Medical Standards Team for sk:n clinics. Dr Lanigan is also an honorary consultant dermatologist at City Hospital Birmingham. He was consultant dermatologist and clinical lead at the Birmingham Regional Skin Laser Centre from 20012009. His main clinical and research interests relate to laser treatment of skin disease. He has over 160 scientific medical publications including one text book, Lasers in Dermatology, and 12 book chapters.

He was editor in chief of Lasers in Medical Science for eight years. He is on the editorial board of three leading laser journals. Doctor Lanigan is an invited speaker and teacher nationally and internationally.

He is an executive committee member of the British Medical Laser Association; and member/fellow of the British Association of Dermatologists; American Society for Lasers in Medicine and Surgery; and European Society for Lasers in Dermatology. He acts as External Advisor for the Medical Devices Agency and National Institute of Clinical Excellence (NICE).

Honours include Bronze Award, National Clinical Excellence, 2004.

26 www.cosmeticnewsuk.com

Removal of the skin surface to improve blemishes and irregularities has been performed for many years. Prior to lasers this was performed by deep chemical peels.

The depth of the injury was often unpredictable and side effects including toxicity and severe scarring were not rare.

Carbon dioxide (C02) and Erbium: Yttrium Aluminium Garnett (Er:YAG) lasers have traditionally been used in ablative resurfacing procedures and are generally considered superior to chemical peels for deep regeneration. These infrared lasers heat up water rapidly in tissue which is converted to steam and superficial layers of skin are effectively vaporized to specific and varying depths. In this process there is complete removal of the superficial skin surface, usually the whole epidermis and a superficial portion of the dermis.

The CO2 and Er:YAG laser heat up tissue water so rapidly in short pulses, that nearly all the energy of the laser beam is used up in forming steam and removing tissue. The Er:YAG laser is so efficient in doing this that the effects are almost entirely ablative, and this occurs very superficially in the skin. The CO2 laser also has a small heating (thermal) effect, so that the surface of ablated skin has a small area of thermal injury.

There are advantages with, and advocates of both lasers. The Er:YAG produces a very superficial wound with no underlying thermal heating so ablation depth can be controlled. However, as ablation proceeds into the dermis, bleeding will occur which prevents any deeper ablation-many consider this an advantage to prevent scarring.

With the CO2 laser the small layer of thermally coagulated tissue will seal blood vessels and give the operator a clear field. It is thought that the small area of thermally damaged tissue will enhance new collagen formation and improve aged skin. However, for the inexperienced practitioner, this extra layer of injury below the ablation field could increase side effects. This haemostatic effect also allows the operator to use the CO2 laser as a

â&#x20AC;&#x2DC;bloodlessâ&#x20AC;&#x2122; scalpel when cutting tissue.

Significant improvements can be obtained with these lasers in the treatment of scars including those from acne vulgaris, cutaneous growths and photodamaged or ageing skin. They do so by smoothing skin surface irregularities, removing damaged tissue and modulating collagen metabolism. However, recovery can be protracted as the wounded skin repairs and resurfaces the area, which can often take a week. The procedure is associated with several side effects, which include, pain, cutaneous infection, changes in pigmentation, prolonged erythema (redness) and scarring. In addition, using this technique on sites other than the face significantly increased the risks of adverse events associated with prolonged and poor wound healing. For all but the most superficial procedures anaesthesia is required either through a general anaesthetic or multiple nerve block injections.

Attempts to mimic the improvements of ablative procedures without the downtime were for many years unsuccessful with minimal if any improvement in treated skin. These were generally non-ablative treatments with dermal heating while preserving the epidermis intact usually by combining the laser with surface cooling.

In recent years a new laser technology, fractional photothermolysis, has been introduced to specifically overcome the drawbacks of conventional resurfacing. Instead of producing one large beam that causes uniform thermal damage to all tissue in its path (as with conventional resurfacing lasers), the output from fractional resurfacing devices consists of thousands of microscopic columns, which each produce thermal damage to a small volume of tissue. These can either be applied by ultrafast scanning of a

stationary handpiece as with the CO2RE CO2 laser from Candela or scanned over the skin as the handpiece moves over the skin surface as in the Fraxel laser from Solta.

There are two main ways of performing a fractional procedure: ablative and non ablative. Ablative fractionated lasers use CO2 and Er:YAG laser technology to produce microscopic columns of tissue removal. Non-ablative fractional lasers such as the Fraxel use wavelengths of light that heat up tissue water and hence tissue to produce coagulation but not sufficiently to cause ablation. The coagulated column therefore remains in place and is known as an MTZ, a Microscopic Treatment Zone, which is the region of coagulated tissue resulting from one pulse from the handpiece. This generates a MEND, which is a MicroEpidermal Necrotic Debris particle. This is a compact condensation of necrotic epidermal debris, which is being pushed up from the Dermal/Epidermal junction and expelled as a part of the healing process. So although nonablative in nature, there is some damaged tissue removal.

MENDS produced by the non-ablative Fraxel Laser typically flake off after four to 14 days. During the flaking process they give the skin a slightly bronzed appearance The Fraxel re:store DUAL Laser System which I use in the sk:n clinic in Birmingham has two infra-red fibre lasers with wavelengths of 1550 nm and 1927 nm. The two wavelength options allows for targeted treatment of different tissue depths. The 1550 nm laser coagulates the epidermis and dermis with a very deep depth of penetration up to 1.6 mm. The 1927 nm laser, which is better absorbed in water coagulates the epidermis and superficial dermis with up to 0.3 mm depth of penetration. The 1550nm wavelength because of its deeper penetration is useful in treating deeper conditions including scarring and significant photo-ageing. The more superficial wavelength works well for superficial lesions including pigmentation. Both wavelengths can be used during the same session. Treatment is well tolerated using anaesthetic creams, and a course of 3 to 5 treatments is generally recommended usually every 4 to 8 weeks. Immediately after treatment mild to moderate oedema (swelling) and redness typically develops and diminishes, or resolves within the first several days posttreatment. A small degree of swelling and/or redness may last longer in some cases. As the redness fades some dryness, darkening and peeling may occur which usually clears by a week after treatment. This laser has a very low incidence of side effects and in particular appears effective in pigmented skin with a low incident of post inflammatory pigment changes.

The CO2RE CO2 laser system which I also use in the sk:n clinic in Birmingham is an ablative fractionated system with great flexibility, it is possible to control the depth of injury from 0.1 to 0.75mm and density of the microspots from 1% to 100% with the laser delivering over 16,000 pulses per second. One of the advantages of the system is

that the scanner is not in the handpiece, as it is with many other fractionated CO2 laser systems but in the device housing itself. This makes the handpiece remarkably light and relatively small and extremely easy to use.

With this laser therefore, treatment can vary from a full ablative procedure to a superficial fractionated ablation.

This can all be achieved with a single handpiece and different areas of the face can be treated in different ways during the same procedure. Even though ablation occurs epidermal healing usually takes only 24 hours by means of keratinocyte migration when using a fractional setting.

The CO2RE laser allows the clinician to offer a range of treatment options from a very aggressive full ablation with its attendant downtime to a lighter treatment with rapid healing. The CO2RE system provides a total of six different treatment modes including four fractional ablative treatment modes and pattern shapes, a traditional resurfacing mode, and an excision mode that includes defined shape and freehand modes for minor dermal excisions. One of the most interesting settings is the fusion mode, which delivers deep and superficial energy in one pass. This is a combined placement of deep, pinpoint wounds within the wider, more superficial ringshaped fractional wounds deposited in the same spot, covering the area in less than a half-second. This can create injuries that are almost 1 mm wide and a hundred microns (0.1mm) deep in the same scan as an injury that is 0.12mm wide and several hundred microns deep.

When used as a fractionated laser, the side effects are significantly reduced. Most patients will tolerate the procedure using topical anaesthetic creams. Depending on the settings used, the healing time may be a little longer than with the Fraxel laser, but fewer treatments may be necessary to achieve the desired results in scarring, sun damage and ageing skin. Side effects will be higher with darker skin so this laser is generally used for lighter skin types. This is an extremely flexible laser, which allows the operator to tailor treatment precisely to the needs and desires of the patient.

Instead of producing one large beam that causes uniform thermal damage to all tissue in its path, the output from fractional resurfacing devices consists of thousands of microscopic columns, which each produce thermal damage to a small volume of tissue www.cosmeticnewsuk.com 27

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FAT TRANSFER

F A T TRANSFER

We speak to Dr Roberto Viel about why fat is the natural alternative to fillers for sculpting, plumping and anti-ageing and why this tried and tested method of rejuvenation is suddenly seeing a resurgence

T

he use of fat transfer in facial and body aesthetics is nothing new, however, in the area of facial aesthetics, the advent of dermal fillers saw this method of rejuvenation and volume replacement take a back seat, until recently. Developments in techniques and understanding of the procedure have meant that fat transfer has seen huge advances and previous issues with inconsistent results and the survival of fat cells have been addressed, making the procedure more viable for the modern, resultsdriven aesthetic client.

DR ROBERTO VIEL

Dr Roberto Viel practises at the Viel London Centre Of Aesthetic Surgery (www.lcas. com) in Harley Street. He obtained his medical degree at the University of Milan, Italy, and finished his studies in aesthetic plastic surgery in London, UK. He has been practising as a plastic surgeon on Harley Street, with his twin brother, Dr Maurizio Viel, since 1990. Dr Roberto Viel is a speaker at international aesthetic congresses and is the co-author of the sold out The Viel’s Beauty Bible. For more than 20 years, the twin brothers have been responsible for pioneering and introducing most of the plastic surgery procedures that are available today making them sought after not only by patients but by medical corporations to help train other surgeons and doctors globally.

The benefit of fat transfer is of course the fact that what is being injected is ‘autologous’ which appeals to many patients. Recent research in the clinical journals has also shown that the fat is one of the most valuable sources of stem cells in the body.

This means that, not only can fat transfer add volume, but it can also improve appearance of the skin externally as well, a fact that is also renewing interest in the procedure.

Loss of fat in the face has been attributed as one of the main causes of an ageing appearance. Dr Roberto Viel explains, “ As we get older, we start to lose fat from our upper face. This loss of fat and associated loose skin starts to show in the cheek area, giving us a sad, gloomy look. By placing the fat in the upper third of our face we produce an uplift effect, reshaping the face to the more youthful years. As well as losing volume from the face, the backs of the hands can also lose volume. Autologous fat is the ideal filler to rejuvenate these areas, most popular being the back of the hands, as well as the nasal labial fold (mouth to nose grooves) or actually any body depression.

“Autologous fat transfer (transferring ones own fat) is today’s number one filling agent for loss of volume and creases on our faces. As we age the appearance of creases on our face is inevitable. Even though these creases are part of the normal ageing process

and there is nothing we can do to stop it, we can fill out the creases with fat, thus making them decrease or appear less prominent. We are seeing great results from this and very natural results too, plus, since it is the patient’s own fat, there is no risk of rejection and no possibility of allergic reaction” This procedure is mainly used to produce a more youthful look and for recontouring of the face, hands and other body contours. Physicians are changing the way they think about rejuvenating the ageing face. Patient options are no longer limited to injection of foreign fillers, surgical tissue removal, or tightly stretched skin. Increasingly, surgeons are choosing to inject autologous fat to plump up and restructure facial volume. An often used analogy is the youthful grape and the aged raisin. You can’t just cut away ‘extra’ skin; you have to re-inflate it to replace the lost volume. Fat’s role is to plump up areas that have hollowed over time.”

MAKING IMPROVEMENTS The procedure is more than 100 years old, dating back to 1893 when Franz Neuber in Germany used a patient’s own fat to fill scarred tissue. Prior to the 1990s, however, few patients experienced long-lasting fat grafts, primarily due to adipose tissue damaged during high-pressure harvesting or harmful processing procedures such as washing and excessive exposure to air.

A pioneer in modern fat grafting techniques. In the early 1990s, Dr Viel perfected a method of negative-pressure harvesting by hand with a 10 mm syringe and blunt cannula, processing with a short standing time and gentle centrifuging, and injection of minute amounts of fat in multiple passes. “You have to place it in very small portions with each pass,” he said. “Not just a big glob of fat next to other fat, but small portions placed close to capillaries. If parcels of fat are touching each other, there is no way for the blood supply to get to the middle of that clump.”

Although some facial plastic surgeons have

www.cosmeticnewsuk.com 29

FAT TRANSFER

While fat transfer has been gaining popularity with patients and surgeons alike, it may attract even more attention in the near future if research with fat stem cells proves benefits beyond plumped-up faces claimed that fat longevity is short because the transplanted tissue is quickly reabsorbed by the body, Dr Viel and others have experienced otherwise. He said that his patients 11 and 12 years out from their procedures still show improvement.

“When it’s done correctly and done over the entire face or to fill in hollows, it is a permanent filler”, he explains. “I’ve got patients I’ve seen eight to nine years after and they’ve still got the majority of fat in place.”

ADVANTAGES, DISADVANTAGES, AND HYALURONIC ACID? The greatest advantage of fat grafting is its safety as an autologous product. It’s also less expensive than hyaluronic acid injectable fillers. “Fat and

HA fillers are both good fillers”, Dr Viel says, “An HA can do some things that fat can’t, like fill finer wrinkles and upper lip lines. However HA is very pricey compared to fat, and lasts four to eight months on average. So, it’s pretty price-prohibitive for someone who needs a lot of volume re-expansion in their face.”

85% of facial rejuvenation patients elect fat grafting over other procedures, the technique should not be used with smokers, due to vascular constriction, or with individuals who take blood thinners, since bleeding may occur in the transfer area, killing the fat. He also has seen better results with normal weight individuals than people who are extremely thin.

THE FUTURE FOR FAT TRANSFER “I think more physicians are starting to do fat grafting”, Dr Viels ays. “I have been lecturing at academy meetings over the last six years and a lot of people have converted to this procedure. One problem, however, is the high learning curve; it takes a few years for someone to become proficient.”

While fat grafting has been gaining popularity with patients and surgeons alike, it may attract even more attention in the near future if research with fat stem cells proves benefits beyond plumped-up faces.

“I’ve noticed for 25 years that when we inject someone with fat, their pores get smaller, their pigmentation gets lighter, even women who were subject to adult acne stopped having outbreaks,” says Dr Viel. “We didn’t know what caused this, but recently we’ve learned it comes from the stem cells within fat. This is what has made people’s skin so wonderful after fat transfer.”

Although more research needs to be done with fat stem cells, the next decade will likely see increased numbers of surgeons-including otolaryngologists-head and neck surgeonsutilising fat grafting for facial rejuvenation.

30 www.cosmeticnewsuk.com

THE PROCEDURE It is a requirement under the Human Tissue Act 2004, that all patients wishing to have their fat stored have a detailed blood test prior to the procedure. This blood test must include the standard profile of a Full Blood Count, Biochemistry Profile, ESR & INR together with the legislation requirements of; HIV 1& 2, Hepatitis B, Hepatitis C & Syphillis. Each patient will be asked to sign a consent form for this test to be completed & will be offered the counselling services from our colleagues at Number One Healthcare, should this be required.

Two weeks before the surgery, patients should not take any medications containing aspirin (acetyl salicylic acid), since these products affect the blood’s clotting mechanism and therefore may lead to excessive bleeding during and after surgery, hence resulting in increased bruising. Taking high doses of vitamin E preparations, eating large amounts of garlic and consuming alcohol can also produce the same result and should be avoided. If pain medication is necessary they can take ibuprofen/paracetamol.

As with any procedure, Dr Viel also advises his patients to quit smoking at least two weeks before and until two weeks after surgery. It is well known that smoking causes narrowing of the blood vessels, which leads to a decreased blood supply to the skin, thus slowing and interfering with the healing process.

Dr Viel performs the procedure either under local anaesthesia or light sedation. Once the harvesting site (area) has been determined (generally the abdomen, but fat may be harvested from the hips and thighs), the area is anaesthetised. Next the fat is harvested with a 1-2 millimetre cannula. The fat is then mixed with a solution called albumin to clean and preserve the fat. The area requiring rejuvenation is anaesthetised and the fat is placed with a blunt cannula.

“The amount of fat put in each area is always more than needed”, Dr Viel explains. “The reason for this is that we know that initially about 40 – 50% will be absorbed by the body, the rest will stay. We always keep some of the patient’s fat in our fat bank freezer. Therefore if in the future you need more rejuvenation to an area, we already have the fat ready to apply. Most patients need around two

to three sessions, but by having the fat stored in our fat bank there is no need to harvest it again.

Pathological studies have shown that we can still use the fat for up to two years after harvesting. The cells of the adipose tissue (fat) maintain all their anatomical and physiological properties for this duration.”

Patients can expect some slight swelling for the first 48 hours. Occasionally patients develop ecchymosis (bruising), which usually disappears within 5-7 days.

They are very easy to cover up with makeup.

Compression bandages are worn on the area where the fat was harvested from, which needs to remain in place for one week. There will also be a suture (stitch) at this site, which is removed after one week.

The patient will need to return to the clinic after one week for the nurse to remove the bandage and suture, as well as to check that everything is healing well.

As with any procedure, there is always a possibility of complications, including reaction to the anaesthesia, infection, haematoma (bleeding under the skin), bleeding – resulting in increased bruising, temporary swelling and a slight asymmetry in healing or scarring.

CONCLUSION Facial fat transfer gives aesthetic physicians the opportunity to enhance or refresh their patients’ appearance with reasonable down time and without major surgery. By using their own body fat there is minimal chance of adverse side effects in the way of allergic reaction and routinely, there are no tell tale stitches or scars.

Dr Viel adds, “A skilled plastic surgeon approaches facial rejuvenation with the goal of making patients look more like a youthful version of themselves. You must consider the individual patient’s facial structure and future ageing possibilities.”

Fat injections may also be used to correct facial deformities and assist in corrective plastic surgery.

Dr Viel concludes, “In my opinion fat transfer is one of the greatest surgical solutions as fat is a natural filler and now we have found rejuvenating tool - Enabling us to sculpt, plump and reverse the effects of age on the face body and hands “

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INJECTABLES

On the head We find out about the results Holly House Hospital has been getting in the use of Botox® injections for migraine sufferers

Although its name has become synonymous with anti-ageing, Botox® has numerous other indications that stretch far beyond the world of lines and wrinkles.

One, more recently approved use for the drug is in the treatment of chronic migraine.

Chronic Migraine is a distinct and severe neurological disorder characterised by patients who have a history of migraine and suffer from headaches on 15 or more days per month with headaches lasting four hours a day or longer. Botox® is the first clinically studied prophylactic treatment to be approved by the FDA specifically for this debilitated patient population.

A leading consultant in pain medicine has described the results in migraine patients following Botox® injections at one of the South East’s leading hospitals as ‘phenomenal’.

Dr Vivek Mehta, consultant in pain medicine, said the treatments carried out at Holly House Hospital are leading to less frequent migraines for sufferers – in one case by up to 90% - as well as a notable reduction in the severity and duration of the attacks.

The treatments have been introduced as a service at the hosptial following provisional approval from health guidance body the National Institute for Clinical Excellence (NICE) last year.

In our industry Botox® is mainly used for cosmetic purposes to temporarily freeze facial muscles and improve the appearance of frown lines and wrinkles, but in trials,

32 www.cosmeticnewsuk.com

analysis showed Botox® was significantly more effective than a placebo in reducing headache frequency, while the effect of the injections compared with a placebo can result in up to 26 fewer migraines a year. In the outcome data of more than 1,300 patients in clinical studies, nearly half of patients (47%) who received Botox® reported a 50% or higher decrease in headache days by 24 weeks following the treatment.

“The treatment works by blocking the transmission of pain through the nerve fibres in the area which is injected,” said Dr Mehta.

“Patients are referred to Holly House from their doctors and we have also taken some referrals from Harley Street. Eligible patients are those who suffer from chronic migraines – this means if they have headaches for more than 15 days in a two to three month-period or more than four severe attacks in a month.

The results have been phenomenal, with patients reporting not just reduced frequency of the migraines but also, when they do strike, the headaches are less painful and do not last as long.”

Nick Mather, a TV producer from Islington, underwent the treatment after suffering from painful tension headaches for seven years. The 35-year-old says the treatment has ‘changed his life’ by reducing the number of migraines by ’90%’ and lessening their intensity and duration. “I was suffering from tension headaches where it felt like I had a

very tight band around my head that gradually constricted and got tighter and tighter,” he explained. “At their worst I was getting them almost every day and they were affecting my ability to sleep. I have tried other treatments, including taking two types of medication for them for the last six years, but when I could feel an attack coming on I often knew the tablets weren’t going to make that much difference, the migraines were that painful.

“Dr Mehta suggested I tried the Botox® treatment and to be honest I didn’t really hold out much hope – but it has been brilliant. I know it won’t totally eradicate the headaches and Dr Mehta explained this wouldn’t be the case, but I’d say I am suffering from 90% less attacks. The other benefit is knowing that when I do get a migraine, they won’t last as long or be as bad. I only started on the treatment relatively recently and will go for another injection every three months, but have already halved the amount of one of the drugs I was previously taking and we’re expecting to be able to reduce the dosage of the other tablets, too. My hope is that in the long term I will only need an injection once a year and the Botox® will mean I’ve found an effective and drug-free solution to my headaches.”

Holly House Hospital has been established for more than 30 years and recently underwent a £20 million development, including a new purpose-built facility to house the majority of the outpatient services. An active researcher, Dr Mehta is also the deputy director of The Pain & Anaesthesia Research Centre at St Bartholomew’s NHS Hospital and Principal Investigator in various academic pain studies.

He has established himself as a key opinion leader in the field, with his contributions widely recognised by several national and international invited lectures.

LOOK HOW YOU FEEL Azzalure Abbreviated Prescribing Information (UK & IRE)

Presentation: Botulinum toxin type A (Clostridium botulinum toxin A haemagglutinin complex) 10 Speywood units/0.05ml of reconstituted solution (powder for solution for injection). Indications: Temporary improvement in appearance of moderate to severe glabellar lines seen at frown, in adult patients under 65 years, when severity of these lines has an important psychological impact on the patient. Dosage & Administration: Botulinum toxin units are different depending on the medicinal products. Speywood units are specific to this preparation and are not interchangeable with other botulinum toxins. Reconstitute prior to injection. Intramuscular injections should be performed at right angles to the skin using a sterile 29-30 gauge needle. Recommended dose is 50 Speywood units (0.25 ml of reconstituted solution) divided equally into 5 injection sites,: 2 injections into each corrugator muscle and one into the procerus muscle near the nasofrontal angle. (See summary of product characteristics for full technique). Treatment interval should not be more frequent than every three months. Not recommended for use in individuals under 18 years of age. Contraindications: In individuals with hypersensitivity to botulinum toxin A or to any of the excipients.

In the presence of infection at the proposed injection sites, myasthenia gravis, Eaton Lambert Syndrome or Amyotrophic lateral sclerosis.

Special warnings and precautions for use: Use with caution in patients with a risk of, or clinical evidence of, marked defective neuro-muscular transmission, in the presence of inflammation at the proposed injection Date of preparation: March 2013

site(s) or when the targeted muscle shows excessive weakness or atrophy . Patients treated with therapeutic doses may experience exaggerated muscle weakness. Not recommended in patients with history of dysphagia, aspiration or with prolonged bleeding time. Seek immediate medical care if swallowing, speech or respiratory difficulties arise. Facial asymmetry, ptosis, excessive dermatochalasis, scarring and any alterations to facial anatomy, as a result of previous surgical interventions should be taken into consideration prior to injection.

Injections at more frequent intervals/higher doses can increase the risk of antibody formation. Avoid administering different botulinum neurotoxins during the course of treatment with Azzalure. To be used for one single patient treatment only during a single session. Interactions: Concomitant treatment with aminoglycosides or other agents interfering with neuromuscular transmission (e.g. curare-like agents) may potentiate effect of botulinum toxin. Pregnancy & Lactation: Not to be used during pregnancy or lactation. Side Effects: Most frequently occurring related reactions are headache and injection site reactions.

Generally treatment/injection technique related reactions occur within first week following injection and are transient and of mild to moderate severity and reversible. Very Common (≥ 1/10): Headache, Injection site reactions (e.g. erythema, oedema, irritation, rash, pruritus, paraesthesia, pain, discomfort, stinging and bruising). Common (≥ 1/100 to < 1/10): Facial paresis (predominantly describes brow paresis), Asthenopia, Ptosis, Eyelid oedema, Lacrimation increase, Dry eye, Muscle twitching

(twitching of muscles around the eyes). Uncommon (≥ 1/1,000 to <1/100): Dizziness, Visual disturbances, Vision blurred, Diplopia, Pruritus, Rash, Hypersensitivity. Rare (≥ 1/10,000 to < 1/1,000): Eye movement disorder, Urticaria. Adverse effects resulting from distribution of the effects of the toxin to sites remote from the site of injection have been very rarely reported with botulinum toxin (excessive muscle weakness, dysphagia, aspiration pneumonia with fatal outcome in some cases). Prescribers should consult the summary of product characteristics in relation to other side effects. Packaging Quantities & Cost: UK 1 Vial Pack (1 x 125u) £64.00 (RRP), 2 Vial Pack (2 x 125u) £128.00 (RRP), IRE 1 Vial Pack (1 x 125u) €93.50, 2 Vial Pack (2 x 125u) €187.05 (RRP). Marketing Authorisation Number: PL 06958/0031 (UK), PA 1609/001/001(IRE). Legal Category: POM. Full Prescribing Information is Available From: Galderma (UK) Limited, Meridien House, 69-71 Clarendon Road, Watford, Herts. WD17 1DS, UK. Tel: +44 (0) 1923 208950 Fax: +44 (0) 1923 208998. Date of Revision: March 2013

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard.

Adverse events should also be reported to Galderma (UK) Ltd.

AZZ/018/0313

STERiGLIDE The Cannula That Glides Visit our EU aESTHETIC STORE at www.tsklab.com

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CANNULAS

TSK force Mr Dalvi Humzah on why the TSK STERiGLIDE: Hybrid Technology represents the next generation in cannulas

“I’m scared of needles “ Dwayne Wade, Athlete 1982 “..but needles in the face scare me, so I don’t really know if I am ever going to do that.” Valerie Bertinelli, Actress, 1960

Mr Dalvi Humzah Mr Dalvi Humzah is a consultant plastic reconstructive and aesthetic surgeon based at Plastic & Dermatological Surgery, West Midlands. Mr Humzah is a KOL for a number of companies in the Aesthetic field. He uses TSK STERiGLIDE cannulas and has presented on behalf of TSK.

Needles have been the main technique of injecting fillers in the aesthetic field, however there is a great deal of apprehension from the patient’s perspective on having to undergo these procedures. The initial insertion and subsequent manipulation is viewed as uncomfortable or painful. The use of cannulas is common in techniques like Fat Transfer and is becoming widely accepted as the product of choice for selective procedures due to its ability to reduce risk of bruising e.g. Tear Trough.

The side port is itself situated towards the end of the cannula and during use, the practitioner can be confident that the product is being delivered towards the tip of the cannula in a similar manner to that of a conventional needle. This provides greater precision in placement of the product.

A problem using cannulas compared to needles is the difficulty of introducing it through the dermis and guiding it underneath the skin.

These issues make the learning curve higher and more difficult for practitioners to work with the same level of accuracy as they do with needles. The TSK STERiGLIDE has a newly designed tip, which may be viewed as a “hybrid” between a sharp needle and a “blunt cannula” - described as “minaret shape” – tip.

This new tip design in combination with TSK proprietary surface treatment enables the cannula to require up to 50% less penetration force and with a 22G cannula closely simulates that of a 22G needle (Fig.2).

Figure 1: Extrusion Force: reduction of 35% (Courtesy TSK / Merz Aesthetics)

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The TSK STERiGLIDE cannula brings together many technological aspects that address concerns and problems that practitioners have when using micro cannulas in their practice. Extrusion force is a common problem that is of concern to many as the pressure required to deliver the product can cause discomfort not only to the patient, but also to the injector with delicate fingers! The TSK STERiGLIDE incorporates ULTRA-thin walls that decrease the extrusion force required even for viscous products by 35% (Figure 1).

The hub of the cannula is manufactured using PRC technology that prevents the embarrassing “popping off” between the syringe tip and hub during the procedure and has a conveniently situated and visible marking to delineate the position of the side port at the tip of the cannula.

The reduced flexibility and surface treatment of the exterior wall of the cannula also results in improvements by up to 50% in gliding which means more accurate and controlled guidance through anatomical structures and planes. This also leads to greater patient comfort during insertion of the cannula and placement of the product. (Fig.3).

The TSK STERiGLIDE is now the main cannula in use at my practice and was also introduced to 2.0 at the Medicosthe cosmetic nurse 2.0 practitioner 2.0 Rx Skin Clinic. Miss Anna Baker independently

Figure 2: Penetration Force 1.5 (Courtesy TSK) 1.5

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www.cosmeticnewsuk.com 35

BEST PRACTICE: LATEX ALLERGIES used these cannulas having used a variety of different cannulas in her own practice.

“I was introduced to the TSK cannula range some Figure 3: GlidingForce and penetration (Courtesy force TSK)(Courtesy TSK) months ago and have 2.0 found that these have 2.0 revolutionised my practice, 1.5 allowing for precise product 1.5 placement and ultimately 1.0 greater patient comfort.

Figure 3: Gliding penetration (Courtesy TSK) Figure and 3: Gliding andforce penetration

1.0

The range of cannula sizes and lengths gives me considerable choice in 0.0 5 10 15 selecting an appropriate 0.0 0 22G, 50mm 5 size depending upon 0 10 15 Standard Needle indication and my 22G, 50mm Figure 3: STERiGLIDE Gliding and penetration Standard Needle force (Courtesy TSK) preference. In my practice Regular Cannula STERiGLIDE I tend to favour the 27G : 2.0 Regular Cannula 25, 38 & 50mm lengths as 1.250 these are wholly versatile 1.5 for most facial indications.

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Patient comfort has been remarkable due to the ULTRA-thin wall and the cannula is flexible enough to pass gently into different tissue planes; working within the subdermal plane is seen with clarity as I am able to place gentle pressure at the base of the cannula to demonstrate tip placement and thus ensure the correct plane. This is an innovative device, which inserts and glides through tissues with ease, allowing for total accuracy as the delivery port is found at tip of the device, rather than the side. TSK also offers a needle/cannula holder, which I utilise in my practice and find this very useful during treatment.

10 15 25G, 50mm5 27G, 38mm Standard Needle 0 5 10 15 Standard Needle STERiGLIDE 27G, 38mm STERiGLIDE Regular StandardCannula Needle Regular Cannula Each pack conveniently STERiGLIDE Regular Cannula comes supplied with sharp needles for initial entry point and makes 0.80

it easy to use.” (Direct quote Miss Anna Baker Cosmetic Nurse Nuffield Health Cheltenham Hospital)

Practitioner 0.60

TSK STERiGLIDE is now used in the practice as it provides a redefined cannula that has been designed to address user and patient concerns (hopefully, Dwane Wade and Valerie Bertinelli will be 0.20 reassured) and will allow practitioners to find new applications and techniques in the future.

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The latex thing How you can make sure you are protecting your patients against life threatening latex allergies As medical practitioners one thing you have to be aware of when deciding on what brand of disposable gloves you are using is latex allergies. Not only will this mean you are safeguarding your patients but also yourself and your staff as studies have shown a growing number of healthcare professionals are developing this potentially life threatening allergy.

Latex allergy affects around 1-6% of the population in the UK – with studies suggesting growing incidence – yet receives almost no mainstream coverage and is largely misunderstood as a result.

The Royal College of Physicians says that up to 8% of health workers now have an allergy to latex rubber and this could be on the increase

As with all allergies, latex allergy can develop at any time.

The number of people affected is on the increase, with particular groups being most at risk of developing it, including healthcare workers. The Royal College of Physicians says that up to 8% of health workers now have an allergy to latex rubber and this could be on the increase. Other workers exposed to latex products in their employment are also at risk from developing latex allergy, including cleaners, carers, hairdressers, caterers and dental practice staff.

And its not just the gloves you need to think about. In much the same way as traces of nuts in food can cause severe reactions in people with nut allergies, even a small amount of contact with latex could potentially contaminate a product and make it dangerous for patients.

To try and improve awareness and understanding, the Anaphylaxis Campaign in conjunction with the Latex Allergy Support Group (LASG) has launched an awareness raising campaign for latex allergy. Together, they hope to highlight the overwhelming impacts this allergy has on those affected and some simple things that everyone can do to make life a little easier for latex allergy sufferers. The Campaign provides tailored services for individual and clinical professional members and also has a corporate membership programme.

The LASG said, “[Latex] is…under the Control of Substances Hazardous to Health Regulations which mandate that employers undertake risk assessments to eliminate, substitute and reduce exposure to hazardous substances, not only for their employees, but also the general public.”

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DR MATTEO TRETTI CLEMENTONI INTERVIEW

PA I N M AT T E R S

Cosmetic News speaks to leading plastic surgeon and laser authority Dr MatteoTretti Clementoni, about pain management and why he feels the new self-occluding local anaesthetic cream from Galderma, Pliaglis®1 (7% lidocaine/7% tetracaine), has transformed the way he deals with pain in his practice Pain or the fear of pain associated with aesthetic procedures is one of the major factors that can deter patients from undergoing treatment. While pain is almost an expected side effect of many surgical procedures, in the non-surgical arena patient expectations about pain and their willingness to deal with it are somewhat different. As such, pain management has become an integral part of the aesthetic practitioner’s treatment protocol.

Dr Matteo Tretti Clementoni Dr Matteo Tretti Clementoni has a Degree in Medicine and Surgery from the University of Bologna and a Specialist Diploma in Plastic and Reconstructive Surgery from the University of Pavia. In 1996 he began working with lasers and has progressively expanded into this field. He is a member of the European Society for Laser Dermatology, World Association for Laser Therapy, European Society for Laser Aesthetic Surgery, International Academy for Laser Medicine and Surgery, International Society for Cosmetic Laser Surgeons and a Fellow of American Society for Laser in Medicine and Surgery. He is also a Founding Member of COSMEDICA and Associate Editor of the South African Journal of Dermatologic Surgery. He is also a reviewer for The Journal of the European Academy of Dermatology, for the Journal of Cosmetic and Laser Therapy, and Aesthetic Plastic Surgery.

He is the author of 192 publications (including some book chapters) and has participated in 197 National and International Congresses.

At the FACE conference in London last month, Dr Matteo Tretti Clementoni gave a lecture entitled “Pain Matters: Innovations in Topical Anaesthesia to Enhance Patient Satisfaction Under Aesthetic Treatments”.

As a leading authority in the field of cosmetic surgery and lasers, Dr Tretti’s insights into the importance of pain management in the aesthetic arena were an integral part of the Equipment conference agenda on the second day of the meeting.

His presentation started with a powerful clip from the TV series House in which its star Hugh Laurie is seen shouting: “Life is pain, I wake up every morning and I am in pain, I go to work in pain”. As the attention-grabbing clip ended Dr Tretti turned to the audience and said: “I do not agree with him”.

Dr Tretti stressed that pain management was an essential part of the ‘conversation’ during the patient consultation and told delegates that how they dealt with the issue of pain in their clinics could have a huge impact

on patient satisfaction levels. “When a patient walks through my door, they have three main questions”, Dr Tretti said. “How does the procedure work?”, “How much does it cost?” and “Does it hurt?”

He then highlighted some powerful statistics from research carried out by MARC (www.

MARCresearch.com) about the barriers that the fear of pain can raise for patients considering and undergoing aesthetic treatments. The research showed that 34% of experienced patients, ranked pain as the second barrier (cost being the first) for having a procedure. It also showed that 58% of experienced patients asked their professional about ways to minimize pain, compared to a staggering 90% of those considering treatment. Pain also led to 40% of experienced patients considering not having a procedure again. Dr Tretti commented, “Pain is a barrier for patients who are already having procedures and patients who are thinking

Pain or the fear of pain associated with aesthetic procedures is one of the major factors that can deter patients from undergoing treatment www.cosmeticnewsuk.com 39

DR MATTEO TRETTI CLEMENTONI INTERVIEW

about having procedures. Pain always comes up in the first three questions a patient asks. When you decide to have a cosmetic procedure you don’t want to feel any pain. If you had to have a therapeutic treatment then you are less concerned about pain but if you are having an elective rejuvenation treatment you don’t want to feel pain.”

Local anaesthetic has long been used as an adjunct to aesthetic treatments but Dr Tretti said he was frustrated with the quality, safety profiles and efficacy of products previously on the market.

He highlighted the risks associated with using compounds saying, “I have been told that compounds are not so commonly used in the UK as they are in Italy and the South of Europe. For me the use of compounds was always a concern and I was worried about the safety, i.e.toxicity.”

Recent studies have shown that demand for topical anaesthetic creams that are fast acting, non-toxic and easy to apply and remove are on the rise. For Dr Tretti it was these issues that were key and so when he heard that Galderma, one of the world’s leading pharmaceutical companies, was launching a new product into this arena called Pliaglis®, he decided to re-look at the management of pain within his clinic.

Pliaglis® (7% lidocaine/7% tetracaine) cream is the first and only clinically proven, FDA approved topical anaesthetic that combines the highest concentrations of lidocaine 70mg/g and tetracaine 70mg/g and Dr Tretti has been highly impressed with its results. “Pliaglis® really changed the approach to pain management with my patients”, Dr Tretti said. “When patients book in for an appointment we tell them to come in half an hour or an hour before so that we can apply the cream. I then do the treatment and because they experience no pain, they are happy and want to come back.”

In fact Dr Tretti was so impressed with the reaction he was getting to the product from his patients that he decided to do an inclinic trial with 28 patients who had already undergone procedures without Pliaglis®. He then got them to have the same procedures with Pliaglis® and tell him the difference. The result was a pain reduction of 70% or higher which led to the patients actually requesting Pliaglis® the next time they came in for treatment. To demonstrate this he showed a video of a woman who had had the cream applied to her face and he then pressed the skin with a needle, even in usually sensitive spots, and she rated the pain as ‘zero’.

One of the most unique features of the product is its selfoccluding delivery system. Not only does this ensure rapid onset, within 30-60 minutes, and long lasting effect, but it also makes using topical anaesthetic in a busy aesthetic clinic easier and less messy as, once the product is exposed to the air it dries to form an occlusive barrier in the form of a ‘mask’, which can be simply peeled off.

Dr Tretti also discovered an added benefit to this – the fact he can do his surgical markings before applying the cream and they will still be intact once it has been removed. He says, “Because a lot of compounds are water based you would end up removing the surgical marking when you took off the cream and would have to do them again. With Pliaglis® you can do the markings and once you remove the mask they are still there. That is a great advantage.”

Because it has a fast onset of action, Pliaglis® can provide effective relief for injectable treatments within 30 minutes. The

40 www.cosmeticnewsuk.com

maximum anaesthetic effect required for the more painful laser ablation treatments is achieved at 60 minutes.

While injectable treatments hold their own pain related concerns, particularly for the needle phobic patient, it is with the more aggressive treatments, such as laser resurfacing and tattoo removal, as well as treatments like dermal rollering and mesotherapy or skinboosters, where pain can be more of a concern for patients and could be the difference between them deciding to undergo, or complete, treatment. It is here that Dr Tretti believes Pliaglis® really comes into its own. He says, “Tattoo removal is becoming more and more popular, especially with younger patients, and they are very worried about pain. These procedures also usually involve a series of treatments and you dont want to lose the patient.”

Unlike other anaesthetic creams, the vasodilating effect of Pliaglis® also gives it an edge with laser treatments, in particular for the treatment of rosacea and skin lesions where the ability to increase the target area leads to enhanced treatment results.“Sometimes you get some vasodilating and redness but this is an advantage for certain conditions rather than an adverse event”, says Dr Tretti. “If you can clearly see the target you can treat conditions like rosacea more effectively.”

Applying the cream at first can be tricky to master but Dr Tretti has some tips. He says, “You need to apply a very thin layer, too much will take longer to dry and removal will not be optimal.

If you can remove it in pieces like a ‘mask’ you are applying it correctly , if not , you can still improve your application technique..

It is a bit more difficult to remove from hair so I apply tape or headband to the hairline to avoid it. Pliaglis® can be stored below 25°C or refrigerated between 2-8°C, I prefer removing it from the refrigerator a couple of minutes before I use it and then maintain the tube in my hand so that it warms up. Temperatures changes should be avoided.”

Pliaglis® represents a significant advance in pain management for the treatment of these indications and has the potential to improve the conversion rate of patients moving from consultation to actual treatment. Providing adequate pain control in your practice can transform your business and is an investment in patient care that no aesthetic clinic can afford to ignore.

[REFERENCES] 1. Pliaglis Summary of Product Characteristics

CLEAN, SIMPLE AND FAST ACTING THE FIRST AND ONLY SELF-OCCLUDING TOPICAL ANAESTHETIC

(7% lidocaine & 7% tetracaine) Indications: For use in adults to produce local dermal anaesthesia on intact skin prior to dermatological procedures

Pliaglis Prescribing Information (UK)

Presentation: 1 gram of cream contains 70mg lidocaine & 70mg tetracaine.

Indications: For use in adults to produce local dermal anaesthesia on intact skin prior to dermatological procedures. Dosage and Administration: For procedures such as pulsed-dye laser therapy, Pliaglis should be applied at a thickness of 1mm for 30 minutes. For procedures such as laser-assisted tattoo removal, Pliaglis should be applied at a thickness of 1mm for 60 minutes. After the required time, the peel must be removed from the skin prior to the procedure. The maximum application area should not exceed 400 cm2. For facial procedures, Pliaglis should be applied by healthcare professionals only. Pliaglis should be applied with a flat surfaced tool, never with fingers. Pliaglis is for single patient use. Contraindications: Hypersensitivity to lidocaine, tetracaine, other anaesthetics of the amide or ester type, to paraaminobenzoic acid or any of the other excipients. Should not be used on mucous

membranes or on broken or irritated skin. Precautions and Warnings: Avoid contact with eyes. Treated area should not be occluded before removing Pliaglis from skin.

Should not be applied for a longer time than recommended. Local anaesthetics, including tetracaine, have been associated with methemoglobinemia. It is not recommended to use Pliaglis before injection of live vaccines as lidocaine has been shown to inhibit viral & bacterial growth. Use with caution in patients with hepatic, renal or cardiac impairment, and in patients with increased sensitivity to systemic circulatory effects of lidocaine and tetracaine. Avoid trauma to skin whilst under effects of Pliaglis. Interactions: No interaction studies have been performed. Interactions following appropriate use are unlikely as only low concentrations of lidocaine and tetracaine are found in the plasma after topical administration of recommended doses. Patients taking drugs associated with drug-induced methemoglobinemia are at greater risk for developing methemoglobinemia. Undesirable Effects: In clinical

trials, localised skin reactions at the application site were very common but were generally mild and transient in nature. Reported adverse reactions include: Very common (≥1/10): erythema, skin discolouration; Common (≥1/100 to <1/10): skin oedema; Uncommon (≥1/1,000 to <1/100): pruritus, pain of skin, pain; Rare (≥1/10,000 to <1/1,000): paresthesia, eyelid oedema, pallor, skin burning sensation, swelling face, skin exfoliation, skin irritation; Not known (cannot be estimated from available data): urticaria. Rare allergic or anaphylactoid reactions associated with lidocaine and tetracaine or other ingredients in Pliaglis can occur. Prescribers should consult the SPC in relation to other side-effects. Packaging Quantities and Cost: 15g £22.95 (NHS). MA Number: PL 10590/0059. Legal Category: POM. Full Prescribing Information is Available From: Galderma (UK) Limited, Meridien House, 69-71 Clarendon Road, Watford, Herts, WD17 1DS. UK. Tel: +44 (0)1923 208950 Fax: +44 (0)1923 208998. Date of Revision: December 2012.

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard.

Adverse events should also be reported to Galderma (UK) Ltd Date of preparation: March 2013

PLI/018/0313

CLINICAL STUDY

A HEL P I NG HA ND We look at the results of a study into the effectiveness of Ellansé™ HANDS

As well as the face, the hands are one of the first places to give away the telltale signs of ageing and, as such, hand rejuvenation has become an increasingly popular indication for aesthetic treatments.

The skin on the hands is exposed to the harshness of everyday life more so than any other part of the body and, as such, is very susceptible to premature ageing. But while many people spend fortunes on looking after the skin on their face, they neglect to look after the skin on their hands, leaving them with the telltale signs of how old they really are.

As well as bulging veins, pigmentation and thinning skin, volume loss in the dorsum of the hands caused by ageing is one of the common complaints patients seeking treatment for this area will have.

Since it entered the aesthetic market, Ellansé has wowed the aesthetic community by engineering a resorbable dermal filler that is long lasting. This innovative product stands apart not only due to the remarkably long-term outcomes achieved, but also because of its constitution.

Ellansé is composed of polycaprolactone (PCL), a 100% bioresorbable soft medical polymer, which has been used for decades in numerous medical devices such as resorbable sutures. The Ellansé Family (S,M,L,E) consists of unique combinations of bioresorbable polymer spherical microspheres and gels, the characteristics of which are the same across all four strengths.

It is the initial PCL chain length within the microspheres themselves that allows for a predictable controlled bioresorption, as well as a tunable longevity of the product within the targeted tissues.

is specifically dedicated to addressing the volume loss experienced in ageing hands,” he noted.

In a recent five patient study with Ellansé HANDS, Dr. Figueiredo treated the typical subcutaneous atrophy observed in the dorsum region of the hands. All patients demonstrated severe to very severe loss of fatty tissue and mild to moderate visibility of veins and tendons.

Each patient was treated with 1.0mL of Ellansé M-strength in the dorsum of both hands. The product was distributed in a retrograde fashion throughout this targeted area with a blunt tip cannula (22 G x 70 mm) using a single puncture technique at the wrist, without the need for topical or infiltrative anesthetic.

At the 24 week follow-up, 90% of patients were evaluated as “very much improved” and 10% “much improved”, compared to baseline. Patient satisfaction was also recorded as high (82%) at the 24-week follow-up. No serious adverse events were reported throughout the study.

Due to its tunable longevity, one can expect the aesthetic results achieved with the M-strength (Ellansé HANDS) to last approximately 12-18 months. The true longevity depends on each patient and the amount of product used.

As we age our skin becomes thinner and we begin to lose fat, so the hands become less plump and veins are more visible through the thinner skin. Loss of volume can lead to hand appearing ‘veiny’ and old. The use of dermal fillers in the hands is becoming an increasingly popular way of addressing this problem.

Ellansé HANDS is the newest addition to the product line and, as the name suggests, is specifically designed to address hand rejuvenation. It is ideal for patients with moderate to severe ageing in this area, which is typically characterised by a loss of tissue volume (i.e. connective tissue and fat) in the dorsum region.

Vitor Manuel Figueiredo, M.D., of the Clinica Milenio in Lisbon, Portugal, feels he was fortunate to be the first physician to use Ellansé for hand augmentation. “To my knowledge this is the only formulation available on the market that

Launched earlier this year at the annual International Master Course on Ageing Skin (IMCAS) conference in Paris, France, Ellansé™ HANDS from AQTIS Medical, is a novel dermal filler product that is specially designed to safely and effectively replace the lost volume in ageing hands.

“ Ellansé is a new option for treating volume loss on the dorsum of the hands. The outcomes are excellent and sustainable for over a year, which is difficult to achieve with other filler products for this indication.”

42 www.cosmeticnewsuk.com

“Ellansé is a new option for treating volume loss on the dorsum of the hands,” Dr. Figueiredo pointed out. “The outcomes are excellent and sustainable for over a year, which is difficult to achieve with other filler products for this indication.”

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THE EFFECTIVE COLLAGEN STIMULATOR For a gradual and natural deep tissue regeneration lasting over 2 years*

0207 467 6920 info@sinclairispharma.com www.sinclairispharma.com *Clinical trial ended at 25 months. Narins et al. JAAD. March 2010.

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Sinclair IS Pharma, Whitfield Court, 30-32 Whitfield St, London,W1T 2RQ

Q&A

DR SAM ROBSON. MBCHB. MRCGP

Dr Sam Robson is a member of the British College of Aesthetic Medicine. She qualified as a Doctor of Medicine from Aberdeen university in 1991. As well as being the medical director of Temple Aesthetics, Sam is a GP appraiser and also has a voluntary post as the Medical Adviser for the RNLI in Aberdeen. She is a firm believer in evidence based practice and so insists on using only scientifically proven treatments and products in her clinical work. She regularly attends courses and conferences in order to remain up to date and at the cutting edge of any new developments in aesthetics. Dr Robson attends regular workshops and seminars to refine her practical skills.

Q&A

We speak to Dr Sam Robson from Temple Aesthetics about why Stylage®is her product of choice Cosmetic News: What made you first decide to use Stylage®?

Dr Sam Robson: Having tried most of the other popular fillers I was intrigued by this new one. The introduction of mannitol seemed to be so sensible and logical – if it could damp down the inflammatory response meaning the product not only lasted longer but would also have less swelling after injection then this could only be a good thing.

CN: What specific aesthetic procedures do you use it for?

SR: It is my lip product of choice. I have treated many of my staff with different fillers over the years and they ALL prefer the result, lack of downtime and comfort of Stylage®. I have two main different types of lip treatment, either a lip definition or creating ‘sweetheart lips’, which have more volume and are more voluptuous.

I also like to use Hydromax in the tear troughs. I have used the volumising products in the cheeks and temples (XL and XXL) as well as S/M/L in the other facial lines as required.

CN: How long does the treatment take?

SR: It takes as long as it takes to be sure that I have done the best job possible. Various patient factors come into it: how comfortable they are; what their time scale is; whether or not it is their first treatment ever or first with me; how many areas they are having treated. I

Before

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allow an hour per client and if there is not enough time to consult and carry out all the intended treatment then we schedule another appointment. The most important factor is, having assessed that there are no reasons not to undertake treatment that they are looking for the same end result as me.

CN: Are there any side effects?

SR: The typical side effects are bruising but this is much less if I use a cannula.

It is my lip product of choice. I have treated many of my staff with different fillers over the years and they ALL prefer the result, lack of downtime and comfort of Stylage®

CN: Did its usage require any training?

SR: Not specifically for Stylage® but I think any new product or technique should be probably taught and practised before trying out on patients. I welcome heaps of training. There is always so much to learn both from watching and treating under supervision.

CN: How do you find selling the treatment to patients?

SR: I give patients the treatment options at their consultation and then tell them what product I want to use. I explain the benefits of this particular product (especially if they have not heard of it before) and I show them some before and after pictures of my own work so that they can see what I can do. I explain the costs, procedure, likely downtime, follow up etc and then let them decide if they need time to consider or

44 www.cosmeticnewsuk.com

whether they wish to proceed with treatment – it is very straightforward really. The consultation lets me see if they are suitable to undergo treatment. If I don’t think they are going to like what I am suggesting then I won’t treat them. I have aborted a treatment just before sticking the needle in because it didn’t feel like the right thing to do (this doesn’t happen often and means I end up wasting the product).

CN: Has it helped boost treatment acceptance levels at Temple Aesthetics?

SR: Treatment acceptance levels have never been an issue. By making sure I treat the right people with the right product and ensure I have a clear idea of what they are looking for then there is not an issue of them not being happy!!

CN: What do you feel are the main strengths of the product? (e.g. its chemical make-up including mannitol, or its practical application, shortened recovery time, long-term care etc) SR: The biggest advantages are lack of downtime, comfort, the fact it is long-lasting, the addition of mannitol and lignocaine and the fact it is an HA. CN: What specific feedback are you getting back from patients who have undergone the treatment?

SR: They love it and often come back asking for it by name.

CN: Would you recommend the product to other dentists offering facial aesthetic care, and if so what specific treatments is it most suitable for?

SR: Specifically I think it is a great product for lips. I believe lignocaine has been introduced across the range but I haven’t yet tried these so can’t comment. I also really like hydromax for tear troughs.

CN: How important are dermal filler treatments to your business?

SR: Very important. I assess each patient as holistically as possible and explain that all approaches are based on restoring health and seeing ageing as a disease in itself, therefore by understanding how somebody has aged and then taking steps to address this, the results can be a striking recapturing of youth, so fillers restore volume, fill lines, give definition. In younger people then fillers are used more to enhance beauty rather than to restore. But fillers are integral to all of that CN: How long has Temple Aesthetics been running and what are your future aims for the practice?

SR: Temple Aesthetics has been running for the past three years with me working full time, before then it was gradually evolving from a ‘hobby’/ new skill that I started exploring back in 2004. Since I went full time it has evolved into a private medical clinic specialising in anti-ageing, problem skin and weight loss and body contouring. We are about to move into premises that are more than three times the size of our current location. This will enable real expansion of current services as well as giving us space to incorporate new treatments. The new premises will also feature a training academy.

PRODUCT FOCUS

SEEING THE LITE We find out about the Regenlite laser treatment from Chromogenex

W

hen it comes to laser skin rejuvenation treatments, patients and physicians alike are looking for something that is safe, fast and effective with minimal downtime. Versatility is also key as every patient’s skin is different and will usually not just have one anti-ageing or aesthetic concern, so being able to target a variety of indications with one system is not only cost effective but time effective too.

One such treatment is Regenlite from Chromogenex.

Regenlite provides laser treatment for a range of skin conditions using the latest generation laser technology. The treatment can be used to address lines and wrinkles, acne and acne scarring and vascular lesions as well as for skin tightening, nonsurgical eye lifts and other diverse indications such as veruccas and warts. Regenlite is a medical laser, which emits a laser light known as SmartPulse ™ from its hand-piece. Regenlite has been engineered to supply exactly the right amount of light energy to the vessels at exactly the right time, taking them to the brink of damage and maximising collagen stimulation without causing long-term impairment. The laser offers swift and effective treatments with no need for cooling or anaesthesia and little or no visible after-effects, allowing the patient to resume their normal routine quickly.

For acne sufferers the laser light kills and reduces the bacteria causing infection and simultaneously stimulates the natural repair mechanisms of the skin. The light penetrating into the blood vessels stimulates the body’s natural response to produce collagen, enhancing skin rejuvenation and reducing wrinkles or acne scarring. Results can be seen after as little as one treatment, with patients usually BEFORE

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AFTER

requiring three treatments plus maintenance for long-term results.

To treat vascular lesions, like port wine stains, spider veins or rosacea for example, then Regenlite uses a higher energy beam which targets and destroys only the blood vessels causing the blemishes – leaving healthy skin unharmed. The effectiveness of the Regenlite has been evaluated and published in multiple peer reviewed publications using bio-chemical analysis, electron microscopy histology and ultrasound imaging. Groundbreaking research into the mechanism of action for its treatment of acne have been published in The Lancet medical journal.

Following on from the clinical success of Regenlite in the management of warts and verruccas, a recent study completed by Dr T Omi at the Nippon Medical School in Japan on Molluscum Contagiosum (MC) has confirmed similar excellent clinical results on this highly contagious viral condition. MC commonly affects infants and children and presents as a number of small, firm raised papules (spots) that develop across the skin and a primary source of infection is believed to be from swimming pool use. The papules are not painful but are often itchy and if scratched can cause scarring. Traditional remedies can often be painful and also risk causing scarring or burns to the surrounding skin but treatment with the Regenlite offers rapid clearance within a couple of weeks of treatment and no reoccurance at the follow up assessment three months later.

A full facial treatment takes approximately 30-45 minutes. Patients will feel a warming sensation but the procedure is not painful and can be used on all skin types and colours. As with most treatments, a course is required to get optimum

results. For acne three treatments are usually recommended with maintenance treatments after that. Vascular lesions, depending on their type and severity, usually require around three treatments while spider veins can be treated in as little as one session.

Regenlite is clinically proven to have negligible side-effects. Its indications are fully cleared by the American Food and Drug Administration (FDA). It also has full CE clearance for Europe.

Some patients experience a small degree of temporary reddening or mild bruising of the skin but this can be easily camouflaged with make-up and they can resume their normal activities straight away.

BENEFITS FOR PATIENTS • Treatment is usually fast, effective and pain-free with lasting results.

• Skin rejuvenation application includes treatment for: lines, wrinkles and eyelid lifts, irregular pigmentation, collagen stimulation for acne or surgical scarring.

• Vascular treatment application includes treatment for: port-wine stains, rosacea, telangiectasia, angioma, warts and verrucas, psoriasis, pigmentation.

• Simple treatment for all grades of acne vulgaris.

THE BENEFITS FOR CLINICIANS • Different operational modes enable treatment of many conditions (see above).

• Intra operative discomfort and postoperative effects are minimal.

• It is simple and convenient to use, enabling fast patient turn-around times.

• Cost effective.

BEFORE

BEFORE

AFTER

AFTER

The most advanced non surgical fat reduction and body shaping system

AS SEEN ON

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FAT CELLS BEFORE & AFTER

4 Technologies In 1 i-Lipoxcell is the third generation of i-Lipo systems from Chromogenex, a world leader in laser innovation. i-Lipoxcell incorporates four technologies for intelligent body fat analysis and measurement, laser diode fat reduction and Radio frequency skin tightening.

Why i-Lipoxcell ?

i-Lipoxcell is comfortable, safe and clinically proven, backed by independent multi centre studies from leading physicians worldwide.

• No side effects

• Clinically proven • Safe and comfortable • Immediate measurable results • Fast treatment time

Book a demo today www.ilipoxcell.com

For further enquiries call +44 (0)1554 755444 or email sales@chromogenex.com UK: +44 (0)1554 755444 • USA: 1-855-438-4547 • South Africa: +27(0)11 079 4242 Australia: 1800 827 817 • Brazil: +55 (11) 4702 4451 • Hong Kong (852) 3965-3175

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chromogenex Leaders in Laser Technology

™

FEEL THE LONGLASTING SOFTNESS OF EMERVEL® LIPS WHAT IS EMERVEL LIPS? Emervel® Lips is an HA dermal filler and part of the Emervel portfolio. Designed using the unique Optimal Balance Technology™ it offers a variety of calibration and crosslinking levels around a fixed HA concentration of 20 mg/mL for safety and longevity.

Emervel Lips is clinically proven to maintain longlasting improved lip fullness, with high patient satisfaction and minimal swelling. It is specifically designed for smooth integration into the delicate lip tissue to create beautiful looking lips, whether a subtle accentuation or a prominent augmentation is desired.

BENEFITS FOR YOU High Patient Comfort - Emervel lips is very well tolerated by patients with mild to moderate swelling, with a mean severity rating of 0.8 on a scale of 0 (none) to 3 (severe).1 Long-lasting – Emervel’s Optimal Balance Technology ensures persisitance in the tissue resulting in long-lasting improved lip fullness when injecting with Emervel Lips.1 High Injection Comfort – Easy to inject2; the Ultra Thin Wall needle technology allows a very precise and well controlled injection using a 30G needle, as well as maximised patient comfort with the inclusion of lidocaine in every syringe.

Excellent tolerability and patient comfort

Clinical studies with Emervel Lips demonstrates excellent tolerability.

Mean ratings (injectors) Swelling

0.8

Bruising

0.2

Pain/Tenderness

0.2

All injection site reactions were assessed using a 4-point severity scale (0=none, 3=severe)1

Long-lasting improvement

Emervel Lips is clinically proven to maintain longlasting improved lip fullness.

1.1

Mean improvement in LFGS

1.2

1 0.8

0.8

Emervel Lips

0.4

72.

7%

of lip fullness is maintained 6 months after treatment (measured with LFGS)

0 0

12

24

Week

Fig 6. Mean change in LFGS from baseline after 6 months according to 3-D measurements.

Adapted from Cartier H et al. 2012.7 Subjects presented with a score of 0 (very thin) to 2 (moderately thick) on the Lip Fullness Grading Scale (LFGS )

References: 1. Cartier H et al. J Drugs Dermatol 2012;11(1 Suppl):s17–26 2. Segura S et al. J Drugs Dermatol 2012;11(1 Suppl):s5–8

EME/011/0513 Date of Prep: June 2013

“I’m ready for my close up” I’ve got the confidence to share the real me

HAPPY PATIENTS 86% of Emervel Lips patients want to be injected with the same product again1 The long-lasting, natural looking results with Emervel Lips provides high patient satisfaction with 83% of patients satisfied/very satisfied with the aesthetic outcome1 and 86% wanting to be retreated with the same product again1, to be ever ready for their close up.

Emervel Lips is available from Wigmore, Med-Fx, Church Pharmacy as well as direct from Galderma.

Contact your preferred distributor or your local rep for more information today.

Galderma (uK) ltd Meridien House, 69-71 Clarendon Road Watford, Herts WD17 1DS Tel: 01923 208950 Email: info.uk@galderma.com

PRODUCT

LIPOGLAZE Case Study 1 Before After

T

he market for non-invasive fat reduction treatments in the UK has shot up in the past couple of years. Recent BAAPS data showed that last year demand for body-shaping procedures such as liposuction and tummy tucks tumbled by 14% and 12% respectively, for both genders combined. This is mainly due to concerns over safety but also because of the increased efficacy of non-invasive treatments.

LoveLite® has been at the forefront on this revolution in safe and effective treatments with cryotherapy fat reduction system Lipoglaze®.

Debra Robson and Donnamarie McBride have over 30 year’s joint experience in the aesthetic beauty industry and strive to deliver a fantastic customer service and brand. Here they talk to Cosmetic News about the developments Lipoglaze® is making.

Cryolipolysis is an exciting new technology. Since the concept was first described five years ago it has changed attitudes towards the subject of non-

Case Study 2 Before

After

invasive spot fat reduction. The technology works by transcutaneously subjecting fat cells to very cold conditions which in turn induces apoptosis - or programmed cell death - through which fat cells are lost resulting in real, measurable reductions in subcutaneous fat.

Previous generations of the cryolipolysis machines have however been very expensive, with high running costs in terms of disposables which has, in turn, resulted in high cost of treatments that in some cases has approached the cost of traditional surgical liposuction.

“Our clinics in Harley Street and in Hertfordshire are fully booked months ahead and sales of the machines to spas and clinics are robust. It’s no idle boast to say that Lipoglaze® has become one of the clear market leaders in the UK, with a huge amount of press coverage and celebrity fans of the treatment”, says Debra.“As a result we are currently treating over 2,000 clients a year with Lipoglaze® spot fat reduction therapy, and that’s not including all of the nationwide clinics who have bought the system. We know from our results that the system is safe and effective. There are American clinical trials and FDA approval for cryolipolysis, but we wanted to go further and publish our own clinical studies to prove the machine’s capabilities to UK medical practitioners.”

Although cryolipolysis certainly appears to work, whether or not it is as effective as traditional liposuction is somewhat less certain and so the high cost of treatment may seem somewhat unjustified to many patients. What is exciting about Lipoglaze® is that it may be able to offer effective cryolipolysis at a lower cost.

50 www.cosmeticnewsuk.com

Like all technology that aims to modify the appearance it is vital that it is underpinned by data from robustly conducted clinical trials that demonstrates both the safety and efficacy of the technology. “At my Aesthetic Medicine Institute in Glasgow we are undertaking a clinical trial of Lipoglaze® to assess key outcomes in terms of safety and efficacy and will look forward to publishing the results early next year”, adds Debra.

LoveLite® are working alongside aesthetic surgeon Dr Darren McKeowan BSc (med.sci) (hons) MBChB MRCS to perform a six-month clinical trial into the effectiveness of Lipoglaze®. The tests at his Aesthetic Medical Institute in Glasgow will prove the effects in fat reduction; quantify exactly what effects there are. Like all technology that aims to modify the appearance it is vital that it is underpinned by data from robustly conducted clinical trials that demonstrates both the safety and efficacy of the technology.

“We are looking forward to getting those results early next year. We already know the treatment works and is safe, we just want to have medical proof that it works, so that all the UK aesthetic practitioners across the country will be happy to add Lipoglaze® to the their menu of non-invasive treatments” LoveLite; 144 Harley St London, Greater London W1G 7LE 0845 505 0805 www.loveliteuk.co.uk/ BAAPS figures taken from their website press release http://www.baaps.org.uk/about-us/press-releases/1558-britonsraise-a-few-eyebrows

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0845 505 0805 info@loveliteuk.co.uk www.loveliteuk.co.uk 0845 505 0805 info@loveliteuk.co.uk www.loveliteuk.co.uk 0845 0845505 5050805 0805 info@loveliteuk.co.uk info@loveliteuk.co.uk www.loveliteuk.co.uk www.loveliteuk.co.uk

PRODUCT TREATMENT SPOTLIGHT

A WEIGHTY ISSUE

Urgent action is required to tackle Britain’s obesity crisis and prevent the country becoming ‘the fat man of Europe’ doctors have warned.

Obesity already costs the NHS £5.1 billion a year and it is feared that the figure will rise to £10 billion by 2050, when, it is estimated, that more than half of adults in the UK will be overweight.

Whilst being a little We find out about Highgate Hospital’s obesity overweight may not management treatment programme cause many noticeable problems, once you are carrying a few extra kilograms (or pounds), you may develop symptoms that affect your daily life.

There are a number of health complications caused be being obese, including high blood pressure, heart disease, type 2 diabetes, asthma and stroke.

The underlying causes of the UK’s obesity epidemic are largely said to be the easy access to cheap, high-energy food and people’s less active lifestyles.

Obesity already costs the NHS £5.1 billion a year and it is feared that the figure will rise to £10 billion by 2050

So why don’t people just stop eating foods high in fat and sugar if they know they can cause physical problems? Scientists are still searching for the answers, but it appears that our brains have been wired to encourage the consumption of calorie-rich foods, even at the expense of good health. Quite simply, these foods bring us pleasure. One recent study revealed that an area of the brain related to addiction and reward - the nucleus accumbens - lights up when a participant is shown calorie rich, fatty foods compared to healthy food. Another area of the brain associated with pleasant tastes and reward, called the orbitofrontal cortex, is activated when we eat fatty foods. We know the stats, we have seen the health headlines, but what is being done to help obese people shed the pounds and start a new healthy, balanced lifestyle? A hospital in North London has recently launched a specialist service to help people who have a dangerous BMI level and have struggled to lose weight through dieting.

Highgate Private Hospital’s weight management service brings together, for the first time, a multidisciplinary team to offer effective, long-term weight loss with pre and post care. Highgate Private Hospital is one of the country’s leading hospitals for weight loss surgery. It has performed around 2,500

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procedures since first offering bariatric surgery in 2005 – more than any other UK hospital. It is also the only private hospital in the UK using EndoBarrier, a procedure which works like a gastric band but without surgery or changing the anatomy of the stomach.

EndoBarrier creates a barrier between food and the wall of the intestine therefore delaying digestion and patients have reported appetite suppression and higher energy levels.

As an experienced bariatric surgeon Professor Nadey Hakim is also the country’s leading surgeon using EndoBarrier. He is teaming up with official EndoBarrier nutritionist Natalie Gillan to offer a unique service at Highgate. Natalie said, “This new package is the only one of its kind in the UK and for the first time it offers the surgery as a whole lifestyle package with pre and post care to give tailormade weight management solutions. I am the only nutritionist in the UK that works with a bariatric surgeon and so this approach will give long-lasting results. We have found in the past that some people who have bariatric surgery put weight back on as they do not know how to manage their lifestyle post surgery.

“Myself and Nadey have been working separately with patients for a number of years – but I have now joined the Highgate team to deliver this package with him. I will offer the pre and post advice, such as giving meal plans to ensure the right amount of nutrients are included in a patient’s diet. If people have a significant amount of excess weight to lose, weight management surgery is life-changing. It can prolong life, improve health and significantly change quality of life.”

The package is available to people aged over 18 with a BMI greater than 30 with associated health problems such as diabetes or high blood pressure and have tried dieting or other non-surgical measures but failed to maintain weight loss. The three procedures offered are a Gastric Band, a Gastric Balloon or the EndoBarrier. The Gastric Balloon is also inserted through the mouth and inflated in the stomach to make people feel fuller for longer. The Gastric Band procedure is performed via keyhole surgery and a band is fitted around the stomach.

Only time will tell if obesity will become the single greatest public health crisis in a generation and with 1,000 people a week dying from obesity related conditions the problem needs to tackled sooner rather than later. So whether a tax on sugary drinks or fewer fast outlets near schools is the answer remains to be seen, but certainly having a well-balanced diet and exercising more will help.

AANew Technology NewDimension Dimension in in Non-Surgical Non-Surgical Technology

revolution in in the non-surgical AA revolution non-surgical aesthetic aestheticskincare skincaremarket... market... setto to create create aa revolution revolution in isisset in the the non-surgical Aesthetic skincare market.

Following the non-surgical Aesthetic skincare market. Following the success successofof the awardwinning winning3D-lipo 3D-lipowhich which combines combines technologies the award technologiesfor forthe the effective treatment of fat, cellulite and skin-tightening we are effective treatment of fat, cellulite and skin-tightening we areset set to launch a phenomenal new multi-functional device for the face. to launch a phenomenal new multi-functional device for the face.

Here are just some of the reasons why 3D-skintech will become the Here are just some of the reasons why 3D-skintech will become the brand of choice in 2013 brand of choice in 2013 • Complete treatment portfolio for anti-ageing, • Complete treatment portfolio for anti-ageing, pigmentation and acne pigmentation and acne • 4 technologies ensure a prescriptive & total approach • 4 technologies to your clientsensure needs a prescriptive & total approach to your clients needs • Used in conjunction with medical peel and • Used in conjunction peel and cosmeceutical skin with caremedical line cosmeceutical skin care line • Unsurpassed results ensures maximum • Unsurpassed client loyalty results ensures maximum client loyalty • Highly profitable with a multitude of • Highly profitable services to offerwith a multitude of • Provides services toyou offerwith a competitive edge in your areaa competitive • Provides you with • Affordable as package price is edge in your area under £10,000 with a product • Affordable as package price is starter pack worth under £10,000 with £1,000 a product • Affordable finance£1,000 packages starter pack worth available • Affordable finance packages available

IT’S ALL YOU WILL EVER NEED…

IT’S ALL YOU WILL EVER NEED…

For more information or a demonstration Please 01788 550or440 For morecall information a demonstration Please call 01788 550 440

Rotational Diamond Peel Microdermabrasion Rotational Diamond Peel Microdermabrasion

Utilising thethe latest technology available you can in conjunction Utilising latest technology available you work can work in conjunction with topical skincare to ensure that hydration and comfort are not with topical skincare to ensure that hydration and comfort are not compromised whilst delivering excellent peeling results. compromised whilst delivering excellent peeling results.

Radio Frequency Radio Frequency Tri-polar Radio Frequency is the most advanced technology Tri-polar Radio Frequency is the most advanced technology

available for skin-tightening ensuring excellent results without the available for skin-tightening ensuring excellent results without the discomfort associated with mono or bi – polar devices. discomfort associated with mono or bi – polar devices.

Mesotherapy Mesotherapy Non-invasive mesotherapy ensures that the active ingredients are

Non-invasive mesotherapy ensures that the active delivered where they are needed most without the needingredients for needles.are delivered where they are needed most without the need for needles.

LED FullLED canopy LED ensures both rapid treatment time and excellent

Full canopy LED ensures rapid treatment time and excellent results are achieved.

Availableboth wavelengths Red (640nm - 700nm), Blue (425nm 470nm), Yellow (590nm) and Green (520 - 564nm) results are-achieved.

Available wavelengths Red (640nm - 700nm), ensures effective-treatment anti-ageing, acne and Blue (425nm 470nm), for Yellow (590nm)pigmentation, and Green (520 - 564nm) detoxification. ensures effective treatment for anti-ageing, pigmentation, acne and detoxification.

3D-skintech peels and clinical skincare A compact range ofpeels medicaland gradeclinical peels and cosmeceutical skincare 3D-skintech skincare products complete the Skintech’s unique offering enables you skincare A compact range of medical grade peels andand cosmeceutical to both use as a “stand-alone” service unique or combine withand equipment products complete the Skintech’s offering enables you protocols. to both use as a “stand-alone” service or combine with equipment protocols.

‘To compliment our core injectable business the 3D-skintech has added an array of new result driven facial services to our clinic’s menu as well as the combination services for ‘Tomore compliment our coreWe injectable business thedevice 3D-skintech hasstand added an array our curative patients. recognized that this offered the alone qualityof new driven facialinservices our clinic’s menu as well combination services for of result each technology a uniqueto machine that will ensure thatas wethe both deliver the results but equally makepatients. money from the start due itsthis affordability.

As a clinician tooalone manyquality our more can curative We recognized that device offered the stand times in the past we have investedmachine huge sums in that a single concept thatthe hasresults of each technology in a unique thatofwillmoney ensure we both deliver proven difficultcan to profit from.

In myfrom opinion system represents future intoo our many but equally make money the this starttype dueofits affordability.

As the a clinician industry.’

Martyn – GP and Clinical director Cosmedic Skin times inDrthe pastKing we have invested huge sums of money in Clinic a single concept that has proven difficult to profit from. In my opinion this type of system represents the future in our industry.’ Dr Martyn King – GP and Clinical director Cosmedic Skin Clinic

www.3d-skintech.com www.3d-lipo.com www.3d-skintech.com www.3d-lipo.com

PRODUCT NEWS AESTHETICARE®

SKINMEDICA

AesthetiCare® extends EndyMed™ 3DEEP® radio-frequency product range

SkinMedica launches Lytera™ Skin Brightening Complex SkinMedica has developed a new hydroquinone-free, skin brightening product – Lytera Skin Brightening Complex.

Featuring a patented blend of ingredients that brighten and even skin tone by reducing the appearance of dark spots and hyperpigmentation, Lytera Skin Brightening Complex contains highly effective antioxidants which help to reveal a smooth, luminous complexion.

AesthetiCare® has announced two extensions to the innovative EndyMed™ 3DEEP® radiofrequency product range: PURE™

by EndyMed™ and the Intensif™ Fractional RF Microneedle Skin Remodeling Handpiece.

PURE™ by EndyMed™ provides the same 3DEEP® technology and results for facial, neck, jaw line, décolleté and smaller body areas such as arms and knees as the EndyMedPRO but in a smaller, more mobile desktop unit. With two fixed handpieces (that can include the FSR option), the PURE™ by EndyMed™ provides a great option for the practitioner focused on the treatment areas listed above and where space utilisation and mobility are important criteria.

The New Intensif™ RF Microneedle handpiece and treatment tips, available from September 2013, effectively and safely delivers RF energy deep into the dermis through high quality, sterile micro-needles at highly controllable depths of up to 3mm.

A unique software and algorithm provides EndyMed™ Fractionated Pulse Mode control of the energy flow through the needles ensuring volumetric as well as precise depth control of the energy and heat.

The non-prescription product is clinically compared to 4% hydroquinone in reducing the appearance of hyperpigmentation and dark spots with comparable results. Clinical experience with over 500 Patients demonstrated significant improvements in the appearance of facial hyperpigmentation seen as early as four weeks with continued improvement at 12 weeks and six months. Key ingredients include: Retinol, 4-Ethoxylbenzaldehyde, Niacinamide and Tetrahexyldecyl Ascorbate.

THE COSMETIC SKIN CLINIC

CAMBRIDGE MEDICAL

Cosmetic Skin Clinic first in UK to offer CoolSculpting® Dualsculpting®

Cambridge Medical Aesthetics Ltd. introduces Uma Jeunesse Velvet

The Cosmetic Skin Clinic has become the first medical practice in the UK to have two CoolSculpting® Systems, allowing the practice to simultaneously treat patients in two different areas with two different systems, reduce overall treatment times, and manage the growing demand for CoolSculpting®.

CoolSculpting® is a non-surgical body contouring treatment that freezes and eliminates fat from the body.

There are no needles, no special diets, no supplements and no downtime. During the procedure, a non-surgical applicator delivers precisely controlled cooling to the treatment area to specifically target underlying fat without harming surrounding tissue. “Since I first began offering CoolSculpting® at The Cosmetic Skin Clinic in 2013, its popularity continues to grow at an impressive rate and having two systems in the clinic helps me meet the incredible demand,” said Dr Mountford, MBBS, MBCAM, founder and medical director of The Cosmetic Skin Clinic. “My patients are thrilled to reduce the length of treatment time in half and still achieve the body contouring results they want non-surgically with dual CoolSculpting®, also known as DualSculpting®.”

Cleared by the US Food and Drug Administration (FDA) and CE Marked, CoolSculpting® freezes unwanted fat cells in the body by inducing a natural, controlled elimination of those fat cells. This scientific breakthrough is based on a vast body of Harvard research that demonstrates fat cells are more susceptible to cold and are selectively destroyed. Results can be seen in two to four months, and the treated fat cells are gone for good. Additional treatments in the same or multiple areas achieve even greater fat reduction.“I am very impressed with my results and that The Cosmetic Skin Clinic worked around my schedule. I highly recommend CoolSculpting® for people with busy schedules who have stubborn body fat that diet and exercise alone do not seem to help,” said patient Kate Battrick.

54 www.cosmeticnewsuk.com

Cambridge Medical Aesthetics Ltd. has added a new product to its distribution portfolio - Uma Jeunesse Velvet.

Uma Jeunesse is a monophasic, hyaluronic acid based dermal implant cross-linked with BDDE. Uma Jeunesse Velvet is a lighter version of the product.

It contains 20 mg/ml lightly cross-linked hyaluronic acid and is ideal for treatment of tear trough, perioral wrinkles, all fine wrinkes, for hydration of lips, for treatment of dehydrated sagging cheeks and much more.

AZTEC SERVICES

Viora Receives CE Certification for V-touch Fractional RF Device AZTEC Services the exclusive UK distributor for Viora, is pleased to announce the acquisition of CE Certification for V-touch, an innovative fractional RF device for skin rejuvenation, skin resurfacing, skin tightening and scar reduction.

Utilising advanced SVC™ technology, developed by Viora, V-touch breaks through existing limitations in fractional RF devices and ensures that physicians in the UK can now provide minimally invasive, safer, less painful, and more effective treatments to their patients. Gaining CE certification positions Viora to support UK practitioners with the most novel fractional RF device available.

Responding to market demand, Viora has implemented the superior facets of SVC™ technology to afford physicians peace of mind, while giving patients true satisfaction during V-touch treatments. With added features for improved efficacy and comfort, V-touch is poised to spark a revolution in the world of fractional RF and allows physicians to address the most requested non-invasive and minimally invasive treatments. Suitable for all skin types and able to treat difficult areas, such as the neck, décolleté and hands, V-touch is the ideal solution for practitioners. V-touch leverages proprietary SVC™ technology – switching, vacuum and cooling – to ensure the highest safety and comfort for patients while providing unprecedented results in fractional non-ablative skin renewal and resurfacing.

MEDER BEAUTY

MEDER BEAUTY SCIENCE LAUNCHES THREE NEW TREATMENTS Meder Beauty Science has added three non-invasive professional treatments to its range. Developed in a leading Swiss biochemistry lab using the very latest advances in biotechnological ingredients, the treatments deliver immediate and visible wrinkle reduction results and overall facial rejuvenation without the use of needles or surgical procedures.

Myo-Fix replaces the acclaimed VAR-FX treatment to offer even greater wrinkle smoothing results. Pregnancy and breastfeeding safe, the newest generation of muscle relaxing peptides work in synergy to block neuro-muscular transmission and smooth out wrinkles around the eyes and forehead without the muscle paralysis often associated with injective treatments. For fast restoration of skin tone and elasticity, Arma Lift uses Stem Cell technology to target the processes of dermal synthesis and effectively decrease the depth and visibility of wrinkles while boosting the production of collagen and elastin.

Lipo Oval is a non-invasive facial liposculpture treatment offering an ideal solution for clients with mature skin with excess facial fat deposits and loss of elasticity in the lower and middle thirds of the face. Powerful active lypolitic ingredients penetrate the skin’s layers to reduce the volume of fatty tissue found in the skin and deliver a drainage effect to improve skin tone and even out the surface of ageing skin. Each treatment follows an exclusive six-step protocol including three stages of skin preparation to enable deep penetration of the active ingredients. A unique mask made of bamboo fibre and soaked in a matrix gel helps to push the active ingredients deeper into the skin’s layers.

Saturday may 17 2014

the City North hotel. dublin

CosmetiC News is delighted to aNNouNCe the lauNCh of the aesthetiCs CoNfereNCe, irelaNd. The first meeting of its kind for the Irish market, the conference will take place on Saturday September 28 at the City North Hotel Dublin. Bringing together the most prestigious and respected speakers in the industry to discuss the Call 01268 754 897 latest topics and demonstrate the most up-to-date or book oNliNe techniques, The Aesthetics Conference, Ireland is CosmetiCNewsuk.Com an ideal opportunity for Irish delegates to network with peers and gain CPD accreditation on their home turf. The delegate rate for the event is just 199 Euros and we are expecting a turnout of more than 150 aesthetic professionals for the inaugural conference.

delegate pass

€199

Call the tiCket hotliNe to purChase your delegate pass 01268 754 897 or book oNliNe www.coSmeticnewSuk.com exhibitors Call us Now

for staNd opportuNities

01268 754 897

IN BUSINESS BUSINESS FOUCS

All change Karen Fewster MSc on the shake up to cosmetic regulations due to take place this month and on how they could impact you and your business

In case you have not noticed there are big changes just around the corner and they affect everyone in the beauty and skincare business.

Cosmetic law in the UK and EU, which covers everything from shampoo to eyeliner to moisturisers, is about to have a significant makeover. From 11 July 2013, the legislation will be brought bang up to date and new rules will apply.

Article 1 of the new Cosmetic regulation (EC 1223/2009) â&#x20AC;&#x2DC;establishes rules to be complied with by any cosmetic product made available on the market in order to ensure the functioning of the internal market and high level of protection of consumer health.â&#x20AC;&#x2122;

The law applies to products intended for sale or given away free in a commercial enterprise.

The main goal of the new regulation is that all products must be safe to place on the market and below are just some of the changes which will ensure that this is the case. Product safety and regulatory compliance will be the responsibility of the responsible person, whose name must appear on the product label. Distributors too have more responsibilities under the new regulations.

It will be directly applicable in every country of the European Union including the UK with no room for different interpretations and will cover all products in both retail and clinic settings, so no-one is exempt. Everyone will be affected by the changes being introduced with this new set of rules, whether you manufacture, sell or import cosmetics and beauty products in the UK and Europe or plan to do so in the future. Current cosmetic rules will still apply, but certain areas have been beefed up â&#x20AC;&#x201C; particularly on the safety front. In future there will only be one central EU system for notification of all products (new and existing) and one responsible person per product across the whole European Union, which will allow for better intelligence on product safety issues and improved traceability across the whole supply chain.

Currently a Product Information File (PIF) has to be maintained for every product. The new regulations go much further and stipulate that an accredited EU based safety assessor must carry out a comprehensive assessment of safety including

HOW WILL IT AFFECT YOUR BUSINESS? Whether you have cosmetic products already on sale or are planning a launch soon, you must comply with the new regulation from July 2013.

56 www.cosmeticnewsuk.com

Everyone will be affected by the changes being introduced, whether you manufacture, sell or import cosmetics and beauty products in the UK and Europe or plan to do so in the future

a calculation of risk based on the individual ingredients, their content in the formula and how the product will be used. Products containing nanomaterials will need to be notified six months prior to placing on the market. Manufacturing facilities will have to comply with EU Good Manufacturing Practice (GMP) standards for the first time and this may be a challenge for some smaller manufacturers and also those outside the EU. There are also some new additions to the list of prohibited ingredients including some hair dyes, which may mean some formulations will have to be changed and the old ones removed from the shelf. For shopkeepers, clinics and distributors the impact of July 11 is the same- all products must be compliant. Not knowing the law is no defence and there will be severe penalties, with heavy fines and even imprisonment open to the courts, for serious non-compliance. Trading Standards will police this as they do now.

By 2016, the European Commission will establish common criteria for justifying the use of claims on cosmetic product. There will be an emphasis on supporting science but it remains to be seen what will be acceptable and I suspect the bar will be set very high as it has been with claims on food. This may bring future challenges for brands promoting their products.

SEEMS A LITTLE DAUNTING? Get good advice now and let the experts manage the process. There is still time to get to grips with all that is required and to be compliant before the July deadline arrives. The closer it gets the more difficult it will be to find a cosmetic safety assessor who is taking on new clients.

Fuel PR is working with expert assessors who can guide you through the regulatory requirements.

By harnessing intelligent regulatory and PR relationships Fuel is able to navigate a way through the new rules for its beauty clients.

IN BUSINESS A DAY IN THE LIFE

The Italian job Antonia Mariconda spends a day in the life of Italian born plastic and reconstructive surgeon Mr Mario Russo

M

r Mario Russo is an Italian born plastic surgeon qualified in plastic and reconstructive surgery. For the last 13 years, Mr Russo has lived and worked in the UK and established himself as a leading surgeon at the forefront of his profession. Registered as a specialist surgeon with the General Medical Council, Mr Russo is also a member of a number of leading European cosmetic surgery associations including the British Medical Association and The European Society of Aesthetic Surgery.

Mr Russo’s skills as a cosmetic surgeon have featured in various press and media features including television appearances on Channel 4’s Embarrassing Bodies and The Discovery Channel. Antonia Mariconda spends a day in the life of Mr Russo as he unveils his new state of the art clinics in London, Rome and Marbella.

“I wake up at 6am and I go to the gym every morning. I have always existed on very little sleep and that process fully awakens and charges me up ready for the day. I live in London, and share my time between London and Rome with my wife and three gorgeous children. Even though I am Italian born, London has been my home for the last 13 years.

I have a strong bond with England and have always been drawn to the fascinating openminded multi-cultural diversity of the country.

I practise surgery throughout various location in the UK, although London is my main hub and base. When I am in London my commute to work is a short five minute walk from my apartment which is wonderful. No matter what the season is London is purely enchanting and walking gives me a chance to organise my thoughts.

For as long as I can remember, I had always wanted to be a plastic surgeon since I enrolled at medical school, my father was a surgeon too I was greatly inspired by his drive and passion, and I remember choosing the specialty of plastic surgery to restore confidence and harmony in peoples lives aesthetically.

I usually consult two full days a week and will be in theatre three days a week. I am a very driven 58 www.cosmeticnewsuk.com

person and enjoy the intensity of the operating theatre, but more so visiting my patients and speaking to them after surgery. This has never ceased to be an amazing experience, watching their elation and relief as they journey towards achieving their goals and objectives.

What I like about the aesthetics interventions industry is that it is continually evolving and developing, the synergy between art and beauty is also one that develops continually, I travel to lots of conferences and meetings and feel proud of the continued research and development in surgical and non-surgical techniques.

and develop. We must not be too proud or too egotistical to continue to learn and develop.

I am so excited about the launch of Russo Aesthetics my new private aesthetics and surgery practice in London, Rome and Marbella, I hope to implement a charitable surgical support facility as part of my service in the very near future as it has always been a great passion and interest of mine.

The best parts of my career have been so many, including a reconstructive abdominoplasty that was filmed for Discovery TV, when I watched it in playback I remember being genuinely moved

I have always been inspired by many people from artists, to musicians, to politicians including an Italian surgeon called Alfredo Fonzone, who always inspired me to be the best I could and be the best surgeon I could for my patients I am very interested in the developments also being made in emotive beauty and I think this will make significant developments in the future as it is very much needed. I am profoundly delighted that the Keogh review is scrutinising the safety of patients and evaluating how to proceed on a safer pathway for the benefit of patient safety.

Any surgeon can experience adversities or complications in surgery, the difference between a good surgeon and not so good surgeon is how we manage those complications and support our patients, as members of the medical profession it is important that we transparently welcome constructive criticism and feedback to grow

to tears by the patient’s relief and elation, it’s moment like these that make it all worthwhile.

I have always been inspired by many people from artists, to musicians, to politicians including an Italian surgeon called Alfredo Fonzone, who always inspired me to be the best I could and be the best surgeon I could for my patients, he inspired me to “think outside the box’ because we shouldn’t be in a box in the first place!, how true that is. In my free time I like to socialise with friends, and my family doing what all Italians love doing which is eating, drinking and having a wonderful time in this journey called life.

My final thought of the day? “La vita e bella” (Life is Beautiful).”

Antonia Mariconda also known as ‘The Cosmedic Coach’ is a health and beauty writer, and author of four books. She is quoted in national and consumer press such as the BBC, Top Santé, The Evening Standard, Daily Mail, and Metro, for her knowledge on beauty and aesthetics, and cosmetic surgery. Antonia also independently advises clients both from the UK and around the world on where and where not to shop safely for cosmetic surgery, beauty, aesthetic medicine, and anti-ageing treatments.

Her client list includes A-list celebrities, Royalty and VIPs. Follow Antonia on Twitter @ CosmedicCoach or join Antonia on Face book where you will be updated about events and happenings in the world of health and beauty. www.thecosmediccoach.com

Large scale exhibition featuring 120 companies International attendance including: Cosmetic Doctors and Nurses I Dermatologists I Surgeons I Clinics I Hospitals 14 days of content at a two day event 3 high level conferences: Non-Surgical I Cosmetic Surgery I Reconstructive Surgery The great live debates Live demonstrations 3 educational workshops Non-Surgical I Surgical I The Business Hub Networking reception

Non-Surgical Programme CPD accredited by

Course Accreditation No: 001/13 Maximum 10 Hours

ONE

MAJOR-SCALE

EVENT from scalpel to syringeâ&#x20AC;Ś

W W W. C C R - E X P O . C O M / A D V E R T

#CCR2013

Contact us today on + 44 (0) 208 947 9177 | email: info@ccr-expo.com Sponsors

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TRAINING NEWS

CHANGE OF DATE FOR AESTHETIC CONFERENCE IRELAND In last month’s Cosmetic News we announced that we would be launching the Aesthetics Conference, Ireland as a new addition to the Cosmetic News portfolio.

The original date for the event was Saturday September 28, 2013, but, in order to make sure the programme for the inaugural event is as cutting edge as possible, we have now pushed the date back to Saturday May 17, 2014.

For more information call the events team on 01268 754 897.

NEW LEVEL 4 QUALIFICATION IN CLINICAL AESTHETICS ADDRESSES KEOGH REPORT’S CONCERNS Coinciding with the publication of Sir Bruce Keogh’s review of the regulation of cosmetic interventions, Sally Durant Training and Consultancy (SDTC) has launched the Level 4 Certificate in Clinical Aesthetics.

The Certificate is offered through the International Institute of Skin Health and Clinical Aesthetics (IISHCA) and accredited by IQ Industry Qualifications. It incorporates flexible learning of the underpinning knowledge alongside hands-on practical training at one of the company’s satellite training locations.

“The establishment of the Level 4 Certificate in Clinical Aesthetics couldn’t have come at better time for the skin care industry,” said SDTC’s founder, Sally Durant. “The Keogh Review has highlighted the need for medical and aesthetic practitioners to be properly and appropriately qualified - not just those performing surgical procedures but also professionals engaged in administering laser therapies, chemical peelings, dermal roller treatments and any other cosmetic treatments ‘where there is a potential risk to skin health.’

“The Certificate, which leads into IISHCA’s Level 4 Diploma, is the first high-level qualification addressing these specific issues and will provide patients and clients with the reassurance that their therapist or practitioner is suitably qualified to deliver the treatment.”

ECAMS 2013 EXPLORES NEW FRONTIERS ‘New Frontiers in Aesthetic Medicine and Surgery’ is the theme for this year’s European College of Aesthetic Medicine and Surgery (ECAMS) meeting.

Sessions will include Surgical Facial Rejuvenation and Lifting, Body Contouring, Cosmetic Gynaecology, Lasers in Aesthetic Medicine, Fat Grafting and Minimally Invasive Facial Rejuvenation.

Among the speakers will be some well-known UK names including Dr Raj Acquilla, who was the winner of the Aesthetic Award for Speaker of the Year in 2012, Mr Chris Inglefield and CC Kat. The congress will take place at the Palau de Congressos de Catalunya in Barcelona on November 8-9, 2013.

For more information visit www.ecams-congress.com 60 www.cosmeticnewsuk.com

DATES FOR THE DIARY

D AT E S F O R THE DIARY WE ROUND UP UPCOMING EVENTS, TRAINING COURSES AND MEETINGS

• JULY •

1 CIBTAC ENDORSED Ultrasound for skin rejuvenation and wrinkle reduction, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 2 Epionce Training, Danbury, Essex, 01245 227 752, carly@edenaesthetics.com, www.edenaesthetics.co.uk 2-4 Advanced Skin Laser Applications (Inc. Core of Knowledge), The Lynton Clinic, South Manchester, 01477 536975, info@lynton.co.uk 4 CIBTAC ENDORSED Diamond Microdermabrasion for Face and Body, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 5 Advanced facial treatment (Combined Course), Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 5 CPR & Anaphylaxis Update, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events/ 6 Microsclerotherapy, Wigmore Medical 21 Wigmore Street, London, www.wigmoremedical.com/events/ 6 Aesthetox Foundation Botox and Dermal Fillers, Birmingham, www.aesthetox.co.uk 6 Botulinum Toxin in Facial Aesthetics: new users - includes all major brands, Greater Manchester, www.innomedtraining.co.uk 7 Dermal Fillers in Facial Aesthetics: new users to hyaluronic acid fillers, Greater Manchester, www.innomedtraining.co.uk 8 Pressotherapy for lymphatic drainage and cellulite reduction, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 8 Platelet Rich Plasma (PRP), Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events/ 8 Epionce Training, Danbury, Essex, 01245 227 752, carly@edenaesthetics.com, www.edenaesthetics.co.uk 9 Agera and Microdermabrasion Training, Danbury, Essex, 01245 227 752, carly@edenaesthetics.com, www.edenaesthetics.co.uk 9 Physical and Chemical, Rejuvenation and Remodelling and Complete Automated dermal needling training with the genuine DermaPen – session includes practical - 58 South Molton Street, London, W1K 5SL. www.skinmed.co.uk/central-training 9 Sculptra, Wigmore Medical 21 Wigmore Street, London, www.wigmoremedical.com/events/ 9 ZO Medical, Kingsmead Medical Centre, Regency Way, Kingsmead, Cheshire, training@wigmoremedical.com 9 Infrared for weight loss and detoxification, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 10 Advanced Non-Surgical Facelift, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 10 Obagi Workshop, Manchester, www.healthxchange.com 11 BioSlimming, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 12 CIBTAC ENDORSED Cryotherapy Induced Lipolysis, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 12 ZO Medical, Wigmore Medical 21 Wigmore Street, London, training@wigmoremedical.com 13 Chemical Peel Systems & Medical Skincare: comprehensive course for new users, Central London, www.innomedtraining.co.uk 14 Mesotherapy for localised fat, cellulite & skin rejuvenation: new users, Central London, www.innomedtraining.co.uk 15 Clinical Update Training, The Lynton Clinic, South Manchester, 01477 536975, info@lynton.co.uk

15 Medik8 Dermal Roller, Wigmore Medical 21 Wigmore Street, London, www.wigmoremedical.com/events/ 16 Skincare & Chemical Peels, Wigmore Medical 21 Wigmore Street, London, www.wigmoremedical.com/events/ 17 Intro to Toxins, Wigmore Medical 21 Wigmore Street, London, www.wigmoremedical.com/events/ 18 Intro to Dermal Fillers, Wigmore Medical 21 Wigmore Street, London, www.wigmoremedical.com/events/ 19 Advanced Toxins & Fillers, Wigmore Medical 21 Wigmore Street, London, www.wigmoremedical.com/events/ 20 Microsclerotherapy, Wigmore Medical 21 Wigmore Street, London, www.wigmoremedical.com/events/ 20 Aesthetox Foundation Botox and Dermal Fillers, Birmingham, www.aesthetox.co.uk 20 Masterclass Aesthetox Botox and Dermal Fillers, London, www.aesthetox.co.uk 22 GloMinerals, Wigmore Medical 21 Wigmore Street, London, www.wigmoremedical.com/events/ 23 GloTherapeutics, Wigmore Medical 21 Wigmore Street, London, www.wigmoremedical.com/events/ 24 Advanced GloTherapeutics, Wigmore Medical 21 Wigmore Street, London, www.wigmoremedical.com/events/ 24 Core of Knowledge, The Lynton Clinic, South Manchester, 01477 536975, info@lynton.co.uk 26 Sculptra Refresher, Wigmore Medical 21 Wigmore Street, London, www.wigmoremedical.com/events/ 27 Intro to Toxins, Wigmore Medical 21 Wigmore Street, London, www.wigmoremedical.com/events/ 29 Body Shaping Workshop, The Lynton Clinic, South Manchester, 01477 536975, info@lynton.co.uk 30 Physical and Chemical, Rejuvenation and Remodelling with practical section - 58 South Molton Street, London, W1K 5SL www.skinmed.co.uk/central-training 30 Agera and Microdermabrasion Training, Upper Wimpole Street, London, 01245 227 752, carly@edenaesthetics.com, www.edenaesthetics.co.uk 31 Complete Automated dermal needling training with practical section for the genuine DermaPen - 58 South Molton Street, London, W1K 5SL. www.dermapen.co.uk/central-training

• AUGUST •

3 Aesthetox Foundation Botox and Dermal Fillers, Birmingham, www.aesthetox.co.uk 3 Mesotherapy, Wigmore Medical 21 Wigmore Street, London, www.wigmoremedical.com/events/ 5-6 CIBTAC ENDORSED Ultrasonic Lipo-Cavitation, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 7 Physical and Chemical, Rejuvenation and Remodelling and Complete Automated dermal needling training with the DermaPen – Session includes practical - Sandon House Clinic, Wyder Court, Millennium City Park, Preston, PR2 5BW www.skinmed.co.uk/central-training 7 Advanced facial treatment (Combined Course), Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 8 CIBTAC ENDORSED Diamond Microdermabrasion for Face and Body, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 9 Infrared for weight loss and detoxification, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 9 Platelet Rich Plasma (PRP), Wigmore Medical 21 Wigmore Street, London, www.wigmoremedical.com/events/ 10 BioSlimming, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com The Dates for the Diary section is now a paid for section of the magazine and is a chance for you to advertise your training courses to our readers both in the magazine and online. Advertisers will get free listings of any training courses as part of their campaign. Anyone else wishing to publish training courses can do so for £300 a year.

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onfidence is Reliable1,2 Rewarding 3 Performance 4,5 BOTOX® is licensed for the treatment of moderate to severe glabellar lines Delivers long-lasting patient satisfaction, time after time 2,3 Has been used for over 20 years in over 26 million treatment sessions worldwide6 Is the world’s first and most studied botulinum toxin*7

Botox® (botulinum toxin type A) Abbreviated Prescribing Information Presentation: Botulinum toxin type A (from clostridium botulinum), 50 or 100 or 200 Allergan Units/vial. Indications: Temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at frown (glabellar lines), 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. Contraindications: Known hypersensitivity to any constituent. Infection at proposed injection site(s). Warnings/Precautions: Relevant anatomy and changes due to prior surgical procedures must be understood prior to administration. Serious adverse events including fatal outcomes have been reported in patients who had received off-label injections directly into salivary glands, the oro-lingual-pharyngeal region, oesophagus and stomach. Do not exceed recommended dosages and frequency of administration. Adrenaline and other anti-anaphylactic measures should be available. Reports of side effects related to spread of toxin distant from injection site, sometimes resulting in death. Therapeutic doses may cause exaggerated muscle weakness. Caution in patients with underlying neurological disorder and history of dysphagia and aspiration. Patients should seek medical help if swallowing, speech or respiratory disorders arise. Clinical fluctuations may occur during repeated use. Too frequent or excessive dosing can lead to antibody formation and treatment resistance. The previously sedentary patient should resume activities gradually. Caution in the presence of inflammation at injection site(s) or when excessive weakness/atrophy is present in target muscle. Caution when used for treatment of patients with peripheral motor neuropathic disease. Use with extreme caution and close supervision in patients with defective neuromuscular transmission (myasthenia gravis, Eaton Lambert Syndrome). Contains human serum albumin. Procedure related injury could occur. Pneumothorax associated with injection procedure has been reported. Interactions: No interaction studies have been performed. No interactions of clinical significance have been reported. Theoretically, the effect may be potentiated by aminoglycoside antibiotics or other drugs that interfere with neuromuscular transmission. 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. Pregnancy: BoTox® should not be used during pregnancy unless clearly necessary. Lactation: Use during lactation cannot be recommended. 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%). In general, reactions occur within the first few days following injection and are transient. 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 to <1/10); Uncommon (>1/1,000 to <1/100); Rare (>1/10,000 to <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. Adverse reactions possibly related to spread of toxin distant from injection site have been reported very rarely (exaggerated muscle weakness, dysphagia, constipation or aspiration pneumonia which can be fatal). Rare reports of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Rare reports of serious and/or immediate hypersensitivity (including anaphylaxis, serum sickness, urticaria, soft tissue oedema and dyspnoea) associated with BoTox use alone or in conjunction with other agents known to cause similar reaction. Very rare reports of angle closure glaucoma following treatment for blepharospasm. New onset or recurrent seizure occurred rarely in predisposed patients, however relationship to botulinum toxin has not been established. Needle related pain and/or anxiety may result in vasovagal response.

NHS Price: 50 Units: £77.50, 100 Units: £138.20, 200 Units £276.40. Marketing Authorization Number: PL 00426/0074 Marketing Authorization Holder: Allergan Pharmaceuticals (Ireland) Ltd., Westport, Co. Mayo, Ireland. Legal Category: PoM. Date of preparation: December 2012.

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard Adverse events should also be reported to Allergan Ltd. UK_Medinfo@allergan.com or 01628 494026.

References: 1. De Almeida A et al. Dermatologic Surgery 2007;33:S37–43. 2. Carruthers A et al. J Clin Res, 2004;7:1–20. 3. Stotland MA et al. Plast Reconstr Surg, 2007;120:1386–1393.

4. Beer KR et al. J Drugs Dermatol, 2011;10(1) :39–44. 5. Lowe et al. Am Acad Dermatol, 2006;55:975-980. 6. Allergan data on file. BoTGL/001/SEP 2011 7. Allergan Data on File VIS/006/JUL2011. *Allergan botulinum toxin type A. Global figures. Launched in 1989 in the US. UK/0008/2013 Date of Preparation: January 2013