Cosmetic News November 2012 by webwax

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the ukâ&#x20AC;&#x2122;s largest trade aesthetics exhibition and conference

cosmetic news

Topical products for treating scars

Scar issues

Body contouring special We examine the rapidly expanding non-surgical body contouring market

also in the november issue of Cosmetic News... Practice management

exhibition and conference

november 2012

Treating Dermatosis Papulosa Nigra

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Cosmetic News The UKs leading trade title for medical aesthetic professionals

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Editor’s Letter Welcome to the November issue of Cosmetic News. It has been an exciting few months in the Cosmetic News office, we have re-launched and re-designed the magazine; seen our new website go live and have now picked all the winners for The Aesthetic Awards, which takes place in London on December 1. The event is already sold out and we are looking forward to celebrating with all the finalists on the night. Our focus now is on the 2013 Cosmetic News Expo and Aesthetics Conference and we have dedicated two pages to telling you what is going on and why you can’t afford to miss out (p14-15). Also in this issue…

cosmetic news the uk’s largest trade aesthetics exhibition and conference

Body contouring procedures are one of the biggest growth areas of aesthetic medicine. With more and more non-invasive devices being brought to market and with the BODY conference taking place in November, we decided that this was the perfect time to examine the latest trends in this exciting sector of aesthetics. We have asked some of the UK’s leading non-surgical body contouring experts to give their views on the products and treatments they think offer the best results (see pages 24-28). We also take a look at topical products for treating scars on pages 38-39 and examine a new technique for treating Dermatosis Papulosa Nigra (p32-33).

e xpo

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I hope you enjoy this month’s issue and look forward to seeing those of you who are attending the Aesthetic Awards on December 1!

The Science of Great Skin Powerful Potent Professional

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Meeting the needs of your business and delivering high satisfaction to your patients Tel: 01234 313130

info@aestheticsource.com

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Contents

Dermaheal biomimetic nanopeptide mesotherapy

INDUSTRY INSIDER 4 EDITOR’S CHOICE

Vicky Eldridge on Dermaheal biomimetic nanopeptide mesotherapy 35 [NEEDLING] 6 INDUSTRY NEWS

We round up the latest industry news 12 NEWS SPECIAL REPORT

We report on measures announced the annual BAAPS meeting in London to stop unscrupulous cosmetic surgery advertising

We find out about Genuine Dermaroller™ Home-Care Epidermal Skin Rejuvenation PRODUCT REVIEWS 38 PRODUCT FOCUS

Topical products for treating scars 40 TREATMENT SPOTLIGHT

14 COSMETIC NEWS EXPO/ AESTHETIC CONFERENCE 2013

Find out who will be speaking at the aesthetic event of 2013

We find out about the Harmony XLi Laser360iQ™ treatment 42 PRODUCT NEWS

We round up the latest product news

16 ON THE SCENE

From clinic openings to the BACN annual conference and the launch of SkinCeuticals’ new peels, we report on what has been going on out and about in the industry this month

IN BUSINESS

18 HOT TOPIC

48 CHARITY SPOTLIGHT

David Reissner, Head of Healthcare at Charles Russell LLP, on the future regulation of cosmetic surgery

Cosmetic News is supporting an appeal by charity, Changing Faces, to raise £10,000 we tell you how you can help

46 BUSINESS FOCUS

Mark Simmons on how owners could be damaging the value of their business

22 PEOPLE IN PROFILE

We speak to the newly elected president of BAAPS, Mr Rajiv Grover CLINICAL PRACTICE 24-28 [DEVICES] BODY CONTOURING SPECIAL

We report on the boom in the body contouring market and examine the market-leading devices in this sector 32 [DERMATOLOGY] DERMATOSIS PAPULOSA NIGRA

Vicki Smith from Absolute Aesthetics Advanced Electrolysis for the removal of Dermatosis Papulosa Nigra

Editor’s choice

50 MEDIA AND PR

Tingy Simoes on why you should talk to the press 52 BEST PRACTICE

Paul McGee, founder of PracticePal, gives us an insight as to why he believes a completely web-based clinic management system is critical in today’s fast moving business sectors 54 A WORKING DAY IN THE LIFE OF…

Antonia Mariconda finds out what a typical day in the life has in store for Professor Bob Khanna 56 TRAINING NEWS AND DATES FOR THE DIARY

The latest training news and dates

Every now and then a new treatment or product range emerges onto the market that creates a bit of a buzz. Out and about in the industry recently I have been hearing a lot about Dermagenica’s Dermaheal range of biomimetic nanopeptide mesotherapy products. When practitioners I know, respect and trust tell me that I must check out a new treatment because they are getting great results with it, it immediately ignites my journalistic curiosity and so I had to find out what all the fuss was about. What makes the Dermaheal range so interesting is that it not only ensures effective rejuvenation through revolutionary nanopeptide technology, but also claims to be more efficient in fighting cellulite, stretchmarks, hair loss, permanent wrinkles and skin discoloration than more traditional forms of mesotherapy. The ultimate success is provided by the unique composition of 50 active ingredients, including biomimetic peptides, and a Nano-Capsulation Delivery System. So why is this important? Well, biomimetic peptides mimic the function of growth factors as messengers in the skin, allowing the epidermis and dermis to communicate more efficiently, which is essential, because reduced communication within the skin results in decreased collagen production and an aggregation of degraded elastin fibers. The Nano-Capsulation Delivery System is a pharmaceutical delivery system, which was originally developed for delivery of the active ingredients in medications. Nano-capsules are like small balls, which engulf the active ingredient in their core. Their outer layer is made of fatty molecules, which allows them to cross the cell membrane. Once they reach the cell membrane, they open up and release their content, allowing the maximum delivery of the active ingredients to the target area. The range includes: Dermaheal HSR for rejuvenation of the face, neck, hands and stretchmarks; Dermaheal SR for wrinkles, acne and enlarged pores; Dermaheal HL for hair loss and alopecia; Dermaheal LL for cellulite and local fat and Dermaheal SB for skin whitening, age spots, freckles and eye shadows. As the magazine goes to print we are about to attend a seminar in London about the products and procedures so I am excited to find out more and try it for myself. See this month’s On the Scene (p16) for our report on the seminar.

Contact the Cosmetic News team on 01268 754 897

Charlotte Body Publisher charlotte@creativemedialtd.co.uk

Loraine Winter Senior Designer loraine@creativemedialtd.co.uk

Vicky Eldridge Editor M: 07940 083 677 vicky@creativemedialtd.co.uk

Emma Bridges Events/Production emma.bridges@creativemedialtd.co.uk

Peter Johnson, Art Director peter.johnson@creativemedialtd.co.uk

Carly Mcfarlane Sales and Events Assistant carly.mcfarlane@creativemedialtd.co.uk

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.

Ground-breakingwww.dermagenica.co.uk news in medicine Dr Gabriela Mercik is a biomimetic mesotherapy expert and a progenitor of biomimetic mesotherapy treatments in the UK.

Fibroblasts - before and after

Biomimetic mesotherapy Tel: 0044 (0) 75945 34735 Email: info@dermagenica.co.uk

After 72 hours we can monitor morphological changes of fibroblast and keratinocyte cells â&#x20AC;&#x201C; an increase of proliferation and density

Dermaheal HSR Dermaheal SR Wrinkles, Rejuvenation, Acne, Stretchmarks

Results of biomimetic mesotherapy Dermaheal LL Cellulite, Local Fat

Before

After

Dermaheal SB Skin Brightening

Dermaheal HL Stops hair loss and alopecia. Stimulates hair regrowth. Meso Roller increases the uptake of substances through your skin, allowing your patients to reap the full rewards of the Biomimetic Mesotherapy product.

www.dermagenica.co.uk

Before

After

Dermagenica, a UK-based distributor for Dermaheal, is organising seminars with workshops accross the UK. More info: www. dermagenica.co.uk/events

bo o k your del eg at e ti ck et f o r c o s m e t i c n e w s e x po INDUSTRY News

b o o k o n l i n e n o w w w w. c o s m e t i c n e w s u k . c o m

cosmetic news the uk’s largest trade aesthetics exhibition and conference

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Sinclair IS Pharma

ihas

Sinclair IS Pharma enters into distribution agreement with Valeant

IHAS launches Safer Injectables campaign with Dr Hilary Jones

Sinclair IS Pharma plc has entered into an exclusive 100 year agreement with an affiliate of Valeant Pharmaceuticals International Inc for the distribution of injectable aesthetic dermal filler products Sculptra® and New-Fill® and the sub-distribution of Succeev® in Western Europe. Sinclair IS will make an upfront payment of €9.0m for the rights. The company will make additional sales-based payments over the life of the distribution agreement.

Dr Hilary Jones has joined forces with TreatmentsYouCanTrust.org. uk to launch a new Safer Injectables campaign.

Sinclair IS will be responsible for sales, marketing and distribution of the products in Western Europe with distribution expected to commence at the beginning of December 2012. Sinclair IS is already established in the European aesthetics market with Kelo-cote®. The company will now take its ambitions in aesthetics a step forward by leveraging its sales and marketing infrastructure, including providing promotional support for the products. Sculptra®is expected to become Sinclair IS’s third largest brand after Kelo-cote®and Flammazine®in terms of sales. The agreement is in line with the company’s strategy to deliver operating leverage by increasing revenues utilising its direct sales infrastructure in the UK, France, Germany, Spain and Italy. Chris Spooner, Sinclair IS CEO commented, “We are delighted to announce this agreement with leading dermatology player, Valeant. The deal extends our dermatology portfolio and enables us to further leverage our existing sales and marketing infrastructure in Western Europe. Our proven ability to add value to existing brands leads us to believe that we can reinvigorate the sales of these products whilst a greater presence in aesthetics is also expected to advance our strategy for Kelo-cote®.” Kelo-cote®are Bronze Sponsors of the 2012/2013 Aesthetic Awards as well as the 2013 Cosmetic News Expo and Aesthetics Conference.

york medical technologies

GloPRP arrives in the UK GloPRP has now arrived in the UK and will be sold and supported by York Medical Technologies, a leading supplier of surgical products to hospitals and clinics, both NHS and private. YMT’s Managing Director, Stephen Blight, PhD, said that they were very excited to be teaming up with GloFinn and would be taking PRP therapy to all areas where it has beneficial effects, including cosmetics for nonsurgical facelifts and skin regeneration, hair restoration, orthopaedics, wound care and pain control. Up to now, obtaining high quality PRP has been a hit-or-miss affair, with reliable high live platelet count PRP typically being produced by the more expensive systems in the marketplace. GloPRP transfers the smarts to a semi-closed syringe system where, through the use of patented materials and design, the process has been developed to give high platelet count with minimum handling and ease of use. The advantage of this is that the cost of equipment drops dramatically and gives a very good performance at reasonable cost, using only a fraction of the blood necessary for some of the more expensive options. Pay back time is very short, leading to greater return on investment for users.

www.cosmeticnewsuk.com

The campaign aims to advise consumers on the best and safest approach to Botox®and dermal fillers whilst the review of cosmetic procedures, led by Sir Bruce Keogh, awaits conclusion. The Safer Injectables campaign launched the ABCs of safe injectables urging consumers to ‘Always Background Check’ their provider and know how to spot and avoid bad practice. With the Medicines and Healthcare Regulatory Agency (MRHA) and Advertising Standards Authority (ASA) both stating Botox®should not be advertised to the public, the campaign also

encourages the public to report bad practice and inappropriate adverts to www.TreatmentsYouCanTrust.org.uk/saferinjectables, to help stamp out poor standards. Dr Jones said, “With the review of cosmetic procedures led by Sir Bruce Keogh underway, consumers are understandably confused on the safest approach for injectable treatments. Whilst Botox®and dermal fillers are non-surgical they are medical procedures and should only be administered by regulated and appropriately trained doctors, dentists and Registered Nurses. The ABCs of safe injectables are simple for consumers to follow to help avoid the known risks associated with treatment by unqualified providers in unsanitary environments.” Baroness Trish Morris, chair of the TYCT Governance Group, adds, “It is imperative that patients are made aware that beauty therapists are not appropriately qualified by the very nature of their non-medical training to administer injectable treatments including Botox®. Whilst there are calls from within the beauty industry for the review to recognise therapists as appropriately qualified injectable providers, such a move would be totally inappropriate. Beauty therapists provide an important role and excellent service for beauty treatments however the outcome of the review must safeguard patient safety for medical procedures including injectables.”

galderma

John Bannon named as new Irish distributor for Galderma aesthetic portfolio John Bannon has taken over distribution of Galderma’s portfolio of aesthetic products in Ireland. Established in 1985, John Bannon Ltd has become a market leader in the Irish Medical Industry. The company’s competitive advantage lies in the fact it has developed strong relationships with its customers built on trust, impeccable customer service and communication. The company will now distribute Azzalure®, Restylane®and Emervel®in the Irish market.

5 finalist

nominations

The ONLY SHR® Painless Laser Hair Removal

double AwArd • winner •

TreATmenT of The yeAr Gold - Soprano Pain Free Hair Removal equipmenT brAnd of The yeAr Gold - ABC Lasers

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the uk’s largest trade aesthetics exhibition and conference

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CN editor edits times supplement

allergan

Vicky Eldridge to edit dermatology supplement for The Times

Allergan launches consumer guide

Cosmetic News editor Vicky Eldridge will be editing her third supplement for The Times this month. The 16-page report on dermatology will be published inside the prestigious newspaper on Wednesday November 7 and includes articles on common skin conditions; at home devices for skin concerns; the psychological impact of skin conditions and skin cancer. The supplements are produced in conjunction with Raconteur Media. Vicky has previously produced reports for them on cosmetic surgery and cosmetic dentistry.

ctia

CTIA rapped by DWP for claiming government funding for beauty therapist injectable training An organisation set up to campaign for inclusion of beauty therapists in the lucrative facial aesthetics marketplace has been reprimanded for claiming government backing for its cosmetic injectable training courses aimed at beauty therapists. The CTIA (Cosmetic Treatments Industry Association) was claiming it had Government backing from the Department for Work and Pensions, however Lord David Freud, Minister for Welfare Reform, has now contacted the organisation to ensure that they do not use the terminology in future and removed them from the DWP’s procurement register. The move came after Baroness Trish Morris, chair of the Treatments You Can Trust Governance Group, wrote to the DWP to air the group’s concerns. Lord Freud said, “We have amended the Jobcentre Plus guidance with specific reference to this type of training, clarifying that only doctors, dentists and registered nurses should be permitted to apply for funding for this type of training. “Despite requests from the DWP, the CTIA failed to remove their strapline from fresh advertisements suggesting endorsement from DWP. The organisation had remained on our procurement register as a provider of other non-contentious training courses. In view of their continued use of the strapline, however, we have concluded that they are in breach of their contractual terms and conditions with DWP and have now removed them from our procurement register.”

Allergan has created an A5 Consultation Guide aimed at advising consumers about facial injectable treatments. The booklet, which is entitled ‘A Step-by-Step Guide to Your Facial Injectable Treatment Consultation’, was launched nationally last month and was developed in partnership with Mr Rajiv Grover, the new president of the British Association of Aesthetic Plastic Surgeons (BAAPS), who has written the forward.

A STEP-BY-STEP

GUIDE TO YOUR FACIAL

INJECTABLE TREATMENT CONSULTATION

It includes clear, simple explanations about some of the most common questions, such as what are the differences between wrinkle relaxing treatments and dermal fillers; where to find reputable, trained and qualified medical practitioners and which online resources to look at for more information. It also includes six suggestions of things to ask, to help consumers make a confident, informed choice. See this month’s People in Profile (p22) for our interview with Mr Grover where he talks about his involvement in the development of the booklet, the Sir Bruce Keogh review and his new role as president of BAAPS.

npd group

Prestige anti-ageing beauty market fragments Latest research by The NPD Group shows that the prestige anti-ageing market is fragmenting into a market of price extremes. Consumers are restricting spending on entry and middle market prestige anti-ageing products with value sales declining in the year to June 2012 by 30% for products priced under £30, and by 8% for products priced between £30 and £50. By comparison, upper and super premium antiageing products are experiencing strong growth, with value sales growth of 28% for prestige products priced between £50 and £100 and a 9% growth for products priced over £200 which proves that this segment simply has not been impacted by the economy. In fact, the strength of the upper and super premium sectors has led to a year-on-year growth of 6% in value sales across the entire antiageing category.

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

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0808 238 1500 NEW 1 ml syringe

Juvéderm® – the world’s no.1 selling dermal filler 4

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 2012 UK/0023/2012

INDUSTRY News

cosmetic news

5 finalist

nominations

iPixel The Ultimate in Anti-Aging Technology. Wrinkles, Scars and Pigmentation

ClearLift The World’s First Fractional NonAblative Q-Switched Laser The Ultimate in Acoustic-Thermal Rejuvenation

Dye-VL The First Narrow-Band Dye Technology

Expandable & Upgradable Supports up to 22 different modules LP 1064nm Alexandrite and many more

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Breakthrough in tattoo removal for all ink colors.

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Multi-Application Platform

Unlimited Options. One Easy Choice. The Leader in Medical Aesthetics Alma Lasers offers the most advanced technologies for today’s most in-demand aesthetic procedures. HarmonyXL is a multi-application platform featuring over 70 FDA cleared aesthetic treatments, including ClearChoice for Onychomycosis (nail fungus), the popular Laser360iQ rejuvenation and anti-aging protocol, and iTED, a revolution in ultrasound trans-epidermal delivery. Clinically PROVEN to safely treat ALL skin types. True Breakthrough in treating the most in-demand indications: Stretch Marks, Melasma, Scars, Acne Scars and many more.

equipmenT BranD of The year GoLD - ABC Lasers

TreaTmenT of The year GoLD - SHR™ Pain Free Hair Removal

bo o k your del eg at e ti ck et f o r c o s m e t i c n e w s e x po INDUSTRY News

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cosmetic news the uk’s largest trade aesthetics exhibition and conference

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alma lasers accolade

acne treatments

Accolade for Soprano in Harpers Bazaar Beauty Hot 100

Celebrity surgeon release book on acne

Soprano Laser Hair Removal has been featured in Harpers Bazaar Beauty Hot 100. This influential hotlist provides an essential guide to the best in UK beauty complied by beauty editors Newby Hands and Katy Young. Soprano was chosen as the best hair removal treatment because it treats a wide range of skin tones and is painless and fast with long-lasting results. Earlier this year Soprano was also featured in the 50th anniversary edition of Asian Woman as one of the most important advancements to shape the Asian beauty industry in recent times. Dr Ziv Karni, Founder and CEO of Alma Lasers said, “Even according to the most conservative estimates, millions of people in nearly every country have used the Soprano for hair removal. The sale of 7,000 systems is a clear sign that practitioners and their clientele are seeking the Soprano and SHR technology for virtually pain free laser hair removal.”

Celbrity surgeon Dr Terry Dubrow has released a new book, which lifts the lid on acne treatments.

The Acne Cure describes a revolutionary, proven treatment program that, he claims, eliminates acne in 95% of all cases in no more than six weeks without prescription drugs. Dr Dubrow is known for his work on The Swan, E!’s Bridalplasty and hit reality TV show, The Real Housewives of Orange County and is married to TV star Heather Dubrow.

new cosmetic tv show

New Harley Street TV shows hits the airwaves A new TV show, which offers expert advice on the latest developments in cosmetic surgery and dentistry as well as revealing the hair, make-up and styling secrets of the stars, has started on Sky. Produced by Blondie Media, Harley Street Beauty will air five days a week from October 15 at 3.30pm, 7.30pm and 11.30pm on Sky 266/Freesat 400. This month’s episodes will feature Dr Dan Dhunna talking about dermal fillers and botulinum toxin for hyperhidrosis; Dr Julian Caplan on Invisalign and Professor James Frame on rhinoplasty, tummy tucks and lipo, among other topics.

aztec services

FACE Raffle Winner Dr Wanda Hargreaves was the lucky winner of a Viora ‘Pristine’ diamond dip microdermabrasion system worth over £5,000 in a raffle held by Viora and AZTEC Services at the FACE meeting this summer. Pictured right: Anthony Zacharek of AZTEC Services hands over the prize to Dr Hargreaves at her practice in Cheshire.

10 www.cosmeticnewsuk.com

Your partner in injectable facial aesthetics

Belotero® now approved by the FDA • One of only 3 HA fillers approved by the FDA currently promoted in the US • Optimal integration1 for superior evenness2 • Minimal local inflammation3 for sustained patient satisfaction4

BEL050/1111/JH

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

INDUSTRY News special report

baaps

the12 steps We report on measures announced at the annual BAAPS meeting in London, designed to protect vulnerable young people from unscrupulous cosmetic surgery advertising At its annual scientific meeting in London, The British Association of Aesthetic Plastic Surgeons announced that it had drafted and submitted a new, strict advertising code to regulator CAP (the Committee of Advertising Practice), which sets out policies for the Advertising Standards Authority. Although continuing to call for an outright ban on cosmetic surgery advertising in all its forms, the BAAPS says that implementing the 12 measures they have outlined is the “bare minimum” that should be considered acceptable to help protect the public – particularly the young – from unethical practices and unhealthy psychological repercussions. Earlier this year, a report published by the All Party Parliamentary Group (APPG) on body image revealed that half the UK public suffer from negative body image, and girls as young as five now worry about their size and appearance. The BAAPS singles out the growing trend of youthful celebrities and Photoshopped models promoting cosmetic procedures, as well as ads on billboards, buses, TV and social media as contributing to the problem. According to consultant plastic surgeon and outgoing BAAPS President Fazel Fatah, “For a long time the BAAPS has expressed concern over susceptible patients being at risk through the unrestricted proliferation of cosmetic surgery advertising. It is clear that some providers take advantage of the vulnerability of people who seek surgical treatments for psychological reasons. Cosmetic surgery is often portrayed as a commodity raising unrealistic expectations rather than as a medical treatment that can have life long effect, which is why we have been campaigning for an all-out ban on this type of advertising. However, in support of the recommendation by the All Party Parliamentary Group that a separate code of advertising be drawn up for cosmetic surgery, we have submitted for consideration a set of 12 measures which we consider to be the bare minimum that should be implemented to protect vulnerable patients.” Consultant plastic surgeon and new BAAPS president Rajiv Grover says, “The government’s review into the sector is underway so this is an ideal time to take action. Posters in the Underground and on the sides of buses, billboards, TV and social media ads promoting cosmetic surgery have become ubiquitous, with no

12 www.cosmeticnewsuk.com

“For a long time the BAAPS has expressed concern over susceptible patients being at risk through the unrestricted proliferation of cosmetic surgery advertising” consideration for the psychological repercussions on the children and teens exposed to them. This is compounded by the glamorizing of young celebrities who appeal to this vulnerable age group, making it seem like undergoing aesthetic procedures - whether surgical or non-surgical - is aspirational and easy.” The list of restrictions demanded by the BAAPS also includes prohibiting financial inducements, time-limited offers, BOGOFs and the use of unrealistic imagery such as Photoshopped models. A number of these measures are also currently being reviewed for implementation as standards at EU level. Consultant plastic surgeon and former BAAPS President Nigel Mercer, who was involved in drafting the EU standards says, “Banking regulators have recently banned product incentives, entirely because they can lead to mis-selling by staff hungry for commissions. Yet the practice of promoting sales of serious medical procedures by providing hard-to-resist financial inducements has been allowed to grow unrestrained. Although new EU standards will provide an ethical framework for the marketing of cosmetic surgery in general we see these specific advertising restrictions as urgent and necessary.” Mr Fatah concludes, “We strongly believe that, in the absence of a complete ban, these measures in their entirety are necessary to ensure that patients are protected from unethical practices and help protect the young and vulnerable from an unhealthy body image. To this end, the BAAPS has also recently awarded funds for research into standardising psychological assessment of all aesthetic plastic surgery patients.”

H av e y ou r s ay

After a meeting with the General Medical Council to highlight their concerns, the BAAPS drafted the following restrictions and submitted them to CAP: 1. Prohibit all advertising aimed at the under 18s for example the use of young spokespeople such as celebrities that appeal to this age group. 2. Prohibit advertising in public places where children can see these ads, such as posters, billboards, sides of buses and television. 3. Prohibit all forms of discounted offers and financial inducements to encourage people having cosmetic surgery including seasonal incentives such as ‘New Year, new body!’, ‘Summer body’, ‘surgical makeovers’ and Christmas gift vouchers for surgery. 4. Prohibit time limited offers e.g., ‘book by Friday!’ 5. Prohibit targeting vulnerable specific groups such as divorced people, brides to be, women after pregnancy e.g.,’Divorce feel-good’ and ‘Mummy makeovers’ discount packages. 6. Ban the principle of loyalty cards as inducement to have multiple or repeat procedures. 7. Prohibit advertising for combined procedures as inducement such as two-for-ones and BOGOFs. 8. Prohibit recruitment of patients for cosmetic surgery by agent, either in the UK or abroad, whether through publications or websites. 9. Prohibit the use of pictures of models or ‘real life’ patients that raise unrealistic expectations from cosmetic surgery such as through the use of Photoshop. 10. Prohibit advertising of money-off and discount vouchers such as Groupon as inducement for booking for surgery. 11. Prohibit giving cosmetic surgery as a prize in any shape or form. 12. Prohibit encouragement of refer-a-friend schemes in return for discount on surgery.

What do you think of BAAPS proposals in regards to cosmetic surgery advertising? E-mail the editor on vicky@creativemedialtd.co.uk

Kelo-cote 速 is the only patented silicone gel clinically proven to smooth, soften and flatten scars while reducing scar redness and relieving itching and discomfort.1,2 In an observational study of 1522 patients, physicians and patients were satisfied with success achieved in terms of scar appearance and feel.1 Kelo-cote 速 is suitable for scars of all ages. It is available as a spray or a gel and with or without SPF 30 UV protection. For more information please visit www.kelo-cote.co.uk

C L I N I C A L LY- P R O V E N S C A R C A R E

PIP codes: 325-7474; 328-7356; 365-6931; 325-7466 References: 1. Sepehrmanesh M. Komp Dermatologie 2006; 1:30-32. 2. Sebastien G et al. Akt Dermatol 2004; 30:450.

September 2012 SIP/KEL/505

Cosmetic News Expo 2013

An Education With the speaker line up for The Aesthetics Conference 2013 taking shape, we tell you why you cant afford to miss this opportunity to gain CPD accredited education

scar Wilde once said that “You can never be overdressed or overeducated” and that is a mantra that the aesthetics industry wholeheartedly embraces. Education has always been at the heart of the Cosmetic News Expo and our fourth event, which will take place at the Business Design Centre in Islington on February 16-17, 2013, promises to take this to another level. Re-branded as The Aesthetics Conference, the educational programme, which runs alongside the Cosmetic News Expo, is an excellent opportunity to gain CPD accredited education and hear from the very best UK and international speakers, discussing the latest topics and demonstrating the most up-to-date techniques. This year the conference not only has a new look and a new name but, for the first time, is being organised by an independent consultant with years of knowledge and experience of the aesthetics industry to make it even more cutting edge. Because the event is now also taking place at the

earlier dates of Saturday February 16 and Sunday February 17, 2013, the Cosmetic News Expo and Aesthetics Conference will now be the first key professional meeting in the UK aesthetics calendar and is the first chance for you to hear what is new in 2013 on home soil. And because tickets for The Aesthetic Conference are a fraction of the cost of other industry events, this is one opportunity you cannot afford to miss.

The Exhibition While education is a key part of the Cosmetic News Expo, what makes the event even more special is the fact it brings together more aesthetics suppliers under one roof than any other event in the UK. Our exhibitors are made up of the leading manufactures and suppliers in the industry, making the Cosmetic News Expo a must visit for those new to the industry who are trying to source suppliers and busy practitioners who want to be able to see all their reps under one roof. With more than 40 exhibitors already

signed up for 2013 and with Merz Aesthetics as Gold Sponsors, Syneron/Candela as Silver Sponsors, Kelo-cote® as Bronze Sponsors and ObvieLine as Hospitality Sponsors, you will want to be there.

Book Today! Tickets for the 2013 conference cost £49 for one day or £85 if you book for both days, if you book in advance. If you pay on the day tickets will cost you £75 per day/£150 for both days. A complimentary lunch will be incorporated into the delegate package, with refreshments provided throughout the conference breaks. Delegates will also receive a complimentary VIP invite to the post show party at The Chapel Bar, which is a fantastic opportunity to network with speakers and exhibitors and let your hair down after the event. To book your place visit www. cosmeticnewsuk.com or call Carly on 01268 754 897. If you are booking tickets for more than two people from the same organisation you will receive a 20% discount. Please quote booking reference BL123 20% when you book.

Speaker Spotlights: Here are just a few of the speakers confirmed for the 2013 Aes Dr Raj Acquilla has developed a

Dr Fernando Galcerán Montal

deserved reputation

Dr Fernando

Dr Raj Acquilla

Dr Gabriela Mercik

surgeons in his field. He completed his

a special interest in Anti-Ageing Medicine. He has clinics in Harley

Dr Gabriela Mercik

in 1975. He has lectured across the

Street and Ipanema in Rio de Janeiro.

is medical director

world, published more than 20 articles

of Hebe Anti-Ageing

in journals on surgical procedures and

and Cosmetic Medicine and has

Exilis

as one of the most skilled, experienced

Galcerán Montal has worked as

and trusted cosmetic physicians in the

medical director in some of the most

Mr Dalvi Humzah

UK. He runs two busy private clinics

prestigious anti-ageing clinics in

in Cheshire, in addition to his own

Barcelona, including Clínica Virtalia,

Medical Aesthetic Academy and is

Oxycell, Elixir Clinic and Revital.

a recognised advanced trainer and

He is also the medical director of

aesthetic surgeon and is the medical

Key Opinion Leader in the field of

Mesoestetic Pharma Group and is a

director of Plastic and Dermatological

non-surgical facial aesthetics.

member of the Spanish Society of Anti-

Surgery and BUPACosmetic’s clinical

Dr Patrick Bowler

Ageing Medicine and Longevity.

Dr Patrick Bowler

Dr Kate Goldie

is a pioneer of non-

Dr Kate Goldie

surgical cosmetic

is the founder of

treatments in the

Medics Direct

UK with 20 years experience. He has

(Europe) Ltd, one of the largest and

lectured extensively in Europe, the

most successful Medical Cosmetic

Middle East, the US and Australia and

training companies in the UK and is

has had his research published in a

renowned in the industry as an expert

number of clinical journals. In 1993

in non-invasive facial restructuring.

he co-founded Cosmeceuticals Ltd and

Dr Ariel Haus

in 1998 opened the first Court House Clinic in Brentwood Essex. He is the Association of Cosmetic Doctors and served as its chairman for the first seven years.

and Aesthetic Medicine Clinics and

written a number of books. He is well

medical director of Dermagenica Ltd.

known as the resident surgeon on TV’s

Mr Dalvi Humzah is

Her research career began in Poland

10 Years Younger.

a consultant plastic

15 years ago and she has been

reconstructive and

published in The American Journal

...best in class

lead. He has been the STEP® Tutor for the Royal College of Surgeons of

Dr Tracy Mountford

England and is an examiner for the Intercollegiate MRCSfor the Royal College ofEXILIS...the Surgeons of Glasgow. award

winning system forDr Tracy Mountford

ADVANCED BODY SHAPING is the founder and medical director of Mr Chris & SKIN TIGHTENING... Inglefield The Cosmetic Skin Clinic. She has over

Dr Robin Stones is the Court House Clinic medical director for the North of England and director of non-surgical business for Surgicare. He has been in private cosmetic dermatology for 10 years and is a national trainer for doctors interested in the use of lasers in dermatology. He holds a BTEC

Chris Inglefield

21 years experience in advanced non-

consultant plastic

and won the accolade of ‘Speaker

is a member of the teaching faculty on

and reconstructive surgeon since

of the Year’ at the 2011 Aesthetic

this course.

1998. He has written several papers

Awards.

...voted “The Best Skin Tightening surgical facial rejuvenation techniques has worked as a Device Award TAS 2012”, Las Vegas

and contributed to many specialist

Mr Jan Stanek

books and journals within the field

Jan Stanek is considered to be one of the leading

out advanced training in Dermatology

prestigious LBPS clinic in London. at www.bodyconference.co.uk 1 6 th a n d 1 7 th f e b r u a ry 2 0 1 3 , t h e b u s i n e s s d e s i g n c e n t r e , l o n d o n

cosmetic news

uk’s largest aesthetics exhibition and“ADVANCED conference Presented by MR JantheStanek andtrade hosted by BTL, titled BODY SHAPING

& SKIN TIGHTENING” or for a free demonstration contact sales@btlnet.com.

14 www.cosmeticnewsuk.com

Dr Robin Stones

of Cardiology. She is an advanced aesthetic trainer in biomimetic mesotherapy, dermal fillers and botulinum toxin.

Register of plastic and reconstructive surgery A cosmetic doctorfor our and has lectured at national and from Brazil, Dr Ariel Workshop oninternational 4th meetings. NOVHe runs the Haus has carried

co-founder and a Fellow of The British

medical degree at Oxford University

e x h i b i t i o n

a n d

2013

c o n f e r e n c e

BTL Industries Ltd, Unit 83, Greenway Business Centre Harlow Business Park Harlow, Essex CM19 5QE

Incorporating

Advanced Award in Lasers, Light and Associated Aesthetic Applications, and

Dr Patrick Trevidic Dr Patrick Trevidic is a plastic reconstructive aesthetic surgeon based in Paris,

Cosmetic News Expo 2013

preliminary conference programme Saturday February 16

1pm-3pm Lunch Break and Exhibition Viewing

9am-10am Registration and Exhibition Viewing

AFTERNOON SESSION – Chaired by Dr Tracy Mountford

MORNING SESSION - Chaired by Mr Dalvi Humzah

3pm-3.40pm Rosacea and Skin Ageing - Dr Stefanie Williams

10.45am-11.30am New Trends in Facial Volumising and Shaping (including live demonstrations) This master class in facial volume replacement will focus not only on anatomical placement and risk management but on how using the most effective products and techniques can enhance treatment outcomes. Speakers will include Dr Kate Goldie and Dr Raj Acquilla.

Leading dermatologist, Dr Stefanie Williams, will present the results of a study based around rosacea/redness and the effects it has on skin ageing. Her presentation will include new findings around triggers, symptoms and treatments for the skin condition to ensure correct diagnosis and treatments for sufferers and to ensure a slowdown in the ageing process.

3.40pm – 4.20pm Sensitive Skin – Speaker TBC 11.30am-12pm Coffee Break 12pm-1pm How to Treat the Tear Trough Area: From Injection Techniques to Managing Complications (including live demonstration) – Dr Patrick Trevedic As we age, one of the changes that is commonly noticed and commented on is the appearance and gradual worsening of dark circles under the eyes. This occurs due to the thinning of the overlying skin and soft tissue over the bony orbital rim. This area has always been notoriously difficult to treat – blepharoplasty has been an option for loose skin removal but there has been nothing to treat dark circles until the evolution of dermal fillers for the tear trough. This session will cover treatment and management of this delicate anatomical area.

The issues around sensitive skin and the huge rise of sensitivity in patients due to external and internal factors will be explored in this session. With figures showing that as many as 55% of UK women now believe they have sensitive skin, this is a very prevalent and often overlooked condition.

4.20pm-5.10pm Menopausal Skin Conditions and Treatments – Dr Tracy Mountford During the menopause the skin undergoes significant changes due to the hormonal imbalance. These changes can include thinning and dryness as well as other issues. Treatments are available to alleviate these conditions and the collaboration of a gynaecologist and skin specialist is an exciting partnership to improve care for this group of women.

5.30pm-7pm Exhibition Viewing

sthetics Conference France and is head of the Surgery Department at the Hospital Sainte-Anne.

Sunday February 17

AFTERNOON SESSION

9am-10am Registration and Exhibition Viewing

3pm-4pm Mesotherapy with Biomimetic Nano-Peptides: A New, Quick, Injectable Treatment for a Wide Variety of Indications - Dr Gabriela Mercik

He has published more than 50 scientific articles in periodicals and international journals and is often called upon to present his work at international congresses. As well as serving as scientific director of Expert2Expert, the renowned noted European group of surgeons and cosmetic specialists, he is also director of the Anti-Ageing Medicine World Congress and Face2Face. In 2010, Dr Trevidic and Dr. Ingallina published “Anatomy of botulinum toxin injections” a reference book and in 2011 saw the launch of the second volume “Anatomy of Volumizing

MORNING SESSION – Chaired by Mr Chris Inglefield 10am-11am Multi-Application Lasers – Dr Ariel Haus With so many lasers on the market, how do you choose what to use? This session will explain the value of a multiapplication laser and how it can benefit your bottom line while offering your patients the best results with the least downtime.

4pm-5pm Medical Devices for Intradermal Injections and the Use of Mesotherapy Techniques for Rejuvenation – Dr Fernando Galcerán Montal

11am-11.30am Coffee Break

injections”.

Dr Stefanie Williams Dr Stefanie Williams is a dermatologist with special interest in cosmetic dermatology. She is an international speaker, lectures at University and has published more than 100 scientific articles.

Is there an injectable treatment that does everything? Find out how the latest cutting-edge mesotherapy technology can enable quick, non-invasive solutions for many different indications including skin brightening, hair restoration, rejuvenation, and lipolysis.

11.30am-12.15pm - Speaker TBC 12.15pm-1pm Advanced Body Shaping and Skin Tightening – Mr Jan Stanek There is much new technology for skin tightening and body shaping - but do these devices work? This session will present the findings of clinical practice.

Mesotherapy has been used widely in Southern Europe but with little uptake in the UK. Now, as techniques and results improve, we are seeing an upsurge in treatments. Dr Galceran Montal is an expert in his field and this session will focus on the treatment of the hands and neck as well as other problem areas that have previously been very difficult to treat.

5pm-6pm Exhibition Viewing 1pm-3pm Lunch Break and Exhibition Viewing

For updates on the conference programme and speakers visit

B o o k T o d ay !

www.cosmeticnewsuk.com

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bronze sponsor

hospi tal i t y sponsor

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on the scene | Out and about in the industry this month

On th e S c e n e British Association of Cosmetic Nurses annual meeting, IET London Savoy The IET at London’s Savoy was the setting for the annual meeting of the British Association of Cosmetic Nurses (BACN). The theme of the day was ‘Beyond Toxin and Fillers’ with a full conference programme running alongside an exhibition. Morning topics included Medical Needling by Dr Lance Setterfield, Carboxytherapy by Sharon King, Top Tips by Jackie Partridge, Consultation Skills by Lorna Bowes, Sclerotherapy by Dr Haroun Gajraj, Before and After Photography by Mr Mike Samuels and a Psychological Approach by Lou Sommereux. Following a networking lunch the meeting continued with a Professional Update by Sally Taber, Skin Tightening by Marea BrennanThorns, A is for Retinol by Roger Bloxham, Free to Fee by Alison Telfer and Facial Anatomy and Anaesthetics by Mr Dalvi Humzah. The event closed with a drinks reception with canapés and entertainment.

The Skin Clinic opening, Brentwood Dr Johanna Ward and The Skin Clinic team unveiled their new clinic in Brentwood to local business owners, journalists, skincare specialists from Obagi, SkinCeuticals and Image Skincare and friends and family last month. Mayor of Brentwood, Ann Coe, cut the red ribbon, declaring the clinic officially open. In attendance with the Mayor was the head of Brentwood Council, Louise McKinlay. She said, “It’s fantastic to see a strong new business in Brentwood and have it so well supported by members of the local business community. I am sure The Skin Clinic Brentwood will do very well.” The Skin Clinic Brentwood is the sister clinic to The Skin Clinic in Sevenoaks, Kent. Medical director Dr Johanna Ward said, “ Having the Mayor officially open The Skin Clinic Brentwood was wonderful. What a great welcome and a great start to business in Brentwood. I look forward to welcoming everyone personally to our new skin clinic.”

Persona Cosmetic Medicineclinic launch, Sittingbourne, Kent Persona Cosmetic Medicine recently opened its new clinic in Sittingbourne, Kent. The Sittingbourne site is Persona’s second clinic, with their flagship clinic in Bexley, and the launch was celebrated with an exclusive party on Thursday October 4 with a number of local businesses. In addition to this, the clinic welcomed to the team Alisha Ashworth as beauty therapist and aesthetician in the Sittingbourne location. Winner of the Pevonia Therapist of the Year award 2011, Alisha is an experienced addition to the Persona team. Dr Delamaine says, “We are delighted to be expanding Persona with our new clinic. Along with our two clinics, we also operate day clinics in other health and beauty businesses so we can serve a wide reach of clientele. Our continued success is a result of our team’s specialist knowledge, commitment and hard work combined with our aim to deliver the highest quality service and results.” 16 www.cosmeticnewsuk.com

SkinCeuticals Micropeel Launch, London Bridge Plastic Surgery, LONDON

Respected surgeon Chris Inglefield hosted the launch of SkinCeuticals’ latest new products Micropeel 20 and Micropeel 30.

After a welcome by Jane Toner from SkinCeuticals, Mr Inglefield gave a presentation to the press on the SkinCeuticals peel portfolio, which also includes SM Gel Peel and Pigment Balancing Peel. Micropeel 20 and 30 are Mr Chris Inglefield presented at the launch new clinical grade peels in a graduated strength, containing 20% and 30% unbuffered glycolic acid with a pH of 1.4. They address sun damaged, prematurely aged skin and help reduce the appearance of fine lines and wrinkles, whilst brightening the appearance of overall skin tone with minimal post treatment sheathing of the skin with a downtime of only two or three days. Mr Inglefield said, “The introduction of the SkinCeuticals Micropeels addresses the need to correct the signs of photodamage while stimulating the skin’s renewal process. The Micropeels work very Cheryl Marshall-Williams well in conjunction with performs the treatment demo SkinCeuticals Phloretin CF Gel, Blemish + Age Defense and Retexturing Activator to restore skin health and help prevent the signs of ageing.”

Dermagenica launch event, London Dermagenica held the launch event for its much talked about range of biomimetic nanopeptide mesotherapy products, Dermaheal. The event was attended by more than 20 doctors and nurses. Dr Patrick Treacy and Dr Gabriela Mercik, director of Dermagenica, spoke about the benefits of biomimetic nanopeptide mesotherapy. Treatments were also performed on models. Dr Treacy said, “This heralds a new era of cosmetic medicine where synthetic molecules can create signals between the epidermis and dermis to stimulate processes such as collagen rejuvenation, hair restoration and fat removal.” See this month’s Editor’s Choice for more information.

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INDUSTRY INSIDER hot topic

Under Review David Reissner, head of healthcare at Charles Russell LLP, on the future regulation of cosmetic surgery

Sadly, it usually takes a tragedy or a scandal before Governments take action in the healthcare sphere for the protection of patients and the public. The Thalidomide tragedy, the deaths of children at Bristol Royal Infirmary, and the murders by Harold Shipman all resulted in major changes to the law and the regulation of healthcare professionals. The public scandal involving Poly Implant Prothese (PIP) silicone breast implants has shone a spotlight onto cosmetic surgery and other cosmetic interventions in general. The Secretary of State for Health has asked Sir Bruce Keogh, the NHS medical director, to convene a panel of experts to look at what can be done to improve the safety of patients. The panel will look at cosmetic surgery such as breast augmentation and non-cosmetic interventions such as injectable dermal fillers. The panel will consider a wide range of issues such as regulation and clinical governance, information and consent, and recording outcomes. Sir Bruce’s review will not extend to clinically indicated interventions such as reconstructive surgery for a

breast cancer patient following mastectomy.

Fitness to Practise cases and the Courts In view of the elective nature of the types of surgery and interventions covered by the review, commercial considerations will on occasions influence decisions and behaviour both of practitioners and patients. Plainly, some patients will be vulnerable. The possible need for further regulation raised by the PIP implant scandal, is reinforced by recent cases that have come before

David Reissner is a partner at Charles Russell LLP where he is head of healthcare. He advises healthcare practitioners and representative organisations on a range of legal, regulatory and ethical issues. David appears regularly as a solicitor advocate at NHS hearings and in fitness to practise proceedings (david. reissner@charlesrussell.co.uk).

18 www.cosmeticnewsuk.com

the GMC’s Fitness to Practise Committee. In December 2011, Dr Phanuel Dartey was erased from the Medical Register because, amongst other things he operated on a patient’s labia majora, and failed to ensure that she understood and accepted the specific risks and complications. Dr Dartey had also forged evidence of membership of a medical defence organisation, and was practising without insurance. In June this year, the GMC’s Fitness to Practise Committee found Dr Aamer Khan’s fitness to practise was impaired because, amongst other things, he unreasonably induced a patient to accept surgery by agreeing to undertake financially discounted cosmetic surgery; did not record relevant documentary information in the preoperative clinical assessment ; did not ensure that the times of administration of the patient’s sedative medicine and vital signs were monitored and recorded; did not record relevant information in the operation note and failed to provide adequate post-operative clinical care. Recent High Court cases have also brought the possible need for further regulation to the fore. The case of Dr David Waghorn illustrates how regulation is currently carried out by the Care Quality Commission. Independent hospitals must be registered with the Care Quality Commission. In March 2010, inspectors from the CQC made an unannounced visit to the Berkeley Clinic in London. They found Dr Waghorn in a basement room, performing liposuction under local anaesthetic on a female patient. Dr Waghorn

was working without assistance and, at the time of the inspectors’ arrival, the procedure had taken four hours and was not complete. Dr Waghorn did not know the patient’s name, and no medical records for the patient were ever found. Dr Waghorn was convicted of failing to register the premises with the CQC, and was fined £2500. Dr Waghorn appealed to the High Court against his conviction, arguing that the premises did not require registration because he did not own the Berkeley Clinic. His appeal was dismissed in June this year. Pending a fitness to practise hearing, the GMC’s fitness to practise committee imposed conditions on Dr Waghorn’s registration that prevent him from carrying out any cosmetic surgical work or aesthetic procedures, including liposuction. Practitioners who are in breach of their duty of care to patients may, of course, also be sued. In the 2011 case of Penny Johnson v Mr Le Roux Fourie, the High Court awarded damages of over £6m, including compensation for loss of past and future earnings, to a high earner who, when 42 years of age, consulted the defendant, a plastic surgeon, about minor plastic surgery to her nose and dark circles under her eyes. In the event the defendant proposed more radical plastic surgery involving a replacement of pre-existing breast

“Being able to sue practitioners can provide patients with a financial remedy after the event, but statutory regulation and fitness to practise measures are mainly intended to prevent instances of sub-standard treatment occurring.” implants, and a face-lift with further surgery to the forehead and eyes. The surgery was carried out negligently, and had serious consequences both physical and psychological. It caused permanent damage to the claimant’s right facial nerve, resulting in an abnormal spontaneous facial movement, known as jactitation, which presents as an abnormal grimace, and is exacerbated by fatigue or stress. As a result of the surgery to her breasts, her left breast was higher than the right, and was an odd shape with unsightly lumpy scarring. The physical injuries resulted in a prolonged adjustment disorder with features of anxiety and depression. Being able to sue practitioners can provide patients with a financial remedy after the event, but statutory regulation and fitness to practise measures are mainly intended to prevent instances of sub-standard treatment occurring.

The Keogh review In announcing the Keogh review, the Department of Health noted that a medical practitioner does not have to be a surgeon to carry out cosmetic surgery unsupervised outside the NHS, and that in any event there is no section of the Specialist Register that refers to cosmetic practice. The GMC’s guidance “Good Medical Practice” makes it clear that doctors are expected to practise only in the clinical fields in which they are competent, but competence is currently self-assessed and cases will only be dealt with by the relevant healthcare regulator if a complaint is made. Moreover, cases will only be investigated if there is likely to be a finding that a practitioner’s fitness to practise is impaired. Specific procedures the Keogh panel will look at include breast enlargement; the use of

PaTIenTs beware! The A-B-C of safe injectable cosmetics

If you administer cosmetic injectables at your clinic, better get registered for the Quality Mark. This autumn’s campaign headed by Dr Hilary Jones goes direct to the consumer. Check it out, he says, demand the Quality Mark, report bad practice, how to know a good clinic – he puts it all there for the discerning consumer. So take advantage of the publicity – national, regional, local – and get the Quality Mark. Go to wwww.treatmentsyoucantrust.org.uk and sign up - then see your business grow. Know of some bad practice? Report it at saferinjectables@rpa-uk.com Issued by Cosmetic IHAS on behalf of www.treatmentsyoucantrust.org.uk

INDUSTRY INSIDER hot topic

“The Department of Health suggests that revalidation will play a role in improving patient protection.” dermal fillers to plump up wrinkles, deal with scarring and augment the lips; chemical peel to improve the appearance of the skin, laser hair removal, and the administration of botulinum toxin. In common with other cosmetic procedures, botulinum toxin can be injected by anyone acting in accordance with the direction of an appropriate practitioner. While this may be a doctor, nurse, dentist or pharmacist, all of whom will be required to follow the professional standards appropriate to their respective professions, the product need not be administered by a member of any healthcare profession. One of the most difficult issues for the Keogh panel to address concerns the cosmetic procedures which can legally be carried out by people with no recognised qualification. Not only can some cosmetic procedures be legally carried out by people with no recognised qualification, but non-surgical cosmetic interventions, including the injection of subcutaneous substances, can be delivered in non-healthcare settings which do not require the premises to be registered with the CQC. For example, beauticians or hairdressers administer dermal fillers or laser hair removal. Some have diplomas, but they may have received no training in relevant cosmetic treatments. They may belong to a relevant trade organisation, but such organisations are not regulated, for example by the Council for Healthcare Regulatory Excellence (soon to be renamed as the Professional Standards Authority for Health and Social Care). The Keogh panel will additionally look at how patients give informed consent for procedures; the appropriateness of information available to them, including the way in which the advertising of cosmetic procedures is regulated; whether all providers should be required to have adequate indemnity arrangements in place; whether there should be a formal “cooling-off” period between consultation and surgery prescribing; and the regulation of products.

Medical Revalidation The Department of Health’s background paper for the Keogh review attaches significant importance to the forthcoming requirement for revalidation, even though ministers have not yet given final approval to the process. The purpose of revalidation is to assure patients and the public that practitioners are up to date and fit to practise. Ministers have not yet given final approval for the details, but doctors will be

20 www.cosmeticnewsuk.com

subject to periodic checks on their competence in all the fields in which they practise, both in the NHS and privately. Revalidation will probably include a requirement for annual feedback from patients and colleagues, as well as evidence of continuing professional development, and reviews of complaints and relevant information about clinical outcomes. What recommendations might be expected? In many areas of healthcare, professional self-regulation is no longer the norm. It seems likely that the recommendations of the Keogh panel will continue this trend, because a higher priority will be placed on protecting patients and the public than protecting the interests of providers, especially where there is a risk that practitioners will be motivated by commercial considerations. The Minister for Health, Earl Howe, has already carried out a review of the actions of the MHRA and the Department of Health in relation to PIP silicone breast implants, and has recommended that Sir Bruce should examine ways of promoting a stronger culture of clinical governance, clinical audit and reporting in cosmetic surgery. This is likely to result in requirements for incident reporting, and reviewing outcome data by individual surgeons and other providers to become the norm. It seems likely that the Keogh panel will recommend that some treatments should be carried out only by medical practitioners and, in some cases, by specialists who are included in a new section for cosmetic surgery in the Specialist Register. In the case of procedures that are not covered by specific healthcare laws, health and safety at work legislation or consumer protection laws may apply. However, these laws were not designed specifically to protect patients who undergo cosmetic surgery or interventions; and enforcement is not in the hands of bodies with healthcare expertise, such as the CQC or MHRA. Primarily, enforcement is the responsibility of trading standards officers employed by local authorities. Most London councils exercise licensing powers over cosmetic clinics, and require compliance with a code of conduct, covering access to expert advice, staffing, maintaining a register, safety, qualification and maintenance of equipment. It would not be surprising to find that the Keogh panel recommends wider use of such powers. It is apparent from recent Fitness to Practise

cases and from the Waghorn case that record keeping in the case of cosmetic procedures is not always adequate. It is likely that the requirements for record keeping will be spelled out, and that the scope will be widened. This may require revised good practice guidance from the General Medical Council and the General Dental Council. Through CQC registration, which will be extended over time across healthcare professions, a legal requirement to provide after-care to patients may also be imposed. The Department of Health suggests that revalidation will play a role in improving patient protection. Doctors will be legally obliged to have clinical indemnity from October 2013, and doctors who work outside their competence may find it difficult to obtain indemnity cover or practising rights in a private hospital. However, revalidation is new to the medical profession, so achieving the desired level of governance and patient protection through a system that is untested may be expecting too much, at least in the short term. Moreover, it seems undesirable to leave insurers and hospitals to police the competence of clinicians. Doing so, would not eliminate the risk that doctors may practise while uninsured or that an insurer or medical defence organisation may decline to cover a claim, thus removing the financial protection patients are entitled to expect. If anything, as one recent Fitness to Practise case has shown, a requirement for insurance will not necessarily prevent unscrupulous practitioners from forging insurance documentation. These rare cases may be the very ones in which patients most need protection – uninsured practitioners are not likely to be able to meet a £6m compensation claim from their personal resources. The Keogh panel will consider whether non-healthcare professionals should be required to audit their processes and take part in clinical audit. It is difficult to see how such activity could be regulated. In any event, there is a more fundamental problem because there is no way of knowing whether beauticians who deliver cosmetic interventions like fillers, Botox®, laser treatments or chemical peels, have the appropriate skills to deliver them, and there is no system for monitoring performance.

Summary Public and press interest in the PIP scandal make it inevitable that the law will be strengthened to protect patients who undergo cosmetic surgery and other treatments. However, it is far from certain that increased regulation will provide protection when surgery or treatment is provided by an unscrupulous or unqualified practitioner.

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INDUSTRY INSIDER people in profile

man of honour As he takes over as president of the British Association of Aesthetic Plastic Surgeons, we chat to consultant plastic surgeon Mr Rajiv Grover about his new role and the challenges currently facing the aesthetics industry At its annual meeting at the end of September, The British Association of Aesthetic Plastic Surgeons announced the appointment of London-based consultant plastic surgeon, Mr Rajiv Grover, as its new president. Highly respected and well-liked among his peers Mr Grover graduated in medicine with a triple distinction from London University in 1989 and became a Fellow of the Royal College of Surgeons (FRCS) after having been awarded the Hallett Prize and gold medal for achieving the highest score in 1993. He then entered eight years of higher surgical training in plastic surgery, during which he was awarded a scholarship from the Royal College of Surgeons to train at Harvard Medical School in Boston, USA. In addition to be being awarded a Doctorate of Medicine (MD) by London University in 1998 he was appointed as a Hunterian Professor at the Royal College of Surgeons. He has been awarded several national and international prizes, including awards from the European Association of Plastic Surgeons (EURAPS) and the American Association of Plastic Surgeons (AAPS). For his work in the field of aesthetic surgery he has twice been awarded the Hackett Memorial Prize by the BAAPS and in 2001 he was awarded the Mentor Prize by the British Association of Plastic Surgeons (now BAPRAS) for his published work on improving safety in the field of facial cosmetic surgery. He has also has authored a number of papers on improving safety and enhancing outcome after cosmetic surgery, and his studies have been widely published internationally. He has been on the BAAPS Council since 2004 and served as Secretary for the Association from 2006 to 2010. Here we speak to the man himself about what those challenges are and how he feels about his new position….

zyy Cosmetic News: You are taking over the presidency of BAAPS at a time when a spotlight is being shone on standards in cosmetic surgery do you think there is an opportunity for something 22 www.cosmeticnewsuk.com

positive to come out of this? Rajiv Grover: The recent upheavals will hopefully herald a new era of healthier skepticism in the media and public, less ‘fads’ and a more robust regulatory framework for our field. PIP remains a big black mark on the industry. Remember there are still 30-40,000 women out there who have had these implants and that is not going to go away. I don’t think one can say there is something good coming out of it but I think that it just allows a light to be shone on the sector in such a way that maybe some improvements, that should have been made a while ago, will be made. The BAAPS has been campaigning about most of these issues for 10 years: no register; lack of aftercare; lack of responsibility etc. Underlying all of this is a re-education of the public and that is probably why that expert group is weighted quite heavily towards the ‘informed consumer’. Over the last 10-12 years cosmetic surgery has become almost like a commodity. Going for a medical treatment is being compared to going out and buying a pair of new socks or pants. It is about making people realise that these are medical treatments and medical treatments have risks and side effects. I look forward to continuing to work alongside the dedicated team at the BAAPS and further cement our organisation’s position as the leading, unbiased resource for those considering aesthetic plastic surgery.

zyy CN: What do you think the implications of the cosmetic surgery review by Sir Bruce Keogh will be? RG: Like it or not the Keogh review is under way. I think that it will change the cosmetic sector in some very significant ways. I think we are likely to see a breast implant register and I think we are likely to see some kind of insurance scheme for products. The PIP situation caught everybody out. You always have a responsibility to patients but with an implant that responsibility goes well beyond the normal length of time and during that time companies can change; doctors can move abroad or retire etc so there are a large number of people who are ‘floating’ and don’t come under the umbrella

of normal post-operative care. I think having this type of insurance will help in two ways: it helps the patient to be reassured that they will be looked after and they are not in the position where they are having to go cap in had to a clinic trying to get something done when they haven’t got the finances to cover it, nor does it have to be a burden on the tax payer for the health service.

zyy CN: You have just written the forward for Allergan’s new consumer Consultation Guide, why was this something you felt it was important to be involved with? RG: There is one word that has been eroded in the last year with the PIP situation and that is ‘trust’. Patients have lost trust in clinics and doctors and practitioners have lost trust in suppliers of certain products – they want to look more carefully at what they are using. There needs to be a re-building of trust all round. There are very good treatments, very good clinics and very good practitioners out there. We want to raise the standard of what may be considered ‘not such good practice’ and make people do a little bit more research and find the answers to questions that would help them get good treatments. Ask what is being used; ask about the qualifications of the practitioner; ask about the risks and complications. It is helping the consumer re-gain trust by getting the answers to those crucial questions and finding the right product and the right practitioner for them..

zyy CN: What are you most looking forward to about your new role? RG: What I really enjoy doing is the stuff for the association – organising the meetings, making sure the teaching is good. Aesthetic surgery is something exciting – let’s get ourselves better educated, let’s learn more about it and, as a result, automatically raise the standards.

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17/09/2012 16:42:30

CLINICAL

Body Contouring

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We examine the growth of the non-surgical body contouring market It is ironic that one of the key areas of aesthetic medicine that is most rapidly growing and fattening up the pockets of cosmetic practitioners across the Globe is body contouring. No longer seen as the ‘poor cousin’ of surgery, body contouring treatments are not designed for ‘weight loss’ but are focused on changing and improving body shape in three key ways: fat reduction and sculpting, skin tightening and cellulite reduction. While procedures such as VASER and laser lipolysis have carved their own niche, bridging the gap between non-invasive treatments and surgery, it is the more minimally invasive sector of the market that is seeing the most growth and there has been a significant boom in the number of devices available on the market in recent years. This growth has largely been driven by advances and developments in technologies, such as ultrasound and radiofrequency, which have significantly enhanced the treatment outcomes of non-surgical devices. One of the areas of aesthetics that truly transcends the gender barrier by appealing to both male and female clients, the Global body shaping market was valued at $857.5m in 2010 and is set to reach $2billion by 2017. A total of 33,000 skin tightening and body shaping devices were installed worldwide in 2011 and five million procedures were performed (data from Syneron Candela). All of this, coupled with increased demand for more cost effective, lower downtime treatments, makes body contouring potentially one of the most lucrative areas of cosmetic medicine and one that aesthetic practitioners cannot afford to ignore. Here we take a look at some of the leading players in the non-invasive body contouring devices market and ask key aesthetic practitioners why these are their products and treatments of choice.

24 www.cosmeticnewsuk.com

Syneron Candela: Ultrashape and Velashape Having just launched a new body division, which will be completely focused on R&D in this category, Syneron Candela looks set to become the goliath of the body shaping market. The company already has 13.2% of the Global body shaping market share and has been watching the trends and investing substantially in this sector. This led to the purchase of Ultrashape for its unique and patented selective focused ultrasound technology, which is clinically shown to reduce fat by causing the destruction of fat cells with no side effects or downtime. During Ultrashape treatment, the patient lies on a bed while the treating practitioner runs a hand-held device over their problem areas. The ultrasound beams penetrate the skin, without causing any damage to nerves or blood vessels, and destroy the fat cells. The fat is then metabolised by the body. The treatment takes between 45 and 90 minutes to complete and a course of treatments is usually required to get the best results. Syneron Candela also owns market-leading cellulite device, VelaShape, which had 40% of the market share in the US in 2011. VelaShape II is the latest addition to the VelaShape family and is the first FDA-cleared noninvasive medical solution for circumferential reduction and the first FDA class II cleared platform for cellulite reduction. Powered by the revolutionary elos™ technology, VelaShape II treats both the deeper tissue, offering a measurable reduction in fat layers, circumference and the upper layers of the skin, resulting in cellulite reduction.

The safety and effectiveness of the technology of the VelaShape II system has been demonstrated in both multicenter clinical trials and in over three million independent treatments performed on patients around the world. Used in combination the Velashape and Ultrashape offer a complete body contouring solution. With such substantial investment in sales education and in resources Syneron Candela is looking to grow its existing market share and come to market with new products. Mr James Bartholomusz VP of Global product development at Syneron Candela said, “We now have the superior technology to achieve the results we want and we are in a great place now to build on that, at a time the market is set to increase dramatically, we are fortunate to have the ability to move forward decisively.”

AZTEC Services: Viora Reaction™ Reaction™, Viora’s leading RF skin tightening and body contouring device utilises CORE™ technology (three different RF modes and a fourth mode channeling all three frequencies into one pulse). Dr Harryono Judodihardjo, founder and medical director of Cellite Clinic in Cardiff has had impressive results with the system, he comments, “Reaction™ provides great skin tightening results and we successfully combine it with the other treatments in the clinic, such as liposuction, to give our clients very satisfying results. “Reaction™ is a multi-frequency RF, bi-polar device that addresses some of the most difficult problems to treat. In addition, it is a very popular device with patients due to the fact that treatments are non-invasive, painless and require no downtime. Reaction™’s Channelling Optimised Radio-Frequency Energy (CORE™) technology is the starting point for these results – three distinct RF frequency channels and an additional fourth multi-channel mode, which encompasses all three frequencies. This proprietary technology allows Reaction™ to have the ability to heat all dermal layers simultaneously, speeding up the heating process. Following this local heat treatment, the collagen shrinks and

the rigid collagen’s cross-links are broken, restoring the skin’s flexibility and thickening the dermis. The Reaction™ device combines CORE with vacuum therapy, which maximizes the penetration of energy in the treatment area. This process increases local blood circulation, stimulates lymphatic drainage and assists in the shrinkage of fat cells volume. This dual action provides excellent treatment control and ensures optimal clinical results. Due to the technological capabilities of CORE™, Viora has been able to develop several original protocols for Reaction™, which we are finding quite popular with clients. ReFit is a solution for treating loose and sagging skin after excessive weight loss, while ReLift is a new concept to address local fat gravity and sagging skin in the jowl line and neck. Both of these treatments allow us to offer our patients viable, effective solutions for their aesthetic needs.”

BTL Aesthetics: EXILIS Exilis is a new highperformance aesthetic device that is claimed to be ‘redefining’ Elixis before Elixis after radiofrequency (RF) technology. In one system, Exilis successfully harnesses RF through its exclusive Energy Flow Control feature to heat tissue and improve crepiness anywhere on the face or body, without disposable costs to the provider or patient. The treatment is gaining impressive recognition by cosmetic physicians across the Globe. “Exilis is unique in delivering monopolar RF with a grounding pad,

so we know it is penetrating to the appropriate, therapeutic skin level - from the epidermis down to the subcutaneous layer – and the results have been outstanding,” said Robert Weiss, MD, Associate Professor of Dermatology, Johns Hopkins School of Medicine and director of the Maryland Laser, Skin and Vein Institute in Hunt Valley. “The built-in temperature sensor permits delivery of enough energy to improve skin without pain. In fact, our patients liken the heat sensation to a warm massage. Using Exilis is like driving a Ferrari with the best brakes. It is high performance yet very safe, and you always feel you are in total control of its power.” He adds, “It can be eloquently summed up that in my practice with 45 devices the only device that we required a duplicate to meet demand has been Exilis. Most of our patients (90%) have been thrilled with the results. Not getting this device in your practice would be the worst mistake anyone could make. What more can I say?”

AesthetiCare: EndyMed™ 3DEEP® EndyMed™ 3DEEP® has been described as the ‘next generation in radio-frequency skin tightening technology’. Until EndyMed™ 3DEEP® all radio-frequency machines used one radiofrequency (RF) generator. RF was delivered through one electrode on the skin (monopolar) or had the energy flowing through two or more electrodes on the skin (bipolar and mulitpolar). EndyMed™ 3DEEP® uses multiple source RF. With six RF generators all powering energy through individual electrodes, sophisticated software phases how this energy flows and is directed between the

electrodes, and in the skin. Multiple flows of energy then interact forcing the energy and therefore heat deep into the skin without over heating its surface. The result is deep, 3 dimensional, volumetric heating which delivers high level and predictable results with great comfort. Instead of delivering heat to the surface of the skin, the EndyMed™ 3DEEP® heats directly into the skin without the need for needles or other additional technologies. Renowned plastic surgeon Mr Chris Inglefield, of LBPS in London, has been using EndyMed™ 3DEEP® in his clinic for nearly two years. Treating more than 350 patients. Patient satisfaction scores for ‘very’ or ‘extremely satisfied’ with EndyMed™ 3DEEP® treatment have been averaging at 94%, in his clinic, comparing very favourably with the 60-65% satisfaction rates experienced with previous radio-frequency devices. Dr Maini of Nottingham based Zenith Cosmetic Clinic has also been experiencing great success with the EndyMed™ 3DEEP® radio-frequency machine since introducing it to his clinic earlier this year. He says, “Having seen the results from our patients, the EndyMed™ consistently outperforms all other non-surgical, skin tightening systems on the market.”

MedContour MedContour (known as VaserShape in the US) is an FDA-cleared medical device that uses ultrasound and cavitation technology to break down fat cells in specifically targeted problem areas without invasive techniques, damage or scarring to the skin. By concentrating the ultrasound directly and only on fat cells, skilled clinicians are able to use a vacuum pump to suck in tissue and maintain its position on the unique ultrasound handpiece head, optimising the focus of the variable ultrasound frequencies to smooth and dramatically improve the body’s contours.

According to Dr Ravi Jain of Riverbanks, one of the first clinics to offer the treatment in the UK, “MedContour can be performed almost anywhere on the body and further aids the body’s lymphatic drainage system by helping the body excrete the fat cells. After the recommended series of four to six treatments the results are long-lasting. In contrast to surgical liposuction there is no recovery time, so clients can resume their normal activities immediately following the effective, gentle and completely safe treatment.” www.cosmeticnewsuk.com 25

CLINICAL

Body Contouring

Ellipse: Venus Freeze™ The Venus Freeze™ from Venus Concept is a novel, all-in-one aesthetic device that can effectively accomplish circumference reduction, cellulite improvement and skin tightening without causing any pain to the patient. Powered by innovative (MP)2 technology (multi-polar radiofrequency and magnetic pulses), Venus Freeze™ creates a synergy between a matrix of bi-polar radio-frequency (RF) and magnetic pulses (PMF), which results in proliferation of fibroblasts, neocollagenesis and neo-vascularity in the targeted areas. The Venus Freeze™ system consists of two applicators - OctiPolar with 8 (MP)• synthesizers for large treatment areas (abdomen, thighs, arms and buttocks) and

DiamondPolar with four (MP)• synthesizers for smaller treatment areas (face, neck and arms). Each synthesizer simultaneously emits both RF and Pulsed Magnetic Fields. The energy rotates between any two synthesizers in an organised matrix that homogeneously raises the temperature over the entire treatment area and creates highly efficient woven dense energy matrix that penetrates deep into different skin layers for maximum efficacy.

ABC Lasers: Accent The Accent family of products incorporates a variety of treatments for body contouring. The Accent MedSpa is designed for cellulite reduction as well as painless skin tightening. The system delivers 40MHz frequency (vs. only 0.5-6MHz conductive RF frequency with competitor devices), for optimal penetration and tissue heating.The device is also FDA approved and has peer reviewed and clinically proven technology. Accent Ultra uses combined hot and cold Selective Resonance Ultrasound with high frequency RF. Split into two modules; the Ultra™ module provides ultrasound energy for treating cellulite and reducing fat whilst the UniForm™ module provides radio-frequency energy and lymphatic drainage for body reshaping and tightening skin. The Ultra module combines two advanced ultrasound technologies. ‘Cold mode’ shear waves deform the fat cell membrane integrity to induce a gradual and natural elimination of the cell. The surrounding non-fat cells tissue remains intact. The ‘hot mode’ compression waves preheat

LoveLite Ice: Lipoglaze The LoveLite cosmetic clinic in Harley Street has seen a 200% rise in bookings for their non-surgical fat reduction treatment Lipoglaze since the Olympics. More bodyconscious women and men are targeting hard-to-hit areas such as the lower tummy, love handles and bingo wings in pursuit of that Olympic body. Lipoglaze is a nonsurgical fat reduction treatment, which literally kills off up to 26% of fat cells in one session. It has been a huge hit in the States and has now been brought to the UK by LoveLite. The technology has been approved by the FDA following vigorous testing in America. The treatment targets stubborn areas in the tummy, arms, legs, and thighs with fast results, no scarring and no pain. The Lipoglaze machine works by first gently heating and then rapidly cooling the target area. This causes the fat cells to crystallise and permanently destroys up to a third of fatty deposits per session. The body then naturally eliminates this waste tissue over the next few weeks. 26 www.cosmeticnewsuk.com

the target fat tissue enhancing the effectiveness of the shear waves. Dr Kim Singh has been using Accent as a stand alone treatment since 2005 as well as to enhance his treatment outcomes from VASER, he says, “Since 2007 when we started doing VASER we have been adding Accent into our posttreatment care protocol. What is does is it smoothes out the end result and it helps with skin tightening if there is any lax skin. After VASER you can often get a few small ripples and Accent can really finish that off nicely.”

The Accent Ultra

The Accent MedSpa

Carlton: ThermaVisage RF8 ThermaVisage RF8 uses radiofrequency and vacuum alongside colour therapy for an effective cellulite reduction treatment for the body. The RF treatment uses waves which excite the molecular structure within the skin’s tissues generating heat. This thermal energy breaks down fat cells in the body, reducing cellulite. ThermaVisage RF8 includes Multi-Polar Radio-Frequency making it straightforward to use, as no frequency adjustment is required. Vacuum treatments help to break down the fatty tissue and cellulite, as well as improving lymphatic and venous circulation whilst toning and improving the appearance of the tissues. Used in combination with RF and vacuum, the colour therapy treatment stimulates the skin’s cells to facilitate change. The inclusion of both red and blue LED lights offers a wide range of benefits. For example, blue assists the vacuum in eliminating toxins.

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CLINICAL

Body Contouring

Silhouette International: Dermalift Profile The Dermalift Profile from Silhouette International is capable of offering a multiplicity of non-surgical treatments from lifting and tightening through to slimming and anti-cellulite procedures. The Dermalift Profile uses a computerised automatic changing algorithm which ensures that all client muscles are toned using several different techniques to provide the best lift and toning treatment in the fastest possible time. The ‘fast slim’ programme delivers the equivalent of 350 sit-ups in just 20 minutes through the 24 pad inch-loss system, delivering noticeable results almost immediately.

MedixSysteme: Ultracontour™ and Spashape© The Ultracontour™ device from MedixSysteme offers dual ultrasonic technology: High Focalised Ultrasound (HFU) and Ultrasound Multi-Lymphatic Drainage (UMD) from one platform. Using this system, physicians apply energy below the skin’s surface in the subcutaneous tissue to treat fat cells and stimulate lymphatic drainage to increase and blood circulation. Ultrasoundlymph cavitation is widely recognised as one

Cavitation

What is cavitation?

produce a triple therapeutical effect: Partitioning of the adipose tissue into single cells and invasion (crazing) of the cell walls; clearance of a content (fat – triglycerides) from a single adipose cell and disruption of a ligamentous septums among adipose cells. During the second stage of treatment Ultracontour™ UMDs, immediately Cavitation at applied ultrasound lymphatic drainage transport the released fat through microscopic levelthe natural metabolic system to the liver and is processed through the normal 1 body waste disposal system. This stage of the treatment assists the complete of the metabolic system. offunction the most effective cellulite reduction and

local fat loss technologies available today. 2 SPASHAPE© combinesno Scanning Diodes to Rafael Nunes, a plastic no scars, CavitationAccording is body sculpting with noMD, aesthesia, no discomfort, downtime and635mn laser therapy with Second generation of High Focalised Ultrasounds (Dynamic HFU) to treat directly at alternative Slim Clinique De Janeiro, presents asurgeon risk free to (Rio liposuction .

is a natural phenomenon based on low frequency ultrasound. The Ultrasound CavitationCavitation produces a strong wave of pressure to fat cell membranes. A fat cell membrane cannot

the fat cells and drain the fluids and theat waste immediately after in the Brazil), “We have a lot of devices in our Cavitation microscopic level lymphatic system. Adding the cold laser enhances the results with its proven clinics: SlimLipo, Accent XL, Accent 3 bio stimulation action. The first treatment phase dynamically stimulates fat Ultra, the Titan, UltraShape VDF, Harmony, Fraxel Dual and Active FX. 1 withstand this pressure and therefore disintegrates into a liquid state. The result is natural fat Ultracontour is one of the best devices to treat body reshaping non-invasively. cell elimination. This results in more fat being treated per pulse, from the first loss. In my practice, the number of non-surgical and is cellulite layers of fat justand under the dermis down to the focus area. A second phase Ultrasound cavitation is widely recognisedprocedures as one ofhas theincreased most effective reduction 4 exposes the patient to scanning low level laser light (635nm) to increase now, up to 70% of my business.” local fateasily, loss technologies available today. 2 HIFU High Focalised no cell metabolism, During the stage of the treatment Ultracontour™ Cavitation is first body sculpting with no aesthesia, no scars, no discomfort, downtime and enzymatic responses and cell membrane permeability and Aftereffect disruption of adipos’s cellular membrane the fat in the form of triglycerides is released Ultrasonic wave with a triple is focused on hips or legs to stimulate vasodilatation and lymphatic flow.into presents a risk free alternative to liposuction . the belly,

What is cavitation?

What happens to the released fat?

the interstitial space between the cells, where they are enzymatically metabolised to glycerol is a natural phenomenon based on low frequency ultrasound. The Ultrasound tionCavitation and free fatty acids. Water soluble glycerol is absorbed by the circulatory system and used produces a strong wave of pressure to fat cell membranes. A fat cell membrane cannot Cavitation at microscopic level

Zeltiq: CoolSculpting® CoolCurve+ as the energy source where as the insoluble free fatty acids are transported to the liver and

1. Before treatment. Fat tissues basic structure 2. During treatment. After 5 Minutes. 3. Liquefaction of basic fat cells is observed. 4. Liquid fat by breakage of membranes in fat cells and micro vessels that are not damaged by the effect of cavitation

1 is natural fat withstand this pressure and therefore disintegrates into a liquid state. The result cavitation? processed as fatty acids from food. Over 400,000 CoolSculpting® by Zeltiq treatments have been seen in 60-90 days when the frozen fat cells are gone for good. loss.

ation is widely recognised as oneand of the effective cellulite reduction and performed worldwide nowmost the list of treatable areas of the body The CoolSculpting® device 4 is positioned on the area of the body to hnologies available today. is more comprehensive with the launch of CoolCurve+, a specially be 2 targeted and using a suction action, draws the fat bulge into the dy sculptingdesigned with noand aesthesia, no scars, no discomfort, no downtime and developed applicator for flanks, and those really CoolSculpting® treatment applicator where two cooling plates are After disruption of adipos’s cellular membrane the fat in the form of triglycerides is released into ee alternative to liposuction . slim people who have stubborn exercise resistant areas of fat. The situated. The correct size applicator is chosen following a thorough the interstitial space between the cells, where they are enzymatically metabolised to glycerol 1. Before treatment. Fat tissues basic anatomically shaped curvature of CoolCurve+ for an effective fit assessment of the area to structure be treated. A firm pulling sensation and atural phenomenon based on low frequency ultrasound. allows The Ultrasound and free fatty acids. Water soluble glycerol is absorbed by the circulatory system 2. During treatment. After 5 Minutes. 3 and used the bodytoand improved tissue draw, making it easier to slight pressure followed by a numbing ng wave oftopressure fat ultimately cell membranes. A fat cell membrane cannot 3. Liquefaction of basic fatcold cells is sensation will be felt as the energy source where as the insoluble free fatty acids are transported to the liver and observed. more areas and a multitude of body shapes. Finalisresults during the treatment. essure andtreat therefore disintegrates into a liquid state. The result naturalcan fat be 4. Liquid fat by breakage of membranes processed as fatty acids from food. in fat cells and micro vessels that are not damaged by the effect of cavitation Fractional Focus RF is the 3rd generation RF technology. Is uses multi polar/electrodes to 4 deliver the RF energy into skin. It is combined with Red Photodynamic energy to optimize the Bio-Therapeutic: 3D-lipo results. of adipos’s cellular membrane the fat in the form of triglycerides is released into 3D-lipo offers a powerful new dimension in the combination of radio-frequency and 3D-Dermology, you are able to ace between the cells, where they- are enzymatically metabolised to glycerol 1. Before treatment. Fat tissues basic Skin Tightening & Lifting treatment & Skin Rejuvination structure non-surgical fat removal, of cellulite combine an effective skin tightening application for both face and body ds. Water soluble glycerol is absorbed by the circulatory system and used the skin 2.layers During treatment. After 5 Minutes. Theand Focus Fractional RF penetrates selectively heat the skin tissue 3. Liquefaction of basic fat cells is skinare tightening forenergy both face andand body. Its and alsoto target cellulite. ource where as the insoluble free and fattythe acids transported to the liver observed. cellular matrix where theproblem collagen fibres are embedded. The local heating causes 4. Liquid fat by breakage of membranes new 3extra Dimensional approach to the tty acids from food. in fat cells and micro vessels that are not an immediate ofoffers collagen fibres, at Dr the same time increases themedical metabolism of LasaDerm Ltd, Milton ensures thatcontraction nothing else a multiand Mohamed GP and director damaged by the effectto of Dewji, cavitation Fractional Focus RF is the 3rd generation RF technology. Issuch uses polar/electrodes the complete fibroblastsand thereby accelerating the production of new collagen and elastin fibres. effective offering yourenergy Keynes says, “As deliver the RF energy into skin. It is combined withsolution, Red Photodynamic to optimize thea clinician I need to know that the treatments we offer clients a true alternative to liposuction. are safe, effective, scientifically based and fit in with our ethos of holistic results. The concentration of collagen fibres and the regeneration of the collagen and elastin deposits, care for our clients. 3D-Lipo has delivered this to us.” tighten the skin layers creating a smoother, healthier and younger looking skin. Unlike other lipo offerings that utilise Diode - Skin Tightening & Lifting & Skin Rejuvination Laser its Cavitation + Cryolipolysis, physically The Focus Fractional RF -energy penetrates the skin layers to selectively heat the skin tissue Body Contouring & Cellulite destroys the fat cell. The advantage of this and the extra cellular matrix where the collagen fibres are selectively embedded. The localthe heating causesof fat cells doing so Focus Fractional RF technology increases temperature that the client is not required to exercise an immediate contractionsimultaneously of is collagen fibres, and and at the same time increases the metabolism of metabolism and release in deep superficial layers of fat. This increases the post treatment in order to metabolisetothe RF is the generation RF technology. multi polar/electrodes the3rd fibroblasts thereby accelerating the production of new cells collagen elastin fibres. of liquid Is fatuses from fat cells. Normal can and support 60°C but fat cells start to be melted at released which energy is a significant nergy into skin. It is combined with41°C. Red Photodynamic to optimize thefat, the fat cells shrink in size and skin is restored After fat, treatment and release ofadvantage liquid over existing methods. Added toofthis, with The concentration of collagen fibres and the regeneration the collagen elastin deposits, closer to its original form, reducing or eliminating and the cellulite appearance. tighten the skin layers creating a smoother, healthier and younger looking skin. www.cosmeticnewsuk.com ng & Lifting28 & Skin Rejuvination Body Contouring & Cellulite ional RF -energy penetrates the skin layers to selectively heat the skin tissue A causes Powerful New in Non-Surgical Fat Removal Focus Fractional RF technology increases temperature of fat cells doingDimension so llular matrix where the collagen fibres areselectively embedded. The localthe heating

What happens to the released fat?

Radio Frequency Skin Tightening Why Fractional Focus Rf Technology?

ppens to the released fat?

Radio Frequency Skin Tightening Why Fractional Focus Rf Technology?

Frequency Skin Tightening

ctional Focus Rf Technology?

Reduction t a F

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CLINICAL

DERMATOLOGY - ADVANCED ELECTROLYSIS

The Absolute way Vicki Smith from Absolute Aesthetics on Advanced Electrolysis for the removal of Dermatosis Papulosa Nigra

Dermatosis Papulosa Nigra (DPN) is a common disorder which develops primarily on black skin and also dark-skinned Asians and Polynesians. It is identified by smooth, dome shaped, brown to black papules seen mainly on the cheeks, forehead, neck, upper back and chest. Absolute Aesthetics and Vicki Smith Absolute Aesthetics is a division of the internationally recognised vein clinic, The Whiteley Clinic. The aesthetics division was set up in 2008 by Vicki Smith who is the director of Absolute Aesthetics and sits on the board of The Whiteley Clinic as director of aesthetics. Vicki has presented her findings on using Advanced Electrolysis for the removal of Xanthelasma at the International Master Course on Ageing Skin (IMCAS) conference held in Paris in January 2012. More recently she presented the results of a case series using Advanced Electrolysis for the removal of Dermatosis Papulosa Nigra at IMCAS Shanghai 2012.

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The papules can measure between 1mm and 5mm in diameter. They do not scale, crust or ulcerate and they are classed as benign lesions which are totally harmless. As such they are not pre-malignant and will not develop into melanoma (cancerous lesion). The cause of Dermatosis Papulosa Nigra is uncertain although it is known that there is a strong genetic basis for this disorder and often the lesions can be seen on several members of the same family. Females are more frequently affected than males. Research by Hairston, Reed and Derbes, 1964* suggests that they are genetically determined with approximately 40 to 54% of patients having a family history of the condition and caused by a nevoid developmental defect of the pilosebaceous follicle. They believe Dermatosis Papulosa Nigra should be classified within the group of epithelial nevi. Dermatosis Papulosa Nigra are not triggered by diet or sun exposure. They tend to begin in adolescence although are rarely seen in children younger than seven. They will generally increase in incidence, number and size as the skin matures throughout adulthood. Once they appear, they do not disappear without intervention. The skin condition is chronic and extremely

common. Sufferers include celebrities such as Bill Cosby, Morgan Freeman and Whoopi Goldberg. Under a microscope Dermatosis Papulosa Nigra closely resemble Seborrhoeic Keratoses (commonly referred to as ‘senile warts’). These are a common disorder that can occur in Caucasian skin types. They are an over-growth of basal cells which are found on the skin and the rapid growth of these cells produces a build-up of keratin on the surface of the skin. The keratin gives each Seborrhoeic Keratosis a typical appearance of being dark brown in colour with a rough, crusty texture to them and borders which appear to be ‘raised’ and well defined.

Indications for Treatment No tests are needed to identify Dermatosis Papulosa Nigra as the condition is easily identifiable and diagnosed clinically. They are generally found in multiples, are small and present themselves as smooth, firm, black or dark brown papules. In some cases, they can irritate the sufferer by becoming itchy. If there is any doubt then lesion(s) can be removed and sent to histology for further analysis. It is not necessary to remove Dermatosis Papulosa Nigra as they are purely

cosmetic but they can become a source of irritation particularly if they are in a place of friction. Sufferers admit to finding them very cosmetically unattractive and this can often affect the individual’s self-esteem and confidence. Cosmetic removal of the lesions should be done with care and precision since the darker skin types have a much higher risk of scarring and causing either hyper or hypopigmentation. With these high risk patients it is recommended to perform a patch test by removing several lesions in a discrete area to assess the risk of scarring.

Current Treatments Current treatments available for the removal of Dermatosis Papulosa Nigra include Cryotherapy (liquid nitrogen), Laser or Surgery. These treatments can be painful, expensive and usually result in a prolonged recovery period of up to five weeks. The patient can also be left with mild scarring, particularly with Cryotherapy as there is a higher risk of hypopigmentation.

Treatment Electrolysis is a radiofrequency procedure which uses a stainless steel one piece needle with a short wave diathermy current. Invented by Dr Charles E Michel in 1875, it was originally developed for the treatment of Trichiasis. Although electrolysis is often thought of as a ‘beauty’ treatment for hair removal only, Advanced Electrolysis has been used successfully for the removal of skin lesions such as skin tags, milia and Campbell de Morgan spots for many years. A low level current of approximately 17 – 19 mhz

“Although it can be slightly uncomfortable whilst the procedure is taking place, the sensation passes as soon as the lesion is removed. There is no discomfort immediately after the treatment so a local anaesthetic is generally not required.” cauterizes the blood flow to the lesion, allowing the lesion to be scraped away and then lifted from the surface of the skin during the procedure. To avoid the risk of scarring on darker skin types, the lesion is completely cauterized and then the debris of the lesion is left to come away with the scab or crust that forms. Although it can be slightly uncomfortable whilst the procedure is taking place, the sensation passes as soon as the lesion is removed. There is no discomfort immediately after the treatment so a local anaesthetic is generally not required. Immediately after treatment, the area(s) from which the lesions have been removed will resemble a graze which can occasionally bleed or secrete serum. These grazed areas will form a small crust or scab which will come away within 3 to 5 days after the treatment. The area of treatment can become slightly itchy as it heals and it is very important that patients do not pick the crusts or scabs on the skin as this can increase the risk of scarring. It is a very delicate technique which enables the Dermatosis Papulosa Nigra to be removed successfully with little trauma to the skin and minimising any risk of pigmentation or scarring.

Areas of Treatment Advanced Electrolysis can be used to remove the lesions from any area of the body where the Dermatosis Papulosa Nigra is present. Some areas are clearly more sensitive or cosmetically important than others and very occasionally topical local anaesthetic can be used to make the procedure more comfortable.

Results Results will depend on a patient’s skin type and their individual healing rates so some patients will heal better than others. Healing will continue for up to three months after the treatment and any blemishes or scars will continue to fade for up to six months. Until the crusts and scabs have fallen away of their own accord, patients are advised to have no direct sun exposure, to avoid using tanning products and heat treatments such as saunas and steam-rooms. Following the simple aftercare instructions is very important to avoid the risk of unwanted scarring. As soon as the crusts and scabs have gone, the patient can return to their normal routine.

Summary Advanced Electrolysis for the removal of Dermatosis Papulosa Nigra is a more precise and cost effective treatment when compared against other current treatments. There is far less downtime for the patient and less risk of scar tissue when compared to surgical excision. Once removed, the lesions will not reform but it is highly likely that new ones will develop over time due to the underlying skin condition. *Reference : Hairston MA Jr, Reed RJ, Derbes VJ – May 1964;89:655-8 (Medline)

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CLINICAL

The Genuine article

NEEDLING

We find out about Genuine Dermaroller™ Home-Care Epidermal Skin Rejuvenation

here has been much discussion and speculation over the years about the efficacy of using shorter needle lengths in micro-needling and the role of home-care skin-needling for skin rejuvenation. What is stimulated? How is the function of the skin affected? What are the results? There are essentially two categories to consider when looking at micro-needling: epidermal skin rejuvenation, which can be a home-care procedure carried out under the guidance of an aesthetic professional, and medical-care, in-clinic, skin rejuvenation and scar repair procedures. Skin-needles of 0.5mm or longer should be considered as falling into this latter category as they penetrate beyond the papillary dermal junction into the dermis. In doing so they are making contact with dermal tissue such as capillaries, nerve endings and fibroblasts. The responsible approach is therefore to use sterile, single-use medical-devices for these treatments and to do so under clinical care. The clinical results and skin improvements following a medical-care micro needling procedure are well known and undisputed. The histological dermal collagen regeneration, demonstrated by Schwarz MD, and the up regulation of TGFβ3, stimulating the fibroblasts to produce ‘non-scar’ forming collagen, reported by Aust MD et al, are proven with medical-care, in-clinic skin-needling when using 1.5mm needle lengths. Peer review studies and clinical reviews have established this as an effective treatment with an excellent safety profile, suitable for all skin-types for improving the appearance of skin ageing, photo damage and scarring. What should not be forgotten is that during the medical-care procedures epidermal stimulation also takes place. The epidermis is a crucial element of the health of the skin and its visual appearance. This is particularly true with respect to texture, tone, luminosity and pigmentation.

Therefore, there is also a key role for a homecare rejuvenation procedure incorporated into a skincare regime. Using a high quality device and needle lengths up to 0.3mm can improve the architecture, texture and tone of the skin and aid the absorption of topical products. Used under the guidance of a trained practitioner, a home use roller can help enhance and maintain the effects of a medical micro-needling procedure. The epidermis is the outermost layer of the skin and consists of a number of sections. The top section of the epidermis is the stratum corneum. Made up of effectively dead cells, in healthy skin these cells are surrounded by a lipid lamellae of skin-lipids such as ceramides, also containing

water loss. They are also the source for many messengers within the skin; growth factors and cytokines that stimulate new cells, and skin molecules such as GAGs that are responsible for holding moisture in the skin. The epidermis is also the site of the skin’s own immunological defence system made up of Langerhan Cells. The basal layer is the home of the melanocytes and the production of melanin, which is eventually deposited into keratinocytes and ultimately the stratum corneum. Binding Proteins such as Keratin 5 (K5), form strong networks of filaments that help attach the keratinocytes to each other, anchoring them to the basement membrane in the epidermis. This

There is also a key role for a home-care rejuvenation procedure incorporated into a skincare regime keratin and natural moisturising factors (NMFs) that keep the cells hydrated and plump. These cells are the outermost protective and visual barrier; they are held together until they naturally slough off at the surface only to be replaced by a process of continuous regeneration from below. In aged and sun damaged skin, this barrier functions less well, adhesion of the cells is compromised, there are less lipids and NMFs. The powerhouse of the epidermis are the keratinocytes; they are the most common type of skin cells and make up 95% of the cells within the epidermis. They are the source of new epidermal skin cells and produce keratin, a protein that provides strength to the skin, hair and nails and forms a barrier against environmental damage such as pathogens, heat, UV radiation and

network of filaments provides strength to the skin, protecting it from friction and other physical stresses which lead to skin damage and ageing. Collagen VII is critical in maintaining adhesion of the epidermis to the dermis and is produced primarily by papillary fibroblasts, found in the superficial dermis immediately under the basal layer. The papillary dermal junction between the epidermis and dermis is crucial. It needs to be compact and convoluted to provide optimum surface area and integrity for moisture and nutrients to move from the dermis into the basal layer of the epidermis and to the keratinocytes. Collagen VI is believed to be produced by both papillary and reticular fibroblasts (found in the deep dermis). This type of collagen is responsible for forming the structure necessary www.cosmeticnewsuk.com 35

CLINICAL NEEDLING

for proper dermal strength, giving support to the extracellular matrix and the structure for Collagen I and III to reside so they can provide the dermis with elasticity and flexibility. The enhanced dermal strength gained through the interaction of Collagen VI and VII provides a sturdy foundation for epidermal adhesion and the architecture of the dermis required for healthy, younger looking skin. Stimulation of the epidermis using the Genuine Dermaroller™ home-care HC9 device has been shown to “switch on” the genes that up-regulate Binding Protein K5 and Collagen VI and VII providing it with a strong evidence base for inclusion in an anti-ageing skin management programme. The Genuine Dermaroller™ Home-Care Epidermal Skin Rejuvenation system uses a specifically designed home-care HC9 device that uses the same Medizinish-Nadel-Technik™ medicalneedle technology practitioners use with Genuine Dermaroller™ medical-care MC devices. The HC9 device creates thousands of tiny needle columns in the epidermis. This physical stimulus triggers the epidermal skin cells to release growth factors which increase epidermal cell proliferation and dermal renewal. It has also been shown to stimulate collagen production and proteins that help improve the structure of the skin and as a result help it look smoother, brighter and healthier. A study conducted by Lilli Fan M.D, and Don Owen Phd, using the Genuine Dermaroller™ Home-Care device displayed a significant increase in the expression of keratinocyte genes, in particular KRT5 which is responsible for the production of Binding Protein Keratin 5. The study also showed a significant up-regulation of the genes responsible for the production of Collagen types VII and VI. They concluded that the use of a micro-needling device with proper needle type and depth can be beneficial in improving the age related effects of epidermal/dermal adhesion. A proper needle depth was concluded to be sufficient as long as there was interaction with at least the basal layer. At this depth there is stimulation of metabolically positive genes without a concurrent up-regulation of proinflammatory genes.

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The Fan study also concluded that the positive effects achieved through the use of the homecare device could be enhanced by the use of appropriate, well tolerated topical products. The absorption of topical agents into the skin is not only highly dependent on the chemical compound and structure of the active ingredients used but also on their ability to cross the physical barrier formed by the stratum corneum. A 2001 study conducted by Professor Dr Alfred Fahr demonstrated the increased penetration of both hydrophilic (water soluble) and lipophilic (fat

The Genuine Dermaroller™ HC9 device is less invasive and not a replacement for the Genuine Dermaroller™ Therapy Skin Rejuvenation and Scar Repair procedures carried out in medical aesthetic clinics. It can help to enhance and prolong the results achieved with the in-clinic procedures or for those with younger or less damaged skin it can be used as part of a normal skincare regime. Ideal for those who do not yet want to embark on a medical procedure or, whose skin does not yet warrant that step.

This physical stimulus triggers the epidermal skin cells to release growth factors which increase epidermal cell proliferation and dermal renewal soluble) topical products in the skin. Compared to the control group in this particular study, the level of penetration of the hydrophilic compound in the stratum corneum was increased by 1.62 times and 1.48 times in the dermis following application to the skin immediately after the use of the Dermaroller™ Home-Care device. When it came to drawing a comparison using lipophilic compounds, the results are even more impressive. The penetration into the dermis was increased 11.4 times and into the stratum corneum, deposition was increased 2.08 times. Application of product to skin pre-treated with a micro-needling device significantly increases the absorption of the product; the product penetrates through the stratum corneum into the epidermis, creating a reservoir from which the product can travel into the dermis. The Dermaroller™ Home-Care device is effective at increasing the deposition of both hydrophilic and lipophilic topical products in the skin; this in turn will increase their efficacy and enhance the results they provide. The increased penetration needs to be carefully considered with respect to efficacy and safety profile and as such should be done under professional guidance.

References and further reading: Genuine Dermaroller™ Home-Care Device November 2012 1. Percutaneous Collagen Induction Therapy: An Alternative Treatment for Scars, Wrinkles, and Skin Laxity. Aust, M.C., et al. American Society of Plastic Surgeons, Volume 121; No 4, 1421 - 1429. 2008. 2. A Prospective Controlled Assessment of Micro-needling with the Dermaroller™ Device. Schwarz, M & Laaff, H. Plastic and Reconstructive Surgery, June 2011 3. DNA Microarray Analysis of Microneedle Effects on MatTek FT Skin Equivalent. Fan, L M.D., Prof Don Owen. Baton Rouge, 2010. 4. Investigation on the efficacy of a new device for substance deposition into deeper layers of the skin: Dermaroller®. Prof. Dr. Alfred Fahr. Institut fur Pharmazeutische Technologie und Biopharmzie, May 10th, 2001.

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product

product focus

Scar issues We take a look at topical products for scars

There is a reason that the word scar has connotations of both the emotional and the physical. Scars not only leave a visible mark on the skin but their appearance on the body, particularly on the face, can cause emotional distress.

scar is an area of fibrous tissue (fibrosis) that leaves a mark on the skin and is a natural part of the wound healing process. The time the skin takes to heal will vary, depending on the degree of damage, and the longer it takes to heal the greater the chance of having a noticeable scar. Scarring is considered to be the final stage of wound healing. All wounds will form scars, but not all scars will become abnormal scars. Normal scars will develop during the first 48 hours after wound closure and can fade within three months, whereas abnormal scars can occur up to 18 months later. Scars are very common – most people have a scar of one form or another – however it is the larger and more visible scars that people more often seek treatment for, because they can have a profound impact on a person’s quality of life, causing low self-esteem and, for some, pain, limited mobility, itching and discomfort.

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There are four main types of scars: hypertrophic, keloid, atrophic and stretch marks. Hypertrophic scars occur when the body overproduces collagen, which causes the scar to be raised above the surrounding skin. Hypertrophic scars take the form of a red raised lump on the skin. They usually occur within four to eight weeks following wound infection or wound closure with excess tension and/or other traumatic skin injuries. Keloid scars are considered to be the most serious form of scarring because they form into large, tumorous (although benign) neoplasms. They can be caused by surgery, accidents or even acne. All keloid scars are hypertrophic, but only a small number of large scars are keloid. Keloid scars can occur on anyone, but they are most common in darker skin types. Although they can be a cosmetic problem, keloid scars are only inert masses of collagen and therefore completely harmless and not cancerous. However, they can be itchy or painful in some individuals. They tend to be most common on the shoulders and chest. Hypertrophic scars and its subset keloids tend to

be more common in wounds closed by secondary intention. Atrophic scars form as sunken recesses in the skin. They have a pitted appearance and are caused when underlying structures supporting the skin, such as fat or muscle, are lost. This type of scarring is often associated with acne, chickenpox or other diseases, surgery, or accidents. Stretch marks, also known as striae, are also a form of scarring and one that medical aesthetic practitioners may often encounter. As their name suggests, stretch marks are caused when the skin is stretched rapidly, most commonly during pregnancy or significant weight gain, however they can also be caused when skin is put under tension during the healing process. Topical products for scars While there are many different treatments for scars available, there has been a recent influx of topical products into the aesthetic marketplace. One of the main advantages of topical products is that they offer a pain free, at home solution to minimising the appearance of scarring on the face and/or body.

Kelo-cote® is the only patented silicone gel clinically proven to smooth, soften and flatten scars; it also Kelo-cote® relieves itching and discomfort; it reduces redness (Sinclair IS and discolouration. Kelo-cote® is recommended by Pharma) physicians all around the world. An observational study conducted by Sepehrmanesh, et al (Sepehrmanesh M , et al. Komp Dermatologie 2006;1:30-32) of 1522 patients using Kelo-cote® to treat scars, demonstrated the effectiveness and tolerability of the product. Both physicians and patients were satisfied with Kelo-cote® and the therapeutic success achieved in terms of scar appearance and feel. Kelo-cote® gel or spray is easy to apply. It rapidly dries within 4-5 minutes to form a transparent, breathable, flexible and waterproof layer; it forms a bond with the outer layer of the skin, protecting the scar and allowing it to mature through normal collagen production. This improves the cosmetic appearance of the scar. Cosmetics and sun protection can be applied, once Kelo-cote® has dried. It is suitable for children and people with sensitive skin; it can be used on irregular scar surfaces, in joint areas, and large area scars such as those caused by burns or major trauma. The recommended minimum treatment time is 60–90 days. Larger and older scars may take longer and continued use is recommended if improvement is still seen after the initial 90 days. Tips for drying: Kelo-Cote®’s drying process is assisted by the temperature difference between the gel and the skin. To reduce drying time in hotter climates, keep Kelo-Cote® in the refrigerator. In colder weather, use the low setting on a hair dryer to reduce drying time. Kelo-cote® is available in a gel formulation (15g and 60g) or a spray (100ml). It is also available in a UV gel formulation (15g), which has SPF 30, so that scars can be protected and healed, without additional damage from the sun.

SilDerm Ltd has just launched Scar Gel and Scar Spray, the ingredients of which have been clinically SilDerm proven to prevent and repair the unsightly scars Scar Gel & caused by surgical operations such as Caesarean Spray section, trauma injury, wounds or burns. Routinely used by plastic surgeons to repair severe post operative scarring, Scar Gel & Spray are a light, odour-free, quick drying silicone gel and spray, and an ideal treatment for clinics to use and sell to their customers for use at home to reduce and improve the appearance of both old and new scars. Scar Gel & Spray’s ingredients have been proven in clinical trial to be safe and effective and with a trial 6g gel tube retailing at only £9.99 Scar Gel is a product that clinics can now confidently recommend to their customers at a cost effective price. Medical studies have proven that silicone flattens, softens and smooth’s scar tissue. It also dramatically reduces the redness and relieves the itching and discomfort often associated with scars. Scar Gel & Spray work by bonding to the outer layer of the skin providing a protective barrier against chemical, physical and microbial contamination of the scar site. The gel and spray dry rapidly to form an ultra thin gas permeable and waterproof silicone membrane, which allows the skin underneath to breath, and the scar to mature naturally through normal collagen synthesis. It leaves no residue on the skin so makeup and sunscreen creams can be applied normally and it will not mark clothing or bed sheets if used at night. Scar Gel & Spray are safe for use in the hair and on all skin colours and types including people with sensitive skin and children. Depending upon the age and condition of the scar, the recommended initial treatment period is 60-90 days and it can be applied immediately after stitches have been removed and the wound has been closed. Scar Gel is available in 6g and 15g tubes; 30ml and 60ml sprays with a recommended retail price of £9.99 and £24.99 for the gel and £32.50 and £52.00 for the sprays.

Amred Healthcare Ltd recently launched a new scar product into the UK. Pro-Sil® is a silicone glide (much like a lip balm) indicated for treatment Pro-Sil® of scars, keloids’ and hypertrophic scars as well (Amred Healthcare) as burns. The product is manufactured in the US by Biodermis™, a company which has been recognised for its innovative contributions to the scar management industry for nearly 25 years, and comes in 17g, 4.25g and a kids’ 4.25 glide (stick). The 17g Pro-Sil® is scheduled for inclusion on the NHS Drug Tariff this month (November 2012), making it available via prescription. Pro-Sil® is revolutionary in its niche market of convenient, silicone-based scar care options because of its solid stick formulation. Competing products utilise a silicone gel formulation, which is prone to drips/runs and a sticky texture, due to the viscous nature of liquid silicone gel. Pro-Sil’s stick formulation has proven itself equally effective to gel products like Biodermis’ own Xeragel®. Pro-Sil® is the only silicone therapy product available in a solid stick. Medical grade silicone effectively provides a fully-encapsulating healing environm nt for scar tissue, and allows the ideal concentration of oxygen and moisture at the scar site. Silicone also provides smooth, even coverage across the scar and surrounding healthy tissue area. These factors help to keep the scar tissue pliable, allowing it to blend more completely with surrounding healthy tissue. The end result is a much improved scar that has a smoother, flatter appearance, and a more natural skin tone. The clinically proven product is easy to use and cost effective and has a shelf life of more than eight years.

SkinMedica® Scar Recovery Gel harnesses the unique properties of Centelline™ and SkinMedica® combines naturally derived ingredients with Scar Recovery scientific innovation to support scar formation Gel with Centelline™ from beginning to end. Centelline™ is made up (SkinBrands) of three key ingredients: Yellow African Bulbine Leaf Sap (Bulbine frutescen), Centella Asiatica Extract and Olive leaf Extract (Oleuropein). Yellow African Bulbine Leaf Sap provides deep hydration by leaving a layer of fatty vesicles on the skins surface. It is also responsible for fibroblast remodeling, increasing mature collagen, protein and DNA production for rapid wound healing. Centella Asiatica Extract is rich in anti-oxidants to help control inflammation. Studies on the active triterpene compounds have shown they decrease scar formation and help to balance collagen. Olive leaf Extract also has anti-inflammatory properties and maintains skin elasticity to prevent damage. In a clinical study of 60 subjects who received small incisions from various plastic surgery procedures, 80% of those using Scar Recovery Gel demonstrated the best possible scar resolution (to Grade 1) in as little as six months compared to 13% of those receiving no treatment. In another study of 30 patients who received large incisions, 80% of those using of Scar Recovery Gel along with an adhesive tape demonstrated scar resolution to Grade 1 as compared to only 20% of those using adhesive tape alone. SkinMedica® Scar Recovery Gel is a must for those with new or recent scars and is a first-of-its-kind treatment. Simply apply this lightweight gel twice daily to problem areas.

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product

iQ test

Treatment Spotlight

We find out about the Harmony XLi Laser360iQ™ treatment Laser360iQ™ from ABC Lasers is one of the most popular treatments for patients looking to improve skin colour, texture, tone and laxity. The treatment uses five technologies and delivers a complete range of skin rejuvenation results and can be customised to meet each patient’s specific needs. Multiple technologies can be combined during a single session or spread out over 60 days. Laser360iQ™ is a non-invasive, comfortable procedure that provides effective, lasting results without surgery or down time. It can be used on any skin type, and normal activities can be resumed immediately after each session. Dr Patrick Bowler, medical director of Court House Clinics said, “This amazingly versatile single platform with five proven technologies provides all the laser/IPL applications you could possibly require for skin rejuvenation in your aesthetic practice. This adds up to an extremely cost effective treatment option.”

Laser360iQ™ combines five distinct technologies: • PULSED DYE AFT TECHNOLOGY AFT Precision Pulsed Dye VL technology evens out skin tone and pigmentation and reduces tiny broken blood vessels and other colour irregularities, heating from beneath and without damaging the skin. • NIR SKIN TIGHTENING Unique narrow band infra-red deep heating stimulates collagen production and causes the realignment of the elastin tissues to firm up any loose skin so your patients regain a more youthful, contoured appearance. This is ideal for treating the mid face and jaw line. • Pixel® Pixel®improves texture and tone. This precision laser creates thousands of microscopic perforations, which stimulate new collagen to grow. The new collagen improves the skin’s texture and tone to smooth fine lines and wrinkles. The skin around each of these perforations remains intact, which allows the skin’s top layer to heal from the edge of these tiny holes very rapidly (www.pixelperfect.com). • HIGH POWERED Q SWITCHED PIXEL 1064/532 NM MODULE The High Power Q-Switched 1064/532nm Module is used for the non-invasive removal of various coloured tattoos and benign pigmented lesions, providing deep penetration for fast, safe, and efficient removal. 40 www.cosmeticnewsuk.com

Before Laser 360iQ™

By utilising the unique 5x5 tip, practitoners can now offer non-ablative fractional skin rejuvenation with this module. Uniquely designed for use with the HarmonyXL platform, it is the only device available with the Q-switch integrated into the module and not as a stand-alone device. With significantly higher power output than other aesthetic medical laser devices, the High Power Q-Switched module delivers double the amount of energy by way of multiple pulses. Unlike single pulse devices, it achieves high peak power with maximum spot size, ideal for treating pigmented lesions. • i-Pixel Pro In Motion Resurfacing With the High Power Pixel 2940, pre-programmed laser, energy passes through the patented Pixel micro optics lens array and penetrates the skin, affecting just 15-20 percent of the surface. It creates an ablative thermal channel at the pixel area - a micro-injury - without disturbing the surrounding tissue. Those micro-injured areas start the process of healing and the untreated area acts as a reservoir for rapid restoration. As collagen remodels, skin tightens and texture improves.The gentleness of

After Laser 360iQ™

the procedure allows delicate areas such as the neck, chest and hands to be treated as safely as the face with little risk of infection. There is little downtime or discomfort, minimal analgesia, and no other disposables are required. The complete Laser360iQ™ treatment consists of four to six treatment sessions utilising select combinations of technologies (AFT, LED, NIR, Pixel QSW and i-Pixel), spaced about 10-15 days apart over a 60-day period. Results can be seen within five days with full effects visible at 30 days. The Harmony®XLi System is the most versatile, expandable light and laser system on the market with more than 20 different treatment modules for numerous combination therapy protocols and 11 distinct technologies with over 70 FDA cleared indications. Harmony®XLi offers tremendous value to practitioners by providing a customisable and upgradeable system that grows with your aesthetic practice. With no disposables and a low cost of ownership it generates a high return on investment. For clients the platform means shorter and virtually painless treatment times with minimum down time and unmatched improvement in skin rejuvenation, hair and tattoo removal.

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Cosmetic News 2012 ISSUE

PRODUCT News aestheticare®

intraceuticals

AesthetiCare® introduces Retriderm™ Protein-Rich Skin Serum

Intraceuticals launches Rejuvenate+ Boosters Collection

AesthetiCare® is pleased to introduce Retriderm™ Protein-Rich Skin Serum, a new Vitamin A Skin Regeneration range fresh from the USA. Retriderm™ Protein-Rich Skin Serum is clinically proven to fight the visible signs of ageing and sun damage and produce significant improvements in the appearance of the skin. The patent pending, protein rich formula harnesses the natural power of Vitamin A by providing Retinol, a bio-available form of the vitamin that is naturally consumed in our diet and available within our body. This unique formula optimises the stability and bio-availability of the skin-essential Retinol, enabling it to ‘go to work’, regenerating the skin from the surface and within. In recent studies conducted by renowned US Dermatologists Dr Michael Gold, Dr Vivan Bucay and Dr Leon Kircik the efficacy of the Retriderm™ Protein-Rich Skin Serums was tested and clinically proven. Looking at both the 0.5% and 1.0% serums the studies demonstrated that the science and efficacy of Retriderm™ Protein-Rich Skin Serums with their protein-rich formulation containing collagen, elastin, hyaluronic acid and Vitamin E can deliver significant results. Improving facial wrinkles, including those around the eye, skin laxity and tightness, hyperpigmentation and skin brightness. Retriderm™ Retinol 0.5% Protein Rich Serum demonstrated very good skin tolerability and is ideal for those with skin that is more sensitive, younger or with less sun damage. It is also Step 1 in a Retriderm™ Vitamin A Skin Regeneration Programme. For those with more mature or sun damaged skin Retriderm™ Retinol 1.0% Skin Serum provides maximum efficacy and would also be used as Step 2 in a Retriderm™ Vitamin A Skin Regeneration Programme. Step 3 in the programme involves the ongoing use of Retriderm™ Protein-Rich Skin Serum as instructed by an aesthetic practitioner.

Intraceuticals has launched a new skincare collection designed to allow practitioners to customise the results of its at home and in-clinic treatments.

vitage®

The Rejuvenate+ Boosters line was developed by isolating the most significant and proven skincare ingredients in concentrated formulas. Unlike typical topicals, these concentrated formulations are delivered to the skin with Intraceuticals’ proprietary hyaluronic technology for instant, visible results. Each Rejuvenate+ Booster has been developed in two forms; a professional Rejuvenate+ Booster Treatment Serum designed to enhance the results of the Rejuvenate Oxygen Treatment performed by a skin care professional and an accompanying take-home Rejuvenate+ Booster product to be added to the Rejuvenate Daily Serum (the athome version of the Rejuvenate Oxygen Treatment). Each product in the collection addresses a different issue for a focused and specific skincare solution. Multiple boosters can be combined into one regimen (morning and night) for a truly personal treatment plan. The range includes: Antioxidant Booster; Collagen Booster; Vitamin C+3 Booster and Vitamin A Booster.

laser physics

Laser Physics unveils new ocular shield options from Oculo-Plastik

Vitage® Advanced Anti-oxidant Skincare™ Skin Calming Aloe Gel

Vitage® has released its new Clinical Essential product, Skin Calming Aloe Gel, a multi-tasking, skin soothing solution for a wide range of treatments and clients. Vitage®Skin Calming Aloe Gel is a professionally formulated Aloe Vera treatment gel to instantly cool, soothe and hydrate all skin types. Made from 100% organic Aloe Vera to deeply hydrate and soften dry or tired skin it is infused with natural extracts of Calendula and Chamomile to heal, calm and restore the skin. This anti-redness formula is gentle enough to use on stressed skin and can be applied following professional treatments such as IPL, laser, waxing and microdermabrasion to balance and reduce post treatment irritation. Skin Calming Aloe Gel is water based and completely absorbed and can be used as a serum under masks and homecare products to boost their hydration and calming abilities. Vitage®Skin Calming Aloe Gel can be twinned with Vitage®Skin Defence SPF 30 to provide a total clinical solution to manage post-operative irritation and environmental protection after a range of treatments making it indispensable in any professional skincare environment.

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Laser Physics has unveiled a range of new ocular shield options from Oculo-Plastik. Made of high heat resistant plastic, the shields are autoclavable with all their surfaces and edges well polished to avoid corneal abrasions. Available in both bilateral and unilateral shield styles, four sizes and a choice of colours, Oculo-Plastik are able to produce a selection catering to the majority of requirements. Their bilateral shields with suction cups can be used on both eyes, simply by reversing them and are available with either use of handles or suction cups. Whilst the unilateral shields with handle are non-reversible, fitting only over one eye, although they are larger superiorly to cover more of the globe. The range of sizes available makes choosing the right ocular shield even easier. With both black and transparent yellow ocular shields available, to block out all light and patient vision, or offer relief to claustrophobic patient and to check pupil dilation, Oculo-Plastik has sought a solution to all your ocular shield needs.

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

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Cosmetic News 2012 ISSUE

PRODUCT News stylage®

Stylage® Launches In South Africa Stylage®, the world’s fastest growing dermal filler, has been launched into the South African market through Medical Aesthetic Group’s South African subsidiary under the medical direction of Dr Stern Pretorius based in Cape Town. Launched in 2008, Stylage®by Vivacy is now the second leading hyaluronic acid filler in France and a leading brand in Europe. The patented IPN-Like technology that combines cross linked hyaluronic acid with the benefits of Mannitol and Sorbitol anti-oxidants, has demonstrated its performance, reliability and durability in several published clinical studies and scientific papers. All hyaluronic acid fillers are cross-linked with a chemical to resist natural degradation and prolong duration. However, Stylage®is also the subject of a patented manufacture process (IPN-Like Technology) that offers an extraordinary capacity of modeling with natural longer-lasting results. Its 3D structure has been created to remain stable to degradation with less cross

linking, therefore requiring less chemical interference. Stylage®claims the lowest levels of BDDE, the cross-linking agent. Stylage®boasts a 12-18 month duration with minimal swelling for most of the range, including the mid-range medium viscosity products. Normally higher duration can be achieved only with increased viscosity. Stylage® can be used to fill and smooth wrinkles, natural lip correction, volume restoration, hydration, chin remodelling, tear trough correction, neck, décolleté & hand rejuvenation. Dr Pretorius says “ We can safely say that all HA fillers are perfect tools for the job, but Stylage®has the added benefit of shortened recovery time and increased duration of results.”

Sterimedix

Neostrata

Silkann Cannulas available exclusively from Med-fx

NeoStrata launches two new powerful serums

Sterimedix has appointed Med-fx, to act as an exclusive distributor of its Silkann cannulas in the UK. Silkann cannulas offer distinct and unique features at competitive prices. Supplied either as cannulas alone or with pre-hole needles included, the Silkann range is the most comprehensive aesthetic cannula product line available Sterimedix manufactures a complete range of single use products cannulas for aesthetic procedure under the Silkann brand name. Sterimedix also manufactures and sells a complete range of single use devices for ophthalmic surgery. All Sterimedix products are manufactured in the UK. The products are now also available in Russia.

NeoStrata has launched two new powerful serums. NeoStrata Antioxidant Defense Serum is a concentrated serum designed to strengthen skin’s defences against photo damage, the leading cause of premature skin ageing. NeoStrata Firming Collagen Booster Serum was developed to enhance and preserve natural collagen and is designed to address loss of firmness due to increased collagen degradation and slowed collagen production in ageing skin.

caci

CACI launches ‘Wrinkle Revolution’

CACI has launched Wrinkle Revolution, a short 20-minute treatment that provides a painless needle-free alternative to targeting facial lines and wrinkles. The treatment uses a hand held wrinkle comb to deliver Red and Blue LED photo stimulation combined with a high frequency micro-current. The deep and powerful action of these two technologies helps stimulate fibroblast cells to naturally increase collagen and elastin products to plump out and soften lines and wrinkles. Results are immediately visible but for optimum effect a course of 10 treatments is recommended followed by monthly top up treatments.

sound surgical

Sound Surgical Technologies introduces cellulite solution Sound Surgical Technologies has announced the launch of VASERsmooth, the latest minimally invasive cellulite solution to hit the aesthetic market. VASERsmooth technology is only available with the new VASER Lipo® System and provides an additional application for the already versatile body contouring device. The accompanying VASERsmooth kit includes a specially 44 www.cosmeticnewsuk.com

designed handpiece and set of probes that selectively emulsify superficial fatty tissue and cut the hardened fibrous septae responsible for skin dimpling and contour irregularities, which is more commonly referred to as cellulite. Early investigators of the technology are impressed with the results they have achieved and are finding that VASERsmooth is almost twice as fast as some of the other technologies currently on the market.

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Cosmetic News November 2012

business business focus

Damage control

Mark Simmons on how owners could be damaging the value of their business

There is evidence that many business owners are delaying the sale of their business, because the recession has depressed the sale value they are likely to achieve, with many awaiting a return to pre-2008 levels. But there is one other major factor affecting the value of many owner-managed businesses that cannot be blamed on the recession.The owner. If the owner-manager or key staff members are unable to work for an extended period, the consequences for the business could be serious. In most situations it is highly unlikely the business would continue to run smoothly, or be able to pursue the same growth path. In the absence of key individuals, even those that are planned for, businesses generally run smoothly for a short time but quickly begin to deteriorate once the vision and guiding influence is absent. It is simple for business owners to evaluate how dependent their business is on their continuing presence, by considering the following questions: • Do you feel that most issues end up on your desk? • Do you feel that nothing happens unless you are involved in everything? If the answer to these questions is yes, it is obvious that any absence of the business ownermanager will result in problems for the business.

How does this affect the value of a business? The degree to which a business relies on the owner or a key individual for success, will ultimately affect the value of that business when it comes time to sell. For example, let us assume a typical profitbased valuation for a business in the aesthetics

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industry indicates a value of £2m could expect to be realized on its sale. Along comes an interested buyer, who is seeking a well-run organisation that will continue to operate successfully after purchase and can be easily integrated with the buyer’s own business. The buyer then completes the due diligence process and makes an offer significantly less than expected. But why the big difference in valuations?

Because the owner is the problem The majority of businesses are directly managed by their owners. The success of these businesses is based on the vision, the insight, the hard work and often sheer bloody mindedness of the owner. Unfortunately, many owner directors feel that no-one working in the business cares as much about business as they do. Owners feel that things will go wrong, if they are not ultimately responsible for every decision, or solve every problem. Any potential buyer will probably identify this

reliance on the owner and reduce their own valuation of the business. This lower valuation recognises the increased risk of purchasing the business and maintaining its success without the key driving influence as part of its future and an expectation of a greater cost of integrating the business with their own. In the worst cases, where the business relies too heavily on the input of the owner, the buyer is likely to walk away from the deal entirely.

Is there a solution? Unfortunately there is no single step to guarantee a queue of buyers prepared to pay the asking price. It is a combination of factors.To generate a sustainable, profitable and valuable business, the owner director needs to take a more strategic, hands-off approach to their business. Or employ someone who will. Emphasis must be placed on the 3 P’s; product; people; process. It doesn’t matter which industry or sector a business operates in, the rules remain the same. Regardless of the type of customer the business serves, or the complexity of doing business in that sector, each business must address the 3 P’s to ensure success. If the answer to one or both of the questions posed earlier was in the affirmative, then some simple questions can help define the solution: • Do the employees really know what is expected of them? • Do they know what to do and when to do it?

“The majority of businesses are directly managed by their owners. The success of these businesses is based on the vision, the insight, the hard work and often sheer bloody mindedness of the owner.”

“Businesses are purchased for many reasons; to reduce the competition, to buy in expertise and to buy turnover, to name but a few. Normally the people within the business play a major part in its value and when they are regarded as a true asset of the business and treated accordingly they will respond in ways that will surprise everyone” •

Do customers consistently complain about the same things? • Are projects consistently delivering less than expected? Looking at the sale process from the buyer’s perspective, it is easy to understand the lower valuations being offered. Anyone buying a business wants to be sure that it could continue to operate once the owner has relinquished control or left the business completely. A common scenario is for the owner to remain within the purchased business to smooth the transition of ownership or integration, but often this proves difficult for the ex-owner to come to terms with and can lead to an earlier than expected exit. Clearly it is in the interests of all business owners, whether they wish to sell now or in the near future, to take steps to reduce the dependency of the business on key individuals, including the owner. So let’s take a closer look at the 3 P’s.

Process The processes a business has, or puts in place can make a significant difference to its fortunes. Too often processes are built up piecemeal, with time and circumstances distorting them from their original purpose. Ask an employee why they do things in the way they do them and commonly they will say that they don’t know, it is just the way they

were shown how to do things. Over time, processes can become overly complex; often self-serving for the staff and missing the magic ingredient of adding value to the product or service the business is selling to its customers.

Service is a product Compelling products and services create business success and thus value. A business must not only create products and services that are right for the market at the right time, but deliver them in the appropriate way – a renewed focus on the client experience becomes critical. However, the ability of a business to create a compelling product or service and deliver an engaging client experience comes back to the people involved. Unfortunately, in an owner managed business, the growth and development of products and services often remains with the business owner, often creating even further dependence on their abilities. The owner usually has a strong understanding of the market and the requirements of clients, but may fail to keep up to date and become stubborn to necessary change. Any potential buyer will want to see a process for innovation, for identifying opportunities and ultimately for growth and greater profitability, that is not totally reliant on the owner.

Mark Simmons Mark is director of Baldwins & Simmons Business Solutions, a consulting services company helping organisations ranging in size from start-ups to multinationals, to effectively identify and implement the changes required to achieve their vision. He is experienced in the full lifecycle of business, working seamlessly with other professional advisers, banks and venture capital companies to deliver the desired outcome. Recent assignments include acting as interim MD to

People In all areas of the aesthetics industry, success is underpinned by the people that work in it. It is the sum of the individual relationships and outcomes that generates the trust necessary for the industry to thrive. Events such as the recent PIP scandal have highlighted this to be true across the entire supply chain.Earlier in this article, business owners were asked to assess their level of involvement for their business to operate successfully, with many no doubt discovering they are too involved. Further questions were posed to help identify a solution and these ultimately revolved around people within the business, their ability to know what they are doing and doing it consistently. Businesses are purchased for many reasons; to reduce the competition, to buy in expertise and to buy turnover, to name but a few. Normally the people within the business play a major part in its value and when they are regarded as a true asset of the business and treated accordingly, they will respond in ways that will surprise everyone. Their full involvement, working within a clear framework will allow the business owner to take on the leadership role vital for generating business success and subsequent value. It’s not just about a business looking good With the pressure on, business owners find it can be difficult to step back and take an objective view of the 3 P’s; product; people; process. More often than not, an owner knows that something needs to be done but has no idea where to start and falls into the trap of doing nothing instead. Seeking the advice of someone from outside the business, who can take a more objective, ‘big picture’ view can help overcome these difficulties, but they must have direct experience and a good track record of successfully implementing change. The owner must also be prepared to hear how it really is. And listen; or it could cost them a lot of business value if they don’t.

turnaround a failing specialist construction business, providing strategic management advice to the MD of a pharmacy group and completing a feasibility study into document management and electronic trading for a NASDAQ quoted business. Mark has a particular interest in strategic growth generated from his experience through financial and IT board positions, operational senior management roles and over 10 years experience advising business owners and senior management in a consultancy capacity.

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business charity appeal

Cosmetic News is supporting an appeal by charity Changing Faces to raise £10,000 we tell you how you can help and why the work this charity does is particularly prevalent to the aesthetics industry

ver one million people in the UK have conditions, scars or marks that affect the appearance of their face or body. Other people’s reactions to their appearance can make their life extremely difficult. It is hard to imagine being constantly stared at, people asking intrusive questions or being teased and bullied on a daily basis, just because of your appearance. People with visible differences often face discrimination in everyday situations, such as going to the shops, attending a job interview or using public transport. These all present significant challenges because of other people’s response to their appearance.

Surgery and other treatments can reduce the appearance of certain skin and congenital conditions; however it cannot always remove it completely. Changing Faces is the UK’s leading charity supporting and representing people with unusual appearances, no matter what the cause. The charity aims to enable everyone, whether directly affected or if they know someone with a visible difference, to live their life with confidence. The charity does not receive any central Government funding and relies on donations to offer its free services, which include: • One-to-one support, in person at its London head office, or by phone and e-mail; • Advice, information and support to help with the psychological effects of skin conditions and disfigurements and addressing individual concerns; • Practical self-help guides to build confidence and selfesteem; • Non-medical advice on how to find out more about specific conditions and treatments, along with group workshops where people can share their experiences with others. As well as support for children and young people including: • An initial discussion at its head office in London, or by phone and e-mail; • Face-to-face meetings (with the child, family, school or health professionals) to reduce bullying and teasing ; • Practical self-help guides to build confidence and selfesteem for carers, parents and children; • Support and information about ways to talk to children and young people about looking ‘different’; • Non-medical advice on how to find out more about the child’s condition.

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To continue to provide these essential free services, especially tackling bullying in schools and campaigning for the end of discrimination of people with disfigurements, the charity needs to raise £10,000. Cosmetic News is supporting this appeal and will be helping the charity to hit its fundraising target. You can also support the appeal by adding a small discretionary donation to each customer purchase or by getting your staff to participate in employee fundraising activities. To get involved simply call Tessa Hazzard on 020 7391 9271 or e-mail tessah@changingfaces.org.uk. You can also make a company donation at www. changingfaces.org.uk All money raised will help to fund Changing Faces’ free help line, tackle bullying within schools and help to cover the costs of providing over 180 free skin camouflage clinics nationwide. Your donations will help this very worthwhile charity to continue delivering its life changing services.

CoolSculpting® by ZELTIQ The safe and targeted removal of fat bulges is in high demand amongst consumers. On average in the UK there has been 6,600 searches online for “fat reduction” information each month* and this form of treatment is now firmly in the media spotlight and becoming increasingly more competitive in the cosmetic aesthetic marketplace. CoolSculpting® by ZELTIQ is ahead of the game with an expert and unique customer service and support programme working in partnership with your clinic. There are many reports both from clinicians and consumers of extremely high levels of consumer satisfaction** post-treatment and here’s why... * Source: realself.com (April 2012) ** Google Keyword Tool

In a league of its own The CoolSculpting® by ZELTIQ Procedure using Cryolipolysis is fundamentally different from other non- or minimally invasive modalities. Other methods of fat removal primarily involve necrotic cell death by damaging fat with heat, high-intensity focused ultrasound, or chemical injections. Each of these alternatives pose potential technical challenges, particularly with respect to targeting the right tissue depth and unintended damage to other structures close to or within the fat layer. Predictability of efficacy using these other techniques is also uncertain. In contrast, the CoolSculpting® by ZELTIQ procedure using Cryolipolysis induces apoptosis only in fat cells to gently and gradually reduce the fat layer while preserving all other tissue.

How Non-Invasive Cryolipolysis Works Some stubborn fat bulges are immune to diet and exercise. CoolSculpting® by ZELTIQ targets and cools fat cells to temperatures that trigger fat cell apoptosis. There is no damage

to nerves or other tissues because fat cells freeze at a different temperature to other cells. Following treatment, affected cells enter an apoptotic death sequence and are gradually removed in the next few weeks and months by the immune system. Fat layer thickness is subsequently reduced which results in an improvement in appearance of the treated area.

Committed to Safety, Efficacy and Evidence Don’t be fooled by imitators who claim to use Cryolipolysis. CoolSculpting® by ZELTIQ stands alone as the only non-surgical fat-reduction technology using Cryolipolysis that’s FDA-cleared in the U.S. and CE marked as a Class IIa medical device. We are committed to ensuring Safety, Efficacy and Evidence at every level. Here’s why CoolSculpting® by ZELTIQ can’t be imitated: THE FIRST

First and only to use Cryolipolysis for non-invasive fat reduction THE MOST PROVEN Backed by more than 20 published clinical papers and abstracts using the patented CoolSculpting® device THE MOST POPULAR More than 400,000 treatments worldwide THE SAFEST Only controlled cooling treatment with built-in safety measures THE MOST RESPECTED FDA-cleared in the U.S., CE marked as a Class IIa medical device and Health Canada approved THE WORLD LEADER More than 1,000 installed devices in 52 countries THE MOST EFFECTIVE Durable and predictable results THE MOST EXCLUSIVE Available only to premier medically based practices

For more information on CoolSculpting® by ZELTIQ call Customer Support Manager on 01293 312 070 or visit www.coolsculpting.co.uk

business Media and PR

Wh y talk to the press? Tingy Simoes Tingy Simoes is managing director of Wavelength Marketing Communications and founder of Cacique Public Relations. She has extensive experience in the world of PR for medical professionals in both the UK and the USA and has run the BAAPS press office for 10 years. She is the author of How to Cut It in the Media: A PR Manual for Aesthetic Plastic Surgeons and Professionals in Cosmetic Medicine recently published online by Informa Healthcare (www. informahealthcarestore.com)

he aesthetic industry has been receiving some bad press recently, following the PIP and remote prescribing scandals, and practitioners are understandably wary about speaking to the media. With 10 years experience in PR and dealing with the media, Tingy Simoes has recently published an online book, How to Cut It in the Media, advising aesthetic professionals on this tricky subject. Here we summarise a chapter looking at why you should speak to the press. At their most basic, aesthetic professionals (whether clinicians, such as doctors, surgeons, dermatologists, nurses, dentists or clinic and hospital owners/ managers) can be divided into two types: (i) Those who actively seek to interact with the media – whether to advance their own profiles or generate business – and; (ii) Those who feel that the limelight is thrust upon them in spite of their wishes or inclination. They see the press as a ‘necessary evil’ and mistrust journalists. Either way, to ignore the power of the press in today’s media-led society is foolhardy. This article will provide

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the tools and insider knowledge to take ownership of your PR endeavours, in whichever of those camps you consider yourself to be. Under what circumstances would a journalist ever need or want to speak with you? The answer is EVERY time they write or report anything having to do with aesthetic treatments or news in the sector, they will need comment from ‘an expert’. I’ve lost count of the amount of times I have been asked by industry players: “What is that clown doing on TV?” The reality is that, whether or not you agree that the person they end up using actually qualifies as an expert, it doesn’t change the fact that ultimately the media needs someone – anyone – to quote and give their story validity. And for better or for worse, the selection of expert mainly comes down to one thing: PR. Either you enjoy the relationship yourself with a journalist, or have a publicist with the right connections … or you don’t! You may choose not to proactively engage with the press, but to ignore the power of the media is more than disingenuous, it’s outright stupid. On the other hand, there are dumb reasons to hire a PR agency and one of them is simply wanting to ‘be on television’. I’ve met experts throughout my career who feel that they entirely missed their calling and actually they just want to appear on TV chat shows. They don’t technically have a unique viewpoint, or any specific news to impart, but feel they themselves are a gift of greatness to be unleashed upon an unsuspecting world. This has a short lifespan as a PR strategy. We might be able to get you on a couple of programmes here and there, but there must be substance behind the gloss and actual value to provide to the media. If you want your life to be more Entourage than Scrubs, consider getting an agent. Another no-good reason – doomed to fail, in fact – to engage a PR agency is because you actually want to spend less time on marketing. A PR agency will need

you to provide material to take to the press and we require your involvement and commitment. To every client I say: “I’m only as good as what you give me.” Having a PR agency will not reduce your hours, if anything quite the opposite, but it will multiply your rewards in terms of recognition.

WHAT THEY NEED FROM YOU So why does the media need you? Because, make no mistake, they need you. They require: • Information • Explanation • Illumination • Expertise and knowledge • Opinion The press just wants a good story! The sooner every medical spokesperson arrives at the understanding that a journalist’s job is simply to produce one, the easier it will be to deal with the media on a regular basis. It is the underlying reasoning and objective to everything they do. Know that journalists are NOT there to inform, rally, reassure, educate or inspire for the greater good. They are not there to make the human race better people, promote safety or encourage commonsense decision-making: their mission is to sell newspapers and magazines, and get their viewer and listener figures up. This is their job. And anyone who helps them to look good in front of their boss will earn their gratitude and a fruitful, long-term relationship. Make it snappy! If you can make sensible advice and viewpoints sound interesting or appealing, you’re halfway there.

CELEBRITY DOCTORS With advances in the sector and new aesthetic treatments being touted everyday as the ‘latest craze from Hollywood’, the urgent need for expert view has risen exponentially. As the new century dawned, a new phenomenon was also making its way into our collective consciousness: the meteoric rise of the celebrity doctor. Of the hundreds of physicians I have worked with over the years my team and I always knew who were the media stars (or ‘media sluts’, as some of their colleagues more rudely put it) who were willing to do interviews anytime, no matter how obscure the outlet. Suddenly the public knew the names of doctors and knew them well – from dramatic makeover shows to reality ‘fly on the wall’ documentaries – the fact that certain medical luminaries had chosen to descend from the perceived Olympian

“The cosmetic surgery sector, having been seen until relatively recently as the preserve of the rich and famous and somewhat shrouded in an aura of mystery, became one of the areas most sensationalised in the press. A succession of makeover shows exploded onto our screens, showing us what transformations could be achieved. We read in magazines who did so-and-so’s face-lift, so-and-so’s boobs” heights of their consulting rooms and walk/ Twitter among the common folk was regarded by the media as nothing short of manna from heaven. Suddenly you could call them by their first names, you knew what they ate for breakfast and they also shared their fitness tips. The most successful ones not only publish books but they’re also on TV, Facebook and Twitter. Clearly it doesn’t translate that they’re necessarily better at what they do than any of their colleagues, but just that they know how to harness the power of media in their favour. In particular, the cosmetic surgery sector, having been seen until relatively recently as the preserve of the rich and famous and somewhat shrouded in an aura of mystery, became one of the areas most sensationalised in the press. A succession of makeover shows exploded onto our screens, showing us what transformations could be achieved. We read in magazines who did so-and-so’s face-lift, so-and-so’s boobs. In some circles, surgery has started to be seen as a badge of honour and some patients want acquaintances to ask “who did your nose?” Doctors, surgeons and professionals in aesthetic healthcare eventually woke to this dawning reality – some more quickly than others – and jumped into frenzied marketing and publicity activity with gusto but rather mixed results. The ‘Wild West’ analogy is used quite often to describe the sector, as providers of aesthetic treatments can seem untroubled by much in the way of statutory limitations on what they can and can’t do. The reality is that, whether provided by board certified, appropriately trained and qualified practitioners or not, the idea of cosmetic surgery has become firmly entrenched in today’s popular culture. There is even a sense of entitlement among the public, with many feeling they ‘deserve’ a little pick-me-up in the form of wrinkle-relaxing

injections or a neck-lift in the same way they view having a haircut. One could posit the theory that the ubiquity of cosmetic surgery advertising and marketing has contributed to its trivialisation in the eyes of the public, leading to their own dangerous undoing in many cases. It is in this environment that it’s more important than ever that reputable clinicians make themselves heard. Sometimes even those dead set against the idea of interacting with the press (‘whoring’ themselves out) in any way may still be forced to give statements to the media if they’re involved in a high-profile case, or they’re – God forbid – ‘doorstepped’. We will be looking at the difference between ‘reactive’ and ‘proactive’ PR in an upcoming article. The reasons for engaging with the press should be clear. Below-the-line marketing (known this way historically because it is not a direct cost like buying an advert, which is considered ‘above the line’) such as public relations is done mainly to foster awareness and generate goodwill from the press, thereby gaining recognition and valuable mind ‘real estate’ among their audiences. Whether ultimately it’s because you want to drive patients to your private practice/clinic, or you want to warn or educate the public about certain trends or dangers, the result of engaging with them is that the media get to know you. The more you make yourself available, the more they’ll call upon you. It’s a well-known marketing adage that, if you don’t seek to secure a position yourself, your competitors and customers will do it for you. Start thinking of PR like going to the gym: paying your membership alone isn’t going to get you any benefits! You need to invest more than money; think creatively, engage and commit to the cause. You know that, if you do, you could be looking pretty hot just a few months from now …

www.cosmeticnewsuk.com 51

business Practice management

All systems go

Paul McGee, founder of web-based patient and practice management system, PracticePal, gives us an insight as to why he believes a completely web-based clinic management system is critical in today’s fast moving business sectors

echnology is moving forward at such a fast pace that it is something you will need to embrace, if you have not already done so, simply to keep up with your competitors. The business advantages of using a web-based PMS gives clinics a clear strategic advantage in what they are able to offer their clients and you definitely don’t want to be left behind. So what exactly are those advantages? Clearly one of the most obvious is a wealth of freedom and flexibility you probably didn’t expect as a business owner as you will have access to your business from any location on almost any device 24/7, not just in clinic. It also means you have effectively outsourced your entire IT infrastructure allowing you to get back to the business of running your clinic which, let’s face it, is exactly what you need to be doing. Be careful here though as there are a few differences in what’s on offer so make sure you read the small print. You want to make sure that your web-based PMS really is ‘webbased’, and not just a part of it. Sounds like a strange point to make but there are many companies offering what is essentially a dial-up service which is simply hosting

“The business advantages of using a web-based PMS gives clinics a clear strategic advantage in what they are able to offer their clients and you definitely don’t want to be left behind” 52 www.cosmeticnewsuk.com

a desktop product, and they charge you a princely sum for doing so. In simple terms that service just isn’t very useable. It also means you can’t actually access your data, in its entirety from ‘anywhere’. Ring any bells? So what other advantages do online PMS systems give you? Well apart from allowing you to sleep better without worrying if your data is protected, they give you complete peace of mind that you are abiding by all the rules. Sounds a little dramatic, but it’s a serious business, there are strict data protection laws detailing where and how your data should be stored and instead of keeping up-to-date with all of this yourself, you can let someone else do it for you. Most decent online PMS’s will automatically back up all of your data for you in more than one place daily and securely within purpose built data centres which are manned by very serious people in white coats. Make sure this all takes place within the EU! As well as web-based, you also need to choose a modern system with all the latest functions expected by clients, and ideally with as many of these functions as possible automated. Software should actually make you money. For example automatic SMS and Email appointment reminders are essential, portraying a professional image and reducing those all so annoying and expensive no-shows. A smart recall system will take care of your ongoing client retention figures, giving your clients a more gentle nudge at the right time for them, compared to a mass mail out which is far less effective. Automated versions of these essential functions will free up significant amounts of time and provide consistency. It would be impossible not to mention here one of the most obvious advantages of your business management

“Make sure you are not being tied-in for long term periods, if the software is any good you will continue to use it otherwise you should be free to leave with your data at no cost”

software being web-based, Ecommerce. More and more nowadays you have to have a strong web presence, and a pretty web site is just not enough anymore. Clients expect to be able to click a button and make or amend appointments when it suits them and just e-mail is not acceptable. Now there are many ‘off the shelf’ on-line-booking systems available, but none of them go any further than that. A fully web-based PMS system will not only capture a new client from your website but also insert them in to your business database. It will provide the on-line booking function, but then so much more, managing your finances, billing, marketing, medical notes, point of sale, ongoing retention and so on, all fully integrated. This means you don’t have to operate several software systems and doubleenter details each time. On another point, consider data security. Imagine losing your laptop or, as is becoming

James Butler of Painless Practice talks about the use of PracticePal in his business... As a renowned business coach for the health sector, James Butler of Painless Practice talks to hundreds of clinics across the country. We asked him what he believes distinguishes the successful ones.

Four factors to improve the customer experience and drive a successful clinic:

“There are a lot of small things that go into a successful clinic, that’s why we have been able to write whole books on the subject! However, we regularly see four key activities that make a difference: •

• • •

more of an issue these days, flood damage. With a web-based system you are back up and running immediately and nobody out there is crawling through your hard drive selling your client database. As a final point, consider price. The days of purchasing expensive software products with huge upfront investment are gone; somebody just needs to tell some of the software vendors out there! With a hosted solution there should not be any setup costs, a simple and transparent monthly fee should be the only commitment, and this should also include full support. Make sure you are not being tied-in for long term periods, if the software is any good you will continue to use it otherwise you should be free to leave with your data at no cost. And finally, don’t be fooled by the overuse of the phrase ‘Simplicity’. If the software system does not have all the bells and whistles it hasn’t been finished yet.

Make sure the phone is answered by a human, not a machine. Even if you are a sole practitioner, it is vital that new customers get to talk to someone - use a phone answering company rather than an answer machine. Make booking easy - whether by telephone or via your website, the customer needs to have easy access to your diary and to confirming their appointment. Make sure they remember their appointment. Simple SMS or email reminders reduce DNAs to a minimum, reducing gappy diaries and increasing revenue. Make contact after you have treated the customer - develop an ongoing, loyal relationship, by sending them newsletters, targeted recalls related to their treatment and other communication to engage them and to remind them you exist, increasing word of mouth referrals and return rates for existing customers.

These four factors will go a long way to improving the customer experience and driving a successful clinic. For these to work well, you need the right people and the right training but especially the right systems. Getting the computer to do the work means practitioners have more time for the hands-on work. To do this effectively, especially if you have multiple clinic rooms or want the flexibility of using mobile devices, a web-based patient management software has to be the fifth success factor.”

• Make sure the phone is answered by a human • Make booking easy • Make sure they remember their appointment • Make contact after you have treated the customer

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business A Day in the Life

Being Bob Antonia Mariconda finds out what a typical day has in store for Professor Bob Khanna

n May 2012 Dr Bob Khanna became Professor of Facial Aesthetics in the University of Seville. Internationally recognised as a leading expert in facial aesthetic procedures involving botulinum toxins and dermal fillers, Prof Khanna has lectured extensively at most senior international conferences since 1997 and is known in the industry as the ‘Trainer of Trainers’. He operates three busy clinics in the UK as well as his well-established teaching institute in Reading, Berkshire. Antonia Mariconda spent a day with the dynamic facial aesthetics supremo. “On a weekday I am normally up by 7am and I’m the first to admit that I don’t jump out of bed! I’m certainly not a morning person so weekends are all about lie-in’s for me. I live with my three musketeers: Parris, Kamran, and Aryan, and leading the Khanna household is my amazing wife, Sonia. Put it this way, mornings are busy! I normally start my day with two poached eggs and a slice of toasted organic rye bread and finish off with a protein shake with added oats. I normally drive, regardless of which of my clinics I am working in – Ascot, Reading or Harley Street. When I am driving I’m either listening to the BBC on the radio or Capital Radio. On a long drive my taste in music depends on my mood...it could be Andrea Bocelli or Pitbull, or anything in between. I’m often on the phone (hands free of course!) so getting through my ‘to do list’ starts early in the car! As soon as I arrive I’m handed a mug of my favourite jasmine green tea and the team huddle begins – a 15 minute debrief of the day, making sure everyone knows the plan for the day, the various appointments and who is responsible for which various tasks etc. For me communication is key to a successful business. I have instilled this in all of my team members and I have to say they are all superb communicators, which does help to limit human error and facilitates a smooth running clinic. We have patients attend from all over the world so patient care has to be optimum on all levels. My patient list starts at 9am. and I’ll normally have three to four surgeries running at any one time, aided by one of my associates Dr Kim Taylor. It is pretty full on but I do prefer to be busy and productive. I will usually have booked in a large oral surgical case involving dental implants and bone grafting or a number of non-surgical facial 54 www.cosmeticnewsuk.com

aesthetic cases to treat.I always break for lunch, as I need food! It also gives me a chance to catch up on e-mails and voicemails etc. I normally take one hour and often go out to my favourite deli to have some fresh food. Every month we run a week of training courses at the Dr Bob Khanna Training Institute, which will be a series of courses in toxins and facial dermal fillers. The courses are all hands-on based, aimed at the complete beginner or those at a more advanced level who wish to obtain masterclass level knowledge and the very latest advances and techniques. On these days we start at 9.30am and finish by 6pm. The afternoon will be very similar to the morning session, but I do prefer wherever possible to do all my intense and complex cases in the morning and my consultations and reviews in the afternoon.

“For me communication is key to a successful business. I have instilled this in all of my team members...they are all superb communicators, which does help to limit human error and facilitates a smooth running clinic” Since the age of 13, I decided to go into dentistry, as I liked the idea of using my manual dexterity in combination with medicine. As time went on and I became more proficient in all types of cosmetic and surgical dentistry, I developed interests in facial aesthetics in the late 1990’s. Since then I have developed a passion for combining my skills as a dental surgeon with providing the ultimate non-surgical solutions to ageing and rejuvenation. Lecturing on the international stage has become a huge part of my clinical life and currently occupies up to 20% of my time. Having done so much public speaking in my life there is no question that any alternative career would have to encompass this accolade. Hence acting would definitely appeal to me, which is why I suppose I am such a movie buff. I suppose being a father I’m very conscious that I have to be a strong and successful role model to my three ‘princes’. Hence ultimately I’m inspired

by my children to be the best that I can so that they can be proud and in turn be inspired to do the same – what greater gift can any parent ask for after all? There are some downsides to the industry that sometimes you wish didn’t exist; there is a degree of unnecessary professional rivalry between colleagues, but I do prefer to alienate myself from such negative activity. Without question I would much prefer it if colleagues could spend more time and energy concentrating on self-development! The upside to this industry is that I love being involved in large conferences around the world as a speaker. It always facilitates fresh opportunities and propagates the sharing of knowledge with likeminded colleagues. Since being made Professor of Facial Aesthetics, I am involved in a number of innovative projects and research programmes. I’m particularly excited with what the future holds for facial aesthetics particularly with advances in Stem cell technology and harnessing the huge potential of plasma rich in growth factors (PRGF). So currently I’m carrying out a large amount of research in these areas with promising results. I normally finish by 6.30pm and latest 7pm. As soon as I arrive home I like to spend time with my boys until their bedtime at 8.30pm. After this mayhem, Sonia and I workout together in our gym, and catch up on the events of the day. I workout at least four times a week with a good mix of cardio and resistance training. For me it’s essential to keep in good shape for optimum health and aesthetics. My other passion is as a singer/songwriter and I have together with a close friend Dr Mil produced an album and am now working on another. Recently, I have also been asked to compose and sing on a track where the proceeds will go to charity in remembrance of the earthquake, which took many lives in New Zealand in 2011. My day will end with unwinding in front of the TV and then to sleep.... bliss! My final thought of the day? Fear and negativity may knock at the door…but always answer with courage and positivity and you will see that no-one is there!

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“Aesthetic Medical Malpractice policies can be difficult to understand and it goes without saying that we must be satisfied that we have the right level of cover to meet our requirements. Jackie Ford, who handled the policy renewals, clearly knows her ‘stuff’, is professional and provides excellent customer service. We will continue to work with PSR for all our insurance needs.”

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training news Laser BTEC comes to London in November Mapperley Park’s gold standard five-day BTEC course has now arrived in London. Mapperley Park has been training for 10 years now, with more than 7,000 industry professionals having passed through their doors in that time. A trial course was delivered in June at London Medical on Marylebone High Street. This will also be the venue for the next course, which will take place on Monday November 19. The level 4 qualification is open to medical, beauty and associated professionals. To enquire, or to book your place on the next course, call Latoyah on 0115 969 0111.

Sigmacon’s Aesthetic Medicine Workshop returns to the North West

dates for the diary

D at e s f o r the Diary We roun d up upcomin g even ts, training courses and meetings

cosmetic news the uk’s largest trade aesthetics exhibition and conference

expo

exhibition and conference

1 6 th a n d 1 7 th f e b r u a r y Incorporating

Sigmacon will be hosting another of its aesthetic medicine workshops this month. Taking place on Tuesday November 13 from 10.30am to 5pm at the Radisson Blu Edwardian Manchester, the workshop provides an excellent opportunity to familiarise yourself with Sigmacon’s wide profolio including Lumenis® LightSheer and LightSheer Duet, Lumenis M22 Universal IPL/ND:Yag Module, AcuPulse Fractional CO2 laser skin resurfacing, Pelleve and Dermaceutic. Speakers will include Dr Elizabeth Raymond Brown, Dr Miguel Montero Garcia and Louis Frisina. For more information contact Clive Swan on 01923 266 339 or e-mail clive@cliveswan.com.

Online course in ‘Goldilocks’ anaesthesia Dr Barry L Friedberg MD, the author of Getting Over

Going Under, has created an online course in his revolutionary Goldilocks Anaesthesia Technique. The four-hour CE program is presented by Dr Friedberg, who explains his propofol and ketamine technique for moderate sedation in the out patient setting. The course is designed to introduce licensed healthcare providers to techniques to safely incorporate the use of hypnotic agents for procedural sedation for ambulatory surgery and office-based practices. Increase patient satisfaction and margin of safety by decreasing the amount of sedatives required and by virtually eliminating post-operative nausea and vomiting. Patients are at less risk when recovery time is significantly decreased from hours to minutes. Dr Friedberg is a board certified anaesthesiologist, and is recognised as a medical expert in anaesthesia by the California Medical Board in addition to the legal profession. His expertise has been lent to a number of peer-reviewed medical journals for review. Dr Friedberg is also a contributor to the letters to the editor section in several anaesthesia and surgery journals and is considered a pioneer in propofol/ketamine or PK anaesthesia techniques. Robert A. Shumway, MD, FACS San Diego said, “Barry Friedberg has masterfully developed the PK Anaestheisa concept and he has honed this technique to perfection. Take his course!” To find out more visit http://www.sedationconsulting.com/ component/content/article/75-uncategorised/161-dentist-p-kcourse-online

56 www.cosmeticnewsuk.com

November 3 Mapperley Park Core of Knowledge Short Course: What you Need to Know; Laser and light Essentials for the Aesthetic Industry. BODY Conference, Royal Society of Medicine, London, www.mapperleypark.co.uk 3 Innomed Training Botulinum Toxin in Facial Aesthetics: New Users (incl. all major brands), Manchester, www.innomedtraining.co.uk 3-4 BODY Conference, Royal Society of Medicine, London, www.mapperleypark.co.uk 4 Innomed Training Dermal Fillers in Facial Aesthetics: New Users to Hyaluronic Acid Fillers, Manchester, www.innomedtraining.co.uk 5 EndyMed Training, Yorkshire, 01937 541122 6 Advanced Skin-Laser Applications (including Core of Knowledge) (3 DAYS), Lynton Training Centre, Cheadle, www.lynton.co.uk 10 Cosmetic Courses Botulinum Toxin and Dermal Filler Seminar, www.cosmeticcourses.co.uk 10 Innomed Training Botulinum Toxin in Facial Aesthetics: New Users (incl. all major brands), Central London, www.innomedtraining.co.uk 11 Innomed Training Dermal Fillers in Facial Aesthetics: New Users to Hyaluronic Acid Fillers, Central London, www.innomedtraining.co.uk 11 Boston Training Academy Tear Trough Class, Bayswater, London, 0207 727 1110, www.bostontrainingacademy.com 12 Clinical Update Training Day, Lynton Training Centre, Cheadle, www.lynton.co.uk 12 EndyMed Training, London, 01937 541122 13 Core of Knowledge Laser / IPL Training, London, training@mapperleypark.co.uk 14 Obagi Workshop, London, www.healthxchange.com 16 Genuine Dermaroller Training, London, 01937 541122 19-23 BTEC Award Laser, Light and Associated Aesthetic Therapies, London, training@mapperleypark.co.uk 19 Genuine Dermaroller Training, Yorkshire, 01937 541122 19 Obagi Workshop, Manchester, www.healthxchange.com 21 CORE OF KNOWLEDGE - (1 DAY), Lynton Training Centre, Cheadle, www.lynton.co.uk 24 Aesthetox Foundation Botox and Dermal Fillers, Birmingham, 0870 080 17460; www.aesthetox.co.uk 24 Aesthetox Advanced Botox and Dermal Fillers, Birmingham, 0870 080 17460; www.aesthetox.co.uk 25 Aesthetox Chemical Peels, Birmingham, 0870 080 17460; www.aesthetox.co.uk

Mapperley Park BTEC Award Laser and Light Based Hair Removal and Photorejuvenation, (dates depend on demand), Nottingham, training@mapperleypark.co.uk

26 Innomed Training Physiology of Ageing and Skin Regeneration Day 1 (Day 2 on December 10), London West, www.innomedtraining.co.uk 28 NEW Fractional Laser Masterclass, Lynton Training Centre, Cheadle, www.lynton.co.uk

December

training@mapperleypark.co.uk 20 Boston Training Academy Mesotherapy: Face. Body and Hair, Bayswater, London, 0207 727 1110, www.bostontrainingacademy.com 21 Innomed Training Sculptra Beginners: Day 1 (Day 2 on February 25) Southampton, www.innomedtraining.co.uk 26 Innomed Training Botulinum Toxin in Facial Aesthetics: New Users (incl. all major brands), Edinburgh, www.innomedtraining.co.uk 27 Innomed Training Dermal Fillers in Facial Aesthetics: New Users to Hyaluronic Acid Fillers, Edinburgh, www.innomedtraining.co.uk

1 Aesthetic Awards in association with Cosmetic News, The Grand Conaught Rooms, Covent Garden, www.cosmeticnewsuk.com 5 Tatto Removal Masterclass (1 DAY), Lynton Training Centre, Cheadle, www.lynton.co.uk 8 Cosmetic Courses Foundation Botulinum Toxin and Dermal Filler Seminar, www.cosmeticcourses.co.uk 8 Aesthetox Foundation Botox and Dermal Fillers, Birmingham and London, 0870 080 17460; www.aesthetox.co.uk 8 Aesthetox Chemical Peels, Birmingham, 0870 080 17460; www.aesthetox.co.uk 9 Aesthetox Advanced Botox and Dermal Fillers, Birmingham, 0870 080 17460; www.aesthetox.co.uk 9-10 Boston Training Academy Foundation Botulinum Toxin and Dermal Filler Course, Bayswater, London, 0207 727 1110, www.bostontrainingacademy.com 10 Obagi Workshop, London, www.healthxchange.com 10 Innomed Training Physiology of Ageing and Skin Regeneration Day 2 (Day 1 on November 26), London West, www.innomedtraining.co.uk 15 Innomed Training Chemical Peeling Systems: Comprehensive Course for New Users, Central London, www.innomedtraining.co.uk 16 Innomed Training Mesotherapy for Fat, Cellulite and Skin Rejuvenation: New Users, Central London, www.innomedtraining.co.uk

9 Innomed Training Chemical Peeling Systems: Comprehensive Course for New Users, Central London, www.innomedtraining.co.uk 10 Innomed Training Mesotherapy for Fat, Cellulite and Skin Rejuvenation: New Users, Central London, www.innomedtraining.co.uk 9 Innomed Training Advanced Botulinum Toxin: Lower Face, Neck, Under-Arm Hyperhidrosis, Southampton, www.innomedtraining.co.uk 10 Innomed Training Advanced Dermal Fillers: Facial Contours, Lip Filler, SkinHydration, Southampton, www.innomedtraining.co.uk 16 Innomed Training Botulinum Toxin in Facial Aesthetics: New Users (incl. all major brands), London, www.innomedtraining.co.uk 16-17 Cosmetic News Expo and Aesthetic Conference 2013, The Business Design Centre, London, www.cosmeticnewsuk.com 17 Innomed Training Dermal Fillers in Facial Aesthetics: New Users to Hyaluronic Acid Fillers, Central London, www.innomedtraining.co.uk 25 Innomed Training Sculptra Beginners: Day 2 Southampton, www.innomedtraining.co.uk

January

March

8 Core of Knowledge Laser/IPL Training, Nottingham, training@mapperleypark.co.uk 13 Mapperley Park Core of Knowledge, Nottingham, www.mapperleypark.co.uk 14-18 BTEC Award Laser, Light and Associated Aesthetic Therapies, Nottingham,

9 Innomed Training Botulinum Toxin in Facial Aesthetics: New Users (incl. all major brands), Birmingham, www.innomedtraining.co.uk 10 Innomed Training Dermal Fillers in Facial Aesthetics: New Users to Hyaluronic Acid Fillers, Birmingham, www.innomedtraining.co.uk

February

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≤ 25°C

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.

1084/BOC/JUN/2012/JH

Date of preparation June 2012

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

onfidence is Reliable1,2 Rewarding3 Performance4,5 BOTOX® is licensed for the treatment of moderate to severe glabellar lines Delivers long-lasting patient satisfaction, time after time2,3 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. 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. 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 preganancy 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. The following other adverse events have been reported since the drug has been marketed: dysarthria; abdominal pain; vision blurred; pyrexia; focal facial paralysis; hypoaesthesia; malaise; myalgia; pruritus; hyperhidrosis; diarrhoea; anorexia; hypoacusis; tinnitus; radiculopathy; syncope; myasthenia gravis; erythema multiforme; dermatitis psoriasiform; vomiting and brachial plexopathy; rash; psoriasiform eruption; anaphylactic reaction (angiodema, bronchospasm); alopecia and madarosis. Adverse reactions possibly related to spread of toxin distant from injection site have been reported very rarely (exaggerated muscle weakness, dysphagia, or aspiration pneumonia which can be fatal). 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: November 2011.

Adverse events should be reported. Reporting forms and information can be found at www.yellowcard.gov.uk Adverse events should also be reported to Allergan Ltd. UK_Medinfo@allergan.com or 01628 494026. 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/1010/2011 Date of Preparation November 2011