APRIL 2025: The Injectables Issue

THE AESTHETICS AWARDS 2025 WINNERS REVEALED April 2025 | VOLUME 13 - ISSUE 5

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References are available upon request. Adverse event reporting information can be found on the reverse.

CPD: Exploring Peptide Therapeutics Dr Ethan Hausman-Marquis presents benefits and clinical applications of peptide therapy

Special Feature: Augmenting the Male Jawline with Injectables Treating Aesthetic Side Effects Caused by Weight Loss Injections

UKI-SCU-2500032 DOP March 2025

ALSO IN THIS ISSUE

Dr Karla Murta explores injectable options to rejuvenate the neck and chest Julie Scott delves into burnout and offers strategies for overcoming it

C E L E B R AT I N G

ANNIVERSARY

PRESCRIBING INFORMATION - UK BOCOUTURE® (botulinum toxin type A (150 kD), free from complexing proteins) 50/100 unit vials. Prescribing information: Please refer to the Summary of Product Characteristics (SmPC) before prescribing. Presentation: 50/100 units of Clostridium Botulinum Neurotoxin type A, free from complexing proteins as a powder for solution for injection. Indications: Temporary improvement in the appearance of moderate to severe upper facial lines (glabellar frown lines, crow’s feet lines, horizontal forehead lines) in adults ≥18 and <65 years when the severity of these lines has an important psychological impact for the patient. Dosage and administration: For intramuscular use only. Unit doses recommended for BOCOUTURE are not interchangeable with those for other preparations of botulinum toxin. BOCOUTURE should only be administered by an appropriately qualified healthcare practitioner with expertise in the treatment of the relevant indication and the use of the required equipment, in accordance with national guidelines. The intervals between treatments should not be shorter than 3 months. Reconstitute with 0.9% sodium chloride. Glabellar Frown Lines: Total recommended standard dose is 20 units. 4 units into 5 injection sites (2 injections in each corrugator muscle and 1 injection in the procerus muscle). May be increased to up to 30 units. Injections near the levator palpebrae superioris and into the cranial portion of the orbicularis oculi should be avoided. Crow’s Feet lines: Total recommended standard dosing is 12 units per side (overall total dose: 24 units); 4 units injected bilaterally into each of the 3 injection sites. Injections too close to the Zygomaticus major muscle should be avoided to prevent lip ptosis. Horizontal Forehead Lines: The recommended total dose range is 10 to 20 units; a total injection volume of 10 units to 20 units is injected into the frontalis muscle in five horizontally aligned injection sites at least 2 cm above the orbital rim. An injection volume of 2 units, 3 units or 4 units is applied per injection point, respectively. Contraindications: Hypersensitivity to the active substance or to any of the excipients. Generalised disorders of muscle activity (e.g. myasthenia gravis, Lambert-Eaton syndrome). Infection or inflammation at the proposed injection site. Special warnings and precautions: It should be taken into consideration that horizontal forehead lines may not only be dynamic, but may also result from the loss of dermal elasticity (e.g. associated with ageing or photo damage). In this case, patients may not respond to botulinum toxin products. Should not be injected into a blood vessel. Not recommended for patients with a history of dysphagia and aspiration. Caution in patients with botulinum toxin hypersensitivity, amyotrophic lateral sclerosis, peripheral neuromuscular dysfunction, or in targeted muscles

displaying pronounced weakness or atrophy. BOCOUTURE should be used with caution in patients receiving therapy that could have an anticoagulant effect, or if bleeding disorders of any type occur. 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. Should not be used during breastfeeding. 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, undesirable effects are observed within the first week after treatment and are temporary in nature. Undesirable effects independent of indication include; application related undesirable effects (localised pain, inflammation, swelling), class related undesirable effects (localised muscle weakness, blepharoptosis), and toxin spread (very rare - exaggerated muscle weakness, dysphagia, aspiration pneumonia). Hypersensitivity reactions have been reported with botulinum toxin products. Glabellar Frown Lines: Common: headache, muscle disorders (elevation of eyebrow).

Crow’s Feet Lines: Common: eyelid oedema, dry eye, injection site haematoma. Upper Facial Lines: Very common: headache. Common: hypoaesthesia, injection site haematoma, application site pain, application site erythema, discomfort (heavy feeling of frontal area), eyelid ptosis, dry eye, facial asymmetry, nausea. For a full list of adverse reactions, please consult the SmPC. Overdose: May result in pronounced neuromuscular paralysis distant from the injection site.

Symptoms are not immediately apparent post-injection. Legal Category: POM. List Price: 50 U/vial £90.00, 50 U twin pack £180.00, 100 U/vial £180.00, 100 U twin pack £360.00.

Product Licence Number: PL 29978/0002, PL 29978/0005 Marketing Authorisation Holder: Merz Pharmaceuticals GmbH, Eckenheimer Landstraße 100,60318 Frankfurt/Main, Germany.

Date of Preparation: April 2024. M-BOC-UK-0540. Further information available from: Merz Aesthetics UK Ltd., Ground Floor Suite B, Breakspear Park, Breakspear Way, Hemel Hempstead, Hertfordshire, HP2 4TZ Tel: +44 (0) 333 200 4143 Adverse events should be reported. Reporting forms and information can be found at https://yellowcard.mhra.gov.uk/. Adverse events should also be reported to Merz Aesthetics UK Ltd at the address above or by email to UKdrugsafety@merz.com or on +44 (0) 333 200 4143.

1.BOCOUTURE Summary of Product Characteristics. Merz Pharmaceuticals GmbH: https://www.medicines.org.uk/emc/product/600/smpc (Last accessed December 2024).

REASONS TO CHOOSE BOCOUTURE • Results seen as early as 7 days, lasting up to 4 months in upper facial lines1 • A well characterised safety profile1 • Convenient – no refrigeration needed prior to reconstitution1

Access injection technique videos now

Merz Aesthetics Exchange (MAX) is a promotional website developed and funded by Merz Aesthetics UK & Ireland.

PRESCRIBING INFORMATION - IRELAND BOCOUTURE® (botulinum toxin type A (150 kD), free from complexing proteins) 50/100 unit vials.

Prescribing information: Please refer to the Summary of Product Characteristics (SmPC) before prescribing. Additional information is available on request. Presentation: 50/100 units of Clostridium Botulinum Neurotoxin type A, free from complexing proteins as a powder for solution for injection.

Indications: Temporary improvement in the appearance of moderate to severe upper facial lines (glabellar frown lines, crow’s feet lines, horizontal forehead lines) in adults ≥18 and <65 years when the severity of these lines has an important psychological impact for the patient. Dosage and administration: For inatramuscular use only. Unit doses recommended for BOCOUTURE are not interchangeable with those for other preparations of botulinum toxin. BOCOUTURE may only be administered by physicians with suitable qualifications and the requisite experience in the application of Botulinum toxin type A. The intervals between treatments should not be shorter than 3 months.

Reconstitute with 0.9% sodium chloride. Glabellar Frown Lines: Total recommended standard dose is 20 units. 4 units into 5 injection sites (2 injections in each corrugator muscle and 1 injection in the procerus muscle). May be increased to up to 30 units. Injections near the levator palpebrae superioris and into the cranial portion of the orbicularis oculi should be avoided. Crow’s Feet lines: Total recommended standard dosing is 12 units per side (overall total dose: 24 units); 4 units injected bilaterally into each of the 3 injection sites. Injections too close to the zygomaticus major muscle should be avoided to prevent lip ptosis. Horizontal Forehead Lines: The recommended total dose range is 10 to 20 units; a total injection volume of 10 units to 20 units is injected into the frontalis muscle in five horizontally aligned injection sites at least 2 cm above the orbital rim. An injection volume of 2 units, 3 units or 4 units is applied per injection point, respectively. Contraindications: Hypersensitivity to the active substance or any of the excipients. Generalised disorders of muscle activity (e.g. myasthenia gravis, Lambert-Eaton syndrome). Infection or inflammation at the proposed injection site. Special warnings and precautions: It should be taken into consideration that horizontal forehead lines may not only be dynamic, but may also result from the loss of dermal elasticity (e.g. associated with ageing or photo damage). In this case, patients may not respond to botulinum toxin products. Should not be injected into a blood vessel. Not recommended for patients with a history of dysphagia and aspiration. Caution in patients with botulinum toxin hypersensitivity, amyotrophic lateral sclerosis, peripheral neuromuscular dysfunction, or in targeted muscles displaying pronounced weakness or atrophy. BOCOUTURE should be used with caution in patients receiving anticoagulant therapy or therapy that could have an anticoagulant effect, or if bleeding

M-BOC-UKI-0514 Date of Preparation December 2024

disorders of any type exist. Too frequent or too high dosing of botulinum toxin type A may increase the risk of antibodies forming. Should not be used during pregnancy. Should not be used during breastfeeding. 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, undesirable effects are observed within the first week after treatment and are temporary in nature. Undesirable effects independent of indication include; application related undesirable effects (localised pain, inflammation, paraesthesia, hypoaesthesia, tenderness, swelling, oedema, erythema, itching, localised infection, haematoma, bleeding and/ or bruising), class related undesirable effects (localised muscle weakness, blepharoptosis), and toxin spread (very rare – excessive muscle weakness, dysphagia, aspiration pneumonia). Serious and/or immediate hypersensitivity reactions have been reported with botulinum toxin products (anaphylaxis, serum sickness, urticaria, soft tissue oedema, dyspnoea, swelling, erythema, pruritis, rash). If serious and/or immediate, appropriate medical therapy should be commenced. Glabellar Frown Lines: Common: headache, Mephisto sign. Crow’s Feet Lines: Common: eyelid oedema, dry eye, injection site haematoma. Upper Facial Lines: Very common: headache. Common: hypoaesthesia, injection site haematoma, injection site pain, injection site erythema, discomfort (heavy feeling of frontal area), eyelid ptosis, dry eye, brow ptosis, facial asymmetry, Mephisto sign, nausea. For a full list of adverse reactions, please consult the SmPC. Overdose: May result in pronounced neuromuscular paralysis distant from the injection site. Legal Category: POM. List Price: Ireland 50 U/vial €103.50, 50 U twin pack €207.00, 100 U/vial €207.00, 100 U twin pack €414.00 Market Authorisation Number: PA 1907/003/001, PA 1907/003/002 Marketing Authorisation Holder: Merz Pharmaceuticals GmbH, Eckenheimer Landstraße 100, 60318 Frankfurt/Main, Germany. Date of Preparation: April 2024. M-BOC-IE-0042. Further information available from: Merz Aesthetics UK Ltd., Ground Floor Suite B, Breakspear Park, Breakspear Way, Hemel Hempstead, Hertfordshire, HP2 4TZ Tel: +44 (0) 333 200 4143 Adverse events should be reported. Reporting forms and information can be found at https://www.hpra.ie/homepage/about-us/report-an-issue. Adverse events should also be reported to Merz Aesthetics UK Ltd at the address above or by email to UKdrugsafety@merz.com or on +44 (0) 333 200 4143.

Contents • April 2025 08 News The latest product and specialty news

17 News Special: Weight Loss Injections and Eating Disorders Aesthetics reports on the impact of weight loss jabs on eating disorders

CLINICAL PRACTICE 19 Special Feature: Augmenting the Male Jawline Three practitioners discuss enhancing the male jawline using injectables

23 Instant Lift, Lasting Boost: Restylane Lyft with Sculptra

News Special: Weight Loss Injections and Eating Disorders Page 17

The evolving approach to facial aesthetics: skin-enhancing treatments

26 Empowering the Aesthetics Community Explore the standout moments from ACE 2025

30 CPD: Exploring Peptide Therapeutics Dr Ethan Hausman-Marquis presents a review of peptide therapy

34 Evolving Aesthetics with Nuceiva® Precision, Purity and Performance

36 Treating Side Effects Caused by Weight Loss Injections Surgeons examine how to address the effects of weight loss injections

38 Stimulating Collagen in the Neck and Décolleté Dr Karla Murta introduces injectables to rejuvenate the neck and chest

Special Feature: Augmenting the Male Jawline Page 19

40 The Aesthetics Awards Winners 2025 Revealed: The 2025 Awards Winners

Clinical Contributors

55 C E Ferulic by SkinCeuticals Dr Jonquille Chantrey discusses the powerful antioxidant serum

56 Case Study: Lip Dissolution and Re-Treatment Dr Bonny Armstrong advises on dissolving overfilled lips

59 The Rejuvenation Revolution Lorna Bowes discusses combining AR with injectables and topicals

60 Restoring Harmony with Perioral Rejuvenation Dr Yousrah Ahmed explores perioral rejuvenation using filler

65 Case Study: Injectables for Collagen Restoration Dr Maryam McMillan analyses a combined approach to facial rejuvenation

68 Aesthetic Care with Innovation and Expertise Aesthetica Solutions empowers businesses to drive growth

69 Abstracts The latest research highlights from Professor Sebastian Cotofana

IN PRACTICE 70 Navigating Burnout in the Aesthetics Specialty Julie Scott delves into burnout and offers strategies for overcoming it

72 Integrating Regenerative Medicine into Aesthetic Practice Dr Dara Suite and Katie Parobek discuss a holistic wellness approach

74 Women in Business: Empowering Success Exploring the power of mentorship, authenticity and leadership

77 In the Life of: Dr Jordan Faulkner Dr Jordan Faulkner shares how imposter syndrome has fuelled his growth

78 The Last Word: Are Dermal Fillers Here to Stay?

Dr Aggie Zatonska addresses concerns over filler longevity reports

NEXT MONTH: Body and Skin Tightening • Treating Cellulite • Polynucleotides for Stretch Marks • Cryotherapy

Dr Ethan Hausman-Marquis is a consultant paediatric oncological surgeon specialising in longevity and regenerative medicine at The Catalyst Clinic. In the medical specialty, he is a member of The American Society of Regenerative Medicine and The International Peptide Society Miss Aoife Naughton is a consultant ophthalmic & oculoplastic surgeon who holds a substantive NHS Consultant post, and is based in London and Portsmouth. She specialises in cosmetic and reconstructive oculoplastic surgery Dr Sean Noronha is a consultant endocrinologist, who has a portfolio career of both NHS and private practice. He qualified from the University of Oxford with first class honours in pre-clinical medicine and a distinction in clinical medicine.

Miss Jennifer Doyle is a consultant oculoplastic surgeon and founder of The Clinic at Holland Park. She also works within the NHS as oculoplastics consultant at Milton Keynes University Hospital NHS Trust. She is a key opinion leader for Sciton, Sofwave, Skinstorm and Ameela.

Dr Karla Orsine Murta Dias is an aesthetic practitioner and clinical trainer at Harley Academy. She is the medical director at Dr Karla Clinic in Marylebone, London. She also works as an ophthalmologist at Moorfields Eye Hospital NHS Foundation Trust.

Dr Bonny Armstrong is an aesthetic doctor, medical director and owner of the award-winning Dr Bonny Clinic in Belfast.

A regional expert and faculty member for Teoxane, the owner of the Dr Bonny Academy and co-founder of the NEXTGENERATION mentorship programme.

Dr Yousrah Ahmed is a dentist, aesthetic physician and trainer working with Interface Aesthetics academy. She is also a KOL for Relife Menarini UK a level 7 qualified practitioner and assessor, and an external examiner in Facial Aesthetics at the University of Salford, UK. Dr Maryam McMillan, founder and clinical director of Ambra Aesthetic Clinic, combines aesthetic dentistry with a passion for facial aesthetics to deliver natural results. She holds degrees in pharmacology and dentistry from the University of Sheffield and is a Royal College of Surgeons member.

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Editor’s letter April is here, and after an incredible few days of celebrating the very best in medical aesthetics at the Aesthetics Conference & Exhibition (ACE) and The Aesthetics Awards, I’ve had time to reflect on just how far this specialty has come. ACE was a fantastic success – Shannon Kilgariff thank you to everyone who attended, spoke Editor & Event and contributed to making it such a valuable Manager experience. It was also amazing to recognise @shannonkilgariff the outstanding talent and innovation in our field at The Aesthetics Awards. Partnering with the BDD Foundation this year was a particularly meaningful highlight. Congratulations to all of those who were recognised on the evening – turn to our Winners’ Spread on p.40 to see who took home the top prizes!

This month, we’re putting the spotlight on injectables, which continue to define most aesthetic practices. For many practitioners entering the field, injectables such as dermal fillers, toxins and biostimulators are the first treatments they master – so it’s only right that we give them the attention they deserve. In our Special Feature, we explore

the art of augmenting the male jawline using different types of filler, providing insights into the techniques that can create a defined, balanced look. We also take a closer look at why HA filler remains a cornerstone of most treatment plans in this month’s Last Word.

The energy and insights from ACE are still fresh, and we’ve got a full post-event write-up to capture the highlights, key learnings and standout moments. And while ACE is behind us, the countdown is now on for the Clinical Cosmetic Regenerative (CCR) Congress, which returns on September 25-26. Make sure to save the date – this year’s event promises to be even bigger and better than ever!

Also in this issue, we’re shining a light on the inspiring women in our field. Our Women in Business panel at ACE featured some of the most talented and influential figures in aesthetics. If you missed it, our write-up on p.26 captures the key takeaways and advice from this empowering session.

As always, I’d love to hear your thoughts on the journal or what’s happening in aesthetics right now. Get in touch if you have feedback or suggestions. Happy reading!

Clinical Advisory Board

Leading figures from the medical aesthetic community have joined the Aesthetics Advisory Board to help steer the direction of our educational, clinical and business content

Sharon Bennett is the former chair of the British Association of Medical Aesthetic Nurses (BAMAN), UK lead of the BSI committee for aesthetic non-surgical standards and member of the Clinical Advisory Group for the JCCP. She is a trainer and a registered university mentor in cosmetic medical practice, and is finishing her MSc at Northumbria University. Bennett has won the Aesthetics Award for Nurse Practitioner of the Year and the Award for Outstanding Achievement.

If you are interested in contributing to the journal, get in touch...

Email: editorial@aestheticsjournal.com

Sharon Bennett, Clinical Lead Mr Naveen Cavale has been a consultant plastic, reconstructive and aesthetic surgeon since 2009. He has his own private clinic and hospital, REAL, in London’s Battersea. Mr Cavale is the national secretary for the ISAPS, president of the Royal Society of Medicine, and vice-chair for the British Foundation for International Reconstructive Surgery.

Dr Mayoni Gooneratne (MBBS, BSc, MRCS, MBCAM, AFMCP) was an NHS surgeon before establishing The Clinic by Dr Mayoni and founding Human Health – an initiative combining lifestyle with traditional and functional medicine to provide a ‘cell-up’ regenerative approach to aesthetics. She is also the co-founder of The British College of Functional Medicine.

Dr Sophie Shotter is the founder & medical director of Illuminate Skin Clinic in Kent and Harley Street, London. Her passion is for natural treatments delivered with utmost attention to safety. She works closely with Allergan as part of their UK and International Faculty.

Miss Elizabeth Hawkes is a consultant ophthalmologist and oculoplastic surgeon. She is the lead oculoplastic surgeon at the Cadogan Clinic, specialising in blepharoplasty and advanced facial aesthetics. Miss Hawkes is a full member of the BOPSS and the ESOPRS, and is an examiner and fellow of the Royal College of Ophthalmologists.

Jackie Partridge is an independent nurse prescriber. She is the clinical director and owner of Dermal Clinic in Edinburgh and a KOL for Galderma. She holds an MSc in Non-surgical Aesthetic Practice and a BSc in Dermatology.

Partridge is a stakeholder group member with Scottish Government/HIS, Honorary BACN member and JCCP Fitness to Practice Nurse.

Dr Anjali Mahto is one of the UK’s leading consultant dermatologists. She is a Fellow of the Royal College of Physicians, member of the Royal Society of Medicine and a spokesperson for The British Skin Foundation. In 2023 Dr Mahto opened Self London, a dermatology and lifestyle clinic aimed at managing skin conditions holistically.

Mr Adrian Richards is a plastic and cosmetic surgeon with over 30 years’ experience.

He is the clinical director of the aesthetic training provider Cosmetic Courses and surgeon at The Private Clinic. He is also a member of the British Association of Plastic and Reconstructive and Aesthetic Surgeons and the British Association of Aesthetic Plastic Surgeons.

Dr Souphi Samizadeh is a dental surgeon with a Master’s degree in Aesthetic Medicine and a PGCert in Clinical Education.

She is the founder of the Great British Academy of Medicine and Revivify London Clinic. Dr Samizadeh is a Visiting Teaching Fellow at University College London and King’s College London.

Dr Stefanie Williams is a dermatologist with a special interest in adult acne, rosacea and aesthetic medicine. She is the founder and medical director of multi-award winning EUDELO Dermatology & Skin Wellbeing in London, and creator of Delo Rx skincare. She is the author of three books and has published more than 100 scientific articles, book chapters and abstracts.

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© Copyright 2025 Aesthetics. All rights reserved. Aesthetics is published by Aesthetics Media Ltd, which is registered as a limited company in England; No 9887184

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.

Insider News

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Legislative Action

BAMAN endorses Bill to safeguard the title ‘nurse’

Talk #Aesthetics Follow us on Instagram @aestheticsjournaluk

This proposed legislation would ensure that only individuals registered with the Nursing and Midwifery Council (NMC) are permitted to use the title in health and social care settings, with the primary goal of enhancing patient safety and upholding the integrity of the nursing profession.

#TheAestheticsAwards2025 Mr James Olding @dr_jamesolding I’m feeling truly honoured my peers chose me as Medical Aesthetic Practitioner 2025 at the prestigious Aesthetics Awards – and Dr Jordan Faulkner is the Rising Star!

#Anniversary DermaFocus @dermafocusuki Five years of DermaFocus!

Thank you to everyone who celebrated with us and to all those behind the name of DermaFocus who drive our success. We had a wonderful night.

#Training Dr Alessandra Haddad @clinicaalessandrahaddad I participated in an anatomy immersion of 40 doctors from across Latin America – such dedicated professionals!

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The British Association of Medical Aesthetic Nurses (BAMAN) has reached out to the Aesthetics Journal to express its endorsement.

“Only an Act of Parliament can put an end to the shocking state of affairs in Britain today, that allows anyone in a uniform to pretend they are a nurse. BAMAN wholeheartedly endorses the legislation initiative lead by the honourable Dawn Butler. Her effort is a crucial step towards highlighting the importance of the word ‘nurse’, not only because legislation must protect legitimate nurses, but also because BAMAN recognises that only this Bill will invigorate the integrity of nursing status and trust.”

The Nurse (Use of Title) Bill had its second reading in the House of Commons on March 28. Aesthetics will report as and when Parliament updates are announced.

Regulation

Scottish Parliament hosts unveiling of aesthetic safety initiative

#ACE2025 Dr Catherine Fairris @drfairris_skinwessex I had a wonderful time at ACE 2025, delivering a talk, participating in two panel discussions and networking with numerous seasoned professionals. Thank you for having me!

#Networking Dr Shino Bay Aguilera @shinobay Honoured to spend the afternoon at the Women in Dermatology Society.

What a powerful and inspiring event!

Labour MP for Brent East Dawn Buter has introduced the Nurse (Use of Title) Bill in Parliament, aiming to protect the title ‘nurse’.

The Scottish Parliament hosted a key discussion on March 5, addressing the need for stronger regulation in the beauty and aesthetics specialty.

The event marked the launch of the Scottish arm of the British Association of Beauty Therapy and Cosmetology’s (BABTAC) T.I.M.E. (Training, Insurance, Monitoring and Evidence) initiative, which aims to help consumers identify safe and qualified practitioners.

Attended by Members of the Scottish Parliament (MSPs), specialty professionals and training providers, the event highlighted concerns around inconsistent standards and consumer safety. Discussions focused on the importance of practitioner accountability and clearer regulatory oversight. Lesley Blair, CEO of BABTAC, commented, “The lack of legislation in our specialty has left consumers vulnerable to unsafe practices, leading to a rise in ‘botched’ beauty treatments in recent years. T.I.M.E. is a simple but powerful tool that helps consumers make informed choices and supports qualified professionals.”

Aesthetics | April 2025

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Aesthetics

Charity

Vital Statistics

The Aesthetics Awards raises £8,000 for BDD sufferers

Out of 2,189 UK participants, 43% of women and 18% of men follow a daily skincare routine

Aesthetics Charity Partner The BDD Foundation was welcomed to The Aesthetics Awards 2025, raising £8,000 in total for the cause.

Funds were raised on the night through £6,000 of generous donations, as well as £2,000 kindly provided by skincare company CellDerma. CellDerma also sponsored the Charity Best Dressed Competition, which saw Ida Bafende and Andrew Bennett crowned most glamorous on the night. Turn to p.53 to see their winning outfits.

Dr Rob Willson, BDD Foundation chair, reflected, “We were delighted for the BDD Foundation to be part of the recent Aesthetics Awards. It meant so much to share the work of our small charity and raise awareness of BDD amongst the aesthetics community. Increasing understanding of BDD is a core aspect of our charity mission, and the event provided a fantastic platform to connect with the specialty and further patient safeguarding. We are so grateful for the generosity shown by everyone at the event, which will directly support those affected by BDD.”

(Teoxane, 2024)

The UK has seen a 94% rise in corrective surgeries for botched procedures abroad over the past three years, with each case costing the NHS around £15,000 (Longevita, 2025)

53% of Brits feel their GP lacks time for thorough consultations, while 18% avoid visits due to poor reception staff experiences

Head to www.bddfoundation.org to give further donations today.

Women’s Health

Young women’s struggle with perimenopause proved

(Medisonal, 2025)

New research published in NPJ Women’s Health has found that more than half of women aged 30-35 experience perimenopause symptoms.

The self-reported data from 4,432 US women aged 30 and over found that 55.4% of those in the 30-35 age range reported what could be classified as moderate to severe symptoms.

These include psychological symptoms like depression, anxiety and irritability, and others such as sexual dysfunction, vaginal dryness, hot flushes, heart palpitations and urinary incontinence. Despite these findings, only 4.3% of these women had sought help for these symptoms.

46% of professionals are worried about their company’s ability to retain staff in 2025 (Robert Walters’s Salary Survey, 2025)

Research

Out of 500 individuals who suffer with acne, 1 in 3 say they dream of the person they’d become if they had clear skin

Research explores dating app and cosmetic surgery link A cross-sectional study has examined links between dating app use, self-presentation styles and cosmetic surgery acceptance in women.

A total of 308 women, aged between 18-72, participated in the study.

Approximately 48% had used a dating app in the past two years.

T-tests revealed that dating app users had significantly more cosmetic procedures and positive attitudes towards surgery. Chi-square tests showed dating app users sought more dermal fillers, eyelid surgery, rhinoplasty and buttock augmentation than non-users.

The results from the study indicated that women who used dating apps reported having significantly more positive attitudes towards cosmetic surgery, compared to women who were not dating app users. The study also suggested the pressure to alter one’s appearance may arise from dating apps, which require a number of clear selfies for profiles.

(AviClear, 2024)

Of 15,000 participants surveyed, 72% agreed with the statement, ‘I am confident in who I am’ (Merz Aesthetics, 2025)

Aesthetics | April 2025

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Insider News

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Events diary 20th May 2025 BAS Sclerotherapy Conference 5th-7th June 2025 The BMLA Annual Conference 18th-19th September 2025 The BAMAN Autumn Conference 25th-26th September 2025 CCR 2025 11th October 2025 BCAM Conference

IN T H E M E D I A What’s trending in the consumer press

Chloe Ferry shares regrets over insecurity-driven surgery TV personality Chloe Ferry spoke on We Need To Talk podcast about how her insecurities led her down the path of plastic surgery, describing it as a ‘dark hole’. She explained, “You always want more – but what is perfection? It doesn’t exist. I was trying so hard to make people like me and stop the nasty comments, but I lost myself along the way.”

Ferry explained that she believed undergoing surgery would prevent internet trolls from targeting her on social media. She decided to get breast implants after one troll called her breasts ‘saggy’. However, it only intensified the scrutiny of her appearance, describing the experience as “soul destroying.”

Ferry concluded, “I’ve wasted my twenties chasing some girl I wasn’t born to be.”

Surgeon raises concern over Katie Price’s post-surgery lifestyle The Mirror reveals that model Katie Price was spotted at a nightclub after undergoing multiple aesthetic procedures, including otoplasty, a thread lift and a nose job. The model was allegedly spotted with her nose still bandaged. Plastic surgeon Mr Gerard Lambe expressed concern over Price’s post-operative behaviour.

“Price runs the risk of exhausting her body’s potential to recover and experiencing wound breakdown and infection, but most worrying is the risk of a bleed,” he said. Price confessed to fans she was in pain after her club appearance, revealing that her eyes were “stinging” and “stuck together.”

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Leadership

BAMAN welcomes election of new chair and vice-chair The British Association of Medical Aesthetic Nurses (BAMAN) has introduced nurse prescribers Amy Bird and Alexandra Mills as its new chair and vice-chair respectively.

BAMAN states that as chair, Bird will provide strategic leadership, chair board meetings and oversee long-term strategic goals for the association. The association added that as vice-chair, Mills will support governance and strategy implementation, acting as a liaison between the board, sub-committees and members.

Bird commented, “I am honoured to take on the role of chair at BAMAN, and excited to lead our association into 2025 and beyond. My priority is to ensure that BAMAN continues to be the leading voice for medical aesthetic nurses, championing patient safety and professionalism at the heart of everything we do. I want to acknowledge the incredible leadership of Sharon Bennett, whose dedication and vision have helped establish BAMAN as the trusted organisation it is today.”

Education

Allergan Aesthetics announces opening of AMI training centres Pharmaceutical company Allergan Aesthetics, an AbbVie company, has announced the launch of training centres worldwide.

The company shared that the launch of the centres will result in participants engaging in hands-on training, roundtable forums, live webcast events and more. Allergan Aesthetics plans to open the doors at its headquarters in Irvine, California, to offer training for healthcare professionals.

An additional two forthcoming US will house the Allergan Medical Institute (AMI), with a launch at its Orange County headquarters later this year, followed by locations in Atlanta and Austin. Allergan Aesthetics also plans to expand more than 10 centres worldwide, with further details coming soon.

Glen Curran, senior vice president US at Allergan Aesthetics, commented, “The new AMI Training Centres are designed to help expand and elevate our existing best-in-class training programmes. The facilities will offer a range of courses for providers at every stage of learning, helping them to safely and effectively deliver excellent outcomes and increase patient satisfaction.”

Conference Report

Human Health Professionals explores integrative healthcare The inaugural Human Health Professionals (HHP) event was held on March 6 at London’s Spaces & Stories.

Founded by aesthetic practitioner Dr Mayoni Gooneratne, HHP aimed to foster a community of clinicians focused on merging wellness, longevity and comprehensive patient care.

The event’s agenda featured a holistic approach to treating skin conditions like acne and rosacea, emphasising a ‘cell-up’ method. Dr Gooneratne highlighted the importance of addressing the root causes of conditions, urging practitioners to go beyond surface-level treatments. The session ‘Test Don’t Guess’ focused on the value of advanced diagnostic tools, particularly in relation to the skin microbiome and internal health. Interactive restorative body sessions, including breathwork and yoga led by fitness trainer Kate Selwood, offered participants insights into the mind-body connection.

Gooneratne shared, “The inaugural event marked a pivotal shift in aesthetics towards integrative healthcare. Treating symptoms at the surface is no longer enough, we must look deeper, addressing the root causes of skin and health concerns at a cellular level.

Today, we have laid the foundation for educating the clinicians who will be working in a future where wellness, longevity and science intersect, driving a new era of transformative, integrative healthcare.”

Aesthetics | April 2025

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Speaking Opportunity

Speaker applications open to take to the CCR 2025 stage The next Aesthetics event – CCR 2025 – will be taking place on September 25-26 at ExCeL, London with two days of jam-packed education, networking and innovations.

Featuring the newest injectable, device, medical longevity, regenerative aesthetics and business content, CCR is the perfect place to further your skills and techniques to expand your business, supported by headline sponsor Galderma.

If you’ve been working hard over the last 12 months researching a concept, technique or innovation, now is the ideal time to share your knowledge and expertise with the rest of the medical aesthetics specialty. CCR is now accepting speaker abstracts, giving you the chance to speak at its numerous stage on either emerging clinical research or advanced business knowledge.

Shannon Kilgariff, editor and event manager at Aesthetics, said, “We are delighted to open our Call for Papers once again! This is the perfect opportunity for aesthetics professionals to submit their ideas, research, techniques and knowledge to share with the specialty. Whether you are an expert in injectables, skin, medical longevity, regenerative treatments or business growth, we want to hear from you!”

Scan the QR code to submit your abstract by April 25, and a member of the Aesthetics team will be in touch if it is a suitable fit for CCR 2025.

BAMAN UPDATES A round-up of the latest news and events from the British Association of Medical Aesthetic Nurses

REGIONAL MEETINGS: CONNECT, LEARN AND GROW As we move into April, BAMAN is firmly in the midst of its regional meetings. These get-togethers offer insightful talks, exhibitor and speaker engagement opportunities, basic life support (BLS) training sessions and dedicated networking time.

Sponsored by leading companies Church Pharmacy, Circa Skin, Croma Pharma, DermaFocus, Dermapenworld, Evolus, FillMed, Neauvia, Teoxane, Wigmore Medical and more, these events offer BAMAN members valuable opportunities to stay informed and connect with specialism experts.

Join one or more of the upcoming CPD-accredited sessions: •

Northern Ireland – Belfast: April 12 2025

•

South Wales – Cardiff: May 2 2025

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South West – Bristol: May 12 2025

•

London: June 2 2025

•

Central – Solihull: June 4 2025

•

Central South – Windsor: June 12 2025

•

North East – Newcastle: October 6 2025

DIGITAL EVENTS: LEARNING ANYTIME, ANYWHERE!

Faculty

BCAM appoints three new trustees to the board The British College of Aesthetic Medicine (BCAM) has announced the appointment of three new aesthetic practitioners as trustees to its board.

Dr Haidar Hassan expressed his commitment to advancing clinical and evidence-based research in aesthetic and regenerative medicine, with a focus on fostering academic collaborations and improving regulatory standards. Dr Ahmed El Houssieny emphasised his dedication to raising safety standards and ethical decision-making in the specialty, with patient care at the heart of his approach.

Finally, Dr Deepa Panchalingam highlighted her enthusiasm for helping shape the future of the profession and raising the bar for patient care and excellence in medical aesthetics.

BCAM president and aesthetic practitioner Dr Catherine Fairris shared, “I am very pleased to welcome our three new trustees who I believe will add significantly to the current board. They bring with them a wealth of experience and skill sets that we believe will help propel BCAM forward and will support it in its endeavours to continue to be a leading voice in aesthetics, representing doctors and dentists. These appointments aim to strengthen BCAM’s leadership and further its mission to advance safe and ethical aesthetic practices.”

Aesthetics | April 2025

BAMAN continues to offer a robust digital learning programme in collaboration with its 2025 strategic partners. With CPD-accredited Zoom webinars, Instagram lives and interactive engagement opportunities, these digital takeovers ensure that members stay on top of their practice.

Having already run events with Circa Skin, Evolus and Wigmore Medical, the rest of the year is shaping up nicely, welcoming along: •

April: Teoxane

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May: Neauvia

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June: Evolus

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July: Dermapenworld

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August: Church Pharmacy

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September: FillMed

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October: Evolus

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November: DermaFocus

•

December: Croma Pharma

This column is written and supported by BAMAN

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Skincare

Epicutis launches in the UK Skincare range Epicutis invited the Aesthetics Journal to trial its line of products following its UK launch.

Event Spotlight: Save the Date for CCR 2025

Based in the US, the brand has officially launched in the UK, and is on sale through aesthetic distributor Healthxchange. The skincare line features a range of products, including the Oil Cleanser, Lipid Serum and Arctigenin Brightening Treatment. Maxwell Stock, CEO and founder of Epicutis, told Aesthetics that his vision behind Epicutis was simplicity, offering a basic skincare routine with products featuring as few as eight ingredients.

Stock commented, “Epicutis is pioneering skincare with Arctigenin Brightening Treatment, a biotech breakthrough replacing unstable Vitamin C with Arctigenin – an advanced compound extracted from burdock seed. Clinically proven to transform skin in as little as 14 days, it delivers unmatched radiance, targeting pigmentation with precision. This is the future of scientifically driven, high-performance skincare.”

Shape the future of medical aesthetics Following a successful 2025 edition of the Aesthetics Conference & Exhibition, it’s time to mark your calendar for the next aesthetics event. The UK’s biggest medical aesthetics conference CCR returns to ExCeL London on September 25-26, 2025, bringing together the best and brightest in the aesthetics specialty for two unmissable days of learning, networking and discovery.

Whether you’re a seasoned aesthetics professional or just starting out in the field, CCR is your chance to experience cutting-edge education, live demonstrations and the latest innovations from top brands. With five dynamic conference stages, the chance to earn up to 16 CPD points, hands-on workshops and expert-led talks, CCR is designed to keep you at the forefront of this ever-evolving specialty.

What’s in store for 2025?

· Live treatment demonstrations from world-class injectors

· New insights into longevity and wellness trends at the Medical Longevity Summit

· The latest in devices, skincare and technology on the exhibition floor

· Practical business strategies to help you grow your clinic · Unparalleled networking opportunities with thousands of specialty professionals Register your interest

CCR isn’t just an event – it’s an experience. Past attendees have called it “inspiring,” “insightful,” and “a must-attend for anyone in aesthetics.” If you’re serious about staying ahead in aesthetics, save the date now and stay tuned for more details.

Register your interest by scanning the QR code!

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Royal Society of Medicine

Royal Society of Medicine to host aesthetics event The Royal Society of Medicine (RSM) is set to host a multidisciplinary conference titled Facial Aesthetics: A Holistic Approach.

Organised by consultant orthodontist Mr Farhad Naini and hosted by the Section of Odontology, the event will take place on September 18, and will examine current approaches to facial aesthetic analysis and treatment.

The programme will cover a range of topics within the field, focusing on the relationship between scientific evidence and clinical practice.

Discussions will address ethical considerations and professional responsibilities in medical aesthetics, particularly in relation to patient safety and the influence of commercial factors. A key area of focus will be the evaluation of facial soft tissue, both at rest and in motion, to support a more comprehensive approach to patient assessment and treatment.

Learning

Harley Academy partners with Prollenium to launch training facility Medical aesthetic training provider Harley Academy has collaborated with medical technology company Prollenium, distributed in the UK by Alma, to launch a training academy in Canada.

The companies have launched the Prollenium Advanced Clinical Education Academy (PACE), a training facility with the aim of advancing education in medical aesthetics. Officially opened on February 27 in Ontario, Canada, the academy aims to raise specialty standards, establish a regulated training framework and equip professionals with the skills to deliver safe aesthetic results, according to Harley Academy.

Founder of Prollenium Ario Khoshbin commented, “The partnership between Prollenium and Harley Academy represents an exciting opportunity to collaborate in advancing our shared commitment to delivering safe and effective facial aesthetic outcomes. Through a robust educational framework grounded in evidence-based anatomical knowledge and refined practical techniques, this collaboration aims to set new standards in aesthetic education and patient care.”

Aesthetics | April 2025

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Insurance

Insider News

Skincare

APIL warns of Scottish underinsurance for ‘low-risk’ treatments

Obagi Medical expands ELASTIderm range Skincare company Obagi Medical, distributed in the UK by Healthxchange, has expanded its ELASTIderm range with two new launches.

The Association of Personal Injury Lawyers (APIL) has issued a warning to beauty therapists and healthcare practitioners in Scotland around underinsurance of treatments.

APIL said practitioners must ensure they have adequate insurance to protect patients in the event of complications during non-surgical cosmetic treatments such as liquid Brazilian butt lifts (BBL) and botulinum toxin injections.

As the Scottish Government considers introducing a licensing scheme for practitioners, APIL has raised concerns about the lack of mandatory insurance for practitioners. This leaves patients vulnerable if things go wrong during treatments.

Gordon Dalyell, APIL’s Scotland representative, said, “Injuries can be serious and even life-changing when treatments go wrong.

But astonishingly, there is no requirement for practitioners to be suitably insured so that injured victims can be compensated. We’ve told the Scottish Government that public liability insurance, as well as treatment risk insurance, should be mandatory for practitioners.

When procedures are performed by healthcare practitioners, their insurance should cover medical negligence.”

APIL has also expressed concerns over the Scottish Government’s risk classification of treatments, warning that some procedures which can cause severe and permanent injuries are being placed in the lowest risk category.

The first product, ELASTIderm Lift Up and Sculpt Facial Moisturiser, aims to restore the appearance of fullness, re-plump wrinkles and smooth crepiness to enhance both skin texture and resilience. The moisturiser is formulated with Bi-Mineral Contour Complex, a blend of zinc, copper and malonate, to develop healthy elastin.

The second is the ELASTIderm Advanced Filler Concentrate, formulated with biomimetic peptide Acetyl Hexapeptide-1, which aims to fill and smooth the appearance of fine lines and wrinkles, according to the company.

Device

BTL Aesthetics launches EXOMIND device

Partnership

DermaFocus and InMode announce collaboration

Aesthetic device company BTL Aesthetics has unveiled its new non-invasive brain stimulation device EXOMIND. This FDA-cleared treatment is designed to stimulate key areas of the brain involved in emotional regulation, cognitive function and self-control, according to the company. They shared that by activating neural pathways, it helps restore healthy brain activity and enhances neural connectivity, improving mental and emotional wellbeing.

Aesthetic distributor DermaFocus and aesthetic device company InMode have announced a partnership to distribute the exosome range Purasomes.

The companies shared that this collaboration is a significant step forward in expanding the distribution of Purasomes, an exosome and growth-factor based range for skin and hair regeneration.

Through this partnership, InMode will integrate Purasomes into its portfolio of innovative energy-based aesthetic solutions, which include the Morpheus8 and Fractora radiofrequency microneedling devices.

Milad Bemana, executive director of DermaFocus, commented, “We are thrilled to partner with InMode, a company that shares our commitment to innovation and excellence in medical aesthetics. By combining our expertise in regenerative treatments with InMode’s extensive distribution network and cutting-edge technology, we are poised to bring the transformative benefits of Purasomes to a wider audience.”

Filip Donner, director of BTL Aesthetics, commented, “EXOMIND technology demonstrates our commitment to wellness by delivering natural, innovative solutions that empower individuals to reach their full potential. This patient-friendly therapy aligns with our vision of promoting holistic health. Unlike conventional treatments, it provides a natural approach to mental wellness, fostering brain resilience without the side effects often associated with pharmaceuticals.”

Discover the Journal Archive Catch up on news, case studies, features and CPD articles www.aestheticsjournal.com/archives

Aesthetics | April 2025

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Skin Health

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Device

ZO Skin Health debuts Retinol + Blemish Complex Skincare company ZO Skin Health has announced the launch of its Retinol + Blemish Complex product.

The company explains that the product uses 0.25% microemulsion retinol and encapsulated salicylic acid to enhance cell turnover, exfoliate the skin, improve the appearance of skin texture and target blemishes and breakouts.

Dr Zein Obagi, dermatologist and the brand’s founder, commented, “We need to improve the skin in totality – that’s what skin health is.

Dermatology is a remarkable specialty that treats the skin, eliminating conditions that affect both appearance and overall health. Restoring the skin to its original, healthy and radiant state is grounded in this comprehensive definition.”

Dermapenworld releases Dp DOCK device station Aesthetic device company Dermapenworld has unveiled the new Dp DOCK docking station for the Dermapen device.

The company shares that the dock includes clear battery level indicators and integrated charging connections. The Sync & Go system also links the device to a range of Dermapen treatments to make procedure preparation easier, according to Dermapenworld.

Kelly Tobin, UK country director, shared, “Dermapenworld UK is delighted to announce the launch of the Dp DOCK in April 2025. The docking station is the perfect accessory for your Dermapen 4 device.

Designed with professionals like you in mind, our new docking station offers a SYNC & GO concept that lets you deliver world-class microneedling procedures.”

Device Launch

InMode Allure platform launches in the UK

Education Initiative

Evolus announces educational grants for BAMAN nurses

Aesthetic device company InMode announced the UK launch of its Allure platform on March 18 at the Hotel Café Royal and Akasha Spa.

Pharmaceutical company Evolus has provided the British Association of Medical Aesthetic Nurses (BAMAN) with educational grants to support professional autonomy and patient care.

BAMAN shares the grant programme aims to strengthen nurse professionalisation in medical aesthetics, as Evolus is providing an unrestricted educational grant to support nurses who are planning to undertake further education in 2025.

Rachel Goddard, chair of the Education and Training Committee at BAMAN commented, “These grants from Evolus will help BAMAN nurses make informed, patient-centred decisions without the need for remote prescribing. Encouraging more nurses to gain their independent nurse prescriber qualification is a strategic pillar for BAMAN in 2025. This is about building a sustainable and progressive future for nursing in the aesthetic medicine sector.”

This month’s newest clinic openings A round-up of the latest aesthetic clinics opening across the UK Caress Flow – a new treatment for vaginal pathologies that is now available in the UK – has opened a new clinic in Holborn, London. This non-invasive therapy addresses a range of vaginal symptoms, combining oxygen and hyaluronic acid to rejuvenate vaginal tissue, according to the company. Ellie Stevenson, business development manager of Caress Flow, commented, “The official UK clinic launch of Caress

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InMode shares that the Allure suite of devices has been designed to offer treatments that aim to rejuvenate, optimise cellular health and enhance skin appearance. The platform introduces two technologies – InMode Lift and Transform X. InMode Lift integrates the Forma device, which aims to boost collagen production for effective skin tightening, with MiniFX, a treatment for targeted fat reduction. The platform also includes a sculpting massage designed to refine and enhance facial contours. Meanwhile, Transform X aims to tighten the skin, reduce fat and tone muscles with radiofrequency (RF) and electrical muscle stimulation (EMS).

Aesthetic practitioner Dr Nina Bal said, “I’m excited to introduce InMode Allure at my new clinic, as it complements my offerings by providing advanced non-invasive treatments that elevate aesthetic results for my patients. As an advocate for skin health optimisation, InMode Allure supports my approach by stimulating collagen production and enhancing long-term skin health, ensuring my patients not only look great but feel confident in their skin.”

Flow was an incredible success, bringing together specialty leaders and clinic owners to witness a true step forward in women’s health. The enthusiasm and engagement we saw reaffirmed the need for innovative, non-invasive solutions like Caress Flow.”

Aesthetic treatment chain EverySkin is set to expand following investment from family-owned firm Middleton Enterprises.

The funding will support the opening of new clinics in London, with plans for further UK growth. EverySkin aims to provide laser hair removal, facials and

injectable treatments for all skin types.

Alice Sagnier, co-founder, commented, “We had always intended to scale the business to meet demand. Middleton Enterprises has given us the security we need to do that. Their experience in financing the expansion of consumer rollout businesses like Sushidog and OneGym appealed to us. As did the opportunity of working with the CEO and Founder, Jeremy Middleton, who has first-hand experience of scaling successful businesses.”

If you’re opening a new UK clinic soon, let us know at editorial@aestheticsjournal.com

Aesthetics | April 2025

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Educational Event

Revanesse hosts inaugural Redefine Conference Injectable company Prollenium, distributed in the UK by Alma, held the first Revanesse Redefine Conference on March 3 at The Ham Yard Hotel in London.

Revanesse shares that the event featured insights on advanced injectable techniques for Revanesse customers, including from keynote speaker Dr Frank Rosengaus, facial plastic surgeon from Mexico.

Alma UK & Ireland’s injectables business unit lead Katie Vaughan opened the event and introduced the panellists to the stage. Aesthetic practitioner Dr Marcus Mehta discussed his methods for attracting new patients into clinic; Dr Johanna Ward discussed her tactics for retaining customers and building a brand identity; and Dr Rosengaus discussed his ‘BEAUTI’ method.

After lunch, anatomist Professor Sebastian Cotofana dialled in to discuss ‘filler fatigue’ and complex anatomical areas with Dr Rosengaus. The afternoon consisted of three live injection masterclasses, with Dr Rosengaus taking an advanced approach to achieving facial harmony and his signature ‘happy face’ treatment. Aesthetic nurse prescriber Sharon Bennett then concluded with a live injection of the tear trough using Revanesse Revise.

Attendee Dr Alison Colville commented, “It has been an incredible day! We’ve been educated on everything from the business side of aesthetics to some really advanced techniques – things I’ve never seen before happening in aesthetics with the use of filler.

It is a really exciting time to be here with Revanesse!”

On The Scene

W-Wellness hosts dinner to unveil 2025 longevity trends The Aesthetics Journal attended the W-Wellness event at Claridge’s where 2025 wellness trends were shared during an expert panel.

The evening began with a champagne reception, bringing together delegates and press for networking before Francesca Ogiermann-White, founder of The Beauty Triangle, introduced the panel.

The panel discussion featured Yasmin Shirazi, Dr Elena Antonovia, Liberty Mills and Dr Nichola Conlon, who delved into the evolving concept of wellness and its intersection with longevity, gut health, fertility and aesthetics.

Dr Conlon emphasised the importance of education in wellness, stating, “Longevity is not just a buzzword; it’s the future. Understanding ageing as the biggest risk factor for disease is crucial. Medical practitioners must guide patients through this shift, providing education to help them on their journey.”

Product Launch

Skeyndor relaunches Aquatherm Skincare brand Skeyndor invited the Aesthetics Journal to the reintroduction of its Aquatherm range at St Pancras Hotel.

The event hosted members of the press for an intimate breakfast, where Skeyndor introduced its reformulated Aquatherm collection. According to the company, the updated range aims to enhance the bioavailability of active ingredients derived from thermal spring water, and is designed to support sensitive skin by soothing and restoring balance.

Lauren D’Ambriose, educator and beauty brand specialist, outlined key products from Skeyndor’s reformulated collection. She noted that the Thermal Cleansing Gel is designed to cleanse without disrupting the skin’s moisture balance, while the SOS Anti-Redness Serum targets irritation and strengthens capillaries. D’Ambriose also discussed the Hydrating Soothing Cream, which aims to provide long-lasting hydration and protect against environmental stressors.

Aesthetics | April 2025

News in Brief Wigmore Presents conference to return this month Wigmore Presents 2025 is set to take place on April 25-27 at the Royal College of Physicians, with 60 speakers taking to the stage. The Friday will focus on injectables, skincare, equipment, devices and rejuvenation. Saturday will offer learning on injectables, skincare (ZO Skin Health in particular), rejuvenation and menopause.

Meanwhile, Sunday will offer a masterclass on cell structure in relation to medical longevity. Dr Lauren Jamieson, co-chair of Wigmore Presents, said, “The agenda offers learning for all aesthetic clinicians, from newly trained solo practitioners to multi-clinic organisations. The nature of the event allows for unprecedented opportunity to converse directly with the speakers, as well as a spirit of healthy debate and discussion.”

Acquisition Aesthetics announces return of cadaver course Acquisition Aesthetics has announced the return of its two-day Cadaveric Dissection course. The course, scheduled for September 19-20, 2025 at the Royal College of Surgeons in Edinburgh, will blend theory and hands-on practice, including anatomy theory sessions and live demonstrations using ultrasound technology. It will be led

by Acquisition Aesthetics founders Dr Lara Watson and Dr Priya Chadha, alongside Mr Jeff Downie and Mr Mark Devlin.

DermaFocus celebrates five years of regenerative aesthetics Aesthetic distributor DermaFocus has marked its five-year anniversary with a gala event. The evening featured a sit-down dinner, live entertainment and a keynote speech from DermaFocus executive director Milad Bemana. Nurse prescriber Khatra Paterson commented, “It was an honour to join DermaFocus for a fabulous evening of five-star hospitality and entertainment! We celebrated the community, safety, education and innovation that are the core values of DermaFocus.”

Croma unveils PolyPhil rebrand Pharmaceutical company Croma Pharma has unveiled the rebranding of its injectable polynucleotide range, PhilArt, to PolyPhil.

The company shares the new name is designed to support their expansion into international markets. Vikki Baker, head of marketing UK&I, said, “With the on-going demand for our polynucleotide portfolio, this name change will better encompass what the product does and will broaden reach in all markets, aiding to global brand awareness.

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News Special Weight Loss Injections

The impact on eating disorders Kimberley Cairns, psycho-aesthetic consultant and board member of the Joint Council for Cosmetic Practitioners (JCCP), shared her concerns with the Aesthetics Journal. “My main worry is that weight loss injections may worsen psychological vulnerabilities in those with eating disorders. The JCCP stresses the importance of understanding aesthetic treatments’ mental health risks, including body dysmorphic disorder (BDD),” she said.

The Impact of Weight Loss Injections on Eating Disorders

Cairns continued, “While these injections offer a quick fix, they can reinforce an unhealthy attitude towards body image, fostering dependency and dissatisfaction. Practitioners must navigate nuanced behaviours, making it vital to distinguish between eating disorders and disordered eating for better patient safety.”

Aesthetics reports on NHS warnings regarding the link between eating disorders and weight loss medication National Health Service (NHS) medical director Professor Sir Stephen Powis has called for stricter regulation of the sale and prescription of weight loss injections. This follows warnings from charities about a growing number of people with eating disorders accessing the drugs.1 The rise of weight loss injections has been significant, with data showing 500,000 people in the UK are currently using GLP-1 medication.2 New data published by The Times revealed that weight loss medication, such as semaglutide and tirzepatide, have been linked to 82 deaths in Britain.3 A breakdown of the statistics revealed that 22 deaths were linked to the drug’s use for weight loss, while the remaining 60 were associated with its treatment for type 2 diabetes.3 The fatalities associated with weight loss injections have raised concerns among various eating disorder charities and the NHS.1 Professor Powis urged online pharmacies and private providers to “act responsibly,” and ensure that these drugs are prescribed only to people with a medical need for them.1 Powis shared, “With eating disorder cases on the rise, it is concerning that some people may be taking these drugs off-label for weight loss. We continue to urge online pharmacies and private providers to ensure that safeguards, such as in-person weight checks, are in place to protect patients from harm.”

The UK eating disorder charity Beat also expressed concern, noting an “incredibly worrying” rise in the number of calls made to its helpline regarding the injections.1 Tom Quinn, Beat’s director of external affairs, commented, “We’re also concerned about what might happen when people finish their prescriptions and potentially gain weight. This could cause feelings of shame and guilt within individuals, which could contribute to the development of an eating disorder.”

In February, the National Pharmacy Association (NPA) urged regulators to implement stricter rules, after raising concerns about individuals with a history of eating disorders or low body weight being incorrectly prescribed the drugs.4 Meanwhile, the Advertising Standards Authority (ASA) is now investigating 10 “priority” cases regarding weight loss injection advertisements, citing concerns that rules may be violated in their public promotion. Additional enquiries are expected to follow shortly.5 The National Institute for Health and Care and Excellence (NICE) published guidance on semaglutide treatment in England in March,6 commenting, “We hope to see measures put in place to make sure semaglutide medication is available for patients who have a genuine clinical need, with appropriate support and monitoring available to them.”

Aesthetic practitioner Dr Mayoni Gooneratne also expressed her worries from a practitioner’s perspective. She discussed the physical impact weight loss drugs can have, explaining, “Common side effects of these drugs include nausea and diarrhoea, while more severe risks include gastroparesis, pancreatitis and thyroid issues. For individuals with compromised health due to eating disorders, these side effects can be particularly dangerous.”

Cairns further highlighted, “These injections may lead to adverse health effects, including nutrient deficiencies and metabolic imbalances, but they can also trigger or worsen disordered eating behaviours, anxiety and depression.”7 Cairns raised the repercussions of weight loss injections amongst media visibility commenting, “Social media and celebrity endorsements further exacerbate these issues by creating unrealistic expectations and pressures to conform to certain body ideals. This can be particularly harmful to individuals with eating disorders or disordered eating behaviours, as they may feel compelled to use these injections to achieve an idealised body image.”

Exploring options for patient safety The Nursing and Midwifery Council (NMC) and the JCCP strictly prohibit remote prescribing for cosmetic procedures. Both organisations emphasise that prescribers must uphold their responsibilities regarding prescription-only medicines (POMs).8 They state that remote prescribing is unacceptable and that a prescriber may only delegate a procedure after assessing the delegate’s competence, emphasising the need for face-to-face consultations to ensure patient safety.8 Cairns proposed mandated training for aesthetic practitioners on the psychology behind aesthetic treatments, alongside stricter screening protocols for accessibility, such as in-person assessments. She encouraged further support, suggesting, “Healthcare professionals can enhance screening and support by adopting a holistic care approach, pursuing ongoing training in psychological safety, establishing support networks with mental health professionals and using psychological assessment tools.” Cairns suggests utilising the Psychological Pre-Screening Tool through PLAST IQ,9 which can be integrated as part of a consultation and provide support to the practitioner and patient.

Protecting vulnerable patients The interviewees emphasised the need for healthcare providers to be well-informed about the risks of prescribing weight loss medications to individuals with eating disorders, advocating for informed decision-making and prioritising patient safety.

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Aesthetics | April 2025

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Special Feature Male Jawline

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Augmenting the Male Jawline with Injectables Three practitioners discuss their methods for augmenting the male jawline using injectable products A well-defined jawline has long been associated with attractiveness, serving as a distinguishing feature between masculine and feminine characteristics. Dimorphic features which define the male face include a broad forehead, prominent brow, broad squared chin and a prominent jawline. Recent trends indicate a growing interest among men in enhancing their jawlines using injectable treatments, aiming for a more chiselled and youthful appearance.1 It has been evidenced that men seek a higher rate of jawline augmentation compared to women, making it a popular concern presented in aesthetic clinics.2 While there are several treatment options available for augmenting the male jawline, injectable treatments are popular in clinic and have shown positive results.

Aesthetics spoke to three practitioners to find out their tips for successfully augmenting the male jawline using dermal fillers, as well as any considerations for optimal results.

Common concerns in male patients When seeking jawline augmentation, male patients often present with specific concerns.

Aesthetic practitioner Dr Aneesha Ahmad notes, “Often men complain about a lack of definition - they feel their jawline is not as structured or sharp enough. Sometimes they feel they have a weak chin where it’s rounded or not projected enough; these concerns are more common with younger men. I’ve noticed that many of them keep a beard to try and disguise a softer jawline. Older men tend to present with heavy jowling, softening of the jawline with age or a double chin.”

Although all practitioners interviewed agree these are the most common reasons for men to present to clinic, aesthetic practitioner Dr Zoya Awan notes that this isn’t always the case, so practitioners should consider everyone on an individual basis. “We can’t use a paint by numbers or one size fits all approach as not everyone falls into definable categories, and not all jawline treatments should be to masculinise. It’s important to explore with the patient what their concern is and what they actually want to achieve from treatment,” she says.

Understanding male facial anatomy The structural differences between male and female facial anatomy are pivotal when considering aesthetic enhancements, as all practitioners interviewed noted. Men generally have a broader skeletal structure, with a wider bigonial distance (the distance between the angles of the mandible).3 The ratio of bizygomatic (cheekbone width) to bigonial distance is approximately 1:1 in men, contributing to a more squared facial appearance.3 Additionally, men typically exhibit a more acute gonial angle (between 90-120 degrees) and a bulkier masseter muscle compared to women.3 Aesthetic practitioner Dr Jordan Faulkner says that consideration of sexual dimorphism is absolutely vital when treating patients. “In my experience, if you say ‘jaw enhancement’, Aesthetics | April 2025

many clinicians immediately become hyperfocused on the angle of the jaw. For me, we need to consider the mandible as a whole, from the condylar process right down to the mental protuberance,” he said.

He also shared that he considers the jaw and chin as a single entity.

He continued, “At the angle of the jaw, I aim to achieve a near-90 degree angle to achieve masculinity, whereas I would open this angle up and aim my cannula more towards the ear lobe when aiming for femininity. At the chin, a more masculine look would be achieved if the width of the chin corresponds to that of the mouth, whereas a more feminine chin would correspond to the nasal alar.”

Conducting an effective consultation All practitioners interviewed stress the importance of a thorough consultation to determine an appropriate treatment plan.

“Personally, I use the Galderma Facial Assessment score,”4 says Dr Awan. “This is where you can go and grade the jawline and the problem in parameters such as contours, definition and width. It also allows them to look at the rest of their face to get a broader perspective. That way they can grade how bad the problem is, and by joining all the dots together we can create a treatment plan based on what is best for them.”

Dr Faulkner adds that practitioners should always rule out any medical or psychiatric contraindications by taking a thorough history. “You should also be sure to get a clear picture of any previous surgical or non-surgical cosmetic interventions,” he says.

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Special Feature Male Jawline

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“Anatomically, you need to be mindful of the facial artery, which lies deep at the anterior border of the masseter muscle. This is why I use a cannula, as there is less chance of bumping into it” Dr Aneesha Ahmad Injectable options for jawline augmentation Several treatment modalities are available for augmenting the male jawline, ranging from non-invasive to surgical interventions.

According to the practitioners interviewed, injectable options are often the most effective for optimal results.

Dermal fillers Collagen stimulating fillers such as calcium hydroxylapatite (CaHA) or hyaluronic acid (HA) fillers are commonly used to enhance jawline definition. A study published in Facial Plastic Surgery by Moradi et al. introduced anatomical zones for safer jawline augmentation using CaHA and high G-prime HA fillers. It emphasised precise injection techniques to enhance the mandibular angle and jawline contour while minimising complications.5 Another study by Bertossi et al. assessed 30 patients treated with high G-prime HA filler, with an average of 4ml injected. Results showed 96.7% of patients rated their appearance as ‘much improved’ or ‘very much improved’ on the Global Aesthetic Improvement Scale.6

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deoxycholic acid (DOC) injections for reducing submental fat (SMF). The analysis included six prospective clinical studies with a total of 3,488 patients. The findings indicated that DOC effectively reduced SMF and increased patient satisfaction compared to placebo groups.9

Practitioner insights on injectable techniques Dr Ahmad shares that her preferred approach is to use CaHA, and her injectable of choice is Radiesse. She explains, “I like this product because it’s got a high G-prime, which in my opinion gives increased sharpness and definition compared with normal HA. It also mimics bone-like firmness, which is particularly good in this area. It stimulates collagen production, which helps tighten the tissues over time. I feel Radiesse sculpts the jaw rather than just adding volume, and since it’s less hydrophilic, it gives a less bulky appearance than traditional HA filler.”

When administering injectables, she explains that she tends to use a cannula. “I typically use a 50mm cannula depending on the tissues I’m dealing with. My entry point tends to be at the pre-jowl sulcus, and I will inject back towards the gonial angle and then reposition my cannula to inject anteriorly towards the chin. I will usually inject subcutaneously along the mandible to increase the width. I sometimes do micro-boluses at the gonial angle, periosteally using a needle. I will also inject along the ramus and in the preauricular region to give further definition and lift,” Dr Ahmad explains.

Safety is a key consideration, as Dr Ahmad warns, “Anatomically, you need to be mindful of the facial artery, which lies deep at the anterior border of the masseter muscle before becoming more superficial as it ascends. This is why I prefer to use a cannula, as there is less chance of injecting into it. You also need to be wary of the mental artery at the chin region, and the parotid gland at the ramus and preauricular area.”

Dr Awan says that she chooses to create a full treatment plan for her patients, using a cake analogy. “There are a lot of layers which all need different ingredients. The icing layer is the skin – although this doesn’t directly impact jawline definition or broadness, it helps with antiageing. We also know that jowling and loose skin in the lower half can really impact how the jawline looks, so having anything that slows the ageing process down can help younger patients.”

Before

After

Poly-L-lactic acid (PLLA) fillers can also be used to augment the jawline. Studies on the jawline specifically are currently limited, but in one review of more than 2,500 patients, PLLA was found to be suitable for a wide variety of facial contour defects.7 Neuromodulators In cases where masseter muscle hypertrophy contributes to a wider jawline, botulinum toxin injections can be administered to reduce muscle size, thereby slimming the face and enhancing jawline definition. This approach is particularly beneficial for patients experiencing teeth grinding or asymmetry due to muscle overactivity. One study showed that BoNT-A is effective and safe in the treatment of muscle hypotrophy and temporomandibular disorder, offering benefits in terms of pain reduction, improvement in muscle and joint function and aesthetic advantages, with effects lasting several months.8 Fat dissolving treatments For patients with submental fullness or a double chin, injectable agents can be used to dissolve excess fat, enhancing jawline visibility. A systematic review published in the Journal of Plastic, Reconstructive & Aesthetic Surgery assessed the efficacy of 20

Figure 1: Male patient before and after jawline augmentation treatment.

Images courtesy of Dr Zoya Awan..

She says that her go-to for men is often Sculptra, a brand of injectable dermal filler that uses PLLA, because it gives a subtle lifting effect and some natural volumisation. Dr Awan explains, “PLLA is for stimulating collagen, adding natural volume and gentle skin tightening and lifting. It allows practitioners to not become reliant on too much filler which can then create a puffy look. It also addresses a key underlying component of ageing and with respect to the jawline and lower face specifically, as worsening skin laxity can contribute to a heavier lower face, jowls and ill-defined jawline.” If she wants to add extra definition, Dr Awan says she will then use HA filler, adding, “I also use Restylane Lyft as my go-to HA filler for defining the jawline.

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"In my opinion, despite the rapidly changing landscape in medical aesthetics, we still don’t have a more effective and safe option than HA filler" Dr Jordan Faulkner

When working on the jaw, it’s important not to introduce too much water into the area; instead, you want a filler with a more clay-like consistency that can mimic bone structure as closely as possible.

I prefer to use the needle that comes with the product, as it provides a more realistic-looking jawline.”

She says for patients looking to widen their face however, she would recommend Restylane Defyne instead, applied with a cannula and fanning technique at the gonial angle. “Unlike Lyft, we don’t go down to the bone with Defyne because it’s softer, giving a more natural, skin-like appearance. It’s also less thick than Lyft, allowing it to integrate more seamlessly with the skin,” she says.

Dr Faulkner says that despite the wide range of injectable options now available, he prefers to stick to using HA filler. He says, “The aim of defining or squaring the jaw is achieved by adding volume.

In my opinion, despite the rapidly changing landscape in medical aesthetics, we still don’t have a more effective and safe option. I do employ neurotoxin to slim the jaw in patients with hypertrophic masseters, but using this for cosmetic purposes in males is uncommon in my practice.”

Before

After

Special Feature Insider NewsJawline Male

He adds that product wise, he generally uses Revanesse Shape.

“It is a high G-prime filler with excellent lifting capacity, great for treating young men who typically have bulkier masseters and thicker skin. The Revanesse portfolio is unique in that it has spherical particles giving low surface area to volume ratio, and also low swell factor. This reduces inflammatory potential and acute swelling, respectively,” he says. Dr Faulkner adds that when treating the angle of the jaw he will typically leave a bolus of filler on the periosteum using the provided needle, then switch to a 23G 50mm SoftFil precision cannula and inject linear threads. “This is to enhance the inferior and posterior borders of the mandible angle. At the chin I use cannula to inject in the subcutaneous layer, whenever I am treating away from the midline,” he says.

Considerations for jawline augmentation Before undergoing jawline augmentation, patients and practitioners should consider several factors to ensure optimal results. Dr Awan says overcorrection is a common issue when treating the jawline, stating, “Remember, with filler a little can go a long way. Make sure all proportions are natural by looking for patients’ individual anatomy and their natural ethnic features, making sure it’s proportionate to the upper part of their face.”

Dr Faulkner adds that his primary concern when using HA filler is minimising the risk of vascular occlusion. “The facial artery is the main vessel to consider – while its course becomes highly variable distally, it remains remarkably consistent at the mandibular border, hugging the bone at the anterior masseter. Here, more superficial injections are preferable.” He adds that he uses a Clarius ultrasound scanner for vascular mapping before injecting filler for added safety, as well as aspirating before injection.9 “I know there’s an ongoing debate about aspiration, but for me, it’s a non-negotiable, simple step to reduce risk,” he says.

If structural deficiencies are too severe, non-surgical options may not be sufficient. If this is the case, surgical referral may be necessary, Dr Awan explains, “If patients have a weak chin or dental misalignment, I will sometimes suggest surgical implants or a referral for orthodontics or a maxillofacial specialist. The same can be said for a severely retrograde chin or for those with an underbite; in these instances there’s only so much injectables can do.”

Respecting anatomy Injectable treatments offer effective, minimally invasive options for male jawline augmentation. A thorough understanding of male facial anatomy, individualised treatment planning and precise injection techniques are crucial to achieving natural, masculine results. As the demand for such procedures continues to rise, practitioners must stay informed about the latest products and methodologies to meet patient expectations and ensure safety.

VIEW THE REFERENCES AT AESTHETICSJOURNAL.COM

Figure 2: 29-year-old patient before and after treatment using a total of 5.4ml of Revanesse Shape. Images were taken 15 months apart. Images courtesy of Dr Jordan Faulkner.

Aesthetics | April 2025

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It was great to reconnect with old faces and meet new ones at the recent show. Building strong relationships is essential, and I'm committed to this for both suppliers and customers.

If you’d like support with your financing options, please get in touch. Let's support your business growth together!”

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www.shireleasing.co.uk frederica.ford@shireleasing.co.uk Tel: 01827 302056

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Instant Lift with a Lasting Boost: Restylane Lyft with Sculptra The landscape of facial aesthetics is undergoing a significant transformation, with an increasing number of patients favouring a ‘less is more’ philosophy.

Aesthetic nurse prescriber Michelle McLean, owner of Aesthetically You clinic, has found that rather than prioritising excessive volume restoration, there is a growing emphasis on skin quality, collagen stimulation and natural-looking results.

Addressing signs of ageing with collagen biostimulators Frequently expressed patient concerns around ageing are fine lines, wrinkles, skin laxity and thickness, depletion of subcutaneous fat, compromised skin health, dullness and dehydration. The introduction of poly-L-lactic acid (PLLA) injectables, such as Sculptra®, offers a comprehensive solution to these concerns while preserving natural facial expression and delivering tangible, long-lasting outcomes while maintaining an acceptable safety profile.1 PLLA has demonstrated considerable efficacy in enhancing skin radiance, smoothness and elasticity while improving hydration.2 Recent studies suggest that PLLA not only stimulates collagen production, but also plays a role in adipogenesis, helping restore facial volume by promoting the differentiation of adipocytes and enhancing the extracellular matrix (ECM) integrity.3,4 This dual mechanism of action – stimulating both collagen and adipose tissue regeneration – further underscores PLLA’s value as a cornerstone treatment in facial rejuvenation.

Unlike other biostimulators that primarily focus on collagen induction, Sculptra uniquely activates regenerative pathways, increasing elastin and ECM components Before

while avoiding excessive inflammatory response, leading to improved skin structure and longevity of results.4 These multifaceted benefits highlight its role in modern medical aesthetics, providing gradual yet profound rejuvenation that aligns with the evolving patient preference for subtle, regenerative approaches to facial aesthetics.

Meet the patient A 59-year-old female patient, a lifelong gym enthusiast, presented expressing concern over facial ageing, describing a ‘melting’ effect from fat inferiorly. Prioritising cardiovascular exercise has contributed to volume loss and reduced dermal support. She seeks a subtle, undetectable natural-looking result.

Following comprehensive consultation and assessment, the patient exhibited hypertrophy and increased prominence of the nasolabial fat compartment, with a shifting of the fat contributing to mid-face volume loss and skin laxity. Additional signs of age-related concerns were also noted, particularly concerning skin health and elasticity.

To address these concerns, the HIT Firm & Lyft protocol was implemented, targeting skin laxity, facial sagging, jawline definition and structural support loss. Soft tissue fillers play a critical role in facial rejuvenation, offering volume, collagen stimulation and improved skin elasticity, which can be further exacerbated by weight loss strategies.5 The combination of Restylane® Lyft™ and Sculptra was selected to provide a multifaceted approach, not only addressing fat pad depletion, but also enhancing collagen and elastin production, supporting long-term dermal health.

After

Advertorial Galderma NASHA technology, utilised in Restylane Lyft, enables structural lift and projection without excessive volume, ensuring a subtle and natural outcome. A recent Phase IV clinical trial assessed the efficacy, safety and patient satisfaction of Restylane Lyft in combination with Sculptra for cheek augmentation and correction of contour deficiencies in patients experiencing facial volume loss due to medication-induced weight reduction.6 Findings at three months demonstrated a significant improvement in facial rejuvenation, reinforcing the benefits of the SHAPE Up HIT™ protocol in restoring facial support and skin quality.6 Technique PLLA (Sculptra) targeting the temporal, pre-auricular and mandibular areas, using three vials in total over three sessions.

Restylane Lyft was distributed along the zygomatic area, deep medial malar area 0.8ml on each side and pyriform fossa 0.2ml on each side, with a total of 2ml.

Patient satisfaction A clinical study found that 88% of patients reported firmer, tighter skin following treatment with Sculptra,7 while 96% of those treated with Restylane Lyft indicated that their outcomes met or exceeded expectations.8 Additionally, an anonymous in-clinic study of 27 participants conducted at Aesthetically You for patients following Sculptra treatment revealed that 85% observed improvements in facial volume, while 90% felt their primary aesthetic concerns had been effectively addressed.

McLean commented, “In my clinical practice, I treat a diverse patient demographic with unique ageing concerns, including volume loss, skin laxity and overall skin quality.

Embracing a ‘less is more’ approach ensures subtle, natural results. The Galderma portfolio offers versatile, evidence-based products that support structure, lift and skin health while preserving natural expression and promoting long-term rejuvenation.”

Michelle McLean is a key opinion leader for Galderma.

Adverse event reporting information can be found on the back cover.

This advertorial was written and supplied by

To learn more, speak with your Galderma sales representative or contact sales.UK@galderma.com UKI-RES-2500026 DOP March 2025.

VIEW THE REFERENCES AT Figure 1: 59-year-old patient before and 20 weeks after baseline, following treatment with Sculptra and Restylane Lyft

Aesthetics | April 2025

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Event Report ACE 2025

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Empowering the Aesthetics Community Explore the standout moments from ACE 2025 Last month, Aesthetics welcomed 3,278 professionals to the Business Design Centre, the Aesthetics Conference & Exhibition (ACE) – a dynamic event dedicated to discovery, networking and celebrating the latest advancements in medical aesthetics.

Over two action-packed days, attendees were welcomed by Healthxchange, ACE Registration and Lanyard Sponsor. Engaged with five cutting-edge educational agendas featuring 100+ expert speakers, explored an exhibition hall showcasing 90+ leading brands, and took advantage of countless networking opportunities. This year marked ACE’s largest gathering to date, with an unprecedented demand for insights into the latest innovations, advanced techniques and best practice guidance.

After the second day of the conference, almost 900 guests came together for The Aesthetics Awards, honouring the outstanding achievements in the specialty over the past year. To see this year’s Winners, turn to p.40.

Shannon Kilgariff, editor and event manager of Aesthetics, commented, “ACE 2025 was a remarkable event, bringing together leading brands and world-class speakers. Attendees had the opportunity to earn up to 15 CPD points across five educational theatres, each offering diverse and educational sessions.

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We extend our heartfelt gratitude to all exhibitors, sponsors, attendees, speakers, associations and partners for their invaluable contributions to the success of ACE 2025. We look forward to seeing everyone again at our sister event – Clinical Cosmetic Regenerative (CCR) Congress taking place in September!”

“Allergan Aesthetics were

Injectable insights with Allergan Aesthetics

services to practitioners. The

Allergan Aesthetics, an AbbVie company, was the event’s Headline Sponsor for 2025. Across the two days, the company presented dynamic sessions packed with valuable insights for aesthetics healthcare professionals, providing live treatment demonstrations for different areas of the face, as well as thought-provoking discussions to help attendees refine their techniques.

Allergan Aesthetics Auditorium

Speakers across the two days included:

· · · · · · · · ·

Dr Manav Bawa Mark Chaplin Dr Glyn Estebanez Natalie Haswell Miss Rachna Murthy Mr James Olding Mr Taimur Shoaib Julie Scott INP Dr Rashpal Singh Aesthetics | April 2025

delighted to have been Headline Sponsor for ACE this year, showcasing our award-winning portfolio and wide array of

held a series of symposiums bringing a range of content suitable for all levels of aesthetics healthcare professionals, where our industry leading brands were presented through live patient consultation and treatment demonstrations, focusing on facial harmonisation and lips."

Djamshid Ghavami, General Manager, Allergan Aesthetics, UK & Ireland

@aestheticsjournaluk

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Event Report ACE 2025

Cutting-edge business expertise at the In Practice Theatre The In Practice Zone returned this year as a hub for visitors’ business queries and education. At the In Practice Theatre, talks covered topics such mental health, running a successful business and the future of aesthetics. The theatre was host to some incredible panel discussions, including the Women in Business Panel, sponsored by Crown Aesthetics, which spotlighted incredible women who were Finalists at The Aesthetics Awards 2025.

The hugely popular Getting Started in Aesthetics Agenda also returned for enthusiastic newcomers, and was hosted by Cosmetic Courses, chaired by Mr Adrian Richards.

Rounding off the two days of content was the Aesthetics Business Blueprint masterclass, chaired by Rick O’Neill. In a packed theatre, the sessions covered methods for patient acquisition and retention, featuring talks by Nick Cooling-McClagish, Joss Henton, Adam Smith, Dr Toby Makmel and Joe Leek.

Outside of the theatre, delegates could find companies and brands dedicated to helping improve their business knowledge.

Exhibitors included:

· · · · · · ·

Aesthetic Nurse Software Cosmetic Courses Dermis AI (Associate Sponsor) E-Clinic Harley Academy Initial Medical Inspire to Outstand

· · · · · ·

Pabau The Glow Group Shire Leasing Vida Glow Web Marketing Clinic Zenoti (Associate Sponsor)

Networking drinks were hosted in the Zone towards the end of Day 1 to allow delegates to connect with the companies and ask them any questions they had about their services.

The latest specialty developments at the Innovation Forum The Innovation Forum, sponsored by SkinCeuticals, was packed with content from a variety of aesthetics companies exploring their latest product launches and technologies. All showcased innovations, from skincare to devices, and sessions covered topics such as exosomes, skin nutrition, comparing Asian and Caucasian facial structures and integrated skincare.

Companies included:

· · · · · · · · · · · · · · · · ·

Acclaro ALLSKIN | MED BTL Aesthetics Croma Pharma Church Pharmacy Cure Medical Cutera Dermalogica PRO Dermapenworld Hydrafacial InMode iiaa Sciton SkinCeuticals S.ThePharm Sofwave VIVACY UK

Ground-breaking injectable content at the Aesthetics Mastery Theatre Attendees were able to immerse themselves in the art and science of medical aesthetics at the Aesthetics Mastery Theatre. There were expert-led live demonstrations and in-depth discussions, showcasing the latest techniques and products. Companies in attendance included AestheticSource, Alma, DermaFocus, Galderma, IDENEL, NEAUVIA and Revanesse.

DermaFocus hosted lunchtime takeover sessions on both days, discussing Plinest polynucleotides, Purasomes, XCell Supplements and the Exosomal Liquid Laser. Both talks featured a live injectable demonstration.

The morning of Day 2 saw the Aesthetics Challenge, chaired by Sharon Bennett and Dr Lee Walker. This was an engaging session featuring three live demonstrations where top injectors Dr Rashpal Singh, Dr Catharine Denning and Frances Turner Traill pushed the boundaries of artistry using their choice of dermal filler. They crafted stunning results with minimal product, showcasing their unique techniques and approaches to sculpting the lips.

Upholding standards in the field at the Association Theatre BRAND NEW for 2025, the Association Theatre brought together all of the specialty’s top associations to promote development, uphold ethics and safety, and provide support for professionals working within the sector. Associations included ACE Group World, BAMAN, BAHRS, BCAM, BMLA, MHRA, The Nurses Network and the JCCP, as well as BAAPS and ISAPS representatives.

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Event Report Clinical Practice News2025 ACE

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Aesthetics

Key topics covered on stage included

The Platinum Hall

upcoming regulatory changes, management

The most sought-after aesthetics brands

of complaints, best practices in the field

and Platinum Sponsors came together in

and much more. The JCCP, BAMAN and

the Platinum Hall to showcase cutting-edge

BCAM collaborated in a panel discussion

products and ground-breaking

on Day 2, chaired by Paul Burgess. The session explored the importance of specialty associations, and how they can aid practitioners in networking, education and training.

Healthxchange x Medik8 Professional was the official sponsor of the Association Zone, hosting two talks across the conference about the clinical future of peptides.

Leading aesthetic brands Alongside the five content streams, all 90+ exhibitors expertly showcased the latest

advancements. With a focus on education, innovation, and clinical expertise, this destination offered delegates unmatched opportunities to elevate their practice, as well as access to the Allergan Aesthetics Auditorium.

The VIP experience with Alma This year’s VIP Lounge, powered by Alma, was a standout feature for the second year in a row, offering delegates a luxurious and engaging experience across both days.

The lounge boasted a live DJ, photobooth, treatment rooms, speaker sessions and exclusive live demonstrations of Alma’s

injectables, skincare, devices, business

latest laser procedures. VIP guests were

solutions and more.

also treated to complimentary hair and

BRAND NEW for this year were the Stand Seminars, providing an intimate learning experience on the show floor.

Companies involved included:

· ACRE · AestheticSource · Allergan Aesthetics, an AbbVie company

makeup services, adding an extra touch of indulgence. Alma further elevated the experience by hosting multiple networking drinks receptions, including a special gathering for Aesthetics Awards Finalists on Day 2, setting the perfect tone for an evening of celebration and recognition of the specialty’s biggest achievements!

· Alma

Meet the Mentor

· Dermalogica PRO

ACE also hosted the very popular Meet

· Dermaroller · Galderma

the Mentor sessions, allowing visitors to connect with experts in the specialty to ask any burning questions and advice on how to

· LPG

run their business. Each mentoring session

· SkinCeuticals

had a different theme, including social media

The ACE Stand Awards returned for the third year, celebrating the exhibitors going above and beyond in design, engagement, and education.

A huge well done to the winners:

gurus, clinic owners and how to start out in aesthetics.

These sessions were designed to foster meaningful connections between aspiring and established professionals in the aesthetics specialty.

· Award for Best Stand – Healthxchange

Uniting the community

· Award for Best Visitor Experience –

Day 1 started with a Speaker Faculty

DermaFocus

· Award for Best Event Marketing Campaign – Alma

· Award for ESG – Medik8

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Breakfast in the Platinum Hall, uniting top experts from across the specialty. Dozens of professionals gathered to enjoy delicious food and drinks while connecting with peers, creating an energising start to the event.

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Event Report Clinical Practice News2025 ACE

The Visitor Experience “As anticipated ACE was a fantastic weekend providing opportunities to learn and network all under one roof. The diverse talks and treatment demonstrations meant I could easily pick relevant ones to my practice and I was able to speak to lots of different companies about a potential device purchase for my clinic” Dr Bethany Rossington, aesthetic practitioner and speaker "I have had a fantastic experience at ACE 2025 - it was very well-organised and structured. I can't wait for future opportunities, and I'm excited about next year already!"

Dr Olha Vorodyukhina, aesthetic practitioner and speaker At the end of Day 1, all delegates had the opportunity to attend the ever-popular networking drinks, sponsored this year by Dermapenworld. Medical aesthetic professionals were able to grab a drink, unwind and discuss the day’s learnings with colleagues old and new. It was the perfect way to round off the first day of jam-packed education, and connect with the rest of the community.

Across both days delegates could gather in the Lumenis Chill Out Lounge to connect with friends and peers, and have a moment to reflect on the learnings of the day. Aesthetic members, exhibitors and speakers could also gather in the Aesthetics Member Lounge to connect with each other and the Aesthetics Journal team.

The two days concluded with the dazzling Aesthetics Awards, taking place at the Grosvenor House, London. Find out the Winners on p.40.

"I think the complications topics covered are so important to help prevent things going wrong and managing unhappy patients. The new Association Theatre was also a really great addition for 2025."

Gillian Murray, prescribing pharmacist and speaker "I really enjoyed ACE 2025! It felt fresh and exciting, with plenty of new things to discover. I kept bumping into friends and meeting new people - it had such a fantastic buzz!"

Dr Brian Franks, aesthetic practitioner

See you next time!

That’s a wrap – another incredible ACE has come to an end! Save the date for March 13-14 2026, when ACE and The Aesthetics Awards make their return. Up next, CCR will take place at Excel London on September 25-26, bringing even more innovation and networking opportunities.

Register your interest using the QR code – we can’t wait to connect with the specialty once again!

25 & 26 September 2025 Excel, London

*AbbVie has part sponsored this event, this includes provision of a stand and/or a speaker program/medical symposium. AbbVie has had no influence over the content/topics covered in other parts of the agenda.

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CPD Peptides

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Exploring Peptide Therapeutics Dr Ethan Hausman-Marquis presents a comprehensive review of potential benefits and clinical applications of peptide therapy Peptides, defined as short chains of amino acids linked by peptide bonds, are essential signalling molecules integral to a vast array of physiological processes.1,2 These versatile molecules function as hormones, neurotransmitters, growth factors and enzymes, regulating critical functions such as growth and development, metabolic homeostasis, immune response and tissue repair.1,2 Recent years have witnessed a surge of interest in harnessing the therapeutic potential of peptides across diverse medical specialties, including oncology, endocrinology, neurology, gastroenterology and dermatology.3-11 This burgeoning field, termed ‘peptide therapy’, focuses on utilising synthetic peptides or peptide analogues to modulate specific physiological pathways, offering promising avenues for the treatment of a wide spectrum of diseases.3-6 This article aims to provide a comprehensive overview of the potential benefits and clinical applications of peptide therapy, encompassing current research findings, ongoing clinical trials and future directions.

Advantages of peptide therapeutics Peptide therapeutics offer distinct advantages compared to conventional small molecule pharmaceuticals. Peptides demonstrate high receptor specificity, mitigating off-target binding and minimising the risk of adverse drug reactions (ADRs).12,13 This inherent specificity arises from their unique structural conformation and ability to interact with high affinity to discrete receptors and intracellular signalling pathways, enabling precise modulation of biological processes.12,13 Furthermore, their low molecular weight facilitates efficient

bioavailability and tissue penetration, while also promoting rapid renal clearance and reducing the potential for accumulation and toxicity.14 Peptides exhibit favourable pharmacokinetic properties, including a wide therapeutic index and generally good tolerability.

They can be administered via diverse routes including parenteral administration (intravenous, subcutaneous, intramuscular) and oral formulations with enhanced bioavailability and topical applications.15 Advances in solid-phase peptide synthesis and recombinant DNA technology have enabled the development of novel peptide analogues with improved stability, prolonged half-life and targeted delivery to specific tissues and organs.16 This versatility in design and synthesis facilitates the development of personalised therapies tailored to specific disease mechanisms and patient needs.

Expanding clinical applications of injectable peptide therapeutics Peptide therapeutics are rapidly emerging as a promising avenue for the management of various medical conditions. The delivery method of these therapies directly impacts their efficacy, stability and bioavailability. Due to their relatively large molecular size and susceptibility to enzymatic degradation, oral administration of peptides is often limited.

As a result, many peptide-based drugs are delivered via parenteral routes, such as subcutaneous, intramuscular or intravenous injections, to bypass the gastrointestinal tract and ensure systemic availability.

Advances in drug delivery systems, including the development of sustained-release formulations and nanocarrier technologies, are enhancing the practicality of peptide

Peptides demonstrate high receptor specificity, mitigating off-target binding and minimising the risk of adverse drug reactions 30

Aesthetics | April 2025

therapy. Additionally, innovative approaches such as transdermal patches, intranasal delivery and oral formulations employing permeation enhancers or protease inhibitors are being explored to improve patient compliance and broaden the accessibility of peptide-based treatments.

In the field of endocrinology, peptide analogues are employed to address hormonal imbalances. For instance, growth hormone secretagogues such as tesamorelin and ipamorelin stimulate the release of growth hormones from the anterior pituitary, offering therapeutic benefits for patients with growth hormone deficiency (GHD).17,18 Furthermore, glucagon-like peptide-1 (GLP-1) receptor agonists, including liraglutide and semaglutide, are utilised in the management of type 2 diabetes mellitus by enhancing insulin secretion and suppressing glucagon release.19,20 These agents also demonstrate efficacy in promoting weight loss and improving glycaemic control. Peptide therapy further holds potential for the treatment of osteoporosis, with ongoing research investigating the use of peptides to stimulate bone formation and reduce bone resorption.21,22 Oncology is another area where peptide therapeutics are being actively explored.

Peptide-based vaccines aim to elicit anti-tumour immunity by presenting tumour-associated antigens to the immune system, thereby triggering a cytotoxic T cell response against cancer cells.23,24 These vaccines are under investigation for various malignancies, including melanoma and prostate cancer. Additionally peptide-drug conjugates represent a targeted therapeutic strategy, where a cytotoxic agent is linked to a peptide that specifically binds to tumour cells. This approach allows for the selective delivery of chemotherapeutic agents, minimising off-target toxicity.25,26 In the realm of neurology, peptides are being studied for their neuroprotective and neuroregenerative properties. Cerebrolysin, a neuropeptide mixture, has shown potential benefits in preclinical and clinical studies for conditions such as stroke, Alzheimer's disease and Parkinson's disease.27,28 Similarly, semax, a synthetic analogue of

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adrenocorticotropic hormone (ACTH), has demonstrated neuroprotective effects and may improve cognitive function in patients with neurological disorders.29,30 Gastroenterology is also witnessing the emergence of peptide-based therapies. Synthetic analogues of vasoactive intestinal peptide (VIP) exhibit anti-inflammatory effects and are being investigated for the treatment of inflammatory bowel disease (IBD).31,32 Moreover, corticotropin-releasing factor (CRF) receptor antagonists are being explored for their potential to alleviate symptoms of irritable bowel syndrome (IBS) by modulating the gut-brain axis.33,34 Peptide therapy has gained significant traction in dermatology and wound healing. Peptides like palmitoyl pentapeptide-4 and copper peptides stimulate collagen synthesis and promote cutaneous regeneration, contributing to antiageing effects and improved skin texture.35,36 Growth factors, including epidermal growth factor (EGF) and platelet-derived growth factor (PDGF), are utilised to accelerate wound healing and tissue repair by promoting cell proliferation, migration and angiogenesis.37,38 Beyond these areas, peptide-based therapies are being investigated for a wide range of conditions, including infectious diseases, cardiovascular disorders and autoimmune diseases.39,40 The versatility and specificity of peptides make them attractive candidates for drug development, and ongoing research continues to expand the clinical applications of peptide therapeutics.

CPD Peptides Semaglutide and liraglutide Semaglutide and liraglutide are glucagon-like peptide-1 (GLP-1) receptor agonists. They mimic the action of endogenous GLP-1, an incretin hormone secreted by intestinal L cells in response to nutrient ingestion.67-69 GLP-1 stimulates glucose-dependent insulin secretion from pancreatic beta cells, and inhibits glucagon secretion from alpha cells. These peptides are primarily indicated for the management of type 2 diabetes mellitus (T2DM), contributing to glycaemic control.

Furthermore, they induce weight loss by increasing satiety, delaying gastric emptying and reducing appetite.72,73

Clinical applications and potential benefits of peptides

Common peptides and mechanisms of action

Aesthetic and regenerative medicine

Growth hormone releasing hormones (GHRH) and analogues

Peptides are transforming the landscape of aesthetic and regenerative medicine due to their unique capacity to modulate specific cellular pathways. In the realm of aesthetics, they stimulate fibroblasts to increase collagen synthesis, resulting in increased dermal density, reduced rhytids and improved skin elasticity.74,75 Furthermore, certain peptides demonstrate efficacy in promoting hair follicle proliferation and prolonging the anagen phase of hair growth, leading to increased hair density.76,77 Peptides also address cutaneous hyperpigmentation by inhibiting melanogenesis through the downregulation of tyrosinase activity, resulting in a more even skin tone.78,79

Peptides such as sermorelin and tesamorelin act as agonists at the GHRH receptor on somatotrophs within the anterior pituitary gland, stimulating the synthesis and secretion of endogenous growth hormone (GH). GH exerts anabolic effects and plays a critical role in somatic development; however, serum GH levels undergo an age-related decline. GHRH analogues can counteract this physiological decline, potentially mitigating age-related manifestations such as sarcopenia, increased adiposity and decreased bone mineral density.

These peptides also hold therapeutic promise for growth hormone deficiency (GHD) and muscle wasting conditions (cachexia).41-43 Growth hormone releasing peptides (GHRPs) GHRPs, including ipamorelin and GHRP-6, also induce GH secretion, but through a distinct pathway involving ghrelin receptor agonism at both the pituitary and hypothalamic level.44-46 While offering similar benefits to GHRH analogues in terms of GH elevation, GHRPs may differentially influence appetite regulation and sleep architecture.47,48 Melanotan II Melanotan II, while effective in stimulating melanogenesis and inducing skin tanning, is associated with several adverse effects and safety concerns. Reported side effects include nausea, flushing, appetite suppression and spontaneous erections, which may limit its tolerability in some individuals.53-55 Additionally, there are concerns regarding its long-term safety, particularly the potential for promoting abnormal melanocyte activity, which could increase the risk of melanoma or other skin malignancies. The lack of regulatory approval in many regions and the use of unregulated or counterfeit products further amplify the risks, as these formulations may contain impurities or incorrect dosages, posing significant health hazards.

BPC-157 BPC-157 is a synthetic peptide fragment derived from a naturally occurring gastric protein. It exhibits pleiotropic effects on wound healing and tissue repair across various experimental models.56,57 Although its precise mechanisms of action remain incompletely elucidated, BPC-157 appears to promote angiogenesis through modulation of vascular endothelial growth factor (VEGF) and nitric oxide (NO) pathways, enhance cell survival via anti-apoptotic mechanisms, and regulate various growth factors involved in tissue regeneration, including fibroblast growth factor (FGF) and transforming growth factor beta (TGF-β).58,59 BPC-157 demonstrates therapeutic potential in conditions such as inflammatory bowel disease (IBD), tendon injuries and skin wounds.60 Thymosin Alpha-1 and Thymosin Beta-4 These are naturally occurring peptides with immunomodulatory properties.61,62 They are integral to thymic function and T cell maturation, influencing both cell-mediated and humoral immunity. These peptides exhibit potential in treating various infectious diseases, promoting wound healing through modulation of inflammatory cytokines and chemokines, and regulating immune responses in autoimmune conditions.63-66 Aesthetics | April 2025

In the field of regenerative medicine, peptides accelerate wound healing and tissue regeneration by promoting angiogenesis, increasing fibroblast proliferation and migration, and stimulating extracellular matrix (ECM) deposition.80,81 Their ability to modulate inflammatory cytokines and immune responses makes them valuable tools for treating a spectrum of conditions, including burns, ulcers and even autoimmune diseases. This targeted action and favourable safety profile position peptides as a promising frontier in aesthetic and regenerative medicine, offering effective solutions for enhancing beauty and restoring health.82,83 Antiageing and hormone optimisation The age-related decline in growth hormone (GH) secretion contributes to various physiological changes, including sarcopenia, increased adiposity, osteopenia and cognitive decline.84,85 Growth hormone-releasing hormone (GHRH) analogues and growth hormone secretagogues (GHRPs) have emerged as promising therapeutic agents to counteract these age-related effects.

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CPD Peptides GHRH analogues, such as tesamorelin and sermorelin, stimulate the anterior pituitary gland to release GH, mimicking the body's endogenous hormone production. GHRPs, including ipamorelin and ghrelin, act on the hypothalamus and pituitary gland via the growth hormone secretagogue receptor (GHS-R) to increase GH secretion.85,86 Studies have demonstrated the efficacy of these peptides in improving body composition, increasing lean muscle mass, reducing fat mass and enhancing bone mineral density in older adults.87,88 Moreover, GHRH analogues and GHRPs have shown potential in ameliorating age-related cognitive decline, improving sleep architecture and enhancing overall wellbeing in individuals with somatopause.

These findings suggest that peptides may play a crucial role in mitigating the adverse effects of ageing and promoting healthy longevity.89,90 Wound healing and tissue repair Peptides have demonstrated remarkable potential in accelerating wound healing and tissue regeneration. BPC-157, a synthetic peptide derived from a stable gastric pentadecapeptide, has demonstrated significant wound healing properties in various animal models and clinical studies.91-93 It promotes angiogenesis, the formation of new blood vessels, which is crucial for tissue repair. Additionally, BPC-157 exhibits anti-inflammatory effects by reducing the expression of pro-inflammatory cytokines, thereby mitigating oedema and pain associated with injuries.91-93 Thymosin Beta-4, a naturally occurring peptide found in various tissues, also plays a crucial role in wound healing and tissue regeneration. It stimulates the production of extracellular matrix proteins, such as collagen and fibronectin, which provide structural support to tissues. Thymosin Beta-4 also promotes cell migration and differentiation, essential processes in wound healing. Studies have shown the efficacy of these peptides in accelerating the healing of various wounds, including muscle injuries, skin lesions and ulcers.94-96 Their ability to promote tissue regeneration and reduce inflammation makes them promising therapeutic agents for a wide range of conditions.97,98 Immune system modulation Peptides have garnered attention for their potential to modulate the immune system, offering therapeutic benefits for infectious diseases and autoimmune conditions.

Thymosin Alpha-1, a synthetic version of a naturally occurring thymic peptide, has demonstrated immunomodulatory effects.99,100 It enhances the activity of T lymphocytes, particularly cytotoxic T cells, 32

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which play a crucial role in cell-mediated immunity. Studies have shown that Thymosin Alpha-1 can improve immune responses in patients with infectious diseases, such as hepatitis B and C, and certain cancers.101-104 Thymosin Beta-4, in addition to its wound healing properties, also exhibits immunomodulatory effects.105,106 It can modulate the activity of immune cells, reducing inflammation and promoting tissue repair in autoimmune conditions such as rheumatoid arthritis and multiple sclerosis.107,108 The ability of these peptides to enhance or suppress immune responses, depending on the condition, makes them valuable tools in managing various immune-related disorders.109,110

Palmitoyl pentapeptide-4 and copper peptides stimulate collagen synthesis and promote cutaneous regeneration Metabolic health and weight management The rising prevalence of obesity and type 2 diabetes mellitus has fuelled the search for effective therapeutic interventions.

GLP-1 receptor agonists, a class of peptides that mimic the action of GLP-1, an incretin hormone that regulates blood glucose levels and appetite, have shown promising results in managing these conditions.111-113 Semaglutide and liraglutide, two FDA-approved GLP-1 receptor agonists, have demonstrated significant efficacy in lowering blood glucose levels in individuals with type 2 diabetes.114,115 Moreover, these peptides promote weight loss by increasing satiety, reducing food intake and improving insulin sensitivity.114,115 Clinical trials have shown that semaglutide and liraglutide can lead to substantial weight loss in individuals with obesity, even in those without diabetes.116,117 The ability of GLP-1 receptor agonists to address both glycaemic control Aesthetics | April 2025

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and weight management makes them valuable tools in combatting the growing epidemic of metabolic disorders.

Other potential applications Research on peptides extends beyond the aforementioned clinical applications.

Peptides have shown potential in various other areas, including cognitive enhancement, pain management and cardiovascular health. For instance, certain peptides such as cerebrolysin and semax have been investigated for their potential to improve cognitive function in individuals with neurodegenerative disorders like Alzheimer's disease.118-121 Additionally, peptides like Melanotan II have shown promise in managing chronic pain conditions,122,123 while others such as vasopressin and Angiotensin II are being explored for their potential to regulate blood pressure and improve cardiovascular health.124,125 While research in these areas is ongoing, the preliminary findings suggest that peptides may offer novel therapeutic approaches for a wide range of conditions.

Safety and adverse events While peptide therapeutics hold significant promise, it is essential to acknowledge their potential for adverse events. The manifestation of these events can be influenced by factors such as the specific peptide administered, its dosage, route of administration and individual patient characteristics. Commonly observed local reactions include injection site manifestations such as erythema, oedema and pain.126 Systemic adverse events, while less frequent, may include gastrointestinal disturbances such as nausea, vomiting or diarrhoea.126 In rare instances, hypersensitivity reactions, including anaphylaxis, have been reported.126 To mitigate these risks, meticulous adherence to established guidelines for dosage, administration and patient monitoring is paramount. Healthcare practitioners must individualise treatment regimens based on patient-specific factors and comorbidities. Continuous pharmacovigilance is crucial to identify and manage potential adverse events.

Patients should be thoroughly counselled on potential side effects and encouraged to promptly report any unusual symptoms.127 It is important to recognise that the long-term safety profiles of many peptide therapeutics remain incompletely elucidated. Further investigations, encompassing large-scale, longitudinal studies, are warranted to comprehensively characterise the safety and potential risks associated with these treatments.

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Targeted action and favourable safety profiles position peptides as a promising frontier in aesthetic and regenerative medicine Future therapeutic directions Peptide therapeutics have emerged as a promising avenue for the treatment of an array of pathological conditions. The inherent properties of peptides, including their high target specificity, efficient transmembrane and intracellular delivery, and pleiotropic mechanisms of action, position them as attractive candidates for drug development.128,129 As outlined in this article, peptide-based therapies have demonstrated encouraging outcomes in diverse clinical applications, encompassing endocrine modulation, wound healing, immunomodulation, metabolic regulation and cognitive enhancement.130-134 However, it is imperative to acknowledge that the clinical translation of peptide therapeutics remains in its nascent stages. Further investigations are warranted to comprehensively elucidate the long-term safety profiles and efficacy of these interventions. Ongoing clinical trials are essential for rigorously evaluating their therapeutic utility, and translating promising pre-clinical observations into robust clinical outcomes.135 The future trajectory of peptide therapeutics is imbued with immense potential. Advancements in peptide design, encompassing rational design, in silico modelling and phage display technologies, coupled with innovations in peptide synthesis such as solid-phase peptide synthesis and chemoenzymatic synthesis, and delivery systems, including nanoparticles, liposomes and hydrogels, will facilitate the development of increasingly targeted and efficacious therapies. As our comprehension of peptide biology, encompassing receptor-ligand interactions, intracellular signalling pathways and pharmacokinetic/pharmacodynamic properties, continues to expand, we can harness their therapeutic potential to address a broader spectrum of diseases and optimise patient outcomes.136

An advancing field Peptide therapeutics represent a rapidly evolving field with the potential to revolutionise modern medicine. Their inherent advantages, including high target specificity, favourable pharmacokinetic profiles and diverse mechanisms of action, position them as attractive candidates for drug development across a wide range of therapeutic areas.

In the field of aesthetics, peptide therapy has emerged as a transformative approach, offering innovative solutions for skin rejuvenation, antiageing and cosmetic enhancement. Peptides such as palmitoyl pentapeptide-4 and copper peptides have gained recognition for their ability to stimulate collagen synthesis, promote skin regeneration and improve elasticity. Additionally, growth factors like EGF and PDGF play a pivotal role in wound healing and tissue repair, offering both functional and cosmetic benefits.

These advancements underscore the potential of peptide therapeutics to not only enhance physical appearance, but also improve emotional wellbeing by fostering confidence and self-esteem.

While challenges remain in terms of optimising delivery systems, elucidating long-term safety profiles and navigating regulatory pathways, ongoing research and technological advancements continue to drive the field forward. The future of peptide therapeutics is bright, with the potential to usher in an era of personalised medicine where treatments are tailored to individual patient needs, ultimately leading to improved healthcare outcomes and enhanced quality of life.

Dr Ethan Hausman-Marquis is a consultant paediatric oncological surgeon specialising in longevity and regenerative medicine at The Catalyst Clinic, with practices in London, New York, Monaco, and Amsterdam.

He also holds a PhD in Cell Biology from the Karolinska Institute. In the longevity medical speciality, he is a member of The American Society of Regenerative Medicine, The International Peptide Society, and The American Academy of Anti-Aging Medicine Qual: MD, PhD, FACS, FSSO

Test your knowledge!

Complete the multiple-choice questions and go online to receive your CPD certificate!

Questions

Possible answers

1. Which of the following is NOT a characteristic advantage of peptide therapeutics compared to conventional small molecule pharmaceuticals?

a. High receptor specificity

2. Which of the following peptide therapies is commonly used in the management of type 2 diabetes mellitus?

3. Which of the following peptides is associated with promoting wound healing and tissue repair through modulation of VEGF and NO pathways?

4. What is a primary mechanism of action of Growth Hormone Releasing Peptides (GHRPs) like ipamorelin?

5. In the context of aesthetic and regenerative medicine, peptides are used for which of the following purposes?

b. High risk of adverse drug reactions c. Efficient bioavailability and tissue penetration d. Rapid renal clearance a. Cerebrolysin b. Melanotan II c. GLP-1 receptor agonists (e.g. semaglutide, liraglutide) d. BPC-157 a. Thymosin Alpha-1 b. Melanotan II c. BPC-157 d. Sermorelin a. Direct stimulation of growth hormone receptors on target tissues b. Ghrelin receptor agonism at the pituitary and hypothalamic level c. Inhibition of growth hormone secretion d. Stimulation of melanogenesis a. Inhibiting collagen synthesis to reduce scar formation b. Stimulating fibroblasts to increase collagen synthesis c. Increasing melanocyte activity to darken skin tone d. Decreasing angiogenesis to prevent excessive tissue growth Answers: B,C,C,B,B

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Advertorial Evolus

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Evolving Aesthetics with Nuceiva® (botulinum toxin type A) Precision, Purity and Performance Let’s talk about precision in medical aesthetics. Whether you’re an experienced practitioner or new to the field, you know how critical precision is for delivering patient satisfaction.

Discover Nuceiva® (botulinum toxin type A) — a neuromodulator that’s designed for precision.

Nuceiva® is indicated for the temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at maximum frown (glabellar lines), when the severity of the above facial lines has an important psychological impact in adults below 65 years of age.1 As readers will know, Nuceiva® should only be administered by healthcare practitioners with appropriate qualifications and expertise in the treatment of glabellar lines and the use of required equipment.

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What’s in the vial?

Each vial of Nuceiva® contains 50 units of botulinum toxin typeA, derived from Clostridium botulinum, along with HSA and NaCl.1 No preservatives, no unnecessary additives — just a simple, precise formula.

Simply store unopened vials at 2-8oC to maintain effectiveness (shelf-life 30 months).1 It’s all about your precise technique.

Neuromodulators require precise intramuscular injection techniques to target the correct glabellar muscles and deliver the desired clinical results.1 Check in with your Evolus team for details of our latest training events.

This is where your skills meet the science to achieve patient satisfaction.

In a study, just over 94% of Nuceiva patients expressed a positive response (improved or much improved) at 30 days after treatment.3 And let’s not overlook safety. According to the label, Nuceiva® generally has a 1% rate of eyelid ptosis.1 As a practitioner, you have options. So why choose Nuceiva®? The answer lies in its combination of precision and patient satisfaction.

At Evolus, we are all about evolving the future of Performance Beauty. Join our community to learn more.

Designed for Precision It starts with the patented Hi-Pure™ technology. This unique manufacturing process yields a product that is ≥95% pure.2* That’s not just a claim; it’s backed by a rigorous manufacturing method.

• The Hi-PureTM technology reduces impurities by utilising a series of anion exchange chromatography columns that absorb process-related and product-related impurities, while allowing the drug substance to flow through for collection2 • The process defines the product: The process combines Hi-Pure technology with vacuum drying to optimise the final product quality and produce a precise product2 TM

• Nuceiva® is a unique neuromodulator1 As with every botulinum neuromodulator, Nuceiva is unique and not interchangeable1 See Prescribing Information (QR Code) for side-effects Contraindications, Warnings, Precautions and local and distant spread of toxin effects.

Adverse reactions possibly related to the spread of toxin distant from the site of administration have been reported very rarely with botulinum toxin. Swallowing and breathing difficulties are serious and can result in death. Injection of this medicine is not recommended in patients with a history of dysphagia and aspiration. Patients or caregivers should be advised to seek immediate medical care if swallowing, speech or respiratory disorders arise. Keep out of the sight and reach of children.

References 1. Nuceiva SmPC (accessed March 2025) 2. Daewoong Method for production of botulinum toxin.

Accessed May 2024. https://patents.google.com /patent/US9512418B2/en 3.Rzany B, et al. Aesthet Surg J. 2020;40(4):413-429 *Purity specification of botulinum toxin type A

The Nuceiva® PRESCRIBING INFORMATION can be accessed by scanning the QR code below.

March 2025 UK-P-2500006

This advertorial was commissioned, written and edited by Evolus for UK healthcare professionals only.

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard or search MHRA Yellow Card in the Google Play or Apple App store. Adverse events should also be reported to Evolus International Ltd at medicalinformation@evolus.com or 08000541302.

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Manufacturer of the Year: Aesthetics Awards 2025

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Advertorial Evolus

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Clinical Practice Weight Loss

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Mechanism of action Semaglutide primarily works on the GLP-1 receptors in the brain to reduce appetite.7,9,10 GLP-1 is a naturally occurring hormone that is released by the intestine after meals and plays a role in regulating blood sugar levels and food intake.7

Treating Aesthetic Side Effects Caused by Weight Loss Injections Miss Aoife Naughton, Dr Sean Noronha and Miss Jenny Doyle discuss the mechanism of action for weight loss injections and consider associated facial aesthetic concerns The popularity of weight loss injections has significantly increased over the last two years, having caused a global shortage throughout 2024.1 This is only set to rise, with NHS figures show that prescriptions for weight loss injections have skyrocketed, as 1.5 million doses given in 2024 compared to 81,000 in 2019.2 The use of the weight loss injections can come with some side effects, which are translating through to an uptick in patients searching for both surgical and non-surgical treatments to remove some of the loose skin and tighten tissues following the weight loss.

In this article, we outline the mechanisms of weight loss injections, and provide treatment options for patients experiencing associated aesthetic side effects.

What are weight loss injections?

The most prescribed weight loss medications are semaglutide (Wegovy), liraglutide (Saxenda), and tirzepatide (Mounjaro).2 First approved in 2019 by the US Food and Drug Administration (FDA) as a once-weekly injectable drug, semaglutide was initially licensed for use in patients with type 2 diabetes.3 However, the additional effect of weight loss led to an explosion in off-label prescription for obesity, with frequent media attention spurring demand.4 Since 2023, semaglutide has been licensed for the treatment of obesity, but the unprecedented demand for this medication resulted in worldwide drug shortages, which are only just resolving.1 Even so, concerns rightly remain about the use of this, and other injectable weight loss medications, if prescribed without proper medical supervision.

2022 saw the launch of a second class of injectable medication for diabetes – the combined GLP-GIP receptor agonist tirzepatide. Compared to semaglutide, this has an even more potent effect at lowering blood sugar, and also for decreasing weight. As of 2024, this has been NICE approved for the management of obesity.5 Currently, semaglutide is the most prescribed, so the article focuses on this particular brand, although it is thought the others cause similar side effects.1

Uses of semaglutide Semaglutide belongs to a class of drugs known as GLP-1 receptor agonists (GLP-1 RAs). GLP-1 RAs have repeatedly shown promising results in reduction of body weight in obese patients with and without diabetes,6-8 but its potential uses are growing. Further trials have also shown that semaglutide offers cardiovascular risk reduction (i.e. fewer heart attacks and strokes), slows the progression of chronic kidney disease and improves fatty liver disease. Emerging research also suggests a role for this medication in obstructive sleep apnoea, alcohol use disorders and even Alzheimer’s disease.9-10 36

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The GLP-1 receptors are found in various regions of the brain, including the hypothalamus, which is involved in appetite regulation and energy balance.6 When semaglutide binds to these GLP-1 receptors in the brain, it activates signalling pathways that help decrease appetite and increase feelings of fullness. This can result in reduced food intake, leading to weight loss.7,8 By targeting GLP-1 receptors in the brain, semaglutide can modulate appetite and promote weight loss in individuals with and without type 2 diabetes.2 The rate of weight loss with the use of semaglutide can vary from person to person.

A large clinical trial of 1,961 participants, published in the New England Journal of Medicine (NEJM), demonstrated an average weight loss of 14.9% body weight in the semaglutide group, versus 2.4% in the placebo group at 68 weeks.11

Potential side effects While the injectable weight loss agents are undoubtedly effective, they do come with potential side effects including nausea, abdominal pain, bloating, diarrhoea and an increased risk of gallstones. Decreased caloric intake is likely to result in muscle as well as fat loss, so it is essential that patients maintain an adequate protein intake, and combine this with resistance exercise – ideally under the supervision of medical professionals. Finally, rapid weight loss can result in unwanted facial aesthetic side effects, which we discuss below.12

Aesthetic considerations Aesthetic side effects are not exclusive to patients using semaglutide and other GLP-1 receptor agonists, as similar changes are often seen in any patient with rapid weight loss. Indeed, one study of seven participants reported that patients who experience massive weight loss appear up to five years older than those of similar ages without a history of extensive weight loss.13 A similar study of 65 patients who underwent bariatric surgery found that their average perceived facial age increased from 40.

8 years before surgery to 43.7 years one year post-surgery.14 This effect was more pronounced in men over 40 and those who lost a significant amount of weight.

Weight loss, including rapid weight loss from medications like semaglutide, can potentially affect facial appearance, principally due to the following two reasons. Weight loss, including rapid weight loss from medications

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like semaglutide, can potentially affect facial appearance, principally due to changes in elasticity and reduction in facial volume.

and requirements, down-time preferences and budget.

Changes in skin elasticity

This should include daily SPF50 and potentially adding collagen-boosting ingredients to their routine.18 A healthy collagen network in the skin can help reduce the risk of stretch marks and sagging skin that may occur during weight loss.18 Ideally this would be well established, prior to commencing a weight loss journey.

Rapid weight loss can sometimes lead to a temporary or permanent reduction in skin elasticity.15 This can result in sagging or loose skin on the face, especially if the weight loss is substantial.15 Reduction in facial volume Significant weight loss can lead to a loss of fat in the face, which may result in a more sunken or hollow appearance. This can affect areas such as the cheeks and undereye area.16,17 Regarding reduction in facial volume, the most commonly affected fat pads include:16,17 1. Buccal fat pads located in the cheeks.

A decrease in the size of the buccal fat pads results in a more sunken or hollow appearance in the lower cheeks.

2. Suborbicularis oculi fat pads situated beneath the skin around the eyes play a role in supporting the eyelids and creating a smooth contour in this area. When weight is lost, these fat pads may also become reduced, which can contribute to the appearance of hollows or dark circles under the eyes.

3. Nasolabial fat pad reduction can result in a loss of fullness and a more flattened appearance along the nasolabial folds.

4. Loss of subcutaneous fat directly beneath the skin can lead to a general loss of fullness and definition.

These effects are likely to be longstanding.

In the event of weight gain, fat usually doesn’t redistribute as it did prior to starting the medication, resulting in persistent signs of facial ageing.

Clinical trials assessing the use of GLP-1 receptor agonists for weight loss rarely report facial fat loss as a side effect.

Consequently, providers prescribing these medications are unlikely to counsel patients before treatment about the potential for undesirable changes in facial appearance.

Individual experiences may vary, and the impact of weight loss on facial appearance will depend on various factors such as genetics, age, overall skin health and the amount of weight lost.

Mitigating the effects If you have patients about to start semaglutide, there are some initial steps you can recommend to potentially reduce the effects of facial ageing.

All of the above treatments can be combined for the most effective outcomes.

Treatment regimens should always be tailored and bespoke for each individual, taking into account their specific concerns

Maintain good overall skincare

Hyaluronic acid fillers Hyaluronic acid (HA) filler can help to replace lost volume. This treatment is usually indicated following significant weight loss, to replace lost volume. The most common areas requiring volume augmentation are the cheeks, temples, tear trough, nasolabial folds, marionette lines and jawline.19-21 Collagen stimulators such as PLLA-based products like Sculptra act to stimulate collagen production and can also offer an option to tackle associated skin laxity and offer lift and subtle volume.22 Energy-based devices These can be used to boost elastin and collagen in the skin.

Synchronous Ultrasound Parallel Beam Technology (SUPERB) delivers ultrasound energy simultaneously from multiple sources in parallel beams. This technology allows for precise and controlled heating of the deep layers of the skin, specifically targeting the dermis, where it triggers heat-induced collagen remodelling, stimulating the production of new collagen and elastin fibres.23,24 Ideally, this treatment would be delivered prior to starting weight loss injections, as it takes three to six months for maximum effect and increased density of collagen and elastin within the dermis.

Currently literature on this is thin, so more studies would be welcomed.

Laser resurfacing options have also been shown to stimulate collagen production in the dermis which can produce a tightening effect in the skin. Erbium laser is an ablative laser resurfacing option that allows tunability in the amount of coagulation and tightening applied, which provides the option of collagen remodelling and tightening while reducing complication rates compared to some of the more traditional resurfacing options.25,26 This can be delivered either in advance of weight loss, or as an effective treatment option to tackle lines, wrinkles and sagging afterwards.

Autologous fat transplantation Transferring a patient's own fat from one area of the body to another is another option for facial volume restoration. Fat is typically harvested from the abdomen, thighs or Aesthetics | April 2025

Clinical Practice Weight Loss buttocks, centrifuged and then injected into the desired facial regions.27,28 This would be recommended as a treatment option for volume replacement where HA fillers are contraindicated, or did not achieve the desired aesthetic outcome.

Healthy lifestyle Apart from weight loss medication, incorporating a balanced diet and regular physical activity into patients’ routine can support overall wellbeing, which includes maintaining healthy skin and delaying signs of ageing.29 Adequate hydration is important for maintaining skin elasticity, which for most adults means around two litres of fluid per day.30

Combatting signs of ageing Semaglutide is a medication which holds promise in encouraging glycaemic control and promoting weight loss in patients. While weight loss can have positive effects on overall health, including reducing the risk of various health conditions, it may also impact the appearance of the face due to changes in facial volume and skin elasticity. These changes can contribute to the signs of facial ageing. With an ever-rising prevalence of use, we are increasingly likely to consult with patients seeking rejuvenating treatments, and having a knowledge of the various aesthetic interventions that can be offered to mitigate these effects is essential.

Miss Aoife Naughton is a consultant ophthalmic & oculoplastic surgeon who holds a substantive NHS Consultant post, and is based in London and Portsmouth. She specialises in cosmetic and reconstructive oculoplastic surgery, including blepharoplasty and ptosis surgery, and lacrimal surgery.

Qual: MB BCh BAO, MRCSI (Ophth), FRCOphth, FEBO Dr Sean Noronha is a consultant endocrinologist, who has a portfolio career of both NHS and private practice.

He qualified from the University of Oxford with first class honours in pre-clinical medicine and a distinction in clinical medicine. He leads the weight management service at The Clinic Holland Park.

Qual: MBBS, BSc, FRCOphth Miss Jennifer Doyle is a consultant oculoplastic surgeon and founder of The Clinic at Holland Park. She also works within the NHS as oculoplastics consultant at Milton Keynes University Hospital NHS Trust. She is a key opinion leader for Sciton, Sofwave, Skinstorm and Ameela.

Qual: BMBCh, MA(OXON), L7Cert, FRCOphth

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Injectables Neck and Décolleté

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Aesthetics

Stimulating Collagen in the Neck and Décolleté Dr Karla Murta introduces the injectable options to rejuvenate the neck and chest areas With the rising interest in facial rejuvenation procedures, imperfections in the neck and décolleté have become a growing concern. The neck and chest can reveal a person’s age as reliably as the face, but are still neglected in terms of treatments.1,2 This article seeks to offer valuable perspectives on collagen stimulation treatments for the neck and décolleté

The importance of neck and décolleté treatments Collagen, the most abundant protein in humans and the primary structural component of the dermis, plays a crucial role in providing strength and support to the skin.1 Over time, the deterioration of structural proteins and essential skin components leads to visible signs of ageing. Intrinsically aged skin is marked by thinning of both the epidermis and dermis, along with the flattening of rete ridges.1 The neck and décolleté areas are highly vulnerable to both intrinsic and extrinsic ageing, particularly photoageing, due to having thin dermal layers and fewer sebaceous glands, plus being frequently exposed to sunlight.1 Women in their 40s and 50s are particularly susceptible due to oestrogen deficiency and menopausal hormone changes, which further exacerbate collagen and elastin loss.2

Anatomical considerations A profound comprehension of the chest anatomy is critical when décolleté injectables are performed. The layers of the superficial chest wall include (from superficial to deep) skin, subcutaneous fat, pectoralis major, fat, pectoralis minor (arising in the midclavicular line) and ribs.3 In addition, it is essential to understand that the skin in this area has a thinner epidermis and dermis compared to facial skin.3 The neck can be divided into anterior and posterior triangles based on surface topography.4 The borders of the anterior triangle, our primary area of interest, are: inferiorly, the clavicles and the sternal notch; superiorly, the chin and lower mandibular border; and laterally, the sternocleidomastoid muscle.4 38

Key anatomical structures that must be avoided during injection are in the posterior triangle, as the great auricular nerve and external jugular vein run along the lateral aspect of the sternocleidomastoid muscle, which lacks coverage of the platysma muscle.4 A critical danger zone lies at the mid-transverse belly of this muscle, approximately 6.5cm below the external auditory canal.4 In the anterior-lateral portion of the neck, superficial veins, along with the anterior and external jugular veins and their tributaries, travel beneath the platysma.4 Additionally, the cervical branch of the facial nerve emerges from the inferior parotid gland, transitioning from the deep parotid-masseteric fascia to a subplatysmal plane to innervate the platysma.4 The marginal mandibular nerve is also at risk in the region extending from the mandibular angle to the oral commissure, within 1cm above and 2cm below the mandible.4 It is of utmost importance to keep the injections in the subdermal plane in the superficial subcutaneous layer to avoid reaching deeper structures.4

Injectable options Calcium hydroxylapatite (CaHA) Calcium hydroxylapatite (CaHA) is sterile, latex-free, synthetic and semi-permanent filler. Some examples of this type of filler used in the UK are HArmonyCa and Radiesse.5,7 For the neck and décolleté, only Radiesse is being used.

CaHA is designed to provide volume and promote neocollagenesis, making it effective for treating both facial and extra facial areas.2 Some studies mention that CaHA fillers can be constituted by 25 to 45 µm size microspheres of calcium hydroxylapatite (30%) suspended in a carrier gel (70%) consisting primarily of water, glycerine and carboxymethylcellulose.2,9 It is biocompatible because it is constituted by minerals that occur in bone and teeth (calcium and phosphate).2,9 The use of this material received approval from the US Food and Drug Administration (FDA) in 2006 for the treatment of moderate to severe facial wrinkles and folds, such as nasolabial folds, as well as for restoring and correcting facial lipoatrophy in individuals with human immunodeficiency virus (HIV).9 Studies have demonstrated that the collagen-stimulating effects of CaHA can Aesthetics | April 2025

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be optimised by diluting it with lidocaine or saline.10-12 This approach has recently been shown to effectively treat neck skin by promoting collagen and elastin synthesis and inducing angiogenesis. The treatment resulted in a notable increase in dermal thickness and enhanced skin mechanical properties, including improved elasticity and pliability.10,12 Animal studies have demonstrated that neocollagenesis begins as early as the fourth week post CaHA injection, and persists for at least 12 months, after which treatment can be repeated.14,15 The use of CaHA has been demonstrated to be safe, with a literature review of 5,081 CaHA treatments on 2,779 patients showing the most common complication was nodules (n=166), followed by persistent inflammation/ oedema (n=4), persistent erythema (n=2) and overcorrection (n=1).14,15 While no infections were noted in this review, the possibility of infection should still be considered when encountering an inflammatory nodule.15 Poly-L-lactic acid (PLLA) Poly-L-lactic acid was first synthesised in 1954 by a French chemist. As a synthetic material, it does not trigger animal sensitivity, eliminating the need for prior allergy testing.

PLLA is biodegradable, biocompatible and immunologically inert, and has been used in the human body since the early 1960s.18 The first PLLA-based product received approval in Europe in 1999 for treating fat loss in HIV patients undergoing antiretroviral therapy.17 Since 2004, its cosmetic applications in Europe have expanded to include the correction of deep nasolabial folds and various wrinkles in patients with a normal immune status.17 There are different brands of PLLA-based filler, including Lanluma and Sculptra, one of the most widely used products. Sculptra consists of microspheres measuring 40-60 µm in diameter, with each particle weighing up to 140,000d.19 Its irregular shape and high molecular weight contribute to its slow absorption. As all PLLA-based filler, Sculptra is supplied as a powder and, when reconstituted with 5ml of sterile water, contains 150 mg of PLLA per 5ml.19 PLLA formulations consist of a sterile, lyophilised substrate contained in a vial. To create a suspension for intradermal administration, a liquid phase – typically water – is added to the vial.19 After the implantation of PLLA, foreign body reaction and subsequent cellular inflammatory responses start in the tissues, leading to development of vascularised connective tissue.17 Later, non-enzymatic hydrolysis of PLLA liberates lactate for enzymatic (L-lactate dehydrogenase) alteration into pyruvate and oxidation to carbon dioxide.17 This process reduces after three months, while the number of collagen

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fibres increases.18 After six months, the synthesis of extracellular matrix components continues to contribute to gradual thickening of dermis.17 The microparticles of PLLA are still present in the tissue, continuing collagenogenesis without signs of inflammation 18 months after the injection.18 After eight to 24 months, a significant increase of type I collagen at the periphery of encapsulated PLLA particles is noticed.

Different techniques can be used to treat the neck and décolleté areas (Figure 1), and either needles or cannula can be used.17 In the neck, when using 25-27G needles, it is suggested the practitioner performs intradermal injections in the border of the dermis and hypodermis, using retrograde linear threads at an angle of 30-40o.17 If a 22-25G cannula is chosen, injections should be in the subcutaneous fat with a retrograde linear thread or fanning technique.17 In the décolleté region, it is recommended to use a 22-25G cannula in the subcutaneous fat, with a retrograde linear thread or fanning technique.17 Contraindications for this treatment include pregnancy or breastfeeding, autoimmune disease associated, a history of anaphylaxis, previous multiple severe allergies and known hypersensitivity to any of the components.2 Injections of PLLA-based products may cause adverse events:

· Injection-related adverse events

Common but short-term issues like haemorrhage, itching and skin tightness, which typically resolve spontaneously.17 In addition, more serious events have been described, including vascular compromise, due to an inadvertent intravascular injection or vascular compression.8 This is normally manifested as blanching, discolouration, necrosis or ulceration at the implant location or in the area supplied by the affected blood vessels.8 In addition, isolated cases of ischaemic events affecting the eye and the brain, causing loss of vision and cerebral infarction, have been described.8 · Implant-related adverse events Nodules or papules are common but usually palpable rather than visible; risk is higher in areas with thin skin.17 Causes may include uneven

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injection, concentrated material or incorrect dilution.17 · Hypersensitivity reactions Rare, delayed responses such as itching, swelling, erythema and granulomas, which require histological examination for confirmation. Treatment includes glucocorticoids and immunomodulation.17 Adverse event prevention strategies include proper injection technique, even distribution of material, correct dilution and post-procedure massage.17 In general, for collagen stimulation injections, cannulas are considered safer than needles. Needles cause more frequent and severe adverse events (AEs), including bruising, swelling and redness, compared to blunt cannulas.16 Moreover, cannulas are associated with significantly lower pain levels.16

Other injectables Polydeoxyribonucleotide (polynucleotides or PDRN), derived from salmon sperm, is gaining recognition in regenerative medicine and dermatology for its role in cellular repair and tissue regeneration. Composed of deoxyribonucleotides, PDRN promotes cell proliferation and angiogenesis, and has anti-inflammatory properties, making it a valuable therapeutic agent. Despite the huge change to number of practitioners using this product, the literature still lacks clinical trials to demonstrate its safety and efficacy in the neck and décolleté.20 The use of hyaluronic acid (HA) fillers for treating horizontal neck lines has become increasingly popular, despite limited published data on its efficacy and safety.

Most existing studies are retrospective and utilise the sharp needle technique.21 Skin boosters are injectable treatments distinct from dermal fillers, though both can be used for neck rejuvenation. Whilst primarily composed of HA, skin boosters contain smaller HA particles that aid in delaying ageing. They enhance skin hydration and revitalisation in the neck area.22 Typically, they are administered through intradermal micropuncture, with small aliquots injected along horizontal lines, approximately 4cm from the midline.22 Botulinum toxin injections into neck muscles have been widely recommended for neck rejuvenation, particularly in the appearance

Injectables Neck and Décolleté of superficial skin. Several studies suggest combining this approach with filler injections to enhance overall aesthetic results.24 The ‘Nefertiti Lift’ technique describes injections of toxin into the platysmal bands and along the inferior mandibular border.25 This technique is particularly suitable for younger patients with pronounced platysmal activity and well-preserved skin elasticity.25 A pilot study described using a combined hybrid mixture of CaHA, incobotulinum toxin type A (BTX-A), cohesive poly-densified matrix hyaluronic acid (CPM-HA) and sterile saline in a single session in 15 female patients with cervical skin flaccidity who sought neck rejuvenation. Retrograde linear fanning pattern in subdermal plane in the submental area and lateral parts of the neck was performed. They were followed up for 90-180 days. At the four-month follow-up assessment, 93.3% of patients demonstrated at least a 1-grade improvement on the 5-point scale. No serious adverse events were observed, with most being mild and temporary.4 Another study describes treating the neck and décolleté areas using the ‘Diamond Technique’. This approach utilises a diamond-shaped acetate device to perform a minimally invasive procedure that integrates CaHA, HA filler and incobotulinumtoxin A. The protocol begins with the application of a CaHA and HA mixture, administering 0.3ml per vector, totalling 1.5ml per cannula insertion site. Following this, once the area is anaesthetised, 0.1-0.2ml of hyperdiluted toxin is injected intradermally at each designated point. Using a combination of CaHA, HA and toxin can enhance firmness, smoothness and hydration while minimising platysmal bands.26

Enhanced collagen rejuvenation Effective rejuvenation of the neck and décolleté requires a tailored approach that considers anatomical features and ageing patterns of these areas. Minimally invasive treatments, particularly collagen-stimulating injectables such as CaHA and PLLA, offer promising results.

Dr Karla Orsine Murta Dias is an aesthetic doctor in London, UK. She also works as an ophthalmologist at Moorfields Eye Hospital NHS Foundation Trust. Dr Murta is dedicated to advancing the field through research, education and patient care.

Qual: MD, Medical Residency in Ophthalmology, PGCert (Aesth)

VIEW THE REFERENCES AT Figure 1: Patterns for neck treatment with PLLA, using a retrograde linear threads method with a needle (left), and a cannula technique with fanning (right)17

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AESTHETICSJOURNAL.COM 39

The

Winners On March 15, the ‘Oscars of Aesthetics’ made a spectacular return!

The Aesthetics Awards 2025 was our most dazzling ceremony yet. The event honoured some incredible achievements within the specialty over the past year, with 26 outstanding Winners receiving well-deserved recognition.

Grosvenor House in Mayfair was the perfect setting for an unforgettable evening filled with breathtaking gowns, endless photo opportunities, hilarious celebrity host Vernon Kay and dancing late into the night at the stunning Healthxchange x Medik8 Professional after party.

A heartfelt thank you to our 100+ judges, who meticulously evaluated each entry with fairness and expertise in line with our Independent Awards Standards Council accreditation, as well as to our nearly 3,000 community voters for their invaluable input.

We also extend our deepest gratitude to our sponsors – your support makes this extraordinary event possible year after year! Particular thanks goes to our Travel Partner Addison Lee for getting us home in style, and our new Strategic Partner the Northern Ireland Cosmetic Medicine Awards for helping us promote the incredible achievements of Northern Irish practitioners.

Congratulations to all our Winners, as well as those who received Commendations and High Commendations. With nearly 500 entries this year, becoming a Finalist is an incredible accomplishment. If you would like to receive feedback on your entry, contact the team via contact@aestheticsjournal.com before April 10.

Thank you for joining us at The Aesthetics Awards 2025 to celebrate the very best in medical aesthetic excellence!

THE AESTHETICS JOURNAL AWARD FOR OUTSTANDING ACHIEVEMENT IN MEDICAL AESTHETICS SUPPORTED BY HEALTHXCHANGE X MEDIK8 PROFESSIONAL

WINNER: DR KATE GOLDIE “I’m so proud. I actually feel a bit emotional about it because it’s been a long journey.

Aesthetics has changed a lot – the field is so innovative and all the people are so creative, so to be part of that and then recognised by it in this way really means something to me. The Aesthetics Awards is such a massive event and it’s so lovely to be a part of it.

I’m delighted!”

Dr Kate Goldie

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Highly Commended: British Association of Medical Aesthetic Nurses (BAMAN) Education & Training Committee Commended: • British College of Aesthetic Medicine (BCAM) MBCAM Award • SKCIN Melanoma and Skin Cancer Education Programme (MASCED Pro)

THE FOTONA AWARD FOR BEST INITIATIVE/ STRATEGIC PROJECT IN AESTHETICS

Finalists: • A List Conference

WINNER: JOINT COUNCIL FOR COSMETIC PRACTITIONERS (JCCP) ONLINE COMPLAINTS PORTAL “This is really fabulous. What’s so good is The Aesthetics Awards recognising the importance of the beginnings of aesthetics regulation. We’re really proud of this programme, the team behind it and how collaborative it’s been. These Awards are unbelievably important for the specialty itself, and being a Winner here tonight is a big breakthrough moment for the JCCP.”

• AestETHICS from IBSA Derma • Allergan Aesthetics, an AbbVie company, MD Codes Worldwide Tour • Beyond the Mirror

Professor John Underwood, JCCP trustee

Highly Commended: Interface Aesthetics Commended: Cliniva Cosmetic Training Finalists: • A Aesthetics North Coast Academy • Facetherapy Academy • Inspired Cosmetic Training • SkinViva Training Academy

INDEPENDENT TRAINING PROVIDER OF THE YEAR

WINNER: COSMETIC COURSES “Our team works so well together, so it’s lovely to win to applaud all their hard work. For The Aesthetics Awards to recognise us like this is amazing, and the team is unbelievably happy.

We’ve got another trophy on our shelf!”

Mr Adrian Richards, medical director at Cosmetic Courses

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COMPANY CHAMPION OF THE YEAR

WINNER: GARETH LEWIS – BRITISH ASSOCIATION OF MEDICAL AESTHETIC NURSES “I feel overwhelmed. It’s really nice to be appreciated in this way, so I’m feeling really grateful. I live and breathe nurses working in medical aesthetics, so it’s really nice to win after working with our BAMAN nurses for so long. The atmosphere here tonight is amazing, so I highly recommend coming along – it gets better every year!”

Gareth Lewis, chief operating officer, BAMAN Highly Commended: Lorna Bowes (AestheticSource) Commended: Faye Barrett (Obagi Medical) Finalists: • Kristina Arshad (Galderma) • Ocean Bellamy (GetHarley) • Caroline Courtney (Crown Aesthetics) • Chloe Fisher (AlumierMD) • Natasha Gahagan (SkinCeuticals) • Ellen Green (Cosmeditech)

THE ALLERGAN AESTHETICS, AN ABBVIE COMPANY, AWARD FOR BEST CLINIC TEAM MEMBER

WINNER: NICKY BARRACLOUGH – CLINIVA MEDISPA “I can’t believe it! I’m lost for words, this recognition is just amazing. I never thought I’d get this far, so you really have to enter and you never know what might happen! I’m having such a good time, it’s always such a great night at The Aesthetics Awards.”

Nicky Barraclough, aesthetician and clinic & training coordinator, Cliniva Medispa Highly Commended: Ellie Sargent (Simply Clinics) Commended: • Alexandra Olaru (South William Clinic Group) • Nefise Tasdelen (Dr Ducu London)

Finalists: • Soulla Alexandrou (Dr Medispa) • Emma Costello (SE1 Medical Aesthetics)

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• Megan Crooks (Balance Wellness) • Mandie Golding (Your Beauty Doctor) • Zoe Rendell (Wellface)

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THE SKINCEUTICALS AWARD FOR BEST NEW CLINIC, UK & IRELAND

WINNER: TIME CLINIC MEDICAL AESTHETICS AND WELLNESS “I’m literally shaking, I’m so happy that we’ve won! It means so much to us – we’ve worked incredibly hard since opening in March 2024, so we’re elated.

The Aesthetics Awards are the Oscars of the specialty, so we’re so proud to be taking this home to our team. The Awards is bigger and better than ever and the atmosphere is electric, so we’re buzzing to have won!”

Yogeeta Bawa, managing director and co-owner

Highly Commended: The One Clinic Commended: • The London Regenerative Institute • The MediShed by Dr Dil

• Dr Olivia MediSpa • Geneviv Medical • iQonic Aesthetics • KinDRed Skin Aesthetics • Pulse Laser Aesthetic Clinic

Finalists:

• R V Aesthetics

• Ciao Bella Aesthetics

• Skin Therapy Medical Aesthetics

• Danú Aesthetics

• The Avery Clinic

THE INMODE AWARD FOR BEST CLINIC IRELAND & NORTHERN IRELAND

WINNER: A AESTHETICS NORTH COAST “I am seriously hyperventilating! We’re so humbled to have won. This truly means a lot to our whole team. Our dream has been to win one of these Aesthetics Awards, so this is amazing. The ceremony is the crème de la crème of the specialty and is an incredible night, so we’re very thankful to have been recognised.”

Dr Ahrooran Sivakumar, medical director

Highly Commended: Array Aesthetics Commended: Dr Bonny Clinic Finalists: • Eden Medical Clinic

• ORA Clinic

• FaceTherapy NI

• South William Clinic

• Med Aesthetics

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Highly Commended: Nuceiva (Evolus) Commended: Juvéderm (Allergan Aesthetics, an AbbVie Company) Finalists: • Ellansé (Sinclair) • Sculptra (Galderma)

THE TSK LABORATORY UK AWARD FOR BEST INJECTABLE PRODUCT

WINNER: PLINEST (MASTELLI BY DERMAFOCUS) “This is a very proud moment for the whole team. To receive this recognition from the medical aesthetics specialty is a fantastic milestone for the brand. We are so happy and excited to be here and to be winners!”

Milad Bemana, DermaFocus executive director

Highly Commended: Perfect Skin Solutions Commended: • Dr Tanja Phillips Medical Aesthetic Clinic • Romsey Medical Practice

Finalists: • Anna Medical Aesthetics • Balance Wellness • Cambridge Clear Beauty • Dr Raquel Skin & Medical Cosmetics • Exthetics

THE MESOESTETIC AWARD FOR BEST CLINIC SOUTH ENGLAND

• Grand Aesthetics Clinic • Harrow On The Hill Dental & Facial Aesthetics • Radiance Aesthetic Clinic • The Doctor Clinic • Wellface

WINNER: ATELIER CLINIC “I’m absolutely chuffed! The Aesthetics Awards is the absolutely pinnacle of what we can achieve as a clinic and as a team – it doesn’t get any better than this! We have expanded the clinic this year, so this feels like an amazing validation of all my team’s hard work alongside the best of the best fellow Finalists.”

Dr Aggie Zatonska, medical director

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Highly Commended: Skinade Commended: Mesoestetic UK Finalists: • Candela • Crown Aesthetics • Totally Derma

THE ACE AWARD FOR BEST MANUFACTURER

WINNER: EVOLUS “This is absolutely unbelievable! We’re a relatively new company and we started as a small player, and what we’ve done over the last few years has been incredible. The team’s passion and grit have made this happen, and it’s just huge. The Aesthetics Awards has a huge buzz, and celebrates everything that’s great about the specialty – what a night!”

Suse Alexander, Evolus general manager UK & Ireland

THE SCITON AWARD FOR BEST CLINIC NORTH ENGLAND

WINNER: DR SOBIA MEDISPA “We are so humbled by this win. We have worked so hard to be the best we can for our patients. We are so happy to be here and to be recognised – it really is the biggest Award we could win in the specialty, so we are so grateful. Thank you so much to The Aesthetics Awards!”

Dr Sobia Syed, medical director Highly Commended: Dr Yusra Clinic Commended: Paragon Aesthetics

Finalists: • Amanda Azzopardi Aesthetics • Bank Medispa • Cliniva Medispa • Dr Kane Aesthetics Co. • Sculpted by Doctors • The Doctor and Company

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Highly Commended: Alastin (Galderma) Commended: • AlumierMD • P-TIOX (SkinCeuticals)

Finalists: • ALLSKIN | MED (AesthetiCare) • CellDerma • Hydropeptide (Wigmore Medical) • Melanopro Peel System (Dermalogica PRO)

SKIN PRODUCT/RANGE OF THE YEAR

• PCA Skin (Church Pharmacy)

WINNER: OBAGI MEDICAL (HEALTHXCHANGE) “This really means a lot to all the people who put the effort in to deliver this range. These Awards are everything to us, so it’s amazing to win! We’re beyond delighted – over the moon!

It’s a very exciting time for Obagi, and this Award is going to elevate us even more. Time to celebrate!”

Faye Barrett, Obagi Medical account manager

• Revision Skincare (AestheticSource) • Skinade (Bottled Science) • skinbetter science (AestheticSource) • System Lab Range (DIBI Milano) • ZO Skin Health (Wigmore Medical)

Highly Commended: • Thames Skin Clinic • The Cadogan Clinic

Commended: The Ghanem Clinic Finalists: • Ambra Aesthetic Clinic • Clinicbe • Dr Leah Cosmetic Skin Clinics • Dr Medispa • Facial Sculpting • House of Saab • London Aesthetic Medicine (LAM) Clinic • London Professional Aesthetics

THE LUMENIS AWARD FOR BEST CLINIC LONDON

WINNER: ADONIA MEDICAL CLINIC

• Self London

“This feels absolutely amazing! What an honour. Everyone at the clinic works so hard, so to be recognised by an Award of this calibre is absolutely huge. This evening is super exciting so it’s great to be here, and to win is the icing on the cake!”

• Takroni Clinic

Dr Ifeoma Ejikeme, medical director

• PICO Clinic

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Highly Commended: Clinic Grower Commended: Transformational Leadership Consulting Finalists: • Aesthetic Nurse Software • Aesthetics Comply • AesthetiDocs • Ignite Growth • Inspire to Outstand • LTF Digital • PatientPerfect • Quirky Frog • SJ Partnership • Zenoti

BEST SERVICE & SOLUTION PROVIDER

WINNER: HAMILTON FRASER “This is absolutely amazing, we’re so thrilled. This is our first win after being here many times, so this year is our year! It’s a credit to the team and a credit to the company, and it’s brilliant for the business to be recognised by the judges in this way. It is a very prestigious Award, so this win is fantastic.”

Tim Frome, Hamilton Fraser executive director

Highly Commended: Adonia Medical Clinic Commended: Dr Sobia Medispa Finalists: • Blend Skin & Medical Aesthetics • Cliniva Medispa • Dermal Clinic • Hampton Clinic • Martina Collins Clinic

THE PATIENTPERFECT AWARD FOR BEST CLINIC TEAM

• Paragon Aesthetics • South William Clinic Group • Thames Skin Clinic • The Aesthetics Club

WINNER: DR YUSRA CLINIC “This feeling is amazing. It’s such an incredible honour to win. It’s a true testament to my team – it’s a reflection of their hard work and I’m so proud of them. This night is awesome – we get to see all the best practitioners raising standards in the specialty, and the buzz is amazing!”

Dr Yusra Al-Mukhtar, medical director

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Highly Commended: PicoWay (Candela) Commended: LaseMD ULTRA (Seriderm) Finalists: • BYONIK Pulse Triggered Laser (Pure Swiss Aesthetics Ltd) • Emerald Laser (Erchonia) • EXION (BTL Aesthetics) • Gentlo (Beamwave Technologies)

DEVICE OF THE YEAR

• IgniteRF (InMode) • SkinPen Precision (Crown Aesthetics)

WINNER: SP DYNAMIS NX (FOTONA UK & IRELAND)

• Syndeo (Hydrafacial)

“It feels amazing to be a Winner! It was such tough competition this year, but we’re so proud to deliver these devices and be recognised for them. Thank you so much for this Award, we’re absolutely delighted and so honoured.”

• XCellarisPro TWIST (Dermaroller)

Dr Tanja Phillips, director of Fotona UK & Ireland

Before

THE SKINADEMD® SURGICAL PROGRAMME AWARD FOR BEST SURGICAL RESULT

WINNER: MR FLORIAN BAST

After

“I am honoured to receive The SkinadeMD Surgical Programme Award for Best Surgical Result 2025! Being recognised among such talented colleagues is truly inspiring. This Award reflects my commitment to natural, precise and personalised results, ensuring every patient receives the highest level of care. It is also a testament to the trust my patients place in me – a responsibility I never take for granted. A heartfelt thank you to my incredible team, supportive peers and wonderful patients. Congratulations to all the nominees and Winners!”

Mr Florian Bast, consultant ENT surgeon Highly Commended: Mr Michail Vourvachis Commended: • Mr Hazim Sadideen • Miss Sujatha Tadiparthi

Finalists: • Mr Nizar Hamadeh • Miss Elizabeth Hawkes • Mr Konstantinos Kopsidas • Ms Dhalia Masud • Ms Aoife Naughton • Mr Adrian Richards • Mr Rishi Sharma

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Highly Commended:

Before

After

• Dr Ana Mansouri • Dr Leah Totton

Commended: • Dr Shabri Chandarana • Dr Ahrooran Sivakumar

Finalists: • Dr Raquel Amado • Dr Bonny Armstrong • Dr Jordan Faulkner • Dr Jessica Halliley • Dr Kiran Judge

THE DERMAFOCUS AWARD FOR BEST INJECTABLE RESULT

• Dr Sita Madaan • Mr James Olding

WINNER: DR ANNA HEMMING

• Mr Hazim Sadideen

“It’s actually incredible to be a Winner, I can’t quite describe it! This is the biggest Awards ceremony in the specialty, so to be a winner here means so much to me. It’s not really about me though, it’s about my patients, because I couldn’t do it without them. The energy in the room tonight is massive – it’s such a huge event and everyone is having a great time celebrating everything we do.”

Dr Anna Hemming, aesthetic practitioner

Before

Highly Commended: Dr Cemal Kavasogullari Commended: Dr Ana Mansouri Finalists: • Dr Yusra Al-Mukhtar • Dr Nina Bal • Dr Rehanna Beckhurst • Dr Ifeoma Ejikeme

After

THE CROWN AESTHETICS AWARD FOR BEST NON-SURGICAL RESULT

• Dr Uliana Gout • Dr Anna Hemming • Dr Ahrooran Sivakumar

WINNER: MICHELLE MCLEAN “Oh my god, I did not expect this! This win means everything to me.

Everything I do is about championing standards in aesthetics and raising awareness for victims of facial palsy, so to receive this Award for this case means the world. The Aesthetics Awards is the best in the business and the atmosphere is electric, so I’m really buzzing to be a Winner.”

Michelle McLean, aesthetic nurse prescriber

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Highly Commended: MediZen Aesthetic Clinic Commended: • HHC Clinics • Pure Perfection Clinic

Finalists: • Air Aesthetics & Wellness Clinic • CJ Aesthetics Clinic • Dr Ana The Skin Clinic • Hampton Clinic

THE DERMAPENWORLD UK AWARD FOR BEST CLINIC MIDLANDS & WALES

• Midland Skin • Skintique Beautiful Smiles • Your Beauty Doctor

WINNER: ZENITH COSMETIC CLINICS “It’s amazing to win! This is 20 years in the making. We’ve never entered before as we thought being outside of the London hub meant it wasn’t for us, but we decided to put ourselves out there, and we’re delighted to have succeeded!”

Malti Maini, clinic director

Highly Commended: • E-50 HAIR Exosomes (Cosmeditech) • ULTRApulse Alpha (Lumenis)

Commended: CMT Post-Procedure Cream (Revision Skincare) Finalists: • BBL HEROic (Sciton Inc) • HA Microneedle Eye Patches (PCA Skin) • Klira Special (Klira) • Purasomes (DermaFocus) • Tri-Wave MD (Dermalux) • V-Tech Serum (Promoitalia UK)

THE DIGITRX BY CHURCH PHARMACY AWARD FOR BEST NEW INNOVATIVE PRODUCT

WINNER: AVICLEAR (CUTERA) “This is amazing, we’re very happy. We’ve worked hard to bring AviClear to the UK, so it’s fantastic to get recognition for that. It’s absolutely buzzing in the room, so it’s time to show off this Award! We always love The Aesthetics Awards, particularly when we win.”

Sam Keene, Cutera UK & Ireland regional director

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Highly Commended: Clinetix Commended: Estheva

Finalists: • Age Refined Medical Cosmetic Centre • Dermal Clinic • The Aesthetics Club

THE GALDERMA AWARD FOR BEST CLINIC SCOTLAND

WINNER: EST-ETHICS WELLNESS CLINIC “I’m so chuffed. It’s a fantastic feeling and it’s a real testament to my team, so thank you to The Aesthetics Awards and the judges. The hard work, sleepless nights and patient care we put into our clinic has all been worth it. This really is the best place to get the most prestigious prize in the field.”

Dr Cemal Kavasogullari, medical director

Highly Commended: Healthxchange Commended: AestheticSource Finalists: • Cure Medical • DermaFocus • HA-Derma • Harpar Grace International • Wigmore Medical

THE CCR AWARD FOR BEST DISTRIBUTOR

WINNER: CHURCH PHARMACY “To receive this Award for our distribution of PCA Skin is fantastic – we’re very proud, so thank you. We weren’t expecting this, but we really appreciate it! Our team is so fantastic, so this is a real validation of them making the company great. The Aesthetics Awards is the most prestigious in the whole UK specialty, so it’s a no-brainer to enter every single year.”

Zain Bhojani, Church Pharmacy co-director

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Highly Commended:

THE ALUMIERMD AWARD FOR RISING STAR OF THE YEAR

• Eleanor Hartley • Dr Cemal Kavasogullari

Commended: Dr Ben Taylor-Davies

WINNER: DR JORDAN FAULKNER

Finalists:

“The fact that I’ve won really hasn’t sunk in yet.

I’m absolutely buzzing to be taking home the trophy, and to get that external recognition. The Aesthetics Awards feels like New Year's Eve to me – it’s the pinnacle of the aesthetics calendar, and to win after all the build-up is amazing.”

• Dr Dorota Chudek

Dr Jordan Faulkner, aesthetic practitioner

• Dr Harry James

• Hollie Evans • Dr Jessica Halliley • Christina Hutchman • Dr Andrew Kane • Dr Sonakshi Khorana • Dr Carol Mastropierro • Dr Hazel Parkinson • Dr Ed Robinson • Dr Bethany Rossington • Dr Ahrooran Sivakumar

Highly Commended: Linda Mather Commended: • Anna Kremerov • Michelle McLean

Finalists: • Danielle Andrews • Amy Bird • Yuliya Culley • Jude Dunican • Áine Larkin

THE EVOLUS AWARD FOR AESTHETIC NURSE PRACTITIONER OF THE YEAR

• Brenda McKibbin • Jacqueline Naeini

WINNER: SARA CHEENEY

• Melissa Pugh • Lisa Waring • Elaine Williams

“I’m still in shock. This is a really amazing feeling. The judging standards at The Aesthetics Awards are so high, and it’s been a huge ambition to win this Award, so this is wonderful. I’m always striving towards patient safety, patient care and patient results, and I really am so passionate about my work in aesthetics, so to receive this recognition is incredible.”

Sara Cheeney, aesthetic nurse prescriber

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Aesthetics | April 2025

Highly Commended: Dr Uliana Gout Commended: • Dr Ifeoma Ejikeme • Dr Anna Hemming

Finalists: • Dr Raquel Amado

THE GETHARLEY AWARD FOR MEDICAL AESTHETIC PRACTITIONER OF THE YEAR

• Dr Nina Bal • Dr Rehanna Beckhurst • Dr Lisa Delamaine • Mr Sotirios Foutsizoglou • Mr Lorenzo Garagnani • Dr Anjali Mahto • Dr Ana Mansouri • Dr Beatriz Molina • Dr Ahmed El Muntasar • Dr Dev Patel • Dr Linda Simpson

WINNER: MR JAMES OLDING “I feel ecstatic! It’s a really unexpected win, but it means a lot.

It’s also really special to have my whole team here because I couldn’t do it without them. This event is standout in terms of the standards, the judging and of course the night itself, so to win is an incredible honour. It’s really inspiring to be here and see so much passion in one room.”

Mr James Olding, specialist registrar in oral & maxillofacial surgery

See you next year!

Massive congratulations once again to all our Winners, High Commendations, Commendations and Finalists! Don’t forget to tag us on Instagram @aestheticsjournaluk when sharing photos and videos of you and your team using the hashtag #AestheticsAwards2025. The Aesthetics Awards will return on March 14 2026, so mark your calendars now! Entry will open for the 2026 edition in early autumn.

Brand new for The Aesthetics Awards 2025 was the Charity Best Dressed Competition, supported by CellDerma.

Congratulations to our gorgeous winners Ida Bafende and Andrew Bennett!

Scan to donate

There is still time to donate to our incredible charity partner the BDD Foundation, which does amazing work supporting people struggling with body dysmorphic disorder.

Scan the QR code to donate now.

Photobooth sponsor

Networking Drinks and After Party sponsor

Aesthetics | April 2025

Charity Best Dressed sponsor

53

C E Ferulic 20+ Years of Proven Results

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Before

After 12 weeks**

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*16-week clinical study conducted on 50 caucasian male and female subjects ages 40-60 years old (USA, 2013). **Individual results (12 weeks daily use). Individual results may vary.

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Advertorial SkinCeuticals

8x Stronger Protection Against External Aggressors C E Ferulic’s triple-antioxidant system provides eight times the skin’s natural defence against oxidative stress.5 It reduces oxidative damage from UV, pollution and metals by up to 48% and lowers protein and lipid oxidation markers by 41%.6 This makes it particularly beneficial for those in urban locations, but is applicable throughout geographical environments.

Clinically Proven Skin Quality Benefits Over 12 weeks, C E Ferulic has been shown to improve skin firmness (+37%), elasticity (+36%) and radiance (+44%).7 It reduces fine lines (-27%) and wrinkles (-36%), improves skin texture (-43%) and minimises discolouration (-39%).8

C E Ferulic in My Clinic – ØNE aesthetic studiø At ØNE aesthetic studiø, C E Ferulic is an essential part of our skincare protocols due to its clinically proven antioxidant protection and post-procedure benefits. We integrate C E Ferulic pre and post treatment, particularly following laser procedures and in-clinic device-led treatments such as IPL to support healing, reduce downtime and enhance results.

C E Ferulic

by SkinCeuticals

C E Ferulic is compatible with all skin types and has been tested for post-laser application, demonstrating reduced oedema and faster recovery.8 In my clinic, we utilise the synergistic vitamin E component to enhance barrier support, particularly benefiting drier, post-menopausal and mature skin types. When combined with additional tailored active topicals, this accelerates healing and provides high patient satisfaction rates.

Dr Jonquille Chantrey discusses the clinically proven antioxidant serum for skin protection and post-procedure recovery

Many of the most remarkable transformations I’ve seen with the product is in patients with photodamage and global fine lines where I have combined IPL and microneedling with radiofrequency during a strategic programme. In these patients, C E Ferulic has reduced downtime and hyperpigmentation, enhanced skin texture and improved radiance, making post-device outcomes even more effective. Due to the high tolerability, patients demonstrate good concordance rates with at-home use.

C E Ferulic by SkinCeuticals is a globally recognised vitamin C serum, formulated under the Duke Antioxidant patent, to ensure optimal stability and efficacy of L-ascorbic acid. With 15% L-ascorbic acid, 1% alpha-tocopherol (vitamin E) and 0.5% ferulic acid, it provides superior antioxidant protection, enhances skin radiance and supports post-laser recovery.

"For 20 years, C E Ferulic has remained at the forefront of antioxidant science and products, consistently proving its efficacy through clinical trials and real-world results.

Its formulation has endured, continually delivering skin protection and rejuvenation, making it a highly valued tool in the portfolio of advanced and integrated, medical skincare regimens."

The Power of 15% L-Ascorbic Acid L-ascorbic acid (vitamin C) is essential for neutralising free radicals, reducing oxidative stress and supporting collagen synthesis. The Duke Antioxidant formulation ensures C E Ferulic meets the three criteria for efficacy: 1.

Pure L-ascorbic acid

2.

An acidic pH (below 3.5) for penetration

3.

An optimal 10-20% concentration1

Dr Jonquille Chantrey MD ØNE aesthetic studiø Cheshire

The 15% concentration achieves strong skin quality and photoprotective benefits while maintaining skin tolerability.

If you are considering an aesthetic treatment, always consult a Medical Professional.

C E Ferulic is a cosmetic skincare product for topical use. Only apply on healed skin."

Ferulic Acid: A Stabilising and Enhancing Agent Ferulic acid (0.5%) stabilises vitamins C and E, increasing their potency and photoprotective effects.2 Studies show combining ferulic acid with vitamins C and E enhances their antioxidant efficacy by up to eight times.3 Additionally, ferulic acid mitigates damage from UV exposure and pollutants like diesel exhaust and heavy metals.4

This advertorial was written by Dr Jonquille Chantrey on behalf of SkinCeuticals

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Aesthetics | April 2025

55

Case Study Lip Dissolving

Case Study: Lip Dissolution and Re-Treatment Dr Bonny Armstrong explains why dissolving overfilled lips and re-treating can be the best option to create facial harmony In medical aesthetics, the goal is to provide natural, understated and undetectable enhancements that complement patients’ features while maintaining harmony with their anatomy. Aesthetic treatments should avoid the risk of ‘overdone’ results, preserving the integrity and balance of the patient’s appearance.

However, we often see lip fillers done poorly or excessively, causing a fear with patients around the potential outcome of lip enhancements. Achieving a natural result requires more than technical skill; it demands a comprehensive understanding of the patient’s unique anatomy, product knowledge and a ‘less is more’ attitude.1,2 This case study explores how careful application of hyaluronidase, followed by a planned re-treatment, can achieve natural and harmonious results for a patient seeking corrective lip augmentation. By highlighting the transformative potential of this approach, this discussion allows us to think about the critical role of ethical practice and evidence-based decision-making in modern aesthetics.3,4

Emphasising natural results In medical aesthetics, treatment results are achieved with a combination of what the patient wants to achieve, and what is possible using our expertise, both anatomically and ethically. We have a duty of care to ensure our patients achieve results that enhance their features without distortion or exaggeration.

A common phenomenon that can cause patients to seek more treatments than necessary is ‘perception drift’, whereby they become accustomed to the initial results, viewing them as the new baseline and seeking additional treatments as they cannot remember how they looked before receiving any treatments.5 This trend can lead to overfilled and unnatural appearances, ultimately undermining the patient’s confidence and aesthetic goals.6,7 56

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Aesthetics

To combat this, we must adopt a structured and evidence-based approach.

Photographic documentation of the patient’s natural anatomy and baseline is an invaluable tool for maintaining perspective. These visual records provide a reference point to help patients appreciate the original enhancements and to guide discussions about further treatments.

In the instance that filler needs to be removed, dissolving with or without re-treating allows practitioners to reset the aesthetic canvas, and offers an opportunity for refinement and improved patient satisfaction. It allows practitioners to restore balance and symmetry and re-establishes patients' trust in the practitioner’s expertise, or in aesthetics as a whole.

Focusing on natural results aligns with a growing demand among patients for subtle improvements, and often translates into greater satisfaction as patients feel more confident and authentically themselves, rather than appearing obviously ‘treated’.7,8

Hyaluronidase in medical aesthetics Hyaluronidase is an enzyme that hydrolyses hyaluronic acid (HA), breaking the bonds between glucosamine and glucuronic acid in HA molecules.2,4 This allows for the effective dissolution of crosslinked HA dermal fillers, whether due to poor outcomes, migration or overcorrection.2,4 The enzyme has a rapid onset of action, with a half-life of approximately two minutes in plasma, although its effects on tissue may persist longer due to local distribution.1,3 It is crucial to wait 10-14 days before re-treatment to allow any residual enzyme activity to subside and ensure stable tissue architecture.1,3 It is crucial to note that while hyaluronidase is commonly used to dissolve dermal fillers, it is not licensed for cosmetic use here in the UK despite its approval for other medical applications, and is therefore used off licence.

Dosage and administration Hyaluronidase is typically supplied in vials of 1,500 units, which must be reconstituted before use. The dose required depends on the volume and density of the filler to be dissolved, the anatomical location and the degree of correction needed. A common dilution method involves mixing 1,500 units with 1-2ml of bacteriostatic saline, though dilution protocols can vary based on clinical judgment and product guidelines.4,7,8 The amount administered per session usually ranges from 10 to 30 units per injection site, with the total dose adjusted Aesthetics | April 2025

Aesthetics

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according to response. Injection techniques include bolus, fanning or microdroplet techniques, depending on the distribution and migration of the filler.4,7,8 Careful injection into the affected areas – such as the vermillion border in cases of lip migration – ensures targeted and even breakdown of the product.

To determine how much hyaluronidase to use, practitioners should consider:

· Type of filler used (higher-density fillers may require more enzyme)

· Extent of migration or overcorrection · Location and vascular considerations · Patient history and previous sensitivity reactions

To improve accuracy and safety, ultrasound guidance is an increasingly valuable tool.

Ultrasound imaging allows practitioners to visualise the exact location, depth and distribution of filler in real-time, aiding in both diagnostic assessment and treatment.

This technology can improve precision when administering hyaluronidase, reduce the risk of incomplete dissolution or inadvertent impact on native tissues, and enhance safety when working near vascular structures.9,10 Contraindications and risks Contraindications for hyaluronidase use include: 9,11

· Known allergy to hyaluronidase or

bee/wasp venom (cross-reactivity risk)

· Active infection or inflammation at the treatment site

· Significant prior allergic reactions requiring medical intervention

Potential complications include:

· Localised erythema, swelling or irritation at the injection site12

· Rare but serious hypersensitivity reactions, such as anaphylaxis4

· Risk of dissolving native hyaluronic acid, though this is transient, as native HA is rapidly replenished within 24 hours 6,11

A small intradermal injection can be considered, of which a diluted test dose is performed on the forearm, observing for any signs of hypersensitivity such as redness, swelling or itching within 20-40 minutes. However, there is debate regarding the necessity of routine testing, as reactions are rare and unspecific.

Practitioners should assess the individual patient’s risk factors and clinical history to determine whether a test is appropriate in their case.

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Case Study Lip Dissolving

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Aesthetics

Case study Patient background The patient, a 28-year-old female, presented with concerns about the aesthetic outcome of her previous lip augmentation. She had undergone five lip filler treatments with unknown products over four years equating to approximately 3ml over multiple sessions, which resulted in an unnatural, overfilled appearance. There was visible migration of filler beyond the vermillion border into the white lip, causing a projected and disproportionate effect (Figure 1).

As is often the case in such situations, when patients realise that their results no longer align with their expectations — or that they have developed an overfilled or unnatural appearance — they may begin to lose confidence in the original practitioner who performed their treatments. This can lead them to seek another injector whom they trust more to correct and refine their results. This highlights the importance of clear patient communication, ethical treatment planning, and managing expectations to maintain trust and long-term practitioner-patient relationships.

On examination, the filler’s density and volume had led to mechanical distortion of the patient’s smile and creasing in the upper lip, creating shadows at the corners of the mouth.

Additionally, an analysis of the patient’s side profile using the E-line (Ricketts line) and Burstone’s line revealed disproportionate protrusion of the lips.13,14 The E-line assessment, which considers the relationship of the lips to the nose and chin, showed that both upper and lower lips extended significantly beyond this ideal aesthetic guideline. Similarly, Burstone’s line, used to evaluate soft tissue contours, indicated excessive forward projection of the lips, disrupting facial harmony.

over-projection. A 4mm 30G needle was used for precision in defining the cupid’s bow, while the lateral lip regions were treated with a 0.5 inch 30G needle.

Aftercare The patient was provided with detailed aftercare instructions on both occasions to help reduce swelling and inflammation, reduce risk of bruising and bleeding and ensure healing. Aftercare advice following both hyaluronidase and filler injections included:4-10

· Avoiding alcohol, non-steroidal anti-inflammatory drugs (NSAIDs) and blood thinners for 48 hours to reduce bruising risk · Applying cold compresses to minimise swelling · Avoiding high temperatures, such as saunas or hot baths, for 72 hours She was instructed to report any signs of complications, such as prolonged swelling, severe pain or vascular compromise, and an emergency contact number was given.

Results and patient feedback At her follow-up two weeks after re-treatment, the patient reported feeling more confident and satisfied with her appearance (Figure 1). The patient reflected openly that she appreciated the honest assessment of her original lip filler, and felt the plan to dissolve allowed her to achieve a more refined result. The patient shared, “I finally feel like myself again. My lips look so natural, and I’m so grateful for the care and attention to detail I received. It’s such a relief to look in the mirror and feel confident in my appearance. I can’t believe the difference in my whole face!”

Before

After Dissolving

After Re-treatment

She had no allergies or ongoing health conditions. She had undergone a rhinoplasty 11 years earlier without complications.

Treatment plan 1.

Dissolution of upper and lower lip fillers: Using hyaluronidase to dissolve the existing filler and restore the lips to their baseline anatomy.

2.

Re-treatment: Reinjecting lip filler 14 days later, focusing on subtle enhancement and restoration of natural proportions. Volume added would be guided by consultation and assessment.

Method of treatment Step 1: Dissolution with hyaluronidase The lips were cleansed thoroughly with hypochlorous acid (Clinisept+) and prepared for injection. Using a 30G needle, 1,500 units total of hyaluronidase diluted with 2ml of bacteriostatic saline were injected into the affected areas in 10-unit boluses. The injections targeted the vermillion border and areas of migration to ensure even distribution and effective filler breakdown.

Promoting facial harmony

After administration, the area was gently massaged to facilitate the enzyme’s dispersion. The patient was observed for 30 minutes to monitor for any adverse reactions, particularly hypersensitivity or anaphylaxis. Post procedure, she was advised to avoid makeup, excessive heat and strenuous activity for 48 hours.11

This case underscores the importance of a patient-centred approach in medical aesthetics. Overfilled and migrated fillers can significantly impact a patient’s confidence and facial harmony. Hyaluronidase is a valuable tool for reversing suboptimal results, enabling practitioners to reset the aesthetic framework to natural anatomy.4,8

Figure 1: 28-year-old patient before, after filler dissolving and immediately after re-treatment.

Step 2: Follow-up and re-treatment Two weeks post dissolution, once the hyaluronidase had taken full effect, the patient’s lips were reassessed and examined. The filler had dissolved completely, and the lips had returned to their natural anatomy with restored symmetry and proportions.

For re-treatment, 1ml of Teosyal RHA2 dermal filler was used.

Employing a micro-bolus and linear thread technique, small amounts were placed strategically along the vermillion border and into the body of the lip to enhance definition without

Dr Bonny Armstrong is a medical director and owner of the award-winning Dr Bonny Clinic in Belfast. A regional expert and faculty member for Teoxane, the owner of the Dr Bonny Academy, clinic management system AesthetiDocs and co-founder of the NEXTGENERATION mentorship programme.

Qual: MBChB

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Aesthetics | April 2025

57

A Year of Innovation. A Future Full of Promise.

AviClear’s 2024 Year in Review At AviClear, 2024 was a year defined by progress and partnership. We broke barriers in acne treatment and delivered solutions that clinics and patients trust.

AS SEEN IN

01 Before

Unveiling Breakthroughs

Proven Results

AviClear is the first FDA-cleared energy device for lasting acne treatment across all severities.

Backed by rigorous clinical research, AviClear delivers visible, reliable, and long-term efficacy.

After 2 Treatment Sessions

Photos courtesy of Dr. J. Fromowitz. Results may vary.

Before

02 After 3 Treatment Sessions

Photos courtesy of Dr. L. Zanetti, ARNP. Results may vary.

Trusted by Industry Leaders

03

Clinics across the UK and Ireland count on AviClear to provide exceptional patient outcomes.

Before

After 3 Treatment Sessions

Photos courtesy of Dr. D. Verma . Results may vary.

Success Stories

04

AviClear is a breakthrough in acne treatment, offering FDA-cleared, long-term effectiveness. Having treated over 50 patients, I’ve witnessed its impressive, lasting results firsthand.

Dr Nestor Demosthenous The Mayfield Clinic

Explore What’s Next with AviClear. Visit cutera.co/aviclearukie2025 or scan QR code to learn more.

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Aesthetics

Advertorial AestheticSource

aestheticsjournal.com

The straightforward protocol combines Sunekos Performa and Sunekos 1200 on day one, followed by two or three further sessions of Sunekos Performa depending on patient needs.

Aura

The Rejuvenation Revolution Lorna Bowes presents an approach integrating augmented reality with injectables and topicals The aesthetics specialty is undergoing a transformative shift with the integration of cutting-edge technologies and comprehensive treatment strategies. This article will explore actionable insights for practitioners looking to elevate patient satisfaction, improve clinic profitability and position themselves at the forefront of aesthetic innovation.

Effective consultations Beyond marketing and other tools we use to bring patients into clinic, our most powerful asset is a truly collaborative patient consultation. A great consultation allows us to build a treatment plan that is aligned not only with the extensive range of clinically proven products we have at our fingertips in clinic, but specifically with our patients’ expectations of outcomes.

New augmented reality imaging technology, combined with improved camera and lighting options, is revolutionising these initial conversations, allowing a more interactive and profound conversation as we get to understand fully what our patients are hoping to achieve.

A treatment portfolio for 2025 Recent research from Rare Group has indicated a trend towards wellness and bio-rejuvenation, with a massive increase in demand for injectables that regenerate and stimulate rather than filling and temporarily effecting change.1 At AestheticSource, we continue to stay at the forefront of trends, working to ensure you can access the most comprehensive clinic menu while being supported by our business development managers and trainers, alongside our marketing and customer care teams. In parallel to these market shifts, we have launched a new integrated portfolio.

Rejuvapen NXT® FDA-cleared as a Class II medical device (clearance number K192138), this microneedling device delivers exceptional skin rejuvenation results with advanced safety features and precision control, ensuring effective and reliable treatment every time. Calibration freedom with an infinite dial adjustment allows for precise needle depth settings. This is supported by flexibility of two tips: Standard ISO™ 12-Needle Tip for standard treatments, and large diameter EXCEL™ 24-Needle Tip. It is made entirely of medical-grade aluminium, which allows for easy disinfection and greater durability compared to devices with plastic components.

Sunekos Sunekos is a pioneering aesthetic brand created by Sunekos Laboratories, the aesthetics division of Professional Dietetics S.p.A., an Italian research and development company dedicated to the medical application of patented amino acid based formulas since 1996.

This advanced injectable biostimulation treatment is renowned for its ability to maximally regenerate the extracellular matrix (ECM) through a patented combination of amino acids and hyaluronic acid (PCT/IB2015). The formulation stands out for stimulating the production of a wide range of essential skin proteins, such as collagen (types I, III, IV, VII), elastin and fibronectin. By acting directly on fibroblasts, Sunekos promotes deep and long-lasting regeneration for visible improvements in skin quality, superficial texture, hydration, elasticity and density.

Aesthetics | April 2025

Developed by Hexagon, the global leaders in reality technology, the Aura 3D Imaging System uses multiple cameras to capture a photo-realistic digital twin of a patient’s face and neck with a single capture, ready for analysis with an easy, fast and intuitive workflow on tablet or desktop. This analysis incorporates facial structures, skin condition and volumetric changes in an instant, creating a shared visual language between patient and practitioner.

By elevating your consultations with this shared visual language and highly accurate data, you can create patient confidence and minimise uncertainty by visualising and discussing real-life transformation before and after treatment.

Building confidence in treatment offerings Over the past 12 years, AestheticSource has supported clinics of all sizes to ensure they are offering their patients the very best treatment options. We travel the world to source the best brands to address the patient concerns you see daily in clinic.

We help you build a passive income alongside your in-clinic treatments with the confidence that we have done the due diligence to ensure not only regulatory compliance, but also results-driven success for patients and businesses alike.

Lorna Bowes is the Founder and CEO of AestheticSource, a leading professional aesthetics distribution company. An experienced business owner, aesthetic nurse and trainer, she has a deep understanding of aesthetic procedures and business management. A founding member of the British Association of Cosmetic Nurses (now BAMAN), Lorna is a respected lecturer and thought leader.

This advertorial was written and supplied by

To find out more, visit www.aestheticsource.com or call us on 01234 31 31 30

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Treatment Focus Perioral Region

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Aesthetics

Restoring Harmony with Perioral Rejuvenation Dr Yousrah Ahmed explores perioral rejuvenation using filler to lift and support soft tissues As patients age, the perioral area undergoes significant structural changes that alter facial aesthetics. This multifaceted process, influenced by both intrinsic ageing and environmental factors, often manifests as deepened nasolabial folds, volume loss, marionette lines and chin retrusion. Given the high vascularity and complex anatomy of this area, perioral rejuvenation poses unique challenges requiring careful technique and product selection.1 This article details a refined approach to perioral rejuvenation using varied viscosities of dermal fillers to provide volume restoration, targeted support and harmonious facial proportions.

Anatomical changes in the ageing perioral region As ageing progresses, the perioral region undergoes structural and functional changes including volume loss, tissue descent, decreased structural support and altered vascularity.

Volume loss and tissue descent Ageing in the perioral area is marked by volume depletion and tissue descent. Soft tissue resorption, along with bony changes in the maxilla and mandible, results in structural deficits that deepen nasolabial folds and marionette lines. Over time, loss of volume and support leads to a more aged appearance in the lower face.2 Structural support decline The perioral region relies on robust muscular and soft tissue support to maintain lip structure, symmetry and youthful contours. With age, the decline in muscle tone and tissue elasticity contributes to the development of perioral lines and diminished lip definition.2 Vascularity considerations The perioral area has a dense vascular network, which may increase the risk of vascular complications making filler injections challenging.3 Key vessels in the perioral area that are of importance are:

· Superior labial artery

Runs superior to the vermillion border along the lateral third of upper lip, then dips below the border as it approaches the middle third (Cupid’s bow).4

60

· Inferior labial artery

Horizontal trajectory in the lower lip at the level of the vermillion/cutaneous junction and is most commonly found between the orbicularis oris and the oral mucosa.4 · Submental artery Emerges from the facial artery near the mandible, curves around the submandibular gland, and runs forward on the mylohyoid muscle below the mandible. It supplies the chin and lower lip area.5 · Facial artery It emerges from the angle of the mandible in the deep plane below the mimetic muscles and courses superficially toward the oral commissure.4 Anatomical awareness is essential to avoid complications such as vascular occlusion, and achieve safe, predictable results.

Treatment approach and objectives The aim of perioral rejuvenation is to restore volume, support soft tissues and enhance overall symmetry of the lower face.5 This technique emphasises a comprehensive assessment of each patient’s unique anatomy, guiding practitioners in developing a personalised treatment plan tailored to the individuals' structural needs, aesthetic goals and safety considerations.6 How to approach patients during consultation In order to perform a successful consultation, practitioners should adopt a structured and patient-centred approach, focusing on both aesthetic and functional considerations.6

· Comprehensive assessment: Evaluate

overall facial balance, symmetry, volume loss, skin quality and functional aspects such as lip movement for a holistic approach. · Patient goals and expectations: Align expectations through clear discussions and visual aids, ensuring an understanding of realistic outcomes. · Risk awareness: Identify high-risk vascular structures and consider previous treatments or surgeries for safe filler placement. · Personalised planning: Select fillers based on tissue density and skin quality, choosing between cannula or needle Aesthetics | April 2025

Aesthetics

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techniques to optimise results and minimise bruising. A staged approach often achieves better outcomes.

· Safety and risk mitigation: Discuss

potential complications and manage risks with aspiration techniques, slow injections, vascular assessments and follow-ups as needed.

· Long-term strategy: Educate patients

on maintenance, combination treatments (e.g. lasers, skin boosters) and follow-up plans for sustained results.

Targeted areas and techniques Pyriform fossa Age-related bone resorption in the pyriform fossa contributes to mid-face flattening and deepening of the nasolabial folds.

Volume loss also affects the appearance of the upper lip.7 Injecting high G-prime fillers supports the nasal base, subtly lifting the mid-face and improving the nasolabial angle. This provides a foundational lift.1 This can improve the appearance of the mid-face without directly over-correcting the nasolabial fold.

Nasolabial fold Deepened nasolabial folds are often one of the first concerns patients report. These folds form due to soft tissue descent and volume loss in the mid-face. Moderate G-prime fillers are injected to soften these folds without over-filling, maintaining natural facial movement and expression.7 It is essential to address the underlying mid-face volume loss rather than overfilling the fold to avoid an unnatural appearance.7 Marionette lines Marionette lines, extending downward from the mouth corners, contribute to a downturned, aged expression, often exacerbated by over-contraction of the depressor anguli oris muscle. Restoring volume with moderate G-prime fillers lifts the mouth corners, creating a more youthful appearance.8 This treatment also indirectly redefines the pre-jowl area by reducing shadows caused by tissue laxity.⁸ As soft tissue support diminishes with age, hollows form around the pre-jowl sulcus, exaggerating shadowing and disrupting jawline contour.

By strategically restoring volume, the treatment softens these concavities, enhancing lower-face definition and creating a smoother, more youthful appearance Additionally, hyperdynamic contraction of the depressor anguli oris muscle may require treatment with a neuromodulator.

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Lips Lip ageing is marked by volume loss, diminished vermillion border definition, and vertical lip lines.⁹ Restoration requires a balanced approach that respects facial proportions. Medium or low G-prime fillers (patient-dependent) restore volume, enhance shape, and define the vermillion border while hydrating the lips.¹⁰ This also stabilises the orbicularis oris muscle, indirectly reducing upper lip lines.10 Filler choice depends on lip characteristics. Patients with thin, delicate mucosa, mild volume loss, or those seeking a soft, hydrated look benefit from low G-prime fillers, while those with thicker, more resilient lips and moderate to severe volume loss require a medium G-prime filler for more structure.9 Practitioners should avoid overfilling, which distorts facial harmony and increases risks of asymmetry, lumps, nodules, vascular occlusion and mucosal distortion.11 A conservative approach preserves natural features, ensuring better outcomes and reducing the need for corrections.

Lower face rejuvenation Restoring lower-face volume and structure is key to facial harmony. Targeting perioral lines, the chin and the pre-jowl sulcus addresses age-related concerns and enhances aesthetics.

· Perioral lines: Commonly known as

‘smokers’ lines’, these fine vertical wrinkles develop due to repetitive orbicularis oris muscle contraction, exacerbated by ageing, smoking history, sun exposure and skin phototype.¹⁰ Low or non-crosslinked fillers treat perioral lines, either directly with a needle or indirectly with a cannula.

Needle injections in the superficial dermis smooth fine static lines but carry a higher risk of bruising. A cannula may be preferable for patients needing more hydration or minimal trauma, especially those with thin, lax skin or a tendency to bruise. For more pronounced wrinkles, combining low-viscosity fillers with skin resurfacing treatments such as laser, radiofrequency or microneedling can enhance outcomes.¹¹ · Chin: Chin volume loss and retrusion disrupt the balance of the lower face.

Chin retrusion refers to the posterior displacement of underdevelopment of the chin relative to other facial structures. This is assessed in relation to the Pogonion. This is assessed using the Ricketts E-line.12 Injecting high G-prime fillers provides structural support, enhancing projection and improving overall facial symmetry.

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Treating the chin also benefits the appearance of the lips and jawline, creating a cohesive rejuvenation effect and a balanced profile. · Pre-jowl sulcus: Ageing in the pre-jowl sulcus contributes to the appearance of the jowls and a less defined jawline.12 The pre-jowl sulcus is the concavity that forms on either side of the chin, along the mandibular border, between the marionette lines and the jowl prominence. Structural loss in this area contributes to jowling through several mechanisms including resorption of the mandibular border, fat pad descent and ligamentous laxity causing further deepening.13 Addressing this area with medium to high G-prime fillers reduces the visual impact of the jowls, creating a smoother transition along the jawline.13 This treatment is particularly effective when combined with chin and marionette line correction.

Filler selection and placement strategy A tailored approach using fillers of varied viscosities or G-prime allows for precise correction of each anatomical area. Selecting fillers based on their rheological properties and applying them in a layered approach is crucial for optimal results. These crucial properties include hyaluronic acid (HA) content, viscosity of the product (G” prime), elasticity (G' prime), cohesivity and hydrophilicity.9 Each of these properties will determine which type of filler will be used in various areas.

A combination of crosslinked and non-crosslinked hyaluronic acid fillers are used. The strategy includes:

· High G-prime fillers: For deep support

in areas requiring foundational lifting, such as the pyriform fossa, chin and pre-jowl sulcus.7 · Medium G-prime fillers: For areas with moderate volume requirements, such as the nasolabial folds and marionette lines, where the goal is to lift without overfilling.8 · Low G-prime fillers: For delicate structures like the lip border, low G-prime and non-crosslinked fillers for perioral lines to refine contours without adding bulk. These fillers are to be injected superficially.9

Treatment Focus Perioral Region compromise.13 Adhering to safety protocols prevents complications like infections and scarring while fostering patient trust.

A combination of needles and microcannulas optimises precision helps to minimise complications.¹³ Cannulas are particularly useful in high-risk areas like the nasolabial folds and marionette lines.

Layering techniques – where deeper injections provide structural support, and superficial injections target fine lines – create a natural, balanced result.¹³ Deeper injections, placed at the subperiosteal level, restore volume and contour in areas like the cheeks, jawline, pyriform fossa and temples. Superficial injections, placed in the dermis or just below the epidermis, address fine lines and texture concerns, particularly in the periocular, perioral and forehead regions. In layering techniques, combining both techniques enhances outcomes, particularly in older patients with significant volume loss.7 The multi-layering technique begins by addressing the deep fat pads and finishes with superficial injections into the mobile subcutaneous fat pads.7

Perioral rejuvenation techniques Perioral rejuvenation requires an understanding of facial anatomy, ageing and filler rheology. This approach tackles the unique challenges of the perioral area, offering long-lasting rejuvenation and enhancing both facial harmony and patient confidence.

Dr Yousrah Ahmed is a dentist, aesthetic physician and trainer working with Interface Aesthetics academy. She is also a KOL for Relife Menarini UK, a level 7 qualified practitioner and assessor, and an external examiner for the Postgraduate Certificate in Facial Aesthetics at the University of Salford, UK. Qual: BDS. BSc. MFDS. PGDIP

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Safety considerations in a high risk-vascular area Precise anatomical knowledge is crucial for safe filler placement in the perioral region. Understanding vascular landmarks – such as the facial, submental and labial arteries – minimises risks. Retrograde injection, small aliquots, cannulas and regular aspiration help reduce vascular Aesthetics | April 2025

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Save the Date!

Shaping the Future of Medical Aesthetics

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25 & 26 September 2025 Excel, London

Mark your calendar 25 & 26 September 2025 Excel, London

CCR 2025 will once again unite the medical aesthetics community for two inspiring days of expert-led education, live demonstrations, and ground-breaking innovation. This year’s event promises more opportunities than ever for practitioners to connect, learn, and enhance their clinical practice.

I think the multi-disciplinary aspect of CCR is so great. People with different expertise and different specialties coming together to share knowledge and share ideas so we can get the best possible patient results Dr Jonquille Chantrey Global Key Opinion Leader ØNE Aesthetic StudiØ

Why the aesthetics community gathers at CCR

EDUCATION

Discover five CPD-accredited theatres with evidence-based panels, live demos, and case studies to keep you at the forefront.

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Clinical Practice Facial Harmony Initial assessment Prior to treatment, the patient was assessed using the Galderma Facial Assessment Scale (GFAS) to allow for a holistic, patient-centred and objective evaluation (Table 1).3 This assessment helped to determine the extent of volume loss and guided the treatment planning discussion. The GFAS outcome facilitated a discussion to align treatment goals, focusing on addressing facial volume loss, skin laxity and overall skin quality, while avoiding over-volumisation (Table 2).

Case Study: A Combined Approach to Facial Rejuvenation Dr Maryam McMillan explores a combined approach to facial rejuvenation for enhanced collagen production and recovery Facial rejuvenation treatments continue to evolve, offering patients a wide range of non-surgical options to address the signs of ageing such as volume loss, skin laxity and fine lines. In many cases, collagen stimulation and restoration are required to provide these rejuvenation results.

This article explores the rationale and evidence behind a typical treatment planning process, associated treatments and protocols, and the clinical and patient outcomes achieved. It also demonstrates how combined therapies – in this case skincare, CO2 laser and poly-L-lactic acid (PLLA) injections – can address complex patient needs and deliver high-quality results.

Patient profile This case report discusses the treatments of a 51-year-old male patient who presented with complaints of facial volume loss and skin laxity. He had not undergone any previous aesthetic treatments or surgery, had a healthy medical history and had never smoked. His primary treatment goals were to improve his facial aesthetics using non-surgical treatments.

Galderma Facial Assessment Scale (GFAS)3 – Scores Baseline 0 – None 1 – Mild 2 – Moderate 3 - Severe

3 Months 0 – None 1 – Mild 2 – Moderate 3 - Severe

6 Months 0 – None 1 – Mild 2 – Moderate 3 - Severe

9 Months 0 – None 1 – Mild 2 – Moderate 3 - Severe

Skin Quality 1. radiance/glow 2. firmness 3. skin colour unevenness

6

3

2

2

Skin Sagging

2

1

1

1

Volume Loss

3

1

1

1

Static Lines

2

1

1

1

Dynamic Lines

2

1

1

1

Table 1: Galderma facial assessment scale (GFAS) scores at baseline, three, six and nine months

Aesthetics | April 2025

Prior to applying the GFAS scale, facial volume loss and laxity were evaluated through visual inspection, palpation and patient history. The areas of the face were clinically assessed for hollowness in key areas such as the cheeks, temples and jawline, along with skin redundancy and elasticity changes. Additional considerations included asymmetry, bone structure and soft tissue support, to determine the degree of volume depletion.

In addition to the GFAS, objective measures such as clinical photography and patient feedback during follow-ups were utilised. The GFAS scoring system evaluates facial characteristics on a four-point scale: 0 – ‘none’, 1 – ‘mild’, 2 – ‘moderate’ and 3 – ‘severe’.

The assessment tracks changes in skin quality, sagging, volume loss, static lines and dynamic lines over the course of treatment. The results in this case demonstrated significant improvements, with scores decreasing progressively across all evaluated parameters.

Treatment planning It was decided that the treatment plan would begin with the SmartXide fractional CO2 laser therapy to improve skin texture and tighten lax skin, making it an ideal preparatory step for the subsequent treatments. The combination of CO2 laser and PLLA demonstrates a synergistic effect in attaining optimal aesthetic outcomes, supported by prior evidence which demonstrates enhanced neocollagenesis when laser treatments are combined with biostimulatory agents.4 The potential risks associated with CO2 laser resurfacing were discussed, which included the common risks of transient erythema and skin roughness, in addition to rarer complications such as localised cutaneous burns and post-inflammatory pigmentation.4-6 To mitigate these risks, post-laser care recommendations included: gentle skincare hydration, strict sun protection and avoidance of active ingredients, such as retinoids, for at least two weeks.8-10 65

Clinical Practice Facial Harmony

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The patient was then informed about subsequent PLLA injections’ role in stimulating collagen production and restoring facial volume over time, with visible results typically appearing between three and six months with potential outcome longevity of up to 24 months.7,8 There are several PLLA brands available, In this case, Sculptra was the product of choice due to its effectiveness in treating volume loss in areas such as the cheeks, temples and jawline that is well-supported by clinical research.1,9 The patient was made aware of the potential side effects of Sculptra which include swelling, bruising and tenderness, as well as rarer risks such as granuloma formation.1,9,13 Alternative options, including hyaluronic acid-based dermal fillers, fat grafting and polycaprolactone-based products were discussed.12 The patient decided against fat grafting due to his desire to have a non-surgical treatment. The treatment plan included a skincare regimen to prepare the skin and enhance the longevity of results. With many brands available, Alastin was the recommended option to prepare the skin and enhance outcome longevity.

Treatment protocol Skincare Skin preparation is a crucial step in aesthetic procedures as it enhances healing, optimises treatment outcomes and reduces the risk of post-procedure inflammation. A well-prepared skin barrier allows for better absorption of active ingredients, reduces the risk of post-procedure inflammation and ensures a more even and lasting result.15-17 In order to optimise treatment outcomes, the patient’s skin was prepared six weeks with Alastin Regenerating Skin Nectar with TriHex Technology, which includes tripeptides and hexapeptides known to support skin recovery and collagen production, is also known to enhance skin recovery and support improved treatment results.11 Additional skincare recommendations included the discontinuation of any retinoid-based products at least two weeks before treatment to reduce the risk of irritation.

Alastin Skin Nectar has also been shown to minimise post-operative erythema and skin roughness following treatment with CO2 laser.4,10 Therefore, the product was continued throughout the treatment protocol in order to optimise the outcome of the rejuvenation procedures and skin maintenance programme. The patient was advised to apply one pump to the face twice daily for the six weeks prior to treatment and during the entirety of the treatment programme. The product was applied immediately after both the laser treatment and Sculptra injections to support healing.

The patient was recommended to apply it with gentle strokes, massage into the area and avoid getting the product in the eyes, rinsing thoroughly with water if contact occurred.11 CO2 laser Prior to poly-L-lactic acid therapy, the patient underwent three sessions of CO2 laser therapy using the SmartXide CO2/ CoolPeel protocol at six weeks apart.14 This protocol differs from traditional CO2 laser therapy, as it delivers fractional laser energy with less downtime, reducing risks while achieving skin resurfacing benefits. CO2 laser resurfacing is known to improve skin texture and laxity through collagen stimulation and skin remodelling.5,6,10 A six-week recovery period was observed to allow the skin to fully heal, to enhance the effectiveness of the subsequent PLLA injections. The Alastin Skin Nectar was immediately applied after the laser treatment was performed.10 Post-laser aftercare Area

Entry

Cannula

Vessels to avoid

Temples

Lateral to temporal fusion line

22G, 50mm, linear retrograde threading at subcutaneous plane

Superficial temporal artery, middle temporal vein

Mid-face

Preauricular

22G, 50mm, fan-shaped retrograde threading at subcutaneous plane

Facial artery, infraorbital artery, angular artery

Lower face

Posterior jawline

22G, 50mm, linear retrograde threading at subcutaneous plane

Facial artery, submental artery, inferior labial artery

Jawline

Posterior mandible

22G, 50mm, long, linear retrograde threading along the jawline at subcutaneous plane

Facial artery, external jugular vein, retromandibular vein

Table 2: This table outlines the entry points, cannula specifications and key vessels to avoid for subcutaneous PLLA threading in various facial areas, ensuring safe and effective aesthetic procedures

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included: applying a cold compress to reduce inflammation and swelling, and use of a bland occlusive moisturiser preparation, such Aquaphor, to keep the treated area hydrated.15 PLLA The patient received an initial treatment with two vials of Sculptra. The Sculptra was prepared by reconstituting 150mg of the product with 8ml of sterile water for injection and 1ml of 2% lidocaine hydrochloride, and was administered immediately after reconstitution using an aseptic technique to minimise discomfort and reduce the risk of infection.1,13,16 A 22G microcannula was used for the injections into four areas (see Table 2).

For additional safety, slow, controlled deposition passes of 0.1ml were performed to minimise the risk of vascular complications and nodule formation.13,16 The injection technique avoided the perioral and periocular areas to minimise the risk of adverse effects.

The patient was instructed to perform the 5x5x5 massage regimen – massaging the treated areas five times daily for five minutes over the course of five days.17 This protocol is essential for ensuring even product distribution and reducing the risk of nodule formation.18,19 Additional aftercare advice included avoiding excessive heat exposure e.g. saunas and hot showers for 48 hours, minimising alcohol intake and vigorous exercise for 24 hours, and using a gentle skincare regimen to support healing.17-19 At the six-week review, an additional two vials of Sculptra were administered using the same technique.

Treatment outcomes Follow-up evaluations were scheduled at three, six and nine months, with baseline and nine-month follow-up photographs taken for comparison (Figure1&2). The GFAS outcomes demonstrated enhanced and sustained improvements in facial aesthetics when compared to baseline, with the most notable improvements being in skin quality and volume (Table 1).

Clinically, reductions in volume loss and skin sagging translated to visible rejuvenation, improved facial contours and greater overall symmetry. These improvements highlight the effectiveness of PLLA injections in collagen stimulation and long-term volumisation, supporting its role in non-surgical facial rejuvenation protocols.

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Before 1

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Clinical Practice Facial Harmony

were significant improvements in overall skin quality, including enhanced skin texture, improved skin volume and a reduction in fine lines around the eyes. His goals of natural enhancement and subtle volume of restoration were achieved, and he appreciated the natural effects that the treatment plan provided.

Before 2

Implications for aesthetic practice

After 1

This case report highlights an evidence-based, patient-centred approach to treatment, combining skincare, CO2 laser therapy and PLLA injections for effective facial rejuvenation. Addressing volume loss, skin laxity, and texture concerns, these treatments provided natural, long-lasting results with minimal downtime, offering non-surgical solutions for ageing signs aligned with the patient’s aesthetic goals.

After 2

The treatment protocols described in this case report are particularly beneficial for individuals seeking non-surgical solutions to combat signs of ageing, providing significant improvements with minimal downtime and durable effects.

Figures 1 & 2: 51-year-old male patient at baseline and nine months after completing a comprehensive treatment plan including skincare, fractional CO2 laser and PLLA injections

Patient follow-up and feedback The patient tolerated the treatments well, reporting minimal discomfort during and after the procedures. When presenting at the follow-up appointments scheduled at three, six and nine months, he expressed high satisfaction with the results and no side effects were reported (Figure 2). Over time, there

Dr Maryam McMillan is the founder and clinical director of the Ambra Aesthetic Clinic. With a background in aesthetic dentistry and a passion for facial aesthetics, she blends medical expertise deliver natural, patientfocused results. Dr McMillan holds an honours degree in pharmacology and a dental degree from the University of Sheffield, later earning membership to the Faculty of General Practice at the Royal College of Surgeons of England.

Qual: BSc (Hons), BDS, MFGDP (UK)

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Advertorial Aesthetica Solutions

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Elevating Aesthetic Care with

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Before

After

Before

After

Innovation and Expertise Aesthetica Solutions empowers businesses with innovative solutions to streamline operations and drive growth As the pharmacy of choice to some of the UK’s leading cosmetic clinics, Aesthetica Solutions is proud to stand for innovation. Always at the forefront of supporting the most advanced and ethical choices, they’ve really made a name for themselves as a competitive online pharmacy service. They are dedicated to customer service, taking the time to understand a client’s needs and striving to achieve a friendly, personal working relationship with each and every client. This partnership approach has proven successful in supporting clinics in their growth.

InstaScript: Fuss-free prescribing Aesthetica Solutions are always looking for new opportunities to streamline business for their clients. They’ve created InstaScript, an online prescription generation platform, custom built exclusively for Aesthetica Solutions. It allows practitioners to create and generate prescriptions online, reducing time that practitioners need to spend on administration. As a further bonus, clients are able to access 1% cashback on all orders placed above £250.

Hot trend: Exosomes Aesthetica Solutions loves to lead on trending aesthetic topics, including exosomes – the hot topic in the aesthetics field. Be among the first to experience the latest breakthrough in regenerative aesthetics, featuring highly concentrated formulations and maximum efficacy achieved through premium-sourced ingredients and a fully-integrated, cultivation and production process.

Xomage: A vial for youth Highly Purified Exosomes by puriMax Technology™ offer a promising, safe approach to aesthetics due to higher biocompatibility and accessibility. These exosomes are engineered for superior skin compatibility delivering long-lasting results. In combination, they promote stronger activity of fibroblasts.

Two female patients aged 35-years-old (top) and 42-years-old (bottom) before and 28 days after four XOMAGE treatments administered via microneedling

How to use XOMAGE · 100mg/1 vial · Add 3ml-5ml of saline into the vial of

lyophilised powder and mix thoroughly

· Cleanse the skin and dry it completely · Apply XOMAGE on the skin immediately after mixing and use microneedling and post laser treatment.

Hair care Xomage products have emerged as an excellent treatment option for hair loss, owing to their regenerative properties.

Exosomes promote hair growth by acting on various cellular and molecular processes involved in the hair follicle.

Before

After

Fibroblasts represent the major skin type in the dermis, where they have a key role in producing and maintaining the extracellular connective tissue that is crucial to maintaining the youthful appearance of skin.

Puri Max TechnologyTM Rediscover safe and authentic exosomes. We offer Purimaxomes standardised regulation and quality system via PuriMAX technologyTM.1 In-house cultivation maximises mass production efficiency, and the purification capability of the exosomes. For full assurance, the research team tests the vial to verify whether each vial retains full viability and particle quantity after the lyophilisation process.1 PuriMAX platform is the newest and most standardised technology for isolation and purification of highly effective exosomes.2

Facial care Aesthetica exosome therapy Xomage is administered via microneedling to renew and proliferate the skin. It stimulates fibroblasts in the dermis to form collagen and elastin fibres to give elasticity to aged skin and shrink pores. It also stimulates collagen production in the body and keeps the cell active.

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Aesthetics | April 2025

23-year-old male patient before an Aesthetica Xomage H therapy treatment and three weeks after his second treatment supplied by Stephanie Hughes @advanced_aestehetics1

This advertorial was written and supplied by

If you’d like to know more about exosome therapy or other high grade aesthetic products, or register for InstaScript, please visit www. aestheticasolutions.co.uk or call us on 0203 876 5222

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Clinical Papers Practice News Abstracts

A Summary of the Latest Clinical Studies The latest research highlight from Professor Sebastian Cotofana and The Harley Academy Research Group World-renowned anatomist Professor Sebastian Cotofana shares a key study influencing the world of medical aesthetics.

Title: Effect of Synchronized Radiofrequency and High-Intensity Facial Electrical Stimulation (HIFES) of the Upper Face Authors: Frank K, et al.

Published: Aesthetic Surgery Journal, January 2025 Keywords: Devices, Muscle Stimulation, Radiofrequency The decline in facial soft tissue filler usage is becoming increasingly apparent, and both practitioners and the specialty as a whole have begun using the term ‘filler fatigue’ to describe this emerging phenomenon. Patients frequently express a desire for a more natural appearance, seeking facial rejuvenation without the stigma of overfilled cheeks or lips. These preferences are understandable and should, in fact, guide every injector in their approach to reducing the signs of facial ageing and enhancing individual beauty.

Alternative treatments have been gaining attention, with biostimulators, neuromodulators and energy-based devices (EBDs) leading in popularity. EBDs utilise various forms of energy

to target facial soft tissues, producing clinically observable effects such as skin tightening, reduced sagging and facial soft tissue repositioning.

A recent study by Frank and his colleagues evaluated the clinical outcomes of synchronised radiofrequency (RF) and high-intensity facial electrical stimulation (HIFES) for forehead treatment. This non-randomised clinical investigation revealed a statistically significant improvement in forehead and lateral canthal line severity at each follow-up visit compared to baseline. Additionally, the medial, centrals and lateral eyebrow positions increased by 3.18 mm, 3.02 mm and 2.27 mm, respectively.

This indicates that applying energy to the forehead can tighten the frontal soft tissues, which results in the elevation of the eyebrows. But if the frontal soft tissues, which include the frontalis muscle, increase in their tone, why does the forehead line severity decrease instead of increase? It would make sense to assume that if the frontalis muscle increases in its tone, more wrinkles are visible. The answer to this question is only accessible if frontal anatomy is understood in greater detail.

The frontalis muscle is covered on its surface by the suprafrontalis fascia, and on its undersurface by the subfrontalis fascia. Both fasciae form a connective tissue coverage for the frontalis muscle; this can be compared to a sleeping bag surrounding the frontalis muscle. When energy is applied to the frontal soft tissues, the sleeping bag tightens, and the frontalis muscle inside can relax without having to exert as much effort to maintain the eyebrows in their regular position, as this is now done by the tightened sleeping bag instead. Therefore, the clinical result of this effect is a reduction in horizontal forehead lines.

Title: Evaluating Poly-D,L-Lactic Acid for Lower Eyelid Rejuvenation: Efficacy and Safety

Title: Cannulated Intravaginal Injection Technique (CIVIT) A Novel Vaginal Injection Technique

Authors: Wan J, et al.

Authors: Leylek O, et al.

Published: Journal of Cosmetic Dermatology, March 2025

Published: Scientific Reports, March 2025

Keywords: Lower Eyelid, Injectables, PDLLA

Keywords: Cannula, Hyaluronic Acid, Vaginal Rejuvenation

Injectable fillers like PDLLA offer a novel approach to addressing lower eyelid rejuvenation. Despite their growing popularity, comprehensive studies on newer products like PDLLA are limited.

This study evaluates the efficacy and safety of PDLLA (Juvelook, VAIM Inc., Seoul, Korea) for treating tear trough deformities in Korean women, aiming to provide a long-term, minimally invasive solution for periorbital rejuvenation. A selected group of Korean women exhibiting tear trough deformities underwent treatment with PDLLA. Patients were assessed pre treatment and followed up at one week, one month and six months post treatment, with outcomes measured by independent clinicians using the Hirmand classification and patient satisfaction scores. PDLLA demonstrated significant improvements in tear trough deformities with high patient satisfaction and minimal adverse effects. Follow-up results showed sustained improvements and no severe complications, indicating a safe profile for PDLLA. The study highlights PDLLA’s potential advantages over traditional fillers, including longer-lasting effects and enhanced collagen production, suggesting it as a superior option for those seeking durable aesthetic improvements. PDLLA is an effective and safe treatment for periorbital rejuvenation in Korean women, providing lasting benefits and high patient satisfaction, warranting further comparative studies for broader applications.

In our study, we aimed to demonstrate a new intravaginal injection technique, cannulated intravaginal injection technique (CIVIT), with which we can perform vaginal injection more homogenously and less traumatically, with more efficacy for the entire vaginal mucosa.

Retrospectively, the data of 44 patients who underwent intravaginal injection of HA manufactured for genital use at a private Female Health Clinic were analysed. Of the 44 patients, 21 were injected using the random needling technique, and 22 were injected using CIVIT. All patients had symptoms of genitourinary syndrome (GUS), a vaginal health index below 15, and were compared based on the Female Sexual Function Index (FSFI) and visual analogue scale (VAS) for GUS before and after the procedures. It was observed that all post-injection values, except for FSFI arousal, were statistically significantly higher in the CIVIT group. Post injection dryness, dyspareunia and discomfort values decreased significantly in the CIVIT group compared to the Random Needling group. Our new technique, CIVIT and random injection, which is a frequently used technique, are two effective techniques for vaginal rejuvenation.

However, CIVIT is significantly more effective than the random technique in improving genitourinary symptoms, vaginal health index and sexual function.

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Mental Health Burnout

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Navigating Burnout in Aesthetics Nurse prescriber Julie Scott delves into her personal experience with burnout and offers practical strategies for overcoming it As I write this piece, I find myself on a much-needed month’s break from my clinic – a deliberate act designed to allow me to pause, reflect and rejuvenate. This respite affords me a rare opportunity to gain perspective on the unique pressures our sector imposes and to contemplate effective strategies for enhancing both personal and team wellbeing.

This wasn’t always my approach. For years, I pushed myself too far, disregarding the ever-present warning signs of mounting stress and chronic fatigue. It wasn’t until I encountered burnout – a profound exhaustion that left me disillusioned and emotionally depleted – that I recognised the vital importance of taking regular breaks. This eye-opening experience taught me that self-care is not a luxury, but a necessity for sustaining a long and fulfilling career in our demanding field.

The pressure of competition and self-promotion Aesthetics is a field of relentless competition, where practitioners often struggle for recognition. With success frequently measured by social media, patient testimonials and accolades, the pressure to stand out can be overwhelming. This constant drive to showcase our skills and maintain a ‘polished’ image fosters an environment ripe for comparison, self-doubt and anxiety, all of which can aggravate burnout.2 I vividly recall a particular Christmas that crystallised my own battle with burnout. The holiday period, traditionally a time of joy, celebration and reflection, felt starkly different for me. Instead of the anticipated joy, I found myself submerged in a deep sense of numbness. The festivities seemed to fade into the background as I grappled with an unshakeable fatigue that no amount of rest could alleviate. In those quiet moments of introspection, it became glaringly apparent that I was experiencing burnout. The relentless pursuit of professional success had left me emotionally drained and physically depleted. My clinic, which had once been my passion, had transformed into an exhausting grind, where every achievement never seemed enough.

This obsession of maintaining a flawless public persona extended beyond my professional achievements and into the personal realm.

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The lines between work and ‘me time’ blurred, leaving little room for genuine relaxation. The fear of falling behind or not measuring up became an ever-present shadow, intensifying stress and contributing to my sense of burnout.

This is a universal experience that can affect anyone, but it is more prevalent among certain personality types and professions.

Perfectionists, type A personalities and highly empathetic individuals are particularly prone due to their self-critical nature and high personal expectations.7 Sectors with high stakes, such as aesthetics, healthcare and education, also see higher rates of burnout due to their intense emotional and professional demands.7 Research highlights that individuals in these groups are more likely to experience emotional exhaustion and stress-related symptoms.7

Recognising the subtle signs of burnout Burnout often manifests in ways that are not immediately evident.

It is not just a state of exhaustion, but can subtly permeate many facets of life. It may present as a sense of numbness, where the initial fervour and passion for one’s work gradually gives way to a muted, mechanical engagement. Emotional exhaustion may surface as an overwhelming sense of being inundated, even when one’s schedule appears manageable.1,6 Physical symptoms, such as persistent fatigue or recurrent ailments, can also signal the onset of burnout. Moreover, burnout can erode personal satisfaction, manifesting as a diminished sense of accomplishment and a growing detachment from both professional duties and personal relationships. Recognising these nuanced signs is crucial for addressing burnout before it fully takes hold.1 Another contributing factor to burnout is imposter syndrome – a persistent feeling of self-doubt and fear of being exposed as a fraud despite any success.4 These feelings often pushed me to overwork, driven by a need to overcompensate for my perceived inadequacies. The chronic self-doubt and anxiety associated with imposter syndrome created a cycle of emotional fatigue and stress, as I constantly felt the need to be perfect and feared failure.

Recognising these patterns in myself, I realised the importance of finding ways to break the cycle and support my wellbeing.

Aesthetics | April 2025

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Strategies for overcoming burnout Once I recognised burnout, I took deliberate steps to recover and create a balanced state. Strategies that have helped me include, acknowledging and accepting, creating a restorative routine, seeking professional help and more.5 Acknowledge and accept The first step is acknowledging burnout. I have found that acceptance allows you to confront the issue and begin healing.

Create a restorative routine Make small adjustments to your routine, like modifying work hours or delegating tasks, to reduce stress over time. Prioritise rest and relaxation through activities like meditation, yoga or walks in nature. A consistent routine helps rebuild energy and reduces overwhelm. Engage in hobbies outside of work to bring joy and balance. For me, riding my horse or gardening provided a sense of purpose and relaxation.

Set boundaries and prioritise downtime Clearly separate work from personal time.

Allocate time for relaxation to unwind and recharge. A colleague advised me to compartmentalise, focusing on one task at a time to manage stress. Sometimes, this will require disconnecting from work and the aesthetics field altogether, allowing for meaningful recovery. You have to remind yourself that this recovery is essential, and fight the FOMO (fear of missing out).

Foster supportive relationships Surround yourself with supportive colleagues, friends and family. I’m fortunate to have a tribe of peers who are honest and open, providing mutual support during stressful times. Encouraging open communication, offering regular check-ins and promoting a collaborative work environment helps to alleviate individual stresses and fosters mutual support. Local groups, associations and networking at conferences can be a great way to do this.

Reevaluate and adjust goals Reflect on your goals and ensure they are realistic. Adjusting them to align with your wellbeing helps reduce stress and mitigate feelings of inadequacy. I set yearly goals based on my intentions for the year ahead, constantly reviewing them and celebrating every bit of progress. This involves considering both my professional aspirations and personal wellbeing in a multifaceted way. For work, I identify what I want to achieve and how I plan to get there. Simultaneously, I think about how to maintain balance – ensuring time for

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family, self-care, rest and recuperation.

It’s not just about achievements; it’s about reflecting on what has brought joy and fulfilment, letting go of things that no longer serve me and learning from past experiences. It’s about saying yes to meaningful opportunities while having the courage to say no when needed, to maintain balance. At its core, my process is about aligning intentions with what brings happiness and joy, because that is the ultimate goal.

Seek professional help Mental health professionals, such as primary care, counsellors or professional organisations like MIND, can offer strategies to manage stress and provide tools for coping with burnout.

Embracing these practices, alongside cultivating authenticity, setting realistic goals and maintaining clear work-life boundaries, has been integral in managing burnout and sustaining a balance between my professional and personal lives.

Expanding strategies for combatting burnout Burnout is a multifaceted issue that demands a comprehensive approach to manage it effectively. Beyond personal self-care and setting boundaries, there are several additional strategies that can help you build resilience and sustain passion for aesthetics.3 Utilise technological tools to enhance efficiency Embrace technology and automation to manage workload effectively. A good CRM system can help scheduling, patient management and record-keeping which reduces time spent on patient admin.2 I also use workflow tools like Asana and Scribe which streamline admin tasks, freeing up time for patient care and reducing burnout risk.

Educate patients on realistic expectations Patient education is crucial. I manage expectations through social media and consultations, emphasising realistic outcomes and eventualities which may lead to refusal of treatment. This approach fosters a positive environment for both patients and myself. I also make sure not to overbook myself in clinic, adhering to a realistic schedule and aiming not to work beyond preset hours so I am making time for myself as well as my patients.

Delegating and sharing work among your clinic team can be helpful here.

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Mental Health Burnout Building strong emotional intelligence when it comes to patient interactions is also key to retention and reducing stress.

My patients know I'm genuinely there for them, which eases their anxieties and minimises out-of-hours calls.

Form and participate in peer support groups I strive to be approachable to colleagues who need support, and am in the process of setting up a peer network for complications. These efforts create a sense of community, invaluable for preventing burnout. I recommend connecting with professional organisations such as the British Association of Medical Aesthetic Nurses (BAMAN) and the British College of Aesthetic Medicine (BCAM), as they provide opportunities to build strong networks. Additionally, online communities like Facebook groups and LinkedIn forums where aesthetic practitioners share experiences can be incredibly helpful.

Finally, attending events such as ACE and CCR offers valuable opportunities for networking and fostering meaningful professional relationships.

Resilience and compassion Burnout in the aesthetics world is a complex issue, intertwined with competition and perfectionism. My own experience highlights the need for a balanced approach. Each time I invest in my professional growth – whether it’s attending seminars, enhancing my skills or presenting – I notice both my burnout and imposter syndrome diminish. This proactive approach has strengthened my skills and mindset, allowing me to enjoy my work more fully. By focusing on growth and self-improvement, we can navigate our field’s challenges with greater resilience and satisfaction.

Julie Scott is an independent nurse prescriber, Level 7 qualified aesthetic injector and trainer with more than 30 years of experience in the field of plastics and skin rejuvenation. She is an aesthetic mentor and international speaker, who has won the Aesthetics Awards ‘Aesthetic Nurse Practitioner of the Year’ in both 2022 & 2024, and ‘Best Clinic South of England’ 2023. She also sits on the Aesthetics Reviewing Panel for the Aesthetics Journal, is a Board member for DANAI and an ambassador and KOL for the JCCP and several leading aesthetic brands.

Qual: INP, PGDip, RGN

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Aesthetic Practice Wellness Approach

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Alignment with patient demand

Integrating Regenerative Medicine into Aesthetic Practice Dr Dara Suite and Katie Parobek discuss taking a holistic approach to medical aesthetics Regenerative medicine is reshaping the aesthetic landscape, offering innovative solutions that extend beyond solely cosmetic enhancements. This area of non-surgical medical aesthetics is becoming extremely popular. Hamilton Fraser’s survey of more than 300 practitioners based across the UK and Ireland, revealed that 64.1% of practitioners are interested in it.1 Where once aesthetics and wellness were entirely separate treatment modalities, the demands of patients today is to achieve balanced healthy lifestyles, a youthful appearance and a longer life.

This article explores why clinics that integrate regenerative treatments can attract wider patient demographic, increase patient retention and command higher-value treatment plans.

The demand for regenerative treatments Regenerative medicine is defined as any treatment that restores normal function to tissues or organs, with an emphasis on harnessing the body’s natural ability to repair itself.3 It tells us that we can tackle the root cause of disease and not just the symptoms.

When it comes to regenerative medical aesthetics, the treatments can be divided into three categories:4

· Biochemical, such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), which stimulate and upregulate transplanted or resident regenerative cells, or local cellular architectures. · Bio-stimulants, such as calcium hydroxyapatite, dermal filler and threads, provide both stimulation and structure to guide and shape regeneration. · Stem cells, acting as paracrine actors, play a pivotal role in maintaining the dermo-epidermal structure as a physiological response to local damage.

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Today’s patients seek treatments that go beyond aesthetics – they want solutions that actively promote healing and long-term rejuvenation. Regenerative therapies not only enhance appearance, but also address concerns like skin damage, joint pain and hair thinning.4,5 However, with the rise of social media trends, many patients come in requesting treatments they’ve heard about online, often without fully understanding their benefits or suitability. This makes patient education a crucial part of aesthetic practice. By guiding patients through the science behind regenerative treatments and setting realistic expectations, practitioners can foster trust and ensure better treatment outcomes.

Practical steps for integration Successfully integrating wellness treatments requires a clear strategy and a step-by-step approach to ensure a smooth transition.

Understanding your target demographic is essential. Patients’ treatment preferences, desired outcomes and budget considerations should shape your service offerings. Even businesses within the same area may cater to vastly different patient profiles, making it crucial to focus on your own clientele rather than mirroring competitors. Leveraging tools like Google SEO and social media analytics can provide valuable insights into patient interests and spending behaviour, helping you ensure your treatment menu is both relevant and in demand.

Essential clinic checklist Introducing any treatments into clinics is an important decision that should be tried and tested thoroughly before presenting to patients. Some fundamental steps include:4-6

· Assess new treatments: Meet with

·

Selecting the right treatments Choosing the right treatments can be daunting, particularly if you are new to regenerative medicine or in the process of launching your clinic and developing a treatment menu. Two often-overlooked factors – ease of introduction and patient demand – should be prioritised when making these decisions.

·

Ease of implementation Choose treatments that can be easily integrated into your clinic with minimal extra training. Assess your existing expertise and focus on procedures that complement your skill set. Where possible, opt for treatments that don’t require new equipment, making use of consumables you already stock.

Selecting versatile consumables that work across multiple treatments can also help streamline resources and keep costs under control.

An example of this is neuromodulators, which are used for both anti-wrinkle injections and the treatment of overactive muscles associated with migraines and bruxism.

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· ·

· · ·

suppliers, attend demonstrations and trial treatments to assess effectiveness. Research suppliers thoroughly, considering their reputation in both the specialty and your region, as compliance varies by location.

Ensure they provide clinical evidence, warranties, maintenance, training and ongoing support, including continual professional development (CPD) and marketing assistance.

Ensure safety and compliance: Verify that all products meet local and national regulations. Practitioners should look out for red flags such as unverified product claims, lack of regulatory approval (e.g. the UK’s Medicines and Healthcare products Regulatory Agency (MHRA), the US Food and Drug Administration (FDA), and the European Medicines Agency), and suppliers unwilling to provide full transparency on sourcing and manufacturing standards.

Train staff: Provide both theoretical and hands-on training, ensuring practitioners can communicate treatments clearly to patients.

Educate patients: Develop materials highlighting treatment benefits, leveraging supplier resources.

Market strategically: Focus on platforms most relevant to your patient demographic to promote new services effectively.

Monitor and adjust: Conduct regular follow-ups to assess progress and refine treatment plans.

Insurance and liability: Confirm regenerative treatments are covered under your indemnity insurance.

Ethical sourcing: Ensure all biological materials come from approved, ethical sources. In the UK, injecting exosomes

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is illegal unless specifically authorised for clinical use. Always verify compliance with regulations before offering such treatments.

Maximising consultation impact The consultation serves as a key opportunity to explore not only patients’ aesthetic goals, but also broader factors such as nutrition, stress, sleep and overall health. These elements play a crucial role in the success of regenerative treatments, the longevity of aesthetic results and the revenue you can gain in your clinic. Practitioners should focus their consultation on obtaining in-depth information about patients’ lifestyles, diets, sleep hygiene, general medical history and any other areas that the patient highlights as unsatisfactory, as this can indicate what other treatments could be offered to them.

To optimise outcomes, treatment plans should integrate regenerative therapies (e.g.

PRP and stem cells) with complementary wellness strategies, including tailored nutritional guidance, stress management and sleep optimisation. For example, improving sleep quality can enhance recovery following PRP or stem cell therapies, ultimately supporting better patient satisfaction and long-term results.7 The consultation is the key opportunity to discuss wellness treatments with patients, introduce options they may not have considered or heard of, and naturally upsell the treatment plan.

Effective patient education Patient education can be informal as part of general chit-chat during consultation and treatment, directing patients to social media pages that are accurate yet accessible to the general public. You can also provide leaflets and other such literature, or host events in clinic to introduce the treatments and present them. Even holding demonstrations or mini consultations as part of the event to bring patients’ awareness to this area of treatment is a good way to provide knowledge to potential and existing patients. Patient safety and transparent communication about potential outcomes are crucial. Practitioners must carefully balance innovation with ethical responsibility to uphold the integrity of regenerative medicine in aesthetic practices.

A multi-pronged approach is beneficial in order to reach different demographics, suit patients’ availabilities and build on their interest levels.

Competency within your team It is essential to ensure your team has adequate training in regenerative medicine techniques to administer these therapies safely and effectively. Proper training with suppliers and reputable training schools, such as Derma Medical or The London

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Academy of Aesthetic Medicine (LAAM), is key to achieving optimal clinical outcomes and minimising complications. Trainers should have medical backgrounds and experience in working in the fields they are providing training in.

Effective training should be continuous, combining both theoretical knowledge and hands-on practice. Theoretical training should be extensive, covering the anatomy, physiology and mechanisms of action behind each treatment. It should also encompass practical aspects, such as treatment delivery and tailoring procedures to individual patient needs. This theoretical foundation enables trainees to conduct informed consultations and develop well-structured treatment plans with confidence.

Practical experience is essential before treating patients, ensuring both confidence and competence. Ideally, this should include hands-on training with models at accredited training schools, as well as practising on models within a clinic setting. This approach allows practitioners to build their own case studies and develop a strong portfolio.

Advanced training (i.e. training that builds on foundational knowledge and focuses on specialist procedures) not only meets the growing patient demand for safety, but also helps foster trust between practitioner and patient. It is often wiser to begin by training one practitioner, perhaps marketing them as the expert in a specific field, before expanding to train the whole team. This approach ensures the investment is scalable and better positioned to meet return on investment (ROI) objectives. The stronger the trust between practitioner and patient, the easier it becomes to upsell treatments, convert sales and build long-term patient loyalty.

Staying updated on regulations, particularly those regarding stem cell therapy and exosome use, is essential. Training with suppliers, and recognised medical bodies, including short courses from institutions like Wigmore Pharmacy, or more extensive programmes from universities, play a key role in ensuring compliance and upholding best practices. Additionally, events like the Medical Longevity Summit (MLS) at the Clinical Cosmetic Regenerative (CCR) Congress offer valuable opportunities for practitioners to stay informed on the latest advancements, regulatory updates and training in regenerative medicine. Attending such conferences helps ensure your team remains at the forefront of the field, delivering safe and effective treatments while maintaining professional credibility.

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Aesthetic Practice Wellness Approach The wellness of your clinic Integrating wellness into a clinic can offer numerous benefits, enhancing both revenue and credibility.

Integrating regenerative medicine into existing treatment protocols enables the creation of new services and treatment combinations without the need for significant investments in new devices or resources.

This also allows marketing strategies to evolve naturally, without the need to adopt entirely new approaches or tools.

By introducing regenerative medicine, clinics can tap into a broader patient base, leading to increased revenue, higher patient retention and improved ROI. For example, a US study found that the global regenerative medicine market was valued at $23.8 billion in 2022 and is projected to reach $97 billion by 2032, growing at a compound annual growth rate (CAGR) of 15.7%.8

The rise of regenerative medicine Integrating regenerative medicine and wellness treatments into aesthetic practices is a strategic move that enhances results and boosts long-term patient satisfaction.

As demand for these treatments grows, practices can attract a wider patient base, increase retention and drive revenue growth. Investing in these innovations fosters patient loyalty and ensures sustained business success.

Dr Dara Suite graduated with honours from Birmingham Medical School. She developed her expertise in aesthetics as a surgical trainee in the plastic and reconstructive surgery department at the Royal Free Hospital, alongside a period of study at the Los Hermanos Ameijeras Hospital in Havana, Cuba. Dr Suite has also taught anatomy to medical students at Queen Mary University of London.

Qual: MBChB, MRCS, PGDip Derm, BSC Katie Parobek, founder and director of The Well Clinic, has a background in the aviation industry, having worked globally delivering both mission-critical systems and backend business solutions.

She took over The Well nine years ago, and has worked to evolve it from offering basic aesthetic services to being a recognised holistic wellness business, integrating a wide range of practitioners and treatment modalities.

Qual: MBA

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Women In Business Empowering Success

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Women in Aesthetics Lead with Mentorship and Empowerment The ACE Women in Business panel explores imposter syndrome, leading with authenticity and finding balance in leadership At ACE 2025, the spotlight was on trailblazing women in the aesthetics field.

They gathered for the Women in Business panel at this year’s In Practice Theatre. The event was presented by Crown Aesthetics.

Hosted by Francesca Ogiermann-White, founder of The Beauty Triangle and Health and Beauty Editor at Large at Tatler, the panel brought together some of the field’s leading experts and esteemed Finalists at The Aesthetics Awards 2025.

Ogiermann-White was first joined by Reena Sandhu, Crown Aesthetics head of marketing and operations UK & Ireland, and international digital lead. Other panellists included Dr Ifeoma Ejikeme, aesthetic practitioner and clinic owner of Adonia Medical Clinic; Lisa Waring, independent nurse prescriber and trainer; and Dr Bethany Rossington, aesthetic practitioner and rising star in the specialty.

Their powerful conversation highlighted the personal and professional journeys of these women, showcasing the impact of mentorship, community and resilience in shaping their careers.

Leading with authenticity The panel kicked off with Reena Sandhu, who was Commended in the ‘Company Representative of the Year’ category at The Aesthetics Awards 2024 for her work with Crown Aesthetics. Additionally, Crown's flagship brand, SkinPen Precision, has been nominated for Device of the Year at the upcoming 2025 ceremony, following its award win in 2024 in the same category.

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Sandhu shared insights into her leadership approach, which is rooted in authenticity and transparency. She emphasised the importance of individuality and acknowledged the challenges that come with staying true to oneself in a fast-paced specialty. "Any challenges that come my way, I see them as a learning curve, an opportunity to grow my character. It’s about being honest with yourself and others and asking for support when you need it," she explained.

Reflecting on the evolution of the aesthetics field, Sandhu highlighted the inspiration she has drawn from the increasing presence of women in leadership roles. "Over the past decade, seeing so many incredible women rise within aesthetics has been uplifting. It’s helped me position myself as a thought leader within Crown Aesthetics." Her openness about her own struggles and her willingness to seek support underscores the power of community, particularly for women in business.

Offering advice to those looking to establish themselves in the field, she encouraged aspiring professionals to embrace their individuality and build a strong support network. "Just be yourself and surround yourself with great women," she advised.

She added that "a good sense of humour always helps when facing tough times."

Balancing clinical excellence with business leadership Next, the panel heard from Dr Ejikeme, who was a Finalist for an impressive four awards this year: The Crown Aesthetics Award for Best Non-Surgical Result, The GetHarley Award for Medical Aesthetic Practitioner of the Year, The Lumenis Award for Best Clinic London and The Patient Perfect Award for Best Clinic Team.

Despite her obvious success, Dr Ejikeme discussed the challenges of managing both the clinical and business sides of her practice. “You have your technical excellence – that’s you learning your craft – and then you have to have your Aesthetics | April 2025

business hat on and know how to get the bills and manage Excel, marketing, finance and human resources,” she explained.

Recognising the need for different skill sets to thrive in both areas, Dr Ejikeme encouraged aspiring entrepreneurs to seek out mentors in both the medical and business sectors.

The key to success, she noted, is knowing when to delegate. “Being a woman, there are certain things that my femininity has accentuated such as being organised and ordered. I have deficits in other areas, and you have to find people that fix your deficits. After a certain point, you can’t do everything yourself. It’s essential to focus on your strengths and find people who are better at the areas you need support in,” she said. She also highlighted the value of learning from others, including employees, and being open to mentorship from younger generations who may have expertise in areas such as social media marketing.

The power of personal development and passion Waring, founder of Facetherapy NI clinic, Facetherapy Academy and the A List Conference, joined the discussion next.

Waring has been nominated four times for the Nurse Practitioner of the Year Award, and this year her businesses were also shortlisted for The Fotona Award for Best Initiative/Strategic Project in Aesthetics, The InMode Award Best Clinic Ireland & Northern Ireland and Independent Training Provider of the Year.

Waring shared her approach to leadership, which centres on fostering a supportive environment where others can grow. "I turned to personal development and it saved me. It truly helped me discover my 'why' and my definite purpose, which was aesthetics. I suppose the reason I'm sharing my personal story is because, for me, it's my passion. And when you're passionate about something, balance just becomes natural," she explained.

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She also spoke about the importance of clarity in her work and life goals, saying, “Obviously, I’ve learned a lot of skills along my journey, and I focus on clarity a lot. I have a clear, defined set of goals that I will work towards, and they say that the best way to predict your future is to create it.” Waring emphasised the value of time management, adding, “I have great time management skills. I think that’s because I’m a woman and we can multitask. But in all honesty, we all get the same 24 hours in a day, and I make each one count.”

Waring also reflected on her ability to delegate, stating, “I have a great support system. And when I lean on my wife a lot, I can delegate really well. But I suppose the reason I do it all is because I want to live the life that I deserve, and it takes a lot of hard work and the ability to wear many hats, spin a lot of plates, but for me, it’s my passion.”

Combining aesthetics with wellbeing Finally, Dr Rossington, an aesthetic practitioner and clinic owner, shared her thoughts on combining medical aesthetics with wellbeing in her practice, Renavé. Dr Rossington, a Finalist for the AlumierMD Rising Star of the Year Award, is an up-and-coming voice in the world of holistic wellness and skin health. Her clinic focuses not only on how patients look, but also on how they feel both during and after treatments.

“Aesthetics is about more than just appearance. It’s about empowering people to feel better about themselves, inside and out,” Dr Rossington explained. She emphasised the importance of creating a welcoming space where patients, especially women who can be apprehensive to undergo treatment for fear of the stigma surrounding aesthetics, feel supported throughout their entire aesthetic journey. “My clinic’s slogan is ‘How will you feel?’ because we want our patients to feel confident and empowered when they leave.”

This approach is following the trend of female patients increasingly seeking treatments that look after their internal health. Dr Rossington wanted to collaborate closely with professionals such as nutritionists, physiotherapists and counsellors to foster this more holistic approach. “I’m sure all of us in the room have said, ‘My skin’s playing up because of diet, stress or even a holiday.’ So, what’s going on inside also plays a massive part in how we look.”

Ogiermann-White echoed Dr Rossington’s sentiment, saying, “I think it’s wonderful that more and more people are starting to see aesthetics as a facet of wellness and not something that’s put in a very separate corner from the conversation.”

The discussion then turned to how Dr Rossington integrates wellness into her own life with a demanding career. She candidly admitted that, while she often talks about balance and self-care, it’s something she doesn’t always practise herself. “Life comes in seasons,” she said. “Sometimes it’s a winter season, and other times it’s summer.”

The panel emphasised the importance of not holding oneself to unrealistic expectations, especially in an age of social media, where everyone seems to be presenting their “perfect” life, creating a sense of pressure which can often deeply affect women in particular. “The balance which we probably think we should achieve, very few people do. I think we need to lower our expectations of ourselves for what balance actually means in life,” shared Dr Rossington.

Women In Business Empowering Success

congratulations on award nominations, I often brush them off,” she shared. Her advice for overcoming these feelings was simple yet powerful, “Learn to accept compliments graciously and, most importantly, acknowledge it with a smile and say, ‘thank you.’”

Dr Ejikeme opened up about her journey of overcoming others’ negative thoughts, particularly during times when she faced rejection or heard the word no. She found that the key to overcoming this was creating a positive inner dialogue. “You need to have a cheerleader within yourself, someone who will always support you, no matter what.” She emphasised, “The thing I found most helpful was understanding that the words you say to yourself are so much more important than the words anybody else will ever say to you.” She encouraged the panel and audience to reframe their thinking by asking, ‘But what if it works?’

Dr Rossington noted that women in healthcare are often motivated and validated by external milestones and educational achievements.

However, she reflected that internal validation is harder to come by when you’re not constantly reaching for the next “stepping stone.” She shared with the panel, “As soon as I was out in the real world, I found it quite hard to know who I really was and to have that self-worth just as me and not as someone tied to my academic achievements.”

Waring echoed similar sentiments, underscoring the power of self-talk. She explained that whatever image you have of yourself is who you will become. “Self-doubt is truly the great paralyser of action,” she said. Waring advised women seeking to overcome this setback to face the things they fear most, and take action rather than shy away from them.

It was evident that the panellists were united in their belief that positive affirmations and self-love are essential in overcoming imposter syndrome. The discussion also stressed the importance of pushing beyond fear. “Move forward, even if it’s only half an inch,” said Waring, quoting a lesson from her daughter’s martial arts instructor. “Even if I don’t succeed, it’s reinforcing the habit of instilling confidence.”

Embracing empowerment The panel ended with a call for women to support one another.

“Don’t be afraid to share your achievements,” Dr Rossington encouraged. “There’s enough space for all of us in this specialty. As a woman, I like to have an abundant mindset. I think there are enough patients for everyone. There are enough opportunities for all of us.”

The women on the panel have each found success in their respective fields by embracing their passions, being authentic and supporting one another. Their stories serve as a powerful reminder of the importance of mentorship, community and empowerment in achieving success in business.

As the speciality continues to evolve, it’s clear that women are leading the charge, creating opportunities for themselves and others to grow and thrive in the ever-changing world of aesthetics.

Overcoming imposter syndrome Imposter syndrome was a theme that resonated deeply with both the panel and the audience. Despite her career achievements, Sandhu candidly admitted that she still grapples with feelings of self-doubt. “When I receive compliments for my work or Aesthetics | April 2025

Each of these incredible women were Finalists at The Aesthetics Awards 2025.

Turn to p.40 for the full list of Winners.

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Mentorship benefits Aesthetic practices

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In The Life Of Dr Jordan Faulkner

In The Life Of Dr Jordan Faulkner

part of large hospital teams. In this environment, mentorship programmes play a crucial role in fostering a sense of community. People should move past competitiveness in the specialty – it's a growing field with enough opportunity for everyone to succeed together.

Dr Jordan Faulkner shares how embracing imposter syndrome has fuelled his growth to make him a Rising Star Aesthetics Awards Winner

Within my programme, I offer both clinical and business mentorships, and we share cases we’re handling. I find social media to be a powerful tool for building businesses, and I've noticed that those who step into the role of a micro-influencer see a transformative impact on their clinics.

A typical working day…

When I transitioned away from working in the NHS, I wanted to structure my day so I could have the mornings to myself, as I really enjoy this time of day. I wake up at 6am every morning and start with my first breakfast, which tends to be oats, Greek yogurt, nuts and fruit, along with a coffee. After that, I take my dog Peggy for a walk; she’s a whippet-poodle cross breed, which means endless energy and plenty of exercise. I have recently purchased my first property by Tower Bridge, and I love walking down by the River Thames every day.

With the demands of busy clinic days, I find that exercising in the morning helps centre me for the day ahead. If I were Prime Minister, I would re-structure the typical 9-to-5pm day to 11-to-7pm, encouraging people to prioritise morning exercise. My own training is centred around the Hyrox fitness competition, which I first completed in December last year – I get such a buzz from it.

I get back from the gym around 9am and have my second breakfast! This meal is smoked salmon, scrambled eggs, asparagus, mushrooms and cherry tomatoes. My clinic, Allo Aesthetics, is also based in Tower Bridge, so it’s only a 12-minute walk from my home. I've practically curated my life within a one-mile radius – everything is close by!

I divide my clinic day into two three-hour stints. The first runs from 10:30am to 1:30pm, and I tend to see four to six patients. At 1:30pm, I take a three-hour break – yes, that’s right! I head back home and take my dog out for another walk. For lunch, I usually have a jacket potato with cottage cheese and tuna.

I use this time to catch up on admin and work through my emails at home before returning to the clinic for the second half of my day from 4:30pm to 7:30pm, where I see another six patients. My patient base tends to be younger than average in the field. I believe you attract what you put out, and being in my late 20s, I’ve naturally drawn a similar demographic. With this group, the focus is on preventative treatments, such as toxins, polynucleotides and skincare consultations.

After exploring a variety of treatments, including peels, microneedling and lasers, I must admit that filler is my favourite. I particularly enjoy performing multi-syringe full-face treatments; These are the cases that really can change someone’s life. I also love the procedural aspect of injecting filler, the process of creating, sculpting and adding an artistic flair is something I truly enjoy, and it’s a unique experience compared to surface-level treatment with an aesthetic device.

My work day finishes at 7:30pm, and I head home and cook dinner. My fourth meal of the day is quite boring – it’s usually chicken, rice and vegetables! When it comes to unwinding in the evening, I like to watch a football game. While my team is Rotherham United, I will watch any game that’s on. I wish I enjoyed reading, but I don’t; I read medical texts all day, so I struggle to unwind with a book. I usually scroll on Instagram, managing four different accounts including Allo Aesthetics and mentorship scheme Unite Aesthetics Initiative, before aiming to sleep by 10pm.

Other work commitments…

Outside of clinic, I run the Unite Aesthetics Initiative with doctors, dentists and nurses across London and Yorkshire. I love the concept of collaboration, especially in the aesthetics field, where new practitioners often feel lonely. Many enter the specialty as independent providers, such as solo injectors or small clinic owners, rather than being Aesthetics | April 2025

I've written multiple articles for the Aesthetics Journal on topics like hyaluronidase dosage and undereye anatomy. I have also appeared on podcasts to discuss filler and injectables, shedding light on the dangers of trend-based treatments.

I have spoken on stage at The Facial Aesthetics Career and Education Expo (FACExpo) for the last three years; I used to feel nervous about public speaking, but one of my career goals was to educate on stage and I've learned to embrace imposter syndrome as my favourite discomfort. I also spoke at ACE 2025 on the Alma VIP stage.

ACE was the first medical aesthetics event I attended, so having the opportunity to speak this year felt like a full circle moment!

Most memorable day in your career…

Without a doubt, the most memorable day of my career so far has been winning Rising Star of the Year for The Aesthetics Awards 2025! Back in 2024, I was Commended for the category, and the very next Monday, I mapped out a year-long plan to push myself further and go for the trophy. I’ve been a bit obsessive in executing that plan, so receiving this recognition feels nothing short of incredible!

What is your dream holiday destination?

I would love to visit Banff, Canada.

Do you have a mantra that you stick to?

If you’re going to do something, do it to the absolute best of your ability or don’t bother at all.

If you could choose a career outside the medical field, what would it be?

I would have to say a personal trainer, I love exercising!

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The Last Word Filler Longevity

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I recommend that all clinicians working with HA fillers should:

· Concentrate on restoring lost volume

rather than creating exaggerated features.

This ensures that the results remain natural and age-appropriate8 · Combine fillers with other non-invasive treatments, such as neuro-modulators, bio-stimulators or energy-based devices, to achieve comprehensive rejuvenation without over-reliance on fillers9 · Have periodic check-ins to enable practitioners to monitor filler integration, encourage patient feedback and adjust treatments as necessary10,11

Transparent communication

The Last Word Dr Aggie Zatonska argues that recent reports around extended filler longevity are no cause for concern The prolonged persistence of fillers in the body, as evidenced by advanced imaging techniques such as MRI and CT scans, has ignited substantial debate within the aesthetics community.

Traditionally, fillers were believed to fully degrade within a 12-18 month timeframe. However, findings have revealed that traces of fillers can persist in tissues for several years.1 Following the publication of several articles in mainstream media, concerns have been raised among patients and practitioners regarding potential risks and ethical considerations.2 As a former ENT surgeon who has worked extensively with head imaging diagnostics, I have long been aware of the remarkable longevity of fillers, as evidenced by their visibility on MRI scans several years after injection.3 This knowledge has significantly influenced my approach to working with fillers throughout my career, as well as shaped my communication with patients during the consultation process. So, while these recent findings may have raised concerns, I believe they present an opportunity to explore safer and more informed approaches to HA filler usage.

In this discussion, we will delve into the implications of filler longevity and explore how the aesthetics specialty can address patient concerns while simultaneously maximising the benefits of HA fillers.

Concerns around filler longevity Long-term filler persistence has been known to some professionals for many years, however recent press publications have raised concerns among both patients and clinicians.4 Patients, many of whom were under the impression that fillers fully degrade within 12-18 months, are now questioning the safety of these treatments.5 Simultaneously, some less experienced clinicians have expressed apprehension about potential complications. For example, over-injecting or repeated treatments in the same area can lead to accumulation, migration or an overfilled appearance.6 These findings have prompted calls for increased caution in the use of HA fillers, with some reconsidering their use as a viable treatment option. However, I believe it is crucial to interpret these findings within the context of evidence-based practice, emphasising patient education, informed consent and responsible application of fillers.

Reframing longevity as a benefit Although long-term filler presence may appear concerning, my view is that it is not inherently detrimental. When administered judiciously, with caution and in carefully calculated amounts, residual fillers can seamlessly integrate with the natural ageing process, offering subtle and enduring outcomes.7 I believe that aesthetic practitioners should not be put off by the recent media attention on HA fillers, and instead ensure that they adopt a conservative approach to filler utilisation which aligns with the principles of ethical practice and patient-centred care.

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Aesthetics | April 2025

Open and transparent discussions regarding both immediate and long-term risks are crucial in alleviating patient anxiety over HA fillers and establishing trust.12 By addressing not only acute risks in the consultation such as vascular occlusion or hypersensitivity but also long-term considerations like filler persistence, healthcare professionals demonstrate thoroughness and build patient confidence. I believe this approach also empowers patients to make informed decisions about their treatment options.

Practitioners should emphasise that when placed correctly, HA fillers are not harmful but can provide ongoing protection for patients’ facial volume and shape.

The future of HA I believe HA fillers should be considered one element within a comprehensive facial rejuvenation strategy, encouraging a holistic approach that integrates other aesthetic interventions and healthy lifestyle habits. Regular follow-up assessments are essential, allowing clinicians to evaluate filler integration, address emerging concerns and guide adjustments in therapy.10 Imaging modalities can also inform ongoing management, providing objective evidence of filler persistence and helping shape future treatment plans.

Dr Aggie Zatonska has more than 16 years of experience in medical aesthetics. As a Board Trustee of the British College of Aesthetic Medicine, Dr Zatonska is committed to upholding the highest standards in the field of aesthetics. Atelier, her award-winning clinic in Surrey, received the Sofwave Award for Best Clinic South England 2024 at The Aesthetics Awards.

Qual: MBBS, BSc, PGD(AAM), CCT(ENT), MBCAM

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UKI-SCU-2500032 DOP March 2025