Cosmetic News

THE VOICE OF YOUR INDUSTRY www.cosmeticnewsuk.com

JANUARY 2010

On wiTh THE dEbATE

Remote prescribing latest

DermA DivA

We chat to skincare guru Jan Marini

weighT LOSS special

In a nation obsessed with losing weight, we examine the growing trend for in-clinic diets as well as some of the best body shaping procedures on the market

image conscious

ALSO IN THIS ISSUE

how much? breast imPlants

improve your image and boost your income the cost of insurance

the case for Pu foam

the uk’s oNlY free of charge medical aesthetics tRAde SHoW The Business Design Centre, April 16th & 17th 2010

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The on e stop a e sthetic s s ho p

eDiTOR’s leTTeR

welcome to the first issue of Cosmetic news for 2010. i hope you all had a good Christmas and are looking forward to the new year.

We are a nation obsessed with weight and no more so than at this time of year. January is the month when most people start thinking about making changes in their lives, and one of the top things on many people’s agenda is losing weight. With the festive season’s over indulgence taking its toll on their waistlines, many of your clients’ minds will be turning to thoughts of shifting those excess pounds, so it is no surprise that the prospect of giving their weight loss bid a helping hand from their cosmetic practitioner is an attractive one. The slimming industry is big business. In the States it is thought to be worth a whopping $46 billion while in the UK it is thought to enjoy an annual turnover of £2 billion. More and more people are becoming overweight every year. Statistics from the NHS say that about 46% of men in England and 32% of women are overweight (a body mass index of 25-30), and an additional 17% of men and 21% of women are obese (a body mass index of more than 30).

In an industry dedicated to looking good, weight loss and body contouring are high up on the agenda and cosmetic practitioners now have many tools at their disposal to help those wanting to improve their bodies. However, treatments can only do so much so many aesthetic practices are now embracing diet and nutrition programmes as part of their clinic offering. In this month’s special feature we explore this in more detail and look at some of the best treatments from removing unwanted fat from laser lipolysis to ultrasound and RF (p32-40).

As well as this we tell you how to boost your income by improving your image (p48-50) and revisit the controversial subject of remote prescribing (p2426). Enjoy!

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P r o p e r t y | Te n a n c y D e p o s i t P r o t e c t i o n | A e s t h e t i c & C o s m e t i c P r o f e s s i o n a l L i a b i l i t y

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The latest on our April 2010 event

process, making it ideal for clients

as speeding up the skin’s recovery who suffer from skin conditions such

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ON The sceNe Out and about in the industry this month

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The BiG DeBaTe The remote prescribing debate continues

as rosacea, vitilligo, acne, dermatitis, eczema, psoriasis, or ichthyosis.

It doesn’t have the weight of traditional foundations and is 100% mineral and free from parabens, talc, synthetic dye and bismuth oxycloride. As well as containing oxygenating ingredients to let skin breath, the product features proprietary EPI-Repair Complex, which helps heal

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peOple iN pROFile

and reduce inflammation, so it is ideal for application after non-surgical

we speak to skincare guru Jan marini

mean it is able to camouflage acne, birthmarks and pigmentation.

procedures as well as post cosmetic surgery. Its coverage abilities also

WeiGhT lOss special: iN-cliNic DieTs

For busy clients who are constantly on the go, like me, the product is

why in-clinic diets are growing in popularity

by the FdA as ‘Very Water Resistant’ which means it will even stay on

also long-lasting and water and sweat resistant, having been rated while swmimming or exrcising. Another selling point is that the make-

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WeiGhT lOss special: BODY cONTOURiNG Post-weight loss body contouring treatments

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VieW ON: iMplaNTs Leading Australian breast surgeon Dr Daniel Fleming on polyurethane foam covered implants

up has anti-ageing properties. It contains ‘Kombucka’ – which comes from fermented black tea, and helps reduce glycation reactions and smooths fine lines and wrinkles as well as the anti-oxidant Tetrahexyldecyl Ascorbate. Zinc Oxide and Titanium dioxide also act as natural sunscreen defence against UVA and UVb attack.

However, one of my favourite things about it is its unique Fitzpatrick Skin Colour Matching System. Having a fairly pale cmplexion, I often find it hard to find the balance between a foundation that makes me look too pale or too ‘orange’. With this product, colour matching is simple

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as the colours relate directly with

how to improve your image and boost your income

warm).

BesT pRacTice eddie hooker from hamilton Fraser on the cost of insurance

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the Fitzpatrick scale (cool, neutral,

DaTes FOR The DiaRY Training course, conference and meeting dates

Charlotte body Publisher 01268 754 897 charlotte@creativemedialtd.co.uk Vicky Eldridge editor 01268 754 897 M: 07931 924 322 vicky@creativemedialtd.co.uk Emilia bronze Associate Publisher 01268 754 897 emilia@creativemedialtd.co.uk Peter Johnson, Art Director 01268 754 897 peter.johnson@creativemedialtd.co.uk Charlie Crocker Designer 01268 754 897 design@creativemedialtd.co.uk Hollie-Jane dunwell Account manager 01268 754 897 hollie.jane@creativemedialtd.co.uk

Register for tickets online at www.cosmeticnewsuk.com

Shauna Peters Production Assistant 01268 754 897 shauna.peters@creativemedialtd.co.uk

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News | Round Up

cOUNTDOWN TO shaReD ReGUlaTiON The independent healthcare Advisory Service (ihAS) is set to launch its Shared Scheme for Providers of Cosmetic injectables (formerly known as Self regulation) this month. The first steps will be to create professional standards for the use of botulinum toxin and dermal fillers for cosmetic treatments for both organisations wishing to register with the scheme and for training courses. By the end of January 2010 there will be a registration scheme for a quality mark for those providers who can achieve the standards and have been through a training course that meets the principles set. Financed by registration fees, it will be enforced by an independent inspectorate and a riskbased inspection regime that takes account of good or bad practice before inspections as well as random sampling.

EVOlENCE ClaSS aCTION Toronto law firm McPhadden Samac Tuovi has commenced a proposed class action against Johnson & Johnson and related companies relative to the injectable collagen dermal filler Evolence. The Evolence claim involves people who were injected with Evolence and allegedly developed side effects that in some cases included disfiguring nodule formation. It is alleged that Johnson & Johnson and related companies failed to warn the public about the potential of these adverse effects. The claim for $15 million is on behalf of all residents of Canada who were injected with Evolence and allege that they suffered injuries and damages.

DR SIbTHORPE TakES THE lEaD

Sally Taber, director of the IHAS has spearheaded the Shared Regulation scheme

It is hoped that the public will trust the quality mark and look for it wherever they go for cosmetic treatments. A high profile launch is currently being planned with the support of Mike O’brien MP, the Minister of Health. The Standards for Cosmetics Injectables has just finished its second consultation and the final version will be available on the IHAS website (www.independenthealthcare.org.uk). The standards were reviewed to ensure the hyperlinks were all up to date. Updates were received from the General Medical Council as, since the original standards were produced, the GMC has updated it prescribing guidance to discourage the use of remote prescribing. Further hyperlinks have been introduced by the Medicines and Healthcare products Regulatory Authority (MHRA) and the Advertising Standards Authority (ASA). CHKS, who are providing the third party registration and inspection scheme are currently designing the web-based registration facility. Providers of cosmetic injectables will be provided with the details of this early this year. Currently only appropriately trained doctors, dentists and Registered Adult Nurses will be suitable for the scheme. See next month’s Cosmetic News for a full report.

secReT sURGeRY Statistics released by the Harley Medical Group have shown that more than 85 per cent of cosmetic surgery patients hide their treatment from colleagues, while almost one in five will keep their surgery secret from their family.

A recent, voluntary survey of 1,000 patients (800 female and 200 male) revealed that 15 per cent of women keep their surgery a secret from their families, 27 per cent from friends and 78 per cent from their colleagues while 22 per cent of men keep their surgery a secret from their families, 52 per cent from friends and 94 per cent from colleagues. liz dale, director at the harley medical group, said, “the majority of our patients are honest about their surgery - at least after they’ve had it done. many patients will keep quiet in the lead up to their surgery and intend to keep it hidden but can’t help revealing their secret when it comes to the unveiling of

Dr Richard Sibthorpe, hosted his first meeting as the british association of Cosmetic Doctor’s (baCD) london Regional Chairman at the exclusive l-Restaurant in kensington. Dr Sibthorpe was joined by more than 30 regional members of the baCD. Members were treated to a three course meal followed by special guest speaker, award-winning health and beauty journalist alice Hart-Davis, who gave her views on why the facial aesthetics market has grown in the last couple of years and what beauty editors are most interested in reporting to their readers. alice was followed by consultant dermatologist Dr Russell Emerson, who presented an overview of Photo Dynamic Therapy (PDT) and its current applications.

GREEN aND GORGEOUS jane iredale mineral-make-up has launched a new refillable compact for its PurePressed base. Each PurePressed base refill comes packaged in an elegant plastic clamshell, manufactured from 100% recycled post-consumer material.

The clamshells are individually bar coded with all product detail printed on the outer surface of the packaging, eliminating the need for additional print materials.

COSMETIC NEWS WElCOMES HOllIE-JaNE DUNWEll Cosmetic News is delighted to welcome Hollie-Jane Dunwell to our team.

Hollie has joined us as our new account manager. and will bring a wealth of knowledge in advertising gained from her previous experience working within publishing at IPC Media on various niche titles.

If you require any information on advertising in Cosmetic News or would like to receive our 2010 media pack e-mail Hollie on hollie.jane@creativemedialtd.co.uk or call 01268 754 897.

their new stomach or boobs.”

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cosmeticnewsuk.com

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Seeing is believing Thousands of patients worldwide have been treated successfully using the Accent system, with unprecedented satisfaction. Treatment results typically become apparent over well-defined courses of multiple sessions, which are often termed “comfortably warm” and cause virtually no downtime for the patient.

Physicians have documented their results in a number of case studies. Below are just a few of them.

“Dr Kim Lloyd: “At Crendon Skin Clinic we aim to bring our clients the safest, most effective, non-surgical cosmetic treatments and equipment available. The Harmony has increased our turnover by 50% and the feedback from clients is fantastic. The Accent is already proving to be even more popular than the Harmony. I am confident our addition of the Soprano xl will be unbeatable combination of the best equipment currently available”.

”

IN-Motion™ is Alma Laser’s proprietary technology that virtually eliminates discomfort during aesthetic treatments, such as those provided by the AccentXL.

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News | Round Up

alleRGaN Releases pOsiTiON sTaTeMeNT OVeR illeGal ONliNe BOTOX® sales The makers of Botox®, Allergan, have issued a statement to Cosmetic news regarding their position on online sales of botulinum toxin.

The statement comes off the back of recent publicity surrounding the promotion of DiY injectables online and concerns about people purchasing counterfeit products.

Allergan said: “botox® and Vistabel® are pharmaceutical medicines available via prescription only and the administration of these products is considered a medical procedure. botox® and Vistabel® are NOT a patient self-administered treatment and cannot be promoted as such.

“Allergan does not support nor supply botox® or Vistabel® for sale through online channels. Allergan takes aggressive legal action to prevent illegal activities such as the distribution of botulinum toxin type A product without prescription.

“It is actually difficult for practitioners in the UK to inadvertently purchase counterfeit botulinum toxin product. Allergan has stringent procedures in place to control the distribution of botox® and Vistabel®. Our policy is that botox® and Vistabel® may only be sold to registered healthcare professionals as defined by UK legislation. When any account is established, Allergan require proof of the healthcare professional’s registration such as with the General Medical Council (GMC) or the General dental Council (GdC). Allergan also requires each applicant to inform them of any change in registration status. In addition, Allergan supply to select pharmacy partners.

“There are, however, several manufacturers of botulinum toxin products around the world, and not all of these manufacturers have the correct licences to sell product in the UK. botox® and Vistabel® is a biologic product which means that even slight changes in manufacturing or structure can have profound effects on the safety, efficacy and other characteristics of the product. For instance, even other botulinum toxin products that are of the same class are not interchangeable.”

eNViRON skiNcaRe laUNches FOcUs-ciT environ has launched a new smaller and more cost effective collagen stimulation device, the Focus-CiT. Designed to help clients enhance the effectiveness of their skincare

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15/12/09 11:55:38

NeWs iN BRieF aqUaMID® SaFE SaYS FOllOW-UP STUDY a new study published in Journal of Plastic, Reconstructive and aesthetic Surgery confirms the long-term safety and efficacy data of aquamid®. In the study aquamid® was administered to 5,676 Oriental patients in the period December 2002 to June 2007 with the follow-up including 4,822 patients. The follow-up period was up to four years with 55 per cent of patients exceeding one year. The article states that “aquamid® is very useful and safe, and has a long-lasting effect as a filler, if one pays particular attention to the rules and criteria. We have not experienced any allergic reaction to aquamid® and no granuloma lesions as compared with hyaluronic acid treatment. Complications manly consisted of infectious lesions. Granulomatous reactions, which are generally seen in foreign-body operations, were never seen in our treatments.”

regimes, the hand-held tool enables them to treat specific areas, such as upper lip lines, lower eyelids, frown lines or individual pigmentation marks, and to reach places that are relatively inaccessible with the larger Cosmetic roll-CiT roller.

Measuring just 5cm, this ergonomically designed device features 15 needles measuring 0.2mm long, set in a 1.5cm diameter head. A gentle pressing action, repeated several times over each target area, is used to create thousands of pain-free micro channels in the stratum corneum, allowing more of the anti-ageing ingredients from Environ’s gels and creams to penetrate and take effect. The Focus-CIT is recommended for use between two and seven times per week after cleansing and toning.

It is ideal to take when travelling and easy to transport and store in its small tube container. It can also be taken along to professional treatments, where therapists can apply to key areas before a facial.

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cosmeticnewsuk.com

ONWaRDS aND UPWaRDS FOR ENERGIST 2009 was a landmark year for Energist. It saw the company’s 10th anniversary in researching, developing and manufacturing light-based treatment systems. It also saw the acquisition of both iPulse™ from CyDen limited and Medart a/S, a manufacturer of FRX CO₂ and diode lasers for medical and aesthetic applications. This month Energist is making waves with the launch of its new SmartSculpt™system. The new product includes both monopolar and bipolar RF handpieces, giving the user two separate RF modalities in one system. The monopolar and bipolar handpieces can be used sequentially in the same session. The system also incorporates Red lED, which has been clinically proven to help combat the signs of ageing by stimulating collagen and elastin production and is also widely used to reduce inflammation of the skin.

ON THE PISTE If you fancy doing a spot of networking whilst brushing up your skiing skills then you may be interested in taking part in a skiing weekend being organised by David leahy from abMETech. a keen skier, David and his team go away skiing every year, but now he wants to extend the invitation and get together a group of people from the industry who are keen to hit the snow.

If you are interested email david.leahy@abmetech.com

E V LIPS HANDS SHAPE SKIN FACE E

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News | Round Up

call TO ReDUce cRUelTY TO Mice iN TesTiNG BOTUliNUM TOXiN

NeWs iN BRieF

Clnics across the UK have received an

Syneron Medical ltd has announced the commercial launch of the elure™ topical whitening products in several asian markets. Skin whitening is one of the fastest growing segments of the global beauty industry. The asian market is estimated to be around US$18 billion per annum in size. The elure advanced dermal whitening product is the first scientifically proven enzymatic skin whitening treatment that targets and decomposes melanin to reveal a visibly lighter and exceptionally luminous skin tone.

This product line is based on the a unique scientific discovery of a naturally occurring bio-active substance, Melanozyme™, working in cooperation with scientists in the field of biotechnology and enzymes and with international cosmetic experts. Melanozyme™ acts to decompose the melanin in a clinically proven, fast and safe manner with no side effects. It is combined with a bio-activator to diminish the dark colored pigment in the skin. Unlike several other whitening products in the market, the elure™ product line does not contain Hydroquinine, which may cause side effects such as skin redness and burning sensation. The new product line will be available for sale in q1 2010 at dermatologists’, beauty salons and spas throughout asia.

email from Dr Katy Taylor, Seceretary of the international Council on Animal Protection in Pharmaceuticals Programs (iCAPPP) and Secretariat of the european Coalition to end Animal experiments (eCeAe) following a Sunday

Times investigation into the testing of botulinum toxin on mice in a lab in hampshire.

The email urged clinics and their customers to contact the manufacturers of botulinum products to ask them to stop testing on mice and instead switch to non-animal methods. The paper claimed that secret footage had shown laboratory staff accidentally breaking the backs of the mice when attempting to break their necks to kill them using ball point pens, following the testing of dysport. dr Taylor wrote: “The bUAV has revealed, for the first time, graphic, disturbing evidence of the cruelty and suffering inflicted on thousands of mice every year for the worldwide craze of using botox products to temporarily reduce facial lines and wrinkles. despite a UK and EU ban on the use of animals for cosmetic testing, there is a loophole in the law which allows animals to continue to suffer dreadfully in tests for botox product that, although licensed for medical use, could very well end up being used – quite legally - for cosmetic purposes.

“We placed an undercover worker in Wickham Laboratories in Hampshire for eight months to the end of October 2009. She secretly filmed the appalling suffering inflicted on thousands of animals inside the facility; in particular the batch testing of dysport. The mice are poisoned using the cruel and controversial Ld50 (lethal dose) test. No pain relief is given to the mice; many of whom suffer increasing paralysis and difficulty breathing and if left will eventually suffocate to death. As a token consideration with respect to animal welfare, workers were supposed to observe the mice and kill any they thought were going to die by breaking their necks with a ball point pen on the corridor floor. The bUAV investigation has shown that during that members of staff often caused spinal injury, breaking backs rather than necks.

“Although the European Pharmacopoeia lists the Ld50 test for every batch of botulinum toxin, there is an alternative test that does not use live animals which is allowed. Called the SNAP-25 assay it instead measures the activity of the toxin in a test tube and can be used to replace the mouse Ld50 tests. botox manufacturers can use this alternative method. In fact, the bUAV believes that under UK law this test should be used. Furthermore, this test has been validated by an official UK government laboratory, the National Institute for biological Standards and Control (NIbSC), and has been used by them since 1999. Inexplicably, the UK Home Office is not insisting on this test even after all these years. “ A spokesperson for Allergan said, “Let me first say that Allergan are shocked and appalled by the reports from the bUAV investigation. We do not use the Wickham labs for our testing work. At Allergan, we have extremely rigid testing and inspection processes for the site we do use, and are confident the work being completed is being done to the very highest standards. We adhere to the strictest rules and principles when it comes to animal handling animals in our care.

“Unfortunately, Ld50 tests are still necessary for the safe manufacture of botulinum toxins and are stipulated by the health authorities around the world. While mandated to conform to these requirements, Allergan strives to minimise animal testing and to make sure that we remain in full compliance with such stringent regulations as the Animal Welfare Act in the United States and similar regulations worldwide.

“Allergan has been working for many years to reduce and refine the current release assay and shares the pharmaceutical industry’s goal of reducing, refining and, wherever possible, eliminating animal testing. In addition, Allergan are investing heavily to develop reliable alternative methods and are at the forefront of the industry in terms of finding an alternative test. We have recently published on several advances we have made in terms of the release assays.”

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APriL16th &17th 2010

cosmeticnewsuk.com

SYNERON DEbUTS ElURE™ aDVaNCED DERMal WHITENING IN aSIa

REDUCED DEMaND FOR bREaST ENHaNCEMENT HITS COSMETIC SURGERY IN IRElaND Spending on cosmetic surgery procedures is forecast to fall by 20 per cent this year, as the recession takes its toll on the sector. Spending in the sector rose steadily in recent years, reaching €54 million last year. However, that figure is expected to fall to €43 million this year, according to figures from aesthetic Surgery Ireland (aSI), a business owned by five consultant plastic surgeons who also have public appointments in Dublin hospitals. according to aSI, there has been a 16 per cent drop in the number of surgical procedures this year, while the number of minimally-invasive procedures fell by seven per cent.

Dermot kelly, chief executive of aSI, said the decline in surgical procedures was mainly driven by the reduced demand for breast augmentation, which is one of the most popular procedures undertaken at cosmetic surgery clinics.

WaTCHDOG baNS COSMETIC SURGERY aD The advertising regulator advertising Standards authority (aSa) has banned an ad campaign by a cosmetic surgery firm, My breast. The company, owned by My aesthetics, ran a radio ad campaign in which it claimed to be a ‘leader in cosmetic surgery’ in the Uk. The aSa received a complaint from Transform Cosmetic Surgery Group questioning whether the company could substantiate the claim. My aesthetics said that its radio campaign promoted the idea that My breast was “leading the way in the development and operation of cosmetic surgery with surgeons who were leaders in the field”. However, the aSa considered that the claim was likely to be understood by listeners to be a comparative one that positioned My breast as better than rivals. “because we had not seen evidence to show that, we concluded the ad was likely to mislead,” said the aSa, which banned the radio campaign.

aRREST FOR DIY bOTUlINUM TOXIN SEllER Undercover officers have raided the home of a woman in the States who they say was selling ‘do-ityourself’ wrinkle treatments. Police confiscated boxes, computers and more at the home of laurie D’alleva in Mansfield. Texas attorney General Greg abbott charged the Tarrant County woman with illegally offering prescription drugs, including botulinum toxin injections, without a license.

The legal action also alleges that D’alleva operated illegal Web sites to market her products. The state obtained a restraining order to keep her from selling the drugs and shut down her Internet sites, Discount Medspa and Ontario MedSpa. The sites included video demonstrations of how to use the prescription drugs, along with customer tesimonials about the results they were getting.

ONE STOP SOlUTION TO RECRUITMENT, TRaINING aND MENTORING OPENS IT’S DOORS The aesthetic industry has seen exponential growth over the past several years, with more and more people electing to undergo facial and body non-surgical treatments. as such access to qualified, competent aesthetic practitioners and personalised training and mentoring initiatives is of ever increasing importance. aesthetic Recruitment offers a new and unique way of ensuring that you have a confident and competent practitioner working for you. The company’s aim is to provide practitioners with the degree of help needed to raise the standard of care to which you and your patients have come to expect, by means of mentoring and an ongoing support system. Its multidisciplinary team is made-up of practicing aesthetic physicians, ex-clinic owners, and specialised aesthetic trainers and mentors, which allows us to have a greater understanding of exactly what you are looking for.

Vivienne Smith RGN.INP, CEO of aesthetic Recruitment said, “Our single minded focus is to find, train and support aesthetic clinics and practitioners. Our desire is to innovate; mixing crucial relationship development combined with cutting edge technology, to deliver an unsurpassed user experience”

the best laser in the world and dont just take our word for it...

I am happy to confirm that the Soprano XL Hair Removal system has been very well received by our patients and that they have all been truly amazed that it is a pain free treatment.

The staff have found the laser system very easy and safe to use and we have been very pleased with the service and support we have received from ABC Lasers. dr rita rakus mBBs Founder member of the BaCd, Clinic in Knightsbridge. Known as the London Lip Queen.

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

“We offer a wide range of treatment modalities for clients seeking to remove unwanted hair using technology supplied

by ABC lasers. The Soprano XL has enabled us to provide previously unavailable pain-free treatment and successfully include darker skin types in our patient pool. We recommend the Soprano XL without reservation.” dr. peter ilori is the founder of ‘the Beauty society’ - a premier provider of medical spa, aesthetic, dental and specialist orthodontic services.

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

“Don’t just be another laser clinic” ‘Settle for nothing but the BEST - With unique SOPRANO treatments’

• PAIN FREE Laser Hair Removal • NEW PAIN FREE Skin Tightening • Patented ‘in motion’ technology • Faster than any other laser, with 10 Pulses per second! chest + abdomen in under 20min.

• Painless = absolute safety!

• Effectively Treats ALL Skin types including skin type 6 • SOPRANO is The only treatment of choice for sensitive areas such as Hollywood / Brazilian Bikini line clearance. uSP for your clinic • NO need for old technology of vacuum or cooling • NO consumables!

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Outstanding patient awareness and demand.

visit: www.painfreehairfree.co.uk and see how your patients can locate you and see treatments Live on tV

News | Round Up

APRIL 16th & 17th

2010

laseR MaRkeT ReMaiNs BUOYaNT saYs cYNOsURe A recent survey of Cynosure clinics nationwide has confirmed that the recession has had little or no impact on their respective businesses. half of the respondents felt that the recession has had only a small impact on their business and a quarter of those surveyed feel that there has been no noticeable impact at all. more than 90 per cent agreed that “The future looks bright for the laser industry” and 65 per cent said “Business is doing well and the recession has not damaged business.” This positivity is replicated by the proactive steps clinics are taking to ensure business continuity. 75 per cent have conducted an advertising campaign during the recession and 50 per cent of those who participated in the survey said they had offered both discounts on courses and introductory offers to entice new clients, all of which had been a success.

Laser hair removal has consistently been regarded as the most popular treatment in the past 12 months and is often seen as the ‘bread and butter’ of a clinic’s operation. In the same period the clinics surveyed have also seen an increase ivn bookings for laser hair removal, demonstrating that treatments that offer proven results have not suffered during the economic downturn.

When comparing the past 12 months to the preceding 12 month period, thread vein removal and pigmentation enquiries have increased by around 41 per cent, but again during that period there was a 71% increase in enquiries about laser hair removal. 60 per cent of clinics surveyed have seen an increase in thread vein removal treatments and 90 per cent have seen an increase in laser hair removal treatments.

Men account for 25 per cent of the business in Cynosure clinics nationwide and this has been steadily increasing over the past five years. Women account for the rest and this has been consistent across the UK with minor variations in and around London.

The cONsUlTiNG ROOM™ laUNches NeW seRVices WeBsiTe The Consulting room™, the UK’s largest online aesthetic information resource, has launched a new website – www. consultingroomservices.com – featuring its wide range of consultancy and business building services, including web design and e-commerce solutions, telephone mystery shopper audits, video marketing, laser maintenance services, aesthetic equipment procurement, plus general business or product consultancy.

“Having worked in many different business models within the aesthetic market over the last 15 years, we were keen to reflect this experience in our new site which highlights our absolute focus on the cosmetic industry”, explains Ron Myers, director of The Consulting Room™.

“Whether you’re an industry supplier or distributor looking to launch a new product in the UK, or a practitioner wishing to grow their aesthetic clinic in an increasingly competitive market place, we provide quality, knowledgeable advice and a wide range of practical hands on services to increase your chances of success.”

The Hyaluronic acid used in our products is naturally integrated into the tissue keeping the skin looking healthy and natural.

Completely free of all animal products

paY as YOU GO laseR The new energize System from Palomar s a unique way for clinics to afford the Palomar StarLux 500 leading platform technology.

This method of purchasing and operating reduces the initial investment

Dermal filler with superior performance and patient satisfaction Biocompatible & Biodegradable Collagen building properties of Dextranomer beads Thixofix cross-linking technology

by up to 50 per cent and permits energy to be purchased as

Manufactured in Canada

Pay‐As‐You‐Go energy shots. This revolutionary top‐up payment system

Available worldwide CE marked

means energy shots can be purchased as they are required for the number of treatments being performed. This is a perfect solution for those building up a business or if treatments are going to be limited rather than the system being in use full time.

APRIL

The initial investment purchase price is reduced by up to 50 per cent as a result of the pay‐as‐you‐go energy shots. For example, the Palomar StarLux 500 with 2/3 handpieces would normally cost in the region of £54,000, whereas on the Energize System, the cost will now be approximately £27,000.

Energy is easy to buy direct from Eden Aesthetics and is simply transferred online to download onto a USb stick. For example the cost per shot is 17.5p so for one hair removal treatment on lower legs, 300 shots will be used, therefore cost of treatment for clinic is £52.50. Average clinic pricing for lower legs hair removal is £195.00 demonstrating good opportunity for fast return on investment.

12

cosmeticnewsuk.com

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A unique range of Hyaluronic Acid Dermal Fillers administered by a qualified medical aesthetic practitioner, gentle injections to immediately smooth away your wrinkles for up to 12 months.

See results of Juvéderm® ULTRA range at our Before & After gallery www.juvedermultra.co.uk If you need more advice ask a qualified and trained healthcare professional. The Juvéderm® range of products are medical injectable devices distributed by Allergan Ltd.

0459

Jan 2010 UK/0892/2009

News | Round Up

seeiNG The liGhT lumenis has launched a new, high speed permanent hair removal system - the lightSheer® duet™. the system reduces hair removal treatment times up to 75 per cent and vastly improves patient comfort, eliminating the need for topical anaesthetics.

3 & 5 section tables a Suitable for intensive Smooth silent operat 3 year guarantee

APriL16th &17th 2010 aValON cOUches BesT OF BRiTish

Full

the machine features two hair removal systems in one versatile platform, enabling clinicians to

Unit 67, B East Port Andover, Tel: 0126 Email: sa

optimise permanent hair reduction anywhere on the body. the platform also includes the lightsheer et system, which is ideal for smaller or bony areas such as the upper lip, chin, or around the ankles. the new lightsheer hs (high speed handpiece) features a large 22x35 mm diode array that is designed for treating large areas such as legs, arms, chests, abdomen, shoulders and backs. lightsheer hs employs fully integrated vacuum

chromophores by blanching vessels and spreading skin pigmentation over a larger area, in addition to pulling the hair follicle closer to the skin’s surface.

Manufactured entirely in the UK, the couches are built around a sturdy steel

with this approach, the targeted tissue is gently stretched and thinned, minimising competing

Facial iNjecTaBles eMeRGe FROM The RecessiON

2422 Avalon 1-4 page AdAW.indd 1

framework for complete reliability, with cushions crafted by a specialist upholsterer. The multi-purpose, fully electric treatment tables offer smooth, silent operation, combining easy height adjustment with fully adjustable back rests, mid-sections and foot-sections. The two main ranges – MultiFlex and MultiStyle – each offer a choice of three or five cushions and are suitable for all body treatments, injectables and other facial treatments. MultiFlex features a wide range of operating heights from 18” to 39” (45 – 99cm)

Despite enduring an almost five per cent decline in market growth

while the MultiStyle, with an adjustable height from 25” to 35”(64 – 90cm),

over 2008, the $1.2 billion global facial injectable market will begin to

combines style and practicality with all moving parts encased within a

recover in 2010, according to millennium research group.

sculpted fibreglass base.

The global authority on medical technology market intelligence has said

The upholstery is moisture resistant and easy-to-clean and can be specified

that, despite patients choosing to delay or forego treatment as a result of

in a wide choice of colour options with a host of accessories, from couch

the economic crisis, the market will begin recovery in 2010, and by 2014, will

covers to support cushions to backrest wedges.

return to the strong pre-recession growth rates of over 15 per cent. MRG’s

Recent innovations across all Avalon couches include new all-metal wheels

facial injectable series, which includes separate reports on North America,

with rubber rims and an improved locking system. The company has also

Europe, Asia Pacific, and Latin America, finds that many manufacturers are

made some cosmetic improvements, such as the concealment of wires

refining marketing strategies and strengthening product portfolios in order to

within white trunking and end caps which match the framework. Currently in

establish optimal market position in the coming years.

pre-production for launch later in the year is a heated couch with cushions

To combat financial pressures and bolster share in advance of economic

which heat up individually.

recovery, some firms that had longstanding plans to enter the US market

All Avalon couches are available for immediate delivery from stock and carry

were granted FdA approval and launched new products in 2009 in hopes of

a comprehensive three-year guarantee. Leasing can be arranged as an

stimulating interest and adoption amongst new practitioners and patients. In

alternative to purchase.

the US, notable releases included the highly anticipated dysport® by Ipsen

For further information, please contact: Avalon Couches, Unit 67,

and Medicis Pharmaceutical, and the approval of Sculptra® Aesthetic

by Sanofi-Aventis. In the European facial injectable market, Ipsen and Galderma launched Azzalure®, a version of dysport® that is rebranded for aesthetic use in Europe. Although these competitors launched their products during difficult financial times, the interest stimulated through these launches will carry through into recovery, positioning the firms favorably for improved cosmetic procedure volumes.

“The launch of these new products has generated a lot of media attention, owing in part to the extensive marketing campaigns and promotional activities that manufacturers are engaging in,” says Lisa Shantz, Analyst at MRG. “Although these newly-introduced products will have a greater impact when the market begins to recover in 2010, many physicians and patients are now much more aware of the different types and brands of products at their disposal. As new manufacturers continue to enter the market, competitive pricing pressures will make treatments increasingly affordable for patients, spurring procedure volume growth.”

14

www.avalo

Avalon Couches is looking forward to another successful year of business in 2010. the company, based in Andover in Hampshire, produces a range of electric treatment tables and couches ideal for aesthetic clinics and medi-spas.

assist technology to gently lift skin into the treatment aperture prior to applying laser energy.

cosmeticnewsuk.com

Basepoint, Portway industrial estate, Andover, hampshire SP10 3Fg Tel: 01264 326316, e-mail: debbie@avaloncouches.co.uk, web: www.avaloncouches.co.uk

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News | Round Up

APriL16th &17th 2010

Face The FUTURe

laseR lipOlYsis acaDeMY

high Profile Technologies Ltd has

gave its first international presentation at the 5-Continent-Congress

launched the Facemap-PrO. The

of Lasers and Aesthetic medicine in nice, France.

digital skin analysis system uses cross

The Academy was founded by dr Gerhard Sattler, German

polarisation, parallel polarisation and

dermatologist in darmstadt. dr Sattler and dr Michael Gold (Nashville,

ultraviolet to capture and analyse an

USA), both faculty members, welcomed more than 80 physicians, users

image of the patient’s epidermal and

and representatives of the laser industry to a wine and cheese reception

dermal layers. The system will capture

overlooking the French Riviera. The networking meeting was supported

a patient’s data in a fraction of a

by Cynosure (USA).

second, then process and scrutinise

The Academy deals exclusively with the issues of subcutaneous

the information using a patented

fat and connective tissue as well as its pathophysiological and

software application. The device displays both visible and underlying

pathomorphological consequences such as cellulite. The field of

skin conditions, including those caused by melanocytes, erythema, skin

liposuction has become considerably more diversified in recent years.

disease, poor pore condition, wrinkling, scarring and dehydration.

New developments now make it possible to respond to the individual

The images and data are examined in real-time using a large touch-screen

wishes and requirements of patients much more effectively.

to identify underlying causes of current visible skin conditions, as well as

“The aim is to establish requisite conditions so that colleagues can

displaying indicators of unseen issues that will lead to future problems.

optimally treat patients independently and in a highly-qualified manner”,

High-resolution images allow for accurate, scientific assessment that

said dr Sattler. The foundation course comprises the theory of anatomy,

cannot be achieved by the naked eye, allowing the accurate and

an understanding of tumescence local anesthesia, pharmacological,

precise prescription of a relevant treatment. An integrated patient record

tissue-physiological and technical operating aspects as well as patient

management system is used to record updated information and output

selection, patient psychology and counseling. A further block of the

histogram data to demonstrate treatment outcome, as well as provide

foundation course will discuss the theory of body shaping and fat

reliable before and after images without variation in lighting or focus.

distribution schemata, which enable a basic understanding in respect to

The company has also recently launched Thermacell to reshape skin tissue

optimal diagnostic evaluation. A correct choice of operating method

and reduce cellulite. Thermacell employs a combination of technology to

and technique can only be made with this knowledge, according to dr

deliver radiofrequency energy to the face and body, providing fast painless

Sattler. Regular one-day workshops featuring Smartlipo MPX have been

results. The device simultaneously delivers dual frequency mono and bipolar

offered by dr Sattler and another prominent German dermatologists, dr

energy to affect tissue from the epidermis right down to the subcutaneous

Anita Rütter.

layer. A hex-polar applicator intensifies the concentration of energy to

In 2010 the Academy will extend activities and courses on an

provide immediate visible results .

International scale with events being planned in the UK.

The international Academy of Body Contouring and Laser Lipolysis

laseR phYsics iNTRODUce DispOsaBle paTieNT eYe shielDs: aNesThesia-aiD laser Physics has introduced Anesthesia-Aid self-adhesive disposable eye shields. Anesthesia-Aid is a quick and efficient way to protect the eye during anesthesia. these latex free hypoallergenic eye shields protect the eye during anesthesia by keeping the eye moist, minimising direct trauma to the eye, preventing corneal abrasions and keeping particles out of the eye. current practice is to either tape the eye, which takes time, is cumbersome with gloved hands, and can cause bruising to the delicate skin around the eye and/or to put ointment in the eye, which can cause temporary irritation. anesthesia-aid is a faster and more efficient solution.

saFeTY OF MesOTheRapY FaT MelTiNG pROceDURe qUesTiONeD French researchers are calling into question the safety of a so-called ‘mesotherapy’ technique to melt away fat. the doctors, writing in the journal Clinical Infectious diseases, warn that the procedure, could leave patients with particularly hard-to-treat and potentially disfiguring bacterial infections. the treatment involves the injection of a reportedly fat-dissolving solution into unwanted fat deposits to break them down. dr stéphanie regnier, of the infectious disease unit of Pitié-salpetrière hospital in Paris and colleagues from another Paris hospital, detail the cases of 16 mesotherapy patients who developed painful, inflamed, oozing infections of the skin. it’s hard to determine how often such infections occur following mesotherapy, the authors note; all 16 patients had been treated by the same doctor at a Paris clinic, now closed, between october 2006 and January 2007. most of them had received multiple courses of mesotherapy. the infections were treated by the research institutions with surgery, drainage of abscesses, and, in most cases, antibiotics. Patients were followed until they were infection-free for six months. the researchers were alarmed at how difficult the infections proved to treat even when combination antibiotics were used. “not only did antibiotics not help to cure these patients, but more surprisingly, antibiotics did not prevent the appearance of new lesions in this group,” they wrote about seven of 14 patients. they concluded surgery may still be the best way to treat such skin infections, and “the rationale behind the use of antibiotics... should be questioned”. in an accompanying editorial, drs Jaap t van dissel and ed J kuijper of leiden university medical center in the netherlands said more study is “urgently needed.” they concluded that physicians should suspect infections if patients develop similar symptoms after any kind of cosmetic skin procedure.

16

cosmeticnewsuk.com

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We provide SopranoXL hair removal, and IPL hair removal. Nd-YAG (Ruby) Q-swithed laser for tattoo removal. Co2 and Erbium Laser for laser resurfacing , and Smart-Lipo laser. We also provide full range of chemical peels, Botulinum Toxin and Dermal fillers and many other treatments.

The Clinic is best suited for someone who has interest in Skin and Beauty industry like -a GP, Dermatologist ,Nurse or a Plastic Surgeon.

Please contact us for an informal visit .Contact the clinic if you are genuinely interested.

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01268 754 897 hollie.jane@creativemedialtd.co.uk www.cosmeticnewsuk.com

News | Round Up

APriL16th &17th 2010

pROTecT YOUR BUsiNess WiTh haMilTON FRaseR

ViRTUal MesOTheRapY

Hamilton Fraser, one of the market leaders in professional liability insurance for the aesthetic

system incorporates Nobel Prize winning

medicine industry, is now offering generous levels of cover to protect your business. If you’re a

electroporation current. the patented four-

doctor, dentist or nurse you can now get the exact protection your surgery, drugs and equipment

current system ensures excellent results

require from Hamilton Fraser.

within the shortest period of time.

the company has introduced a surgery insurance package tailor-made to suit your business.

mesoscience breaks through the resistant

whether you have an individual clinic or large medi-spa, hamilton fraser will search their panel of

barriers in the skin, transporting active

leading insurers to ensure you get the right cover at the right price.

ingredients to an unlocked cell, whilst providing

eddie hooker, managing director of hamilton fraser insurance said, “we are pleased to be able

a lift to the skin at the same time.

to offer our customers a complete insurance service. whatever your insurance need we have the

specific treatment programmes include line

solution. now practitioners can obtain professional liability cover for their practice of aesthetic

filling of the face and neck area with hyaluronic

treatments and insure their clinic as well. more than 80% of businesses go bankrupt after a serious

acid, pigmentation reduction and melanin

fire if they are not properly covered. therefore it is critical practitioners are fully insured and obtain the

regulation via the use of concentrated vitamin

correct cover”.

c, cellulite reduction and firming and toning treatments. the latest addition to the treatment

hamilton fraser offers flexible payment options to help practitioners manage their cash flow as well

range offered, mesolift works on a system of micro and macro lifting to sculpt, firm and lift the

as expert claims management. for more information or to arrange a quote call 0845 310 6300 or

facial skin.

visit www.hamiltonfraser.co.uk.

Pre-programmed chipped cards are provided with the mesoscience virtual mesotherapy

Mesoscience virtual mesotherapy is the newest development by Skeyndor. the

device for ease of use guiding the therapist through the four stages of each treatment.

sTeReX laUNches NeW ‘TRaNsGeNDeR’ cOURse

compared to injectable method’s the mesoscience virtual mesotherapy device can treat much larger areas of application in one session and the use of nano technology products guarantee deep penetration of active ingredients. for best results a course of weekly treatments are required and these should be followed by monthly maintenance treatments thereafter.

November saw the launch of the first ever transgender electrolysis course developed by

Sterex. Held at the company’s state of the art Academy in Birmingham, it is the latest in a

transgender client and gender reassignment surgery as surgeons and clients can experience

Dcl laUNches pepTiDe plUs

difficulty in finding electrologists prepared, willing or experienced in treating pre-op

dCl has launched Peptide Plus eye

transgender patients.

treatment. New to the UK, this multi-

sterex was approached a few years ago by a member of the transgender community who was

functional eye cream uses three simple

trying to locate a practitioner prepared and experienced in this specialised field. however due

complexes to target all signs of ageing

to location difficulties they were unable to help and other associations had also drawn a blank.

around the delicate eye area.

saddened by the apparent lack of organised support and help for these clients elaine stoddart,

the Peptide complex retails at £75 and

director of training for sterex started working on the idea of a course and ultimately a uk database

utilises a multitude of peptides to help target

of experienced practitioners specifically designed to support the rapidly growing transgender

the underlying causes of age related skin

community and their ‘life journey’.

damage to the eye area. the hydrating

laurie cartmell co-owner of sterex said, “when the idea of the course was broached i embraced

complex brings much needed hydration to

it as i could see there was a need and a definite value for the transgender community. i

the eye area and the antioxidant complex

wholeheartedly endorse the course and am confident it will go from strength to strength whist firmly

is enriched with Vitamins a, c, e, and k to

endorsing sterex mission statement ‘to set the standard for our industry to follow and then strive to

protect skin from the damaging effects of

exceed it’.

oxidative stress, including free radical damage

elaine stoddart said, “sterex aim to have a current and authentic database of trained experienced

thus preventing premature signs of ageing.

growing portfolio of specialist electrolysis subject areas and proved a great success. the course consists of a two-day specialist training programme educating experienced and knowledgeable electrologists in transgendered techniques and bridges the gap between the

practitioners in all areas of work in this field that are prepared to treat and support this minority group of clients. electrologists who will embrace the community with dignity, sensitivity, compassion and professionalism all backed up with high skill levels.” the course comprised of both theory and practical training, treating all hair including the genital area, on transgendered clients at the beginning of their journey. all successful delegates who attend this course and achieve the required practical skill level receive a sterex certificate and will be entered into the national database. the training not only teaches practical techniques but is also

After many years of thorough market and design research, and with almost 15 years of professional skincare experience, including dermatology, Skinov8 aesthetics have

aimed at improving communication and consultation procedures specifically for transgendered

launched into the market.

clients. Joanna darrell, the area representative for the beaumont society, a self-help body run by

the company’s range of professional machines are aimed at upmarket clinics and salons

transgendered and transvestite people since 1966 to enhance awareness and continue with their

wanting to break into the field of microdermabrasion, radiofrequency technology and oxygen

support for the transgendered community, attended and gave a fascinating and all encompassing

treatments. their products are designed to compliment the clinical surroundings and are

presentation. Joanna stated her appreciation that a well known company such as sterex was trying

compact and easy to use, while also being multi-functional and cost effective.

to work and support this specialist area.

Packages include training and ongoing support, with a focus on growing your business and

elaine added, “as far as we are aware this is the first of its kind in the uk and maybe the world and

increasing your profits whilst providing a professional and effective service to your clients.

we are very excited. it is the aim of sterex to always push the boundaries and continue to support

the company will be exhibiting at the cosmetic news expo in london on april 16 and 17.

and make a difference to peoples lives.”

18

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THERMALIPO II The latest radiofrequency system for combined facial and body contouring • Body treatments for lax skin, localised fat & cellulite reduction and improved skin appearance & texture • Facial treatments for lax skin, superficial wrinkles, enlarged pores and improved skin texture • Safe and easy to use • Comfortable treatments • Automatic frequency control for consistent tissue heating • Bipolar electrodes for safe, controlled application • Ergonomic design and no consumables

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THE VOICE OF YOUR INDUSTRY

THE VOICE OF YOUR INDUSTRY

www.cosmeticnewsuk.com

THE VOICE OF YOUR INDUSTRY

www.cosmeticnewsuk.com

managing

complications The dos and don’ts of dealing with problems

tOp Of the dOcS We speak to

The big debAte

Dr Carl Thornfeldt

Are sunbeds ever safe?

fILLeRS SPECIAL

breASt

botulinum toxin special 20 years of Botox®, exclusive Jean Carruthers interview, Azzalure® launch and much more

roLL wItH It

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WHAT WOMEN WANT? Skincare desires revealed

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Launch issue

MATISSE

ALSO IN THIS ISSUE

Now ANd tHEN Advances in liposuction techniques

BIg dEBAtE

Permanent fillers: yes or No?

tHE Uk’S oNLy frEE of CHArgE mEdICAL AEStHEtICS trAdE mAgAzINE

in show

We take a look at the evolution of implants

SkincAre special

We give you the lowdown on the UK dermal fillers market, from the science behind the products to the latest developments and advances

The ingredients that have shaped the cosmeceuticals market

no sweat treating hyperhidrosis

ALSO IN THIS ISSUE

speedy recovery enhancing post-procedure healing

to market marketing your business

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

ALSO IN THIS ISSUE

light fantistic faceBook etc Question time led therapy for photorejuvenation

using social media networking sites

Why market your business?

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

libEl LAw

Protecting yourself agianst defamation

MALEORDER

We take a look at the rise in popularity of treatments for men and examine the latest trends for this growing market

COsmEtiC NEws ExpO 2010 Everything you need to know

the big debate remote prescribing under fire

ALSO IN THIS ISSUE

all abroad

the bacd meeting in monte carlo

know how

how to market your practice

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

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

lynton-halfCNJAN10.indd 1

17/12/2009 16:32:29

PLATINUM SPONSOR

ShOw OF

a

STRENGTH

s we count down to the first ever Cosmetic news expo, we give you the latest on what will be happening at the UK’s first free of charge trade show and educational meeting for the aesthetics industry The Cosmetic news expo is shaping up to be an unmissable event, giving you the opportunity to network, exchange information with your peers and find out about the latest technologies and products on the market.

Taking place at the business design Centre in Islington, London on April 16 and 17, the Cosmetic News Expo aims to bring together more aesthetic practitioners under one roof than any other event in the UK. The only free of charge trade show and educational meeting in the UK, the philosophy behind the Cosmetic News Expo comes from body Media’s extensive experience in running shows for other niche markets. We believe that education should be available to everyone, no matter what their budget, so we have designed an event that allows you to gather knowledge about the latest treatments and developments at the same time as attending hands on workshops and lectures, for free.

Educational workshops will be held throughout the two-day event with industry leading practitioners, manufacturers and suppliers educating you on how to improve your business and get the most out of your clinic by offering the best treatments and products.

The event will be sponsored by manufactures and suppliers who are also dedicated to offering continued education and training to professionals working within this exciting

and expanding sector. Pharmaceutical giant Galderma has already signed up as the events Platinum Sponsor and more than 50 other specialist companies from within the industry will be taking part in the event. Our exhibitors range from distributors of dermal fillers, botulinum toxins, skincare, chemical peels and lasers and IPL to industry associations and business solutions companies. Including: ABC Lasers AesthetiCare ArC recruitment Boston medical group Ltd Cosmetic Courses Cynosure e Clinic euromedical Systems Ltd galderma (Platinum Sponsor) hamilton Fraser

Lumenis Lynton Lasers my Cells Pharma esthetica Polaris Lasers Skinov 8 Solta Sound Surgical Zanco models

Whether you are a cosmetic doctor, aesthetic nurse, dermatologist, plastic surgeon, cosmetic dentist, aesthetician or practice manager there is something for you at the Cosmetic News Expo 2010. The event is designed for industry professionals only and is not open to the public. delegates/visitors will be asked to register in advance so they can be given appropriately colored badges to show what their profession is. Workshops and lectures featuring prescription only medicines will only be open to suitably trained medical practitioners.

need advice on any aspect of running your business? Then book an appointment with one of our experts at our drop-in Business Clinic. whether you want to find out about how to promote your business through marketing or Pr, are confused about insurance or need legal advice, we will be bringing together some of the industry’s leading experts to give you one-on-one advice for free. For more information contact our events team on 01268 754 897.

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Workshop programme Educational workshops will be running throughout the two-day event covering everything from business skills and how to build a successful practice to the latest techniques and treatments with lectures from

both UK and international speakers. As well as this there are also workshop rooms where hands-on training and masterclasses will take place. The event will also be CPD accredited.

The conference auditorium at the Business Design Centre has the capacity for 450

people so make sure you book your place in advance. Keep an eye on our website www. cosmeticnewsuk.com as well as future issues of Cosmetic News for updates on speakers and full programme details. You can also register for tickets online.

FRIDAY APRIL 16

SATURDAY APRIL 17

MAIN AUDITORIUM – BOTULINUM TOXIN

MAIN AUDITORIUM – BODY CONTOURING

Undoubtedly the most popular non-surgical procedure, this exclusive botulinum toxin session will include lectures by renowned US physician Dr Benjamin Asher and leading UK practitioner Dr Bob Khanna. Looking at how the toxins market has changed with the emergence of new products and examining advanced treatments. This is one workshop not to be missed. *Please note as this workshop is about a prescription only medicine it will only be open to appropriately qualified medical practitioners

Body contouring has become big business. We explore the growth of the body shaping market and examine some of the machines that have been making waves from ultrasound to radiofrequency and laser liploysis.

MORNING SESSION

MORNING SESSION

WORKSHOP ROOM 1 – DERMAL FILLERS One of the cornerstones of any aesthetic practice, we take a look at the most recent developments in dermal fillers. From some recently launched products to new techniques.

WORKSHOP ROOM 2 – SKINCARE WORKSHOP ROOM 1 – CLINIC MARKETING Whether you want to know how to stand out from your competitors or are just looking to refresh and improve your marketing, this workshop is for you. With advice from some of the medical aesthetic industriy’s leading marketers, this is a workshop not to be missed.

WORKSHOP ROOM 2 – REGULATION UPDATE 2010 will see the introduction of the new Shared Regulation scheme. We look at how this is going to impact the industry and tell you how to make sure you qualify for the quality mark. We will also explore the topic of laser regulation and CQC registration. With speakers including Sally Taber from the IHAS.

AFTERNOON SESSION MAIN AUDITORIUM – HOW TO CHANGE A FACE How do you change a face? We look at how clinics can transform someone’s skin. From the importance of diet and nutrition to skincare and treatments our panel of experts will ponder this question with interaction from the audience. Speakers will include US medical skincare specialist Denise Byrnes.

Nearly every clinic now carries a skincare line, but what are the key things a good cosmeceutical needs and are these products really proven to work? We explore everything from ingredients to delivery systems and retailing in this workshop.

AFTERNOON SESSION MAIN AUDITORIUM – MEDICO LEGAL It is a legal minefield out there so if you want to know how to cope with everything from malpractice claims to bad press then this workshop is for you. Speakers will include media and libel lawyer Sarah Webb.

WORKSHOP ROOM 1 – MANAGING STAFF Finding the right staff can be a huge challenge so we have brought together some of the aesthetics industry’s recruitment experts to give you advice on how to find and keep the best staff. From motivating your team to recruiting the right people for the job and carrying out interviews. We will also take a look at the importance of front of house staff with some revealing secret shopper examples of how a badly run reception can damage your business. Speakers will include Vivienne Smith, Martyn Roe and Ron Myers.

WORKSHOP ROOM 2 – LASER WORKSHOP Lasers have so many roles within an aesthetic practice. We look at the different and most advanced technologies and examine their applications, from hair removal and facial rejuvenation to skin tightening and fat removal. Speakers will include Dr Jon Exley.

WORKSHOP ROOM 1 – WEB WORKSHOP From building a website to the dos and don’ts of online advertising and using social networking media, this in depth workshop will cover everything internet based. Speakers will include Ron Myers from Aesthetic Business Services and ConsultingRoom.com as well as Stephen Handisides from MyFaceMyBody.com

To pre-book a place on any of our workshops please contact the events team on 01268 754 897. Places are limited and are on a first-come-first-served basis.

WORKSHOP ROOM 2 – MEDICAL NEEDLING

Hollie-Jane Dunwell

One of the most talked about treatments in 2009, we bring you everything you need to know about medical needling, from the products to use to treatment protocols.

Live demonstrations will also be held to show you how the treatment is performed.

CONTACTS For further information regarding exhibition space please contact: T: 01268 754 897 E: hollie.jane@creativemedialtd.co.uk For event-related sponsorship opportunities contact:

Emilia Bronze

T: 01268 754 897 E: emilia@creativemedialtd.co.uk

cosmeticnewsuk.com

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ON The SCene OUT ANd AbOUT IN THE INdUSTRY THIS MONTH

Semi-permanent make-up queen Debra Robson-Lawrence, Dawn Forshaw (Finishing Touches) and Cosmetic News editor Vicky Eldridge

James Haldane (Macom Compression Garments), Jazz Dhariwal (Bioform) and Stpehen Ritchie (Solta Medical)

Mary-Kay Sheehy (Sciton) and James Haldane

Vicky Eldridge and Lee Huggon (Courthouse Clinics)

Cosmetic News was joined by a few industry friends for some festive drinks in London. Here are a few pictures from the night…

Tracey and David Beesley (SkinBrands)

Ron Sullivan and Lynne Thomas (Flipside PR)

COSmeTiC newS ChriSTmAS DrinKS, LOnDOn

Sheridan France and Rob Eaglestone

Stephen Ritchie and Amanda Cameron

Vicky Eldridge and Karen Sergeant (Glancey Medical Aesthetics)

James Haldane, Karen Sergeant and Dr Ravi Jain (Riverbanks Clinic)

BeAUTY BiBLe AwArDS, LOnDOn in the glamorous surrounding of One Alfred Place in the heart of the capital, mark Smith and Stefania Shaw from mrA Pr were invited as representatives of jane iredale to celebrate the success of the mineral make-up brand at the first ever Beauty Bible Awards.

Stefania Shaw, Sarah Stacey, Jo Fairley and Mark Smith

Entrepreneur (and founder of Green and blacks) Jo Fairley and renowned health and beauty editor, Sarah Stacey, who created the well respected awards, hosted a fantastic evening with delicious canapés surrounded by the beauty elite including the Telegraph’s Kate Shapland, Vogue’s Nicola Moulton and John Frieda.

The beauty bible Awards were launched to acknowledge the achievement of the brands, which made it onto the pages of the series of beauty bible books including beauty Steals and the Green beauty bible. jane iredale mineral make-up products were mentioned in the latter publication and products which were recognised as award winners included PurePressed Powder in the mineral foundations catergory and Circle/delete Under Eye Concealer and disappear in the concealer category.

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Big Debate | Remote Prescribing

MaTTeR of

FACTS

In response to an article published in the November issue of Cosmetic News, mai Bentley writes about the controversial issue of remote prescribing remote prescribing – now there’s a phrase guaranteed to get everyone talking! Following an article in Cosmetic News on this subject, I thought it might be timely to remind everyone of some clear facts and to help nurses to access the information that they need. No more arguments for and against remote prescribing, no more ranting and raving against the NMC, just pure basic facts which are simple to understand and easy to follow. So here goes‌..

Fact: Remote prescribing is a legal method of prescribing. Indeed there are guidelines written by the MHRA, the GMC and the NMC to help those individuals who are involved in the act of mai Bentley is a registered nurse and an Independent Nurse Prescriber (NIP). She is one of the directors of Intraderm Ltd and runs aesthetic training courses in London and Leicester. Intraderm are also offering

assessing patients and prescribing medications remotely. There are also guidelines for those who must then follow the remotely- given direction to administer the prescribed drug.

Fact: It is true that, in the community, many patients are remotely assessed and drugs are prescribed for those who may be particularly vulnerable such as oncology patients, the elderly, the

the Independent and Supplementary

disabled etc. A nurse will follow a remotely-given direction to administer the drugs. It is a useful facility

Prescribing Course for Nurses (V300) in

to call upon when drugs are required and a prescriber cannot physically reach or see the patient.

association with de Montfort University. It is currently the only prescribing course with specific aesthetic input.

Fact: It is true that in the early days of my own cosmetic practice, when the medical director could not see my patients in clinic, he would talk to them by telephone and sometimes assess them, prescribe and give a direction remotely. I happened to mention the remote prescribing method to a doctor at the FACE conference in 2002 and the information was used to launch a national remote assessment and prescribing service. There were no specific guidelines from the NMC at this time relating to remote assessment and prescribing in aesthetic medicine and hundreds of nurses found the new service exciting and a useful and safer way to practice.

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T

he advent of remote assessment and prescribing services in aesthetics has meant that the ability to use botulinum toxins has become a possibility for peripatetic nurses and for nurses in clinics without a regular doctor in attendance. With some doctors having carried out thousands of remote consultations and in the process having made a lot of money (basic mathematics based on £40 per consultation) there are certainly some happy doctors out there! There are also many happy nurses with flourishing businesses and of course many thousands of very happy patients. So why all

the fuss now about remote prescribing if everyone is so happy?

In truth, many people have always been unhappy about the routine use of remote assessment and prescribing in aesthetics. My personal view is that if the remote assessment is a thorough one – it often took 10 to 15 minutes in my practice – then it can certainly be a useful and safe alternative at certain times. However, we are all aware that some remote consultations offered today may well fall short of what is truly a safe and thorough procedure.

The big issue though is that times have changed and new guidelines have now been written and introduced for nurses by the Nursing and Midwifery Council. Whether we like them or not the new guidelines exist. Nurses cannot pick and choose which standards to adhere to and which ones they would rather not acknowledge, simply because they make life uncomfortable or difficult! The NMC guidelines state: “remote prescriptions/directions to administer should only be used in exceptional circumstances and not as a routine means to administer injectable cosmetic medicinal products.”

These are the words that all aesthetic nurses out there need to read, understand and take on board right now. It really is that simple.

It is easy for nurses to listen to the many debates being offered on this subject.

It is easy for nurses to accept that it must be safe for them to use remote services

remote prescriptions/ directions to administer should only be used in exceptional circumstances and not as a routine means to administer injectable cosmetic medicinal products

because the MHRA and GMC bodies say it is a legal and acceptable practice. It is nicer for nurses to accept this as it allows them to carry on working easily and without interruption. However, it does not change the guidelines issued by the NMC. It does not change the fact that nurses are answerable to the NMC and not to the GMC or MHRA. Even if a nurse denies having any knowledge of this latest NMC information, all nurses will be familiar with the term that ‘ignorance is no defence’ in a court of law.

all nurses will be familiar with the term that ‘ignorance is no defence’ in a court of law

cosmeticnewsuk.com

25

T

he NMC took note that some nurses found the original advice from them confusing and possible to interpret in different ways. They have now gone that extra step further to clarify the issues. By introducing these words: "remote prescriptions/directions to administer should only be used in exceptional circumstances and not as a routine means to administer injectable cosmetic medicinal products", the guidance is now very clear indeed! If a

member chooses to not adhere to this guidance and this is brought to the attention of the NMC (for example by a doctor who wishes to report a nurse for using a remote service – not beyond the realms of the imagination these days in our competitive industry) the NMC have no choice but to investigate the case as a ‘fitness to practice’ case. Who is going to be the first nurse to be in this unenviable position? Could it be you?

The NMC has said that if a nurse chooses to ignore its guidance

Sceptical individuals are already complaining that

then it may be concluded that s/he is not fit to practice and

undertaking a prescribing course does not suddenly make a

s/he may be removed from the NMC register. This is because,

nurse safe to prescribe botulinum toxins. This really is a subject

in theory, s/he could also choose to go against any other

for another day but in short it must be remembered that

guidance set by the NMC, which ultimately could endanger

the prescribing courses today are taught at degree level at

patients’ well-being. Ultimately, we must remember that the

university. Written pharmacology examinations set at an 80

NMC is there to protect the patient – not the nurse.

per cent pass rate and mathematics examinations set at a 100 per cent pass rate are not for the faint hearted. Besides,

So what does this mean for the thousands of nurses currently

were all doctors and dentists taught to prescribe the entire

using remote prescribing services? It means that although

contents of the BNF at medical school? More importantly,

remote assessment and prescribing is legal and is used in other

were any of them taught to prescribe botulinum toxins in

areas of nursing and medicine,

particular? The answer of course is no.

it cannot be used “as a routine

They were taught pharmacodynamics

means to administer injectable

and pharmakinetics. They were taught

cosmetic medicinal products”.

It means that nurses doing so will be going against the guidance set by their own governing body, the NMC. It means that the NMC has the right to bring such nurses to a fitness to practice hearing and that such nurses may be removed

we owe it to them (our patients) to be safe and ethical at all times

from the NMC register. In short, it means that you are throwing

how groups of drugs work and their interactions. They were taught how the body processes drugs and uses them. It may be a surprise to some but nurses can be taught these things too! Nurses currently run anticoagulant clinics, methadone clinics, diabetic clinics, asthma clinics, contraceptive clinics, walk in centres for minor ailments etc. They prescribe in all these areas much to the great relief of their medical colleagues who are

away your NMC registration and right to practice as a registered

educated beings who understand the training that their

nurse in the UK. if you are reported for using a remote assessment

nursing colleagues have undertaken to perform these roles.

and consultation service for administering cosmetic medicines.

More importantly there is mutual respect.

There does not need to be a problem with the treatment for this to happen. The fact that you are using a remote assessment and

Perhaps that is the key word in all of this – respect. Nurses should

prescribing service is the problem. There is no ‘amnesty’ period.

learn to respect and value themselves, their registration and their profession. It is not a commodity to be discarded in order

Whether we like it or not the era of remote assessment and

to make a few pennies. Doctors/prescribers should respect the

prescribing in aesthetic medicine has come to an end. The way

guidelines that are now in place for nurses and should not seek

forward for nurses is one of undertaking an independent nurse

to mislead nurses in order to benefit financially from them.

prescribing course or employing a prescriber to see all patients prior to each botulinum toxin treatment. To merely see a patient

Above all we should have respect for our patients. They put

every three months or so means that the nurse would then be

their trust in the nursing and medical professions and we owe it

practising supplementary prescribing – illegal if she has not

to them to be safe and ethical at all times. Without them, there

undertaken a prescribing course.

would be no aesthetic industry.

In summary Remote assessment and prescribing is legal but it cannot now be used for administering cosmetic medicines, according to NMC guidelines The MHRA and the GMC have guidelines on the subject but, if you are a nurse, they are not your governing bodies. The extra guidance from the NMC must also be adhered to if you are a nurse. Going against the NMC guidelines means that you are risking your registration, career and livlihood. The guidelines are in place now and must be adhered to immediately. There is no ‘amnesty’ period of adjustment.

The NMC guidance is in writing on the NMC website under ‘Advice by Topic’. It is also available on the website www.nurseprescribingcourse. com. If you require advice or wish to speak to someone in confidence about prescribing issues you can call 0845 45678 56.

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New University Masters Degree in Cosmetic Medicine First modules available January 2010 Fast Track option for Independent Prescribers holding the BTEC Medical/Skin Laser qualifications or those with relevant clinical experience/postgraduate diplomas

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Competitively priced packages provide the clinic registers and supporting materials for successful registration plus attendance at our unique CQC Compliance Workshop.

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the uk’s oNly free of chArge m

be pArt

cosmetic

The Business De

April 16

A body of informAtion for the The Cosmetic News Expo is the UK’s first free of charge trade show for the aesthetics industry, giving you a unique opportunity to gather knowledge about the latest treatments and developments at the same time as networking with your peers and attending hands-on workshops and lectures, without breaking the bank.

With Galderma signed up as Platinum Sponsor, this is the one date in the aesthetics calendar that you can’t afford to miss.

Whether you are a cosmetic doctor, aesthetic nurse, dermatologist, plastic surgeon, cosmetic dentist, aesthetician or practice manager, there is something for you at the Cosmetic News Expo 2010. * Please note that the Cosmetic News Expo is designed for industry professionals only and workshops and lectures featuring prescription only medicine, such as botulinum toxin, will only be open to suitably trained medical practitioners.

www.cosmeticnewsuk.com

medicAl Aesthetics TrADE shoW

of the

rEvolUTioN

esign Centre, Islington, London

6th & 17th 2010

e AEsThETiCs iNDUsTry the ultimAte tool for your business The Business Design Centre, Islington, London April 16th & 17th 2010

PLATINUM SPONSOR

People in Profile | Jan Marini

The Face OF The brand

we talk to skincare guru Jan marini Jan Marini epitomises the brand that she has developed and given her name to. Once dubbed the ‘derma diva’ by a magazine, Jan is the embodiment of beauty and brains. A smart, scientifically minded and shrewd business woman, she has worked with some of the world’s leading physicians and research scientists and is responsible, not only for developing one of the best known professional cosmeceutical ranges in the world, but also pioneering the trend of selling skincare through the clinic environment.

“Trust your instincts. many of the world’s greatest achievements started with the admonition that ‘it can’t be done’”

a

product researcher for more than 30 years, Jan’s area of expertise lies in the field of ingredients, but science was not the original path she imagined for herself as a glamorous teenager growing up in California. A budding model, Jan’s passion for therapeutic, medically-evidenced skincare was ignited after she developed severe cystic acne at the age of 19. Having gone through High School with flawlessly perfect skin, the experience caused her a lot of distress. disappointed at the treatments available to her, she launched herself into a lifelong mission to research and develop products that could help others in the same position.

“back in the early days my expertise was really in deciphering skincare ingredients. When you pick up a skincare product and look at the labeling there is often very long, complicated and intimidating lists of ingredients. How do you really know if something is going to combat your lines and wrinkles or discolouration etc? So I did a lot of lecturing, not only to physicians but to skincare professionals and consumers, about ingredients. I also did a lot of talk shows, which was really good because people want to know what’s in their products and what works. As time went on I began to develop associations with researchers and scientists, not only in the US but all over the world, and I began to focus more and more on research and development.”

In 1989 Jan financed and helped bring to market Md Formulations and Md Forte and took the

unprecedented step of approaching doctors to sell the products where every other skincare line at the time went down the classic department store route. It was a radical idea and took scientific knowledge, business logic and passion to convince the doctors, however Jan had confidence that it would work, and she was right.

“When I secured the distribution rights, I believe Herald Pharmacol assumed that I would market the products through the traditional retail channels, such as department store cosmetic counters. However, I envisioned an entirely unexplored, and what could be considered, highly controversial marketplace, the physician dispensing market”, she says. “At the time physicians were not selling product out of their offices, in fact it was considered by most physicians to be somewhat on the side of being unethical.

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“Today carrying a skincare line is commonplace, in fact it is considered to be essential as a part of the revenue stream of a practice and also a way to attract patients to a practice. At medical conferences a good number of the physicians who come up and talk to us who are getting ready to go into practice, one of the first things they are doing is considering ‘what products am I going to carry?’

“However, many of my colleagues at the time thought I was certain to fail and that along the way I would also irreparably damage their reputation. I learned a critical lesson then – never let anyone determine your limitations!

Trust your instincts. Many of the world’s greatest achievements started with the admonition that ‘it can’t be done’.”

gOing iT ALOne

all over the world for rosacea, for lines and

“with virtually every ingredient you can see a contrary study from somewhere. But glycolic acid has roughly 30 years of in depth medical research into it... it really is an amazing and efficacious ingredient”

wrinkles, acne – it is really an amazing and efficacious ingredient. Plus more and more pharmaceutical firms are putting glycolic acid into prescription products and when you do that of course you are coming under much more stringent regulation and have to prove that the product is safe and efficacious.”

BrAinS AnD BeAUTY Jan is always hungry for knowledge and keeps herself up to date with the latest developments in dermatology and antiageing science by immersing herself in medical journals and studying the results of clinical trials. but it is not just from these sources that she gains inspiration for the innovative products that have earned her a

Predicting the growth in medi-spa style clinics

speak about your products at medical conferences

offering results-driven treatments in the US, Jan

and recommend them to their peers I think gives

developed her own range, Jan Marini Skin Research

a line tremendous credibility. We have a very loyal

“I read probably 30 medical journals a month

(JMSR), in 1994 as a line of medically researched

following. I would also say it is the channel that we

and I read in every speciality whether its oncology,

products to treat a variety of skin complaints from

are in – the professional market. Our position in the

general medicine, dermatology or plastic surgery

fine lines and wrinkles to acne, rosacea, scarring

market is as a professional product system that

because I find that there are many innovations in

and pigmentation.

offers clients achievable, visible results and enables

other areas that may be related to something we

practitioners to build a successful business.”

can address in skincare ”, she says. “So some of

Today JMSR distributes to more than 80 countries

number of entrepreneurial awards.

that has inspired my creative juices but then the

The gLYCOLiC DeBATe

biggest inspiration can sometimes just be listening

that addresses hormonally influenced breakouts for

As one of the pioneers of the use of glycolic acid in

containing microscopic particles to soak up the oil

adult women. Jan is also very proud of their current

skincare, what does Jan think of recent controversy

but not the water. We became the first company

eyelash-enhancing product, Marini Lash Eyelash

surrounding the use of AHAs as a skincare

in the world to use this type of technology in a

Conditioner, a non-prostaglandin formulation that

ingredient including claims that it thins the skin as

sunscreen so it does not feel greasy on the skin.”

contains a proprietary peptide and other essential

well as comments by US professor, dr Sam Epstein,

factors and addresses the problem of thinning

chairman of the Cancer Prevention Coalition who

So what keeps Jan going and motivates her to

eyelashes and eyebrows because of alopecia,

said that anti-ageing creams containing alpha-

continue developing new products? “boy, I can tell

menopause, hormonal imbalances and stress.

hydroxy acids were “probably the most dangerous

you I am always asked that question“, Jan laughs.

cosmetic products on the market”.

“I always had an interest in skincare. I can’t really

worldwide and includes almost 100 products for both professional and home use. The line’s signature products include their Age Intervention Peptide Extreme with a proprietary blend of four peptides as well as an acne product with a specific ingredient

The company is also due to launch a new exciting

to the concerns that people have. I am always looking for the next breakthrough. The idea for our sun protection cream came from an article I was reading about oil spills and how they use absorbents

tell you where that came from but I think that first

product this month, a skin primer. Jan explains,

“Okay, let’s talk about skin thinning first of all”, she

of all I love to educate and I think that it empowers

“It is a product that we have had unbelievable

says. “As you age the outer layer of your skin, the

people and I love to give them information they

emotional resonance with, almost like we did

stratum corneum, gets much thicker and coarser

have never heard before or put it into a different

when we launched the first eyelash product. It

and your collagen decreases and eventually your

perspective. Also I am passionate about what I do

is like priming your wall before you paint it, when

epidermis can ‘collapse’ onto your dermis. So

because I develop products as much for myself as

you put your make-up on it kind of floats on the

what you want to do is you actually do want to

for anyone else.

top and gives you that air brushed perfection. Skin

thin your skin, you want to thin and compact the

primers are very common but what we have done

stratum corneum because the thinner and more

“I am no different to anyone else, I am always

is packed it full of anti-ageing ingredients including

compact the stratum corneum is the more perfect

looking for ‘hope in a jar’ I am always looking to

some that haven’t been on the market before. One

and translucent the skin. The glycolic thins and

get rid of all the different concerns that I have or

of these ingredients is an extract, which actually

compacts the stratum corneum but it also thickens

could have. I believe that I am truly in the greatest

works on the functionality of elastin fibres. For years

the dermis.

and most rewarding business in the world. I believe

we have had things that we have been using to

that you must partner with your marketplace to

stimulate collagen but elastin is a whole other story.

“With virtually every ingredient you can see a

fulfill a need, provide value and make it possible

The comments we have been getting are fantastic,

contrary study from somewhere. but glycolic

for others to succeed. I believe that you must

people have been saying they just can’t live

acid has roughly 30 years of in depth medical

share your knowledge and freely give of your

without it because it makes them look so amazing.”

research into it. In fact in 1994 there was an entire

time and expertise so that others can realise their

medical conference held in Florida where all they

goals and ambitions in order to ‘live their passion’. I

did was talk about glycolic acid. The studies that

believe that every day is filled with possibilities and

where presented by every physician were very in

opportunities. And most of all, I believe that no

“I would say number one is the fact that the

depth. So the data we have on glycolic acid is

one can do it for you, but you don’t have to do it

products really work”, she says. “When physicians

overwhelming. It is an anti-inflammatory, it is used

alone.”

So what does Jan attribute the success of JMSR to?

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Weight Loss Special | In-Clinic Diets

A weighTY

issue

Cosmetic news looks at the growing trend for offering medically supervised in-clinic diets plans to compliment aesthetic treatments

W

e are a nation obsessed with weight and no more so than at this time of year.

January is the month when most people start thinking about making changes in their lives and one of the top things on many people’s agenda is losing weight. with the festive season’s over indulgence taking its toll on their waistlines many people’s minds will be turning to thoughts of shifting those excess pounds.

Weight loss is big business. About 46 per cent of men in England and 32 per cent of women are overweight (a body mass index of 25-30), and an additional 17 per cent of men and 21 per cent of women are obese (a body mass index of more than 30). The UK slimming industry is thought to enjoy an annual turnover in the region of £2 billion and clinics are now cashing in on this by complementing their aesthetic treatments with diet and nutrition plans.

The riSe OF The in-CLiniC DieT diet and nutrition have often been seen as a separate entity to the world of aesthetic medicine, but while aesthetic treatments can help shape those unwanted bulges for people who are at a healthy weight, they are not designed as method for weight loss or for people who are overweight or obese, and as such more and more clinics are embracing the idea that diet programmes can not only enhance, but help maintain the results of both non-surgical and cosmetic surgery procedures.

in-CLiniC DieTS – The LOwDOwn PrOmeDiS The Promedis diet is a high protein, calorie controlled plan that can be tailored to individual patients’ needs with 1,000 calorie-a-day, 1,2000 calorie-a-day and 1,500 calorie-a-day weight loss plans. There is also a maintenance plan to help stabilise weight and curb hunger pangs.

Promedis products have been distributed exclusively to professionally supervised obesity and diet clinics throughout North America since 1996 and were first introduced to the UK in 2006. The products are distributed in the UK by Medical Aesthetic Group and include a selection of bars, soups, shakes, deserts, lunches (such as chili con carne) and supplements which are used in combination with fresh fruits and vegetables and healthy proteins like fish and chicken.

The hallmark of the Promedis plan is ready-to-serve meals and shakes with a focus on taste and clinically proven quality ingredients. The use of structured meal plans, which allows protein intake at regular intervals, keeps patients feeling satiated with no feeling of hunger, a continual problem for most weight loss programmes.

The science behind it is that to maintain lean body tissue while on a calorie restricted diet, an average of

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PrOmeDiS SAmPLe PLAn – 1,500 CALOrieS Daily recommendations: 8-10 glasses of water (1 glass = 8 fluid oz/250ml), 1 Promedis cereal bar, 2 Promedis choloate/yogurt coated bar,s 1 Promedis hot meal, 1 ready to serve Promedis pudding, 5 portions of vegetables (I serving = 4oz/115g), 3 Promedis shakes, 2 servings of fruit (1 serving = 4oz/115g), 1 serving of meat/poultry (3oz lean beef or pork or 5oz poultry) , vitamin supplements BreAKFAST (320 Calories) 1 Promedis shake (80 calories) 1 Promedis cereal bar (150 calories) 1 serving of fruit (90 calories) miD-mOrning SnACK (150 calories) Promedis choloate/yogurt coated bar LUnCh (270 calories) 1 Promedis hot meal (140 calories) 2 servings of vegetables (50 calories) 1 Promedis shake (80 calories) miD-AFTernOOn SnACK (150 calories) Promedis choloate/yogurt coated bar Dinner (435 calories) 1 Promedis shake (80 calories)*half an hour before meal 2 servings of vegetables (50 calories) 1 serving of meat/poultry (215 calories) serving of fruit (90 calories) evening SnACK (100 calories) 1 ready to serve Promedis pudding (100 calories)

between 80 and 120 grams of protein is needed. Protein supplements must contain high quality protein with a proportional ratio of carbohydrates and remain low in overall calories.

They should also contain essential amino acids such as tryptophan (a precursor of seratonin) that has been shown to work on the satiety centre of the brain making people feel full and content. Like carbohydrates, protein supplies calories which provide energy to the body, however the body burns more calories converting protein into energy than it does with simple carbohydrates.

James Lamper, a leading weight management expert and founder of the WeightMatters

Ann Russek lost 15.2 lbs and lost 9.48% body fat

Clinic in London has been using the Promedis plan for three and a half years with his clients and has even carried out an anti-obesity study with the plan. He explains, “Promedis approached me with their products and I said ‘how good are they and what research has been done?’ and they said ‘not very much’ so I said ‘ok I tell you what I will do a study’ and of course they were up for that. It was good, it was good healthy weight loss, it wasn’t too extreme and it was something that people could maintain afterwards.”

After carrying out the obesity study, James was quoted as saying, “Our proprietary clientcentered approach combined with the Promedis formulas could very well be the most effective, safest obesity treatment, aside from gastric bypass surgery, for those individuals who are severely challenged and struggle with their diet and weight.” Three years on does he still agree with this? “Absolutely”, he says. “At the end of the day if someone is that extreme that they need weight loss surgery, they need a drastic intervention around food management and if they were to then go on the Promedis regime which is then totally supported by someone like myself and my team, then absolutely it is better than going for weight loss surgery.”

James who specialises in the psychology of eating and eating disorders, and is also a nutritionist and personal trainer, is all too aware of the importance of not just prescribing a diet plan but offering emotional support and guidance. James gets his clients to keep a food diary to monitor their progress and offers individual support either via the telephone, on Skype, faceto-face or via email. “You need someone to help you manage the changes to your eating behavior “, he says. “The psychology element is huge, it is about changing habits, changing thoughts and perspectives, it is about dealing with body image issues and it is about dealing with lifestyle factors that trigger you to eat badly and what you can do instead/differently.”

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Weight Loss Special | In-Clinic Diets Exercise is also an important element of the plan. “Exercise is

majority of the people who are obese have insulin resistance.”

fundamental”, James says. “by reducing your calorie intake and following

If you are planning to integrate weight loss services in to your practice,

a plan, it is definitely going to help but at the same time you can increase

James believes the best way is to bring in a dedicated weight

your calorie burn through exercise and obviously you are going to lose

management specialist. He says, “I think the best way is to get a

fat/lose weight faster. For people who are obese and are insulin resistant

weight management consultant, someone who specialises in weight

the only thing that will allow glucose to get back in the cells is exercise

management coaching and has the physiological skills to be able to deal

– the only way you can reverse insulin resistance is to exercise – and the

with behavior change.”

ALiZOnne Alizonne Therapy is a weight loss and body-contouring plan that doctors are saying ‘could be the cure for obesity’. Alizonne is not just a diet but a total body overhaul. It provides astonishing, predictable weight loss results of six to 12kg per month and, if followed correctly, will completely transform your clients’ body shape and size for life. Alizonne is a medically-designed approach to weight loss, developed over several years by dr Claudia van der Lugt Md, founder and medical director of the exclusive Alizonne Clinic in the Netherlands and an internationally renowned medical specialist in the treatment of overweight patients Alizonne’s unique approach and custom-designed programme dramatically reduces body fat (and all the health risks associated with obesity such as high blood pressure, diabetes, cholesterol etc), without the risk of baggy skin being left behind. With four essential elements designed to target specific aspects of weight loss and body shaping, Linda and Russell Walker before going on the Alizonne plan at Courthouse Clinics

results are achieved and maintained at an astonishing rate.

Alizonne Nutritional Therapy involves a medical assessment to determine the client’s personal metabolic rate and a custom-designed medical nutritional supplementation and eating plan designed to alter the body’s metabolic rate for optimum, rapid and constant breakdown of fats. When accurately followed through several phases, weight loss is quick, controlled and predictable.

Unlike with other diets, the metabolic rate is kept high and blood sugar levels in balance ensuring the body’s chemistry is optimised, whilst rapidly breaking down and burning up stored fat.

Weekly Alizonne Ultrasound Therapy

Linda and Russell after following the plan

“The UK slimming industry is thought to enjoy an annual turnover in the region of £2 billion”

Side view of Russell before treatment

Russell after treatment

treatments specifically break down diet resistant fat cells under the skin, promoting fat loss and shaping the body’s contours in all the right places. The fat released also provides the body with additional energy, ensuring the patient won’t feel hungry or weak during treatment. In addition Alizonne Skin Therapy stimulates the skin activating specialised cells into producing collagen and elastic fibres, causing contraction, firming and an increase in elasticity, tightening and smoothing of the skin.

Once the client has achieved their ideal weight, monthly medical check-ups and a long term eating plan, precisely calculated for your new metabolic rate, ensure it stays off. As a less expensive and risk free option to surgery, Alizonne is the answer for rapid and dramatic weight loss, remarkably improved body contours and a longer, healthier life. Court House Clinics has been using the plan successfully at their clinics. Patient Lynne Horner from darlington says, “Five months on and five stones lighter, I feel younger, fitter and healthier.

My blood pressure is normal and I look fantastic (told by everyone!). This treatment saved my life – worth the time, effort and definitely worth the money. No baggy skin or tummy tuck needed – fantastic!”.

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THERAPEUTIC FORMULAS

PHARMACEUTICALLY PURE

TRUSTED SCIENCE

WEIGHT LOSS PROMEDIS® is a protein based diet system developed to support a weight loss program.

PROMEDIS® is owned by Jamieson Laboratories, a world leader in the manufacture of health care products, and has been successfully sold in the USA for over ten years. A range of dietary supplements support the weight loss programme.

PROMEDIS® offers a great range of delicious bars, shakes, meals and desserts all high in protein while low in carbohydrates and fats, making it easy to reduce daily calorie intake and achieve effective weight loss.

We offer a “Direct to Customer” shipping system, which means you hold no stock and get paid before we invoice you and ensures that your clients receive fresh products!

ANTI AGING PROMEDIS® is a new generation of pharmaceutically pure and clinically proven anti aging skin care. The range of oral and topical products complement and enhance the procedures performed by the cosmetic professional.

PROMEDIS® addresses the major concerns of anti-inflammatory, antioxidant, collagen production and derma cell regeneration.

A healthy diet shows in the skin and it is proven that good hydration, essential fatty acids and antioxidants support and protect the skin structure.

PROMEDIS® takes an inside out approach to anti aging and problem skin.

For further information about these innovative products call Medical Aesthetic Group on 02380 676733 or visit www.magroup.co.uk Medical Aesthetic Group 67 Priory Road, Southampton, Hampshire SO17 2JQ Tel: 02380 676733 Fax: 02380 676744 Email: info@magroup.co.uk www.magroup.co.uk

Weight Loss Special | Body Contouring

ShAPing UP we take a look at some of the best body contouring procedures to complement weight loss

with dieting and weight loss at the forefront of many people’s minds as we move in to 2010, now is one of the best times for clinics to cash in on the growing demand for body contouring procedures. The global body contouring market has seen continuous growth over the past few years, with demand for procedures that can reduce areas of localised fat and improve body appearance, with minimal downtime, driving this trend. while aesthetic procedures, both surgical and nonsurgical, are not a quick fit to weight loss or a solution for those who are overweight or obese – the ideal candidate for any body contouring procedure whether it is surgical or non-surgical is someone who is at or near to their ideal weight and has pockets of fat that have not responded to a healthy lifestyle including diet and exercise – they certainly can add the ‘finishing touches’ to any weight loss bid by getting rid of stubborn love handles or tummy fat, which can be hard to shift, even for those who have a healthy Bmi.

POST weighT LOSS COSmeTiC SUrgerY With obesity on the increase and the number of obesity surgeries, such as gastric banding, being performed dramatically on the rise – statistics released by cosmetic surgery clinic chain SurgiCare, which offers gastric banding and gastric bypass surgery, in 2008 showed a massive 460 per cent increase in patients undergoing these procedures since 2007 – cosmetic surgeons are beginning to see the first waves of a generation of people who need cosmetic help after having undergone extreme weight loss.

Cosmetic surgeon Patrick Mallucci says, “It is still early days but we are all awaiting this big Tsunami of patients. It takes possibly 18 months for people to lose the weight after having a gastric band fitted. We are starting to see them trickle through now but by all accounts, and by looking at the statistics, I would be expecting many more to come.”

The main side effect of drastic weight loss for obese patients is excess skin, which, although not as physically damaging to their health as the weight, can be as psychologically damaging. Mr Mallucci explains, “When they come to see us the weight has gone but the thing that absolutely devastates them are the huge curtains of skin they have got and that becomes the new noose around their neck. It is interesting because a lot of people who haven’t managed to get their treatment through the NHS and can’t afford to have it done privately will say they wish they had never lost

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the weight. There is nothing more they can do, there is no amount of gym or

surgery, those who have had a less drastic change in body shape can

diet that will get rid of it, the only thing that can correct it is surgery.”

certainly benefit from some of the newer non-invasive technologies which

Aside from ridding patients of excess skin post dramatic weight loss,

have emerged in the market in recent years. While cellulite and skin

cosmetic liposuction remains a popular procedure. Although statistics from

tightening treatments have also benefitted from the weight loss market, it

the british Association of Aesthetic Plastic Surgeons showed a 29 decline

is non-surgical body contouring that has seen the most significant boom in

in the number of liposuction treatments performed by members in 2008,

medical aesthetics clinics.

perhaps due to the emergence of new less invasive options such as VASER, liposuction remains the most effective way for those who have lost weight

Speaking at the American Academy of dermatology’s SKIN academy

and want to improve their body shape.

(Academy) last year, leading dermatologist Jeffrey dover, said, “There is a

“The classic four areas for the post weight loss patients are the abdomen,

strong demand for non-invasive procedures that can address the concerns

the inner thighs, the arms and the breasts”, says Mr Mallucci. “We tell

of people who are not considered overweight, but despite diet and exercise,

everybody that liposuction is never a means of losing weight, it is really

have pockets of fat that bother them. While traditional liposuction and laser

a tool that you use when people have lost all the weight they possibly

liposuction are invasive surgical procedures that are designed for overall

can and can’t shift those last stubborn bits. It is re-contouring rather than

fat reduction, new procedures are emerging that are non-invasive and are

sucking someone’s weight out.“

showing promise in clinical studies for removing fat without the potential risks and downtime of invasive procedures.”

nOn-SUrgiCAL OPTiOnS

Here we examine some of the technologies that have been taking the market While the side effects of extreme weight loss can only be corrected by

by storm: ultrasound, radiofrequency and laser lipolysis.

ULTrASOUnD There are a variety of different ultrasound-based treatments currently on the market that all work in different ways.

ACCenT® ULTrA

Accent® Ultra (AbC Lasers) is the world’s first and only body reshaping workstation to combine two stateof-the-art technologies for safe, non-invasive and painless body reshaping. Accent® Ultra advanced body contouring treatment penetrates through the epidermis and dermis to the subcutaneous fat, for effective treatment that meets the clinical needs of patients and physicians. Split into two modules; the Ultra™ module provides ultrasound energy for treating cellulite and reducing fat whilst the UniForm™ module provides radiofrequency energy and lymphatic drainage for body reshaping and tightening skin.

The Ultra module combines two advanced ultrasound technologies. ‘Cold mode’ shear waves deform the fat cell membrane integrity to induce a gradual and natural elimination of the cell. The surrounding non-fat cells tissue remains intact. The ‘hot mode’ compression waves preheat the target fat tissue enhancing the effectiveness of the shear waves.

The UniForm™ module combines Alma Lasers’ core RF UniPolar™ technology in parallel with mechanical lymphatic drainage technology for non-invasive cellulite treatment and skin tightening. dr dave Allamby, the only person in the UK currently using the new system, “The device works by vibrating fat cells at their resonant frequency until the walls of the cells break open. Most importantly, because of this ‘selective resonance’, other structures in the area such as nerves, blood vessels and collagen fibres are not damaged because they do not have the same resonant frequency as fat. The fat safely passes into the lymph channels and then into the veins before being processed by the liver. The liver can easily handle the extra fat, in the same way as it does if you had eaten a fatty meal.”

“Many people are interested in getting a better, slimmer figure but have found that willpower alone is not enough to diet or exercise successfully. Plus many have decided against surgery either because of the risks involved, such as infection, scarring or a general anaesthetic, or the downtime needed after an operation. The great advantages of Ultra are that treatment is non-invasive and with no downtime, so patients can go straight back to their lives. This is a huge step forward in fat reduction treatment, and fully non-invasive”.

vASer One of the most talked about procedures of the last year has been VASER Liposelection.

Although it was launched in the US in 2002 and the UK in 2005, the technique has gained huge popularity over recent months.

The system uses a patented device/probe, which delivers ultrasound energy from all sides, as well as from the tip, allowing the practitioner to sculpt more precisely. This means that there is less risk of damaging the surrounding structures such as blood vessels or nerves than with previously used ultrasound liposuction techniques. Like many forms of surgical liposuction, a saline solution containing adrenaline and lignocaine is also introduced through a small incision in order to numb the area and loosen up the fatty tissue before the fat is liquefied and sucked out. Although it is less invasive than liposuction, the treatment still has downtime and should be considered as a minor surgical procedure.

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Weight Loss Special | Body Contouring LiPAwAY The Lynton LIPAWAY system uses the latest biological cavitation ultrasound technology to achieve volume reduction in body tissue. The cavitation effect relies on the formation of bubbles within interstitial areas of the body. When these bubbles collapse the resulting shock wave leads to a temporary change in the permeability of the fat cell walls, which allows fatty material to drain out of the cell and be removed by the body’s lymphatic system. The power density and frequency of the Lynton LIPAWAY system make it particularly effective for the destruction of consistent quantities of adipose mass most typically found in areas such as the abdomen, gluteus and thighs. After just one treatment it is possible to achieve a reduction in body

ULTrAShAPe

circumference of up to 3cm.

Another form of ultrasound-based technology for body contouring is Ultrasonic

LiPOSOniX

body Contouring or Ultrashape. Ultrashape is a non-invasive ultrasound device that

LipoSonix uses high-intensity ultrasound to target adipose tissue via

uses focused selective ultrasound waves to break down fat cells with no associated

thermo-coagulation. The epidermis is not damaged because the

heat generation and therefore no side effects or down time. The patient lies on

energy is distributed across the surface at a relatively low level but

a bed while the treating practitioner runs a hand-held device over their problem

focuses at a higher intensity in the subcutaneous fat. The body’s

areas. The ultrasound beams penetrate the skin, without causing any damage to

natural inflammatory response then sends macrophage cells to the

nerves or blood vessels, and destroy the fat cells. The fat is then metabolised by the

treated area to engulf and transport lipids to waste. A full abdomen

body. The treatment takes between 45 and 90 minutes to complete and a course

takes between 30 and 60 minutes to treat and the adjustable energy

of treatments is usually required to get the best results. The best candidates for this

and depth settings allow the practitioner to adjust the treatment to

treatment weigh no more than 6kg (just under a stone) over their ideal weight.

suit the patient.

LASer LiPOLYSiS The advent of laser lipolysis enabled non-surgically trained practitioners, such

PALOmAr SLimLiPO

as cosmetic doctors, to start performing fat reducing treatments in their clinics

distributed by Eden, the Palomar SlimLipo

under local anaesthetic, offering patients an alternative to more invasive

body-sculpting laser ‘melts’ unwanted fat

surgical liposuction for the first time. deka’s Smartlipo system was the first on the

efficiently and effectively by selectively

market and has since been followed by a plethora of other devices including:

targeting adipose tissue. The laser

Smartlipo MPX (Cynosure), Slim Lipo (Eden), ProLipo Plus (Sciton), OSYRIS

wavelengths used in SlimLipo (a blend

Pharaon Laser Lipolysis System and the Fotona XP2 (AMbETech).

of 924nm and975nm) are preferentially absorbed by lipids for efficient fat melting,

Laser lipolysis works by using laser energy (delivered by inserting a fibre-optic

and produce just enough heat to provide

probe under the skin) to break up and liquefy the fat cells. The liquefied fat can

skin tightening without causing unnecessary

be left to be naturally eliminated by the body however experience has shown

and unsafe heating of surrounding tissue.

that far superior results are gained by also using aspiration.

The combination of continuous wave output and selective wavelengths of

dr Ayham Al-Ayoubi comments, “The most important thing to remember is that

SlimLipo allow for better, safer control of

for laser lipolysis treatments, such as Smartlipo MPX, to be effective in a weight

energy deposition to surrounding tissue.

loss patient, they must use all medical, surgical and wellness tools available

Small incisions mean faster healing, less

to them, which includes strict help from a dietician. The Smartlipo MPX will

bruising, reduced pain, and minimal blood

get rid of excess fat from the problem areas however the patient must also

loss and swelling and less downtime for

accompany this with a strict diet and exercise regime. The benefit of Smartlipo

patients who need to return to work or

MPX for weight loss is that it gives an immediate boost to patients to continue

other activities the same day. The SlimLipo

to keep the weight off as you can see immediate results. Combined with a

treatment tip moves easily through all

good healthy diet from a dietician it’s a healthy way to lose weight but it can’t

treatment areas - even fibrous tissue.

be used alone and the patient must understand this. They must work hard with

Physicians can treat patients in areas that

medical team and be sent to a specialised doctor to make sure any underlying

are not normally treated with traditional

medical problems are under good control. e.g diabetes. To summarise, make

liposuction, such as small areas and contour

sure any underlying health problem is under control before using Smartlipo

deformities. Continuous wave technology

MPX as a treatment for weight loss and it needs to be combined with all tools

gives superior control of thermal effects

available - medical, surgical and diet, wellness to be effective.”

while dual laser wavelengths of 924nm and 975nm give optimised fat and dermal tissue lasing.

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SmArTLiPO mPX Smartlipo MPX (Cynosure) is the first and only FdA approved dual wavelength laserlipolysis workstation on the market. The Smartlipo MPX allows the physician to customise treatment protocols based on the patients needs. It allows each wavelength to be used individually and sequentially in a ‘blended fashion’ for optimal results. The Smartlipo MPX utilises both the 1064nm and 1320nm wavelengths. Each of these wavelengths brings unique characteristics to the laser lipolysis

before Smartlipo MPX

procedure. One is better suited for liquefying and coagulating and the other is more aggressive and suited for targeted tightening. The 1064nm wavelength has a greater affinity toward oxyhemoglobin, but demonstrates less absorption in water, which produces a larger scattering effect than the 1320nm wavelength. due to this strong scattering effect with the 1064nm wavelength, the laser energy would be distributed in a more homogenous manner (broader region) in fat tissue. The 1064nm wavelength also has a more diffused distribution of the laser energy which will help to safely heat the collagen bundles in dermis, resulting in tissue tightening.

Three weeks after treatment with Smartlipo MPX with dr Ayoubi

The 1320nm wavelength has strong absorption and less

FOTOnA XP2 FOCUS distributed by AbMEtech, the Fotona XP2 Focus represents the culmination of more than ten years research and development to design the ultimate surgical laser system. The system is capable of three key treatments: laser lipolysis, endovascular occlusion and dermatology.

The laser lipolysis mode uses a 0-30 watt variable1064nm power output to enable

scattering in fat tissue; therefore, most of the laser energy is deposited into a small (localised) region near the laser fiber tip in the subcutaneous layer. This results a high efficiency toward heating the subcutaneous layer and disrupting fat cells with the 1320nm wavelength. This blending of wavelengths is actually called Multiplexing (MPX). Multiplexing or blending wavelengths gives you the ability to maximise safety, effectiveness and overall patient outcomes and satisfaction. It allows the physician the option to blend these wavelengths to achieve optimal results.

Two months after treatment with Smartlipo MPX with dr Ayoubi

safe and effective lipolysis of both large and smaller more challanging body areas.

STrAwBerrY Following the success of the Laser Lipo Lapex bCS, the Strawberry

PrOLiPO PLUS

takes inch loss to a new level, by

The ProLipo plus (Sciton) is a minimally invasive, ultra high-powered laser-assisted

reducing treatment times and

lipolysis system for melting unwanted fat and coagulating tissue resulting in a

increasing the size of treatment

tighter, slimmer body. ProLipo plus employs dual wavelength capability (1064nm

areas. The Strawberry –so called

and 1319nm), providing the choice to use each wavelength individually or to

because of its unique shape – is

combine the benefits of both for optimal body sculpting results. With up to 40

the only low-level laser on the market that can

watts of power on 1064nm and up to 40 watts on 1319nm, the system provides

boast up to 60 diodes, equivalent to seven and a

flexibility in tailoring advanced treatments. A wide range of customisable

half paddles. And its multi-purpose functions not

treatment parameters enables body sculpting treatments that are personalised

only help inch loss, but can also reduce stretch

for each patient.

marks, eye bags and ‘man boobs’.

rADiOFreqUenCY Radiofrequency (RF) treatments use

SmArTSCULPT

radiofrequency energy to penetrate

Launched this month the new SmartSculplt system (Energist)

the skin, without damaging it, in

includes two separate RF handpieces: Monopolar and bipolar

order to break down fatty cells and

as well as red LEd. The monopolar and bipolar hand pieces can

stimulate collagen production, which

be used sequentially in the same session. Red LEd has been

improves skin tone and elasticity.

clinically proven to help combat the signs of ageing by stimulating

Radiofrequency treatments can be

collagen and elastin production, resulting in further skin texture

used to treat excess pockets of fat on

and tone. SmartSculpt was designed for ease of use, including

the stomach, hips and thighs, reduce

user changeable treatment tips. For the body a typical treatment

cellulite and tighten saggy skin caused

course consists of six to eight sessions.

by weight loss or pregnancy. There are variety of different machines used for cosmetic body treatments which utilise radiofrequency technology, some of which combine RF energy with other modalities such as infrared light.

Treatments utilising RF include Accent, Velashape, Tripollar and SmartSculpt.

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Weight Loss Special | Body Contouring ACCenT Accent uses two separate hand-pieces to deliver different types of RF energy into the deep tissue lasers (2mm to 6mm depth under the skin). Its bipolar handpiece is designed to tighten the skin while its monopolar hand-piece reduces cellulite and fat. Patients have described the treatment as feeling like a ‘warm massage. The treatment takes less than an hour and requires no recovery time. The treatment works by using controlled heating of the tissue to break down cellulite; releasing and flushing away toxins and fatty deposits; draining excess fluid; and boosting collagen production to improve the skin’s appearance. The Accent treatment has been cleared by the FdA and risks are extremely low.

veLAShAPe

ThermALiPO ii

Velashape combines radiofrequency energy

THERMALIPO II (Lynton) uses unique AMFLI (Automatic

and infrared light to heat localised fatty tissue,

Multi-Frequency and Low Impedance) technology to

while a vacuum and mechanical massage

break down fat cells and promote collagen formation

manipulates and smoothes and tautens the skin.

without causing damage to surrounding tissues, nerves or

Velashape can reduce unsightly cellulite and

blood vessels. With visible results after the first few sessions

take inches off of the thighs, buttocks, arms, love

the THERMALIPO II represents a true alternative to invasive

handles and the abdomen. The combination

liposuction surgery and laser techniques. Treatments are

of infrared and RF energies is delivered through

easy to administer, very gentle, low risk and pain-free.

a hand held device, which passes over the

body treatments are recommended for localised fat

skin using rollers and a vacuum action. The

reduction, a reduction of the appearance of cellulite, and

Velashape device precisely heats the underlying

circumference and volume reduction. Treatments also

tissue within the targeted treatment area. This

induce collagen contraction which results in tightened skin.

heat causes shrinkage and tightening of the fat cells and increased lymphatic drainage, resulting

ThermACeLL

in a reduction of the dimpled appearance of

High Profile Technologies has introduced the

cellulite, smoothing of the skin’s surface and a

Thermacell treatment system to reshape skin tissue and

reshaping and firming of the treated area. The

reduce cellulite.

Velashape procedure takes around 40 minutes

Thermacell employs a combination of technologies to

to one hour, with little or no downtime. Four to six

deliver radiofrequency energy to the face and body to

initial Velashape treatments are recommended

provide fast painless results. The device simultaneously

performed at one week intervals. Maintenance

delivers dual frequency mono and bipolar energy

Velashape procedures are then required at six

to affect tissue from the epidermis right down to the

monthly intervals.

subcutaneous layer. A hex-polar applicator intensifies the concentration of energy to provide immediate

TriPOLLAr

visible results that continue to develop after the treatment application has ended.

The TriPollar device combines monoploar and

The treatment produces controlled thermal trauma,

bipolar energy in one handpiece to induce

causing a response of ‘neocollagenesis’ in skin tissue

fat and cellulite reduction and skin tightening

and the outcome is the tightening and accelerated

simultaneously. TriPollar energy is delivered

regeneration of collagen proteins. The thermal

simultaneously into the deep and shallow

damage caused to the collagen misleads the body, as

layers of the skin protecting the surface layer.

it doesn’t recognise the remodelled collagen structure,

Collagen is heated and stimulated, creating an

which then reacts by increasing collagen production in

immediate contraction, followed by remodeling

those areas.

of the deep skin layers by promoting new

The result of the Thermacell device is lifted, sculpted

collagen growth, which produces tighter, more

skin tissue with the epidermis displaying a rejuvenated

youthful skin. A typical treatment course consists

appearance due to collagen enrichment. The system

of six to eight sessions. during treatment, a mild

also causes lipids and fluids in the subcutaneous layer

heating sensation can be felt. Immediately after

to degrade, leading to localised reduction. The two

treatment, some redness and warmth can be

treatment outcomes work harmoniously together

seen and felt on the skin. both should disappear

offering a decrease in volume without the by-product of lax or sagging skin tissue.

within an hour or so following the treatment.

dr Ashish dutta, director of The Aesthetic beauty Centre and Fellow of the American Society of Laser Medicine and Surgery, trialled the system and is now using the Thermacell in his clinic. He says, “The combination of technology delivers the energy in such a way that is effective and painless for the patient, and very straight forward for the user. The system succeeds in these areas where other radio frequency devices have traditionally failed.”

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View On | Implants

The case FOR

PU FOAm Dr Daniel Fleming has Australia’s largest breast augmentation practice. he has performed more than 3,000 breast implant operations using smooth, textured and polyurethane foam covered implants. here he explains why the published evidence, accumulated over 40 years, and his own experience has led him to recommend polyurethane foam covered implants to all patients seeking breast augmentation…

The first polyurethane foam covered silicone gel breast implants were used by Ashley in 1968.1 They have always been known to reduce contracture rates but there have been concerns about their safety, specifically about the possible degradation of the foam to 2,4 TdA, a known carcinogen in high doses in rodents. This was one of the reasons why textured implants were developed in 1984, some 16 years after foam. Interestingly if you look up the patent applications for textured implants, including Allergan’s biocell texturing, they all start by stating the patent applied for is for a process of texturing the surface of silicone implants “to simulate an open cell foam to reduce capsular contracture” or words to that effect. Texturing was therefore an attempt to reproduce the benefits of the foam. As we shall see it did not work.

The long term evidence has consistently shown that PU foam implants dramatically reduce contracture rates compared with both smooth and textured implants.2,3 Surgeons who use these implants have also found they reduce the incidence of displacement and rotation compared with implants with other surfaces, allowing them to use anatomical implants without the fear of early or late rotation. Evidence accumulated from more than 40 years of in vivo experience with these implants has proved conclusively that they are safe and, with the exception of a temporary rash in 1% of patients, have no greater incidence of other complications compared with smooth and textured implants.2,3

CAPSULAr COnTrACTUre How common is capsular contracture? Some surgeons do not feel capsular contracture is much of a problem anymore. You can find a published paper to support any figure you like from 1% to 50%. When I talk to surgeons having given presentations about the foam many of them tell me that they don’t see much capsular contracture in their patients but, “I see a lot from other doctors”. They often fail to make the connection that “other doctors” may well be seeing their contractures!

All of the evidence shows that when independent assessments of a surgeon’s contracture rate are made they always are much higher than the surgeon had thought. This was brought painfully home to me when I was involved in the trial of titanium coated gel implants. because these patients were in a trial follow up was formalised and comprehensive. My one-year grade three and four rate was 7% (incidentally no different for titanium and non titanium implants). Previously I would have estimated my one-year rate to be about three or four per cent. Other doctors in the trial had the same experience. Were we bad doctors? How come we were not replicating the very low rates sometimes published by the so-called leaders in the field?

The baker classification is universally used to report contracture rates, with only grades III and IV being considered contractures. So a grade II does not count and a grade III does. Of course all grade III capsules were once a grade II. It is necessarily a subjective judgement, made by the examiner in each patient, whether a capsule has reached the criteria of grade III and is therefore reported as a contracture, or if the patient is still a grade II and thus contracture free. The implications for observer bias especially when assessing one’s own patients are obvious.

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cosmeticnewsuk.com

Scott Spear, commenting in PRS has observed:

I cannot find it on their other international sites.

“The information that plastic surgeons will be most

The results for secondary cases are of course substantially worse.

interested in would be that regarding single-lumen textured and smooth silicone gel implants. The very best data regarding those devices are available from the core clinical studies that were submitted to the Food and drug Administration over the last year as

Also these were all round implants. Had anatomical implants been included in the studies it is likely the re-operation rate would have been even higher because of rotation.8

SmOOTh verSUS TeXTUreD

part of the Premarket Approval process by both Inamed (now Allergan) and Mentor.”4

Why was there no difference between textured and smooth in the core study? because most textured implants behave like smooth

Commenced in 2,000, these are 10 year, prospective, multi-

ones. Ask yourself of all of the textured implants you have ever

centred studies in the US of smooth and textured silicone gel

removed how many had Velcro like adhesion to the capsule?

implants. The FdA required these studies as a condition for

Not many is the answer every surgeon I have asked has given. It

the re-approval of gel in the US in 2006. The FdA also required

could be argued this was because they are a self selecting group

that Mentor and Allergan make available to patients the results

of patients because they needed removal for complications. If so,

of the core studies.

then the uncomplicated other side which is often removed at the

Allergan’s data show a re-operation rate of 30% at seven years for 455 primary augmentation patients operated on by

same time for cosmetic reasons should have been adherent. Was it? Also consider patients who have textured implants removed

multiple surgeons. 40% of the re-operations were for one of two

solely for cosmetic reasons such as size change? Were these

reasons – capsular contracture or displacement. The grade III and

adherent? When visiting South America I found most surgeons using

IV contracture rate at seven years was 15.5% with no difference

textured implants there advise their patients to massage them in

between textured and smooth.5 Mentor’s data is published

the post operative period – what does that tell you? The mantra

for six years of follow up and they have a contracture rate of

that textured implants offer less contracture than smooth is based

10%.6 Handel et al have shown using Kaplan Meier analysis that

on the meta-analysis by barnsley,9 which only showed this for sub

contracture rates will increase with time7 so Mentor’s rate will be

glandular placement and not for sub muscular. Meta-analyses are

higher at seven years. Kaplan Meier analysis is also the statistical

of course only as good as the original papers they were analysing.

method approved by the FdA for the core studies.

The extreme subjectivity of whether a capsule is labelled a grade

The core studies, “the very best data” according to Spear, reveal

II and therefore not considered a contracture, or a grade III and

what happens in the medium term in the real world. With respect,

therefore included in the contractures, is one difficulty in comparing

none of us really know what our contracture rate is unless we

or meta-analysing contracture studies. Add to this the fact that

involve ourselves in this kind of supervised trial. Not surprisingly

contractures increase over time and many studies have a follow

Allergan is not promoting the results of its core study. because of the

up of only a few years, it is then not surprising there is such a diverse

FdA requirement perhaps it can be found deep in their US website.7

range of reported incidences for textured and smooth implants.

The rATiOnALe FOr FOAm COvereD imPLAnTS Why should the foam reduce contracture rates so much? This is revealed by histological analysis of the normal capsules associated with different implant surfaces. The collagen fibres, which make up the capsule around both smooth and textured implants are aligned end on end. If a stimulus to contract occurs (whatever it may be), the fibres can shorten over one another concentrically around the implant causing a shrink wrap effect and the consequences with which we are all too familiar. PU foam implants work because the foam becomes integrated into the full thickness of the capsule. The foam is a 3d matrix or lattice and the collagen fibres wrap around the foam struts. They are no longer end on end but disjoined and cannot shorten over one another causing the concentric shrinkage. Thus contracture rates are literally decimated at least. A strong Velcro effect between the capsule and the implant invariably occurs. When removing these implants after some months there is a cleavage plane between the implant surface and the capsule. The explant is no longer covered in foam as this now resides in the capsule (Figure 1). This creates a stable marriage between the implant and the capsule. Rotation has not been described and the medium to long term downward displacement commonly seen to a greater or lesser extent with smooth and textured implants has also not been reported.

FigUre 1: Comparison of unused foam implant surface and foam implant explanted after six month.

Explantation cleaves the implant from the foam, which is integrated into the capsule.

Textured implants, even when they do adhere, can only at best affect the capsule/implant interface as the texturing remains on the surface of the implant. This is insufficient to alter the full thickness of the capsular architecture and therefore to reduce contracture rates. The images below taken form Handel’s paper2 show the histologies of smooth, textured and foam capsules and should clarify the above.

FigUre 2: Smooth surfaced implant capsule with collagen stained blue on the left and textured surface capsule with collagen stained pink on the right. Note the end on end alignment of collagen fibres.

FigUre 3: Polyurethane foam covered implant capsule with collagen stained blue. Note interlacing and consequent disjoining of collagen fibres around the foam matrix, which shows as the triangular structures as illustrated below in Figure 4 (from Sinclair10).

FigUre 4: Note interlacing and consequent disjoining of collagen fibres around the foam matrix, which shows as the triangular structures as illustrated below in Figure 4 (from Sinclair10).

cosmeticnewsuk.com

43

View On | Implants SAFeTY

once they are in, they are too difficult to put in or you need a bigger

Are polyurethane foam covered implants safe? Unequivocally yes.

operative videos by the author, which prove this.

incision. These are simply not true and Silimed has been provided with

They have been used in hundreds of thousands of women for up to four decades. The Handel 2006 data2,7 and Vazquez and Pellon’s

what are the real disadvantages? The temporary rash over the

18 year experience3 show that other complications occur, at worst,

breasts occurs in about 1% of patients in the second post-operative

at the same rate as for other implant surfaces. The temporary rash

week and lasts for one to two weeks. It is itchy and the patient is

in 1% of patients is the only exception to this. Handel was using an

well so it is easily diagnosed and distinguished from infection. It is

older incarnation of foam implants from Surgitek, a division of bristol

treated symptomatically with anti histamines or topical steroids,

Myers. Vazquez and Pellon were using Silimed implants which is

has no long-term effects and does not recur. Removal of foam

what we have available today. Their results in a large number of

implants, although much less likely than with other implants,

patients closely followed for 15 years, all in front of the muscle, show

is sometimes, but not always slightly more difficult than with

a contracture rate of 1%. The attachment of the foam to the Surgitek

non-foam implants. It is however perfectly possible. If all of the

implant surface was less reliable than Silimed’s vulcanisation process

prosthetic material needs to be removed then a capsulectomy

and this may explain why Vazquez and Pellon got even better results

will be required if the implants have been in for more than three

than Handel.

weeks as the foam will have started to integrate into the capsule.

“The learning curve for using these implants is not difficult as long as you know that these implants stay where they are put. They do not “settle” into the pocket. if they are too high the day after surgery they will remain so.”

In cases of infection this is not always necessary as removal of the prosthesis alone and appropriate antibiotic treatment is usually enough to allow successful re-implantation after three months.

Late infection with atypical mycobacteria however would require total capsulectomy.

The learning curve for using these implants is not difficult as long as you know that these implants stay where they are put. They

The foam does biodegrade very slowly over many years.10 Concerns

do not “settle” into the pocket. If they are too high the day after

arose when two case reports were published by Chan et al11,12

surgery they will remain so. because smooth and textured implants

showing measurable levels of 2,4 TdA in the urine of two patients who

often do “settle”, subconsciously we may tend to put them in

had PU foam implants. Importantly it was not found in their blood.

slightly high to allow for this. When surgeons start using the foam if

The Health board of Canada commissioned research by an Expert

they are not made aware of this they may place the implants too

Panel on the Safety of Polyurethane-covered breast Implants.13 The

high. However, if you know about it and sit the patient up before

panel could find no evidence of a significant risk but called for further

closing it should not be a problem. In fact I would argue that this is

investigation. This was done by Hester et al14 under FdA supervision. In

an advantage since it affords control and predictability of implant

summary, the reason no free 2,4 TdA was found in the patients’ blood

position to the surgeon.

was that it was never in the blood. Chan’s method of preparing the urine samples prior to detecting TdA is relevant. The urine was treated with 6 times normal hydrochloric acid and then boiled for one hour at

USe in reviSiOnAL PrOCeDUreS

105o C. The elevated urinary TdA subsequently detected was present as an artefact caused by in vitro acid hydrolysis. This had cleaved 2,4

The predictability of placement can be helpful when treating

TdA off from the harmless oligomers that are produced as part of the

displacements and synmastia as the implant does not exert

slow metabolism of PU foam by inflammatory cell esterases. This has

the same pressure post operatively on any areas of the

been the conclusion of other investigators as well.15

pocket, which may have been closed with sutures. Rotation of anatomical polyurethane foam covered implants has not been

It is also important to realise that 2,4 TdA has never been shown to be

described in secondary cases.

carcinogenic in humans at any concentration and two occupational studies of workers exposed to it over long periods did not show any

If a patient has a grade III or IV capsule then the gold

increase in cancers of any type.16,17

standard treatment is the creation of a virgin tissue to implant

Also 2,4 TdA was detected intermittently in the urine of control

interface and the use of polyurethane foam implants. This is

subjects with no implants. Hester et al concluded the miniscule

either achieved by making a new pocket or a plane change

amounts of free 2,4 TdA found in the non-hydrolysed urine of

depending on the specific circumstances of the patient. Such

implanted patients posed no significant risk, a conclusion shared

treatment will reduce her risk of recurrent contracture to 2% even

by the Health board of Canada and Australia’s Therapeutic Goods

though she has already had a contracture. If a capsulotomy

Administration. Even if it was assumed that 2,4 TdA was equally

only is performed and a new tissue to implant interface not

carcinogenic in humans as it is in rodents, the levels found in the

created, the foam is unable to exert the same effect on the

urine would equate to a lifetime risk of developing breast cancer

existing capsule and recurrence is increased to 50%. These figures

increased by less than one in a million. A risk defined by the WHO

come from Hester, Tebbetts and Maxwell.18 This paper was never

as unmeasurable.

published, I am informed, because they thought there was no

It is pertinent to compare this theoretical risk with the known real

point as foam is unavailable in the US.

risk of death from a general anaesthetic given to a healthy patient undergoing a capsulectomy which she would not have needed it had she had foam implants – about one in 80,000. It should also be mentioned polyurethane foam itself has no association with an increased risk of cancer in any species and is used in other human prosthetic devices, such as pacemekers and prosthetic heart valves.

PerSOnAL eXPerienCe AnD COnCLUSiOnS I have used these implants for more than five years in both primary and secondary patients. In the last 18 months I have used them in

44

DiSADvAnTAgeS - mYThS AnD reALiTY

more than 500 patients and now use them exclusively. They are not

In addition to the misperceptions concerning safety, other myths

pocket on my part combined with suture breakage. I have not

about these implants abound such as you can’t remove them

seen the insidious slight downward displacement over time, which

cosmeticnewsuk.com

a panacea but I have yet to see my first capsular contracture. I have had one unilateral downward displacement, which occurred the day after the surgery presumably due to over dissection of the

If you’re considering breastaugmentation, make sure it’s an intelligent choice.

Silimed’s polyurethane coated breast implants are statistically proven* to have the lowest rate of capsular contracture and are now available in UK. Manufactured in Brazil and with more than three decades of experience, Silimed is internationally renowned for its quality and safety and offers a variety of shapes, sizes and profiles to suit your individual needs.

Make an intelligent choice.

Ask your doctor about.

Silimed’s breast implants.

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

View On | Implants detracts from the final long-term results with non-foam implants.

Other complications have occurred with the same incidence as with

reFerenCeS

other implants. In short, my results have simply mirrored the results of

1. Ashley F.L. A new type of breast prosthesis; preliminary report. Plast. Reconstr.

surgeons overseas who have used these implants for longer than me.

Surg 45:421-424 1970

Whereas previously I was loathe to use anatomical implants unless they were really necessary because of the risk of rotation, now the

2. Handel N. Long-term safety and efficacy of polyurethane foam-covered

majority of implants I use are anatomical. The ability to control three

breast implants. Aesthetic Surg J 2006; 26: 265-274

dimensions with an anatomical implant rather than only two with a round, allows me to get better results in many patients.

3. Vázquez G. and Pellón A. Polyurethane-coasted silicone gel breast implants used for 18 years. Aesthetic Plast. Surg.31:4, p.330-6, 2007.

All elements of the operative plan are critical to optimising outcomes for breast augmentation patients. The choice of

4. Handel N, Cordray T, Gutierrez J and Jensen J.A. A long-term study of

implant surface is one very important part of the plan, which is

outcomes, complications, and patient satisfaction with breast implants. Plast.

entirely controllable and has predictable consequences. Handel’s

Reconstr. Surg.117:3, discussion 768-70, Mar, 2006

finding that “Curves from Kaplan-Meier survival analyses reveal that contracture is a progressive phenomenon, and the longer any group of patients is followed, the greater the cumulative risk

5. http://www.allergan.com/assets/pdf/M1209-02_Silicone_Aug_Label.pdf p.34

of developing contracture” is central to an understanding of the

6. Cunningham b, McCue J. Safety and effectiveness of Mentor’s MemoryGel

importance of this.

implants at 6 years. Aesthetic Plast. Surg. On line May 2009

In Handel’s own words, “This contradicts the widely held belief that

7. Handel N, Cordray T, Gutierrez J, Jensen JA. A long-term study of outcomes,

if patients remain contracture-free for a year or two they probably

complications, and patient satisfaction with breast implants. Plast. Reconstr. Surg.

will not develop significant contracture.19 This finding may also

117:3, 2006

have some relevance in understanding the cause of capsular contracture. If the risk of contracture persists for many years after implantation (as it appears to), it seems less likely that it is related to

8. baeke J. Plast. Reconstr. Surg. 109:7 pp2555-64, 2002

acute events such as bacterial contamination, surgical technique,

9. barnsley G P, Sigurdson, L J, barnsley, S E. Textured surface breast mplants in

drains, antibiotics, or other ancillary measures that have a short-term

the prevention of capsular contracture among breast augmentation patients: A

impact and more likely related to some chronic effect of implants

meta-analysis of randomized controlled trials. Plast. Reconstr. Surg. 117:7 pp 2182-

on adjacent tissue.” 7

2190, 2007

The evidence clearly shows you can modify this chronic effect and

10. biodegradation of the polyurethane covering of breast implants. Sinclair T,

dramatically reduce the risk of the commonest complication and

Kerrigan C, buntic R. Plast. Reconstr. Surg. 92:6, 1993

the commonest reason for reoperation by choosing one implant surface (with a 40 year proven safety record) over another. The

11. Chan, S. C., birdsell, d. C., and Gradeen, C. Y. detection of toluenediamines

evidence also suggests it is highly likely you can substantially reduce

in the urine of a patient with polyurethane-covered breast implants. Clin. Chem.

displacement, the second commonest complication and reason

37: 756, 1991.

for reoperation as well. It is difficult therefore to justify not using such an implant or not telling patients about it. Certainly when patients

12. Chan, S. C., birdsell, d. C., and Gradeen, C. Y. Urinary excretion of free

are given the evidence to consider they virtually all choose foam.

toluene diamines in a patient with polyurethane-covered breast implants. Clin.

It is probably only a matter of time before the lawyers realise this

Chem. 37: 2143, 1991.

and a patient with contracture will sue on the basis that she was not offered an implant which was available and, had she been

13. Expert Panel on the Safety of Polyurethane-covered breast Implants. Can

informed about it, she would have chosen it and very likely not

Med Assoc J 1991; 145 (9) 1125

needed further surgery for contracture.

14. Hester T.R. Ford N. F. et al. Measurement of 2,4-toluenediamine in urine

If any one of us were a patient considering breast augmentation

and serum samples from women with Même or Replicon breast implants. Plast

would we want to know about this option? How will you respond to

Reconstr. Surg. 100:5 pp1291-1298, 1997

the next contracture or bottomed out patient who asks you “why didn’t you tell me about the foam implants?”

15. Personal communication from Professor Paul Santerre, department of biomaterials, University of Toronto, 2008

In August 2009, dr Leroy Young gave a presentation about polyurethane foam covered implants at the American Society of

16. Sorahan, T., and Pope, d. Mortality and cancer morbidity of production

Plastic Surgeons annual breast meeting in Santa Fe. There were a

workers in the UK flexible polyurethane foam industry. br. J. Indus. Med. 50: 528,

number of surgeons present who had used the devices when they

1993.

were available in the US and, unanimously, they said were the best implants they ever used.20

17. Hagmar, L., Welinder, H., and Mikoczy, Z. Cancer incidence and mortality in the Swedish polyurethane foam manufacturing industry. br. J. Indus. Med. 50: 537,

I have been fortunate to have given talks on these implants around the world. I always ask the audience if there any surgeons present

1993.

who have used these implants for any length of time who have

18. Capsular contracture following augmentation mammoplasty: Long-term

subsequently reverted to smooth or textured implants. I have not

follow up of treatment with polyurethane-covered prostheses. Hester T.R., Maxwell

found one yet.

G.P, and Tebbetts J.b. Unpublished.

19. Camirand, A., doucet, J., and Harris, J. breast augmentation: Compression.

A very important factor in preventing capsular contracture. Plast. Reconstr. Surg.

104: 529, 1999.

20. Personal communication from dr Leroy Young, Plastic Surgeon, St Louis. 2009

46

cosmeticnewsuk.com

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Business Focus | Improve Your Image

imAge iS

eVeRYThiNG

hilary Ford on how to improve your image and boost your income have you ever wondered why patients choose your practice for their aesthetic medical needs rather than someone else’s? why they choose to put their trust in you rather than another, equally qualified, practitioner?

It would be nice if you could put it down to your qualifications and expertise, but sadly most people don’t have the in-depth knowledge to make a judgement on you based purely on your years in the business and the letters after your name.

So they look to areas that they do have some knowledge on to make their decision – and for most people, that is their overall impression of you, your staff and your hilary Ford is one of three directors at blue Horizons.

This image is influenced by the location and building in which your clinic is situated, the

years, in a wide range of sectors including luxury

decor, the attitude of your staff, and the quality of the communication and marketing

yachts, call centre recruitment and, for the last eight

materials that they see.

years, the dental and medical sector in the UK and

Let’s step outside the clinical sector and look at accountants for a good example of how

Europe. blue Horizons offer a full range of marketing

this works. Some are relatively cheap at around £50 an hour, some cost a lot more - £150

services, including patient welcome packs, treatment leaflets, websites and consultancy.

48

practice. In other words, they judge you on their perceived image of you.

She has been working in marketing for almost 20

cosmeticnewsuk.com

an hour or more. They all have more or less the same qualifications and are quite capable of handling a calculator and tax forms – so what is the difference between them?

Business Focus | Improve Your Image

Quite simply, it’s all about image. The cheaper accountant probably offers

but you know their prices will be low. Higher end ones like Waitrose have

a basic service, and may well view you more as a number than a human

an image of quality and are aspirational – but your weekly grocery bill is

being. Their offices may look a little tired, and you may feel a little rushed

likely to be higher.

when you visit. They may not bother to keep in touch with you, and their website and literature may have a slightly dated, home-produced feel to

As you can see, image is important. It helps define the prices you can

them.

charge, and sets your clients’ expectations. It’s not just about visual imagery either – it’s more about the overall impression that you give.

The more expensive accountant will probably seem completely different.

They are likely to greet you by name, remember to ask after your family, and make you feel as if they have all the time in the world to devote to you and your needs. Their offices should look great, the staff should be friendly and professional, and you will almost certainly be offered a drink.

They will probably stay in touch with you, send you extravagant-looking Christmas cards, and their website and literature are likely to exude quality.

If accountants aren’t your thing, then just a quick look at supermarkets can show the difference as well. budget ones like Aldi and Lidl don’t look great,

Image is important. It helps define the prices you can charge, and sets your clients’ expectations

The imPOrTAnCe OF imAge in The meDiCAL AeSTheTiC SeCTOr

ChOOSing YOUr imAge

Clients looking for aesthetic treatment are naturally very image

the type of clients you wish to attract. if you would like to focus on the

conscious. They want to look good, and they will usually expect you,

younger end of the market, then your image will need to be youthful

your team and your practice to look good too.

and modern. if you prefer to treat older people, maybe focussing on

The image you choose to project should be targeted specifically at

anti-ageing treatments, then you may want to consider a more classic So you need to ensure that you meet their expectations. This doesn’t

or traditional image.

mean having to attain perfection, you just need to look the part. Your practice should look up-to-date and cared for, and you and your team

Make sure that your image is consistent throughout – your premises, your

need to look professional and well turned out.

staff, your logo and brand colours, your practice literature and advertising, your website – everything needs to have the same image and feel to it.

We appreciate that in some cases it isn’t easy to control the environment in which you see patients – many surgeons use private hospitals for both

Falling short in just one area could make a big difference to your success

their consultations and their surgery. but you can still control other aspects

in converting enquiries into clients. For example, if you send a potential

of your image such as your marketing and the levels of customer service

new client a somewhat dated, cheap-looking leaflet and a competitor

you and your secretary offer.

sends a gorgeous up-to-date pack with lots of inspiring imagery, the chances are your client may go to your competitor. Or maybe your pack is fantastic, but when the potential client arrives at your practice they are disappointed in what they see and go elsewhere instead.

ADDing The ‘wOw’ FACTOr The ‘wow’ factor is simply adding those little extra touches to your service that make your client say “wow!” it is all about surprising and delighting your clients, providing that special something that makes a lasting impression, and that they may well tell friends and family about.

For example, you may want to offer clients tea and coffee. An easy small touch, and one that will be even more impressive if presented nicely, perhaps in china cups and with a small plate of biscuits. Fresh fruit and/or flowers on display are a nice touch, and nice toiletries in the bathroom are always appreciated.

You may also want to consider other ways in which you can go the extra mile. For example, you could send flowers to patients who have undergone surgery, to arrive on the day they get home. Or you could provide a small gift of skincare product to someone who has undergone anti-ageing treatment.

Anything which makes you stand out from the crowd, without requiring a disproportionate amount of effort or expense, is well worth considering, especially in such an increasingly competitive sector.

50

cosmeticnewsuk.com

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Best Practice | Insurance

aT WhaT

COST T

eddie hooker on professional indemnity insurance he arguments for purchasing a commercial professional indemnity policy are numerous and are made more difficult by the reluctance of some defence organisations to officially publish their stance on what protection, if any, they provide to their members undertaking aesthetic procedures for commercial gain. The difficulty for commercial risk takers is where they pitch their pricing

and whether certain treatments are already protected by the defence organisations and thus cover is being duplicated. But it is getting better. Both the mPS/DDS and mDU/DDU

are now starting to make clear distinctions on their membership rates and procedure exclusions for their sectors of the medical profession.

In most cases the issue boils down to how much the practitioner is willing to pay for his or her protection. defence organisations normally charge an additional membership fee for practitioners undertaking cosmetic procedures – the scales of charges depend on the amount of work performed and the types of procedure undertaken. Therefore, a practitioner whose main income derives from aesthetic procedures may find that paying the higher membership fee is more beneficial than buying top up insurance from a commercial provider. but you must check that the procedures that you perform are covered by your membership scale. For example, the MPS/ddS will only provide cover for ‘non-permanent’ fillers and do not allow the eddie hooker is managing director of

use of laser treatments (IPL cover is available).

Hamilton Fraser Insurance. Eddie and Hamilton Fraser Insurance first started to insure

When setting premium rates for

cosmetic practitioners as early as 1996 when

aesthetic procedures, insurers look

they became involved with nurses practicing

at various risk indicators: product

in collagen injections. Hamilton Fraser

and procedure understanding,

launched the UK’s first ‘aesthetics specific’

training and qualifications and the

medical indemnity policy in 1998 and now

cost of litigation.

insure more than 2,000 individual practitioners and businesses within the sector, growing by more than100 new practitioners each and every month.

PrODUCT AnD PrOCeDUre UnDerSTAnDing The number of new products and procedures entering the aesthetic market is increasing almost monthly.

Many products are derivatives or the re-branding of older more well-established products whilst some are variations on a theme.

However, insurers are not generally

52

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“The arguments for purchasing a commercial professional indemnity policy are numerous and are made more difficult by the reluctance of some defence organisations to officially publish their stance on what protection, if any, they provide to their members undertaking aesthetic procedures for commercial gain”

“it is no good for a manufacturer or distributors salesman to blind the insurance market with science and expensive brochures and presentations. evidence of safeness and honesty in the success of the procedure are of more importance”

of the practitioner performing the procedure. It is important that the practitioner administering the aesthetic treatment is well trained. It makes sense that the better the training the fewer the claims, resulting in a better price for the practitioner. Many insurers now ask for evidence of training.

The COSTS OF LiTigATiOn Insurers have a great understanding of the costs of litigation – after all, it is their day job! Cosmetic techniques are relatively expensive and are used in elective procedures. The patients that request these treatments tend to be a self-selecting group with sometimes high or unrealistic expections. These factors taken together represent an above average potential for litigation, and due to the nature of medical claims, with the volume of evidence and counter evidence that changes hands, these can invariably drag of for many months. Sadly, litigation costs are often

medical experts so their understanding of these

the largest part of claims within this sector and the

products is crucial to their view of the risk presented

legal fees regularly exceed any settlements made to

to them. Insurance is broadly based on historical data

claimants.

and in the case of aesthetic medicine, evidence of credible clinical trials are of paramount importance if

In certain areas, the Republic of Ireland for example,

an insurer is to accept and place a price on insuring

the costs of litigation are extremely expensive as are

the procedure. Too many products are brought to

the award for damages when the claim is commonly

market without this information and without a thought

found in favour of the patient. Consequently the cost

for insurance for the practitioners who are to use them.

of insurance in the region reflects this fact, an issue

The marketing and use of a product with unknown

highlighted by the fact that many cosmetic procedures

long term side effects become the problems of the

are uninsurable by local insurers.

insurer many years down the line when claims start to come in. The problems in obtaining insurance, for

In summary, for insurance premiums or membership

example, that were experienced by certain weight

costs to slow their increase or in fact to start to reduce, the aesthetic and cosmetic industry needs to start to

“whilst most evidence points to the majority of aesthetic procedures to be safe, should something go wrong the results can often be catastrophic”

improve its standards and provide more concise and understandable information to the insurance industry and patients alike. After all, without insurance it is ultimately the practitioner that will suffer in the long term.

loss treatments stemmed from the lack of clinical trials and however safe the product was thought to be by sectors of the medical profession, many insurers and defence bodies alike refused to cover the procedure.

It is no good for a manufacturer or distributor’s salesman to blind the insurance market with science and expensive brochures and presentations.

Evidence of safeness and honesty in the success of the procedure are of more importance. Assist the underwriter to understand and he may be more willing to accommodate the product.

TrAining AnD qUALiFiCATiOnS Of equal importance to an insurer is the competence

cosmeticnewsuk.com

53

DaTes FOR The DiaRY

We round up upcoming events, training courses and meetings

January

8-11 International Master Course on Aging Skin (IMCAS), Paris, France, www.imcasweb.com 15-17 World Anti-Ageing Academy of Medicine 1st Mexico Congress, Mexico City, www.waaam.org 15 FaceTec+ Training Open Seminar for people interested in finding out more about facial aesthetics, www.facetec.info 16 FaceTec+ Training Introduction to Botulinum Toxin, Watford, www.facetec.info 16 Med-fx Basic Hands-on Botulinum Toxin Course, Birmingham, www.medfxtraining.co.uk 17 Med-fx Basic Hands-on Dermal Fillers Course, Birmingham, www.medfxtraining.co.uk 17 FaceTec+ Training Introduction to Dermal Fillers, Watford, www.facetec.info 18 Mapperley Park Core of Knowledge Laser Training, Nottingham, www.mapperleypark.co.uk/training 18 Laser/IPL Safety Core of Knowledge, www.lcsacademy.co.uk 18 Dr Bob Khanna Training Institute, Beginners Botulinum Toxin, www.drbobkhanna.com 19 Mapperley Park Laser Protection Supervisor (LPS) Skills Workshop, Nottingham, www.mapperleypark.co.uk/training 19 Dr Bob Khanna Training Institute, Advanced Botulinum Toxin, www.drbobkhanna.com 19-21 Lynton Skin-Laser Applications - Advanced (three day), www.lynton.co.uk 20 Dr Bob Khanna Training Institute, Beginners Dermal Filler, www.drbobkhanna.com 20 Wigmore Medical Training NeoStrata Peels, London, www.wigmoremedical.com 21 International Congress of Aesthetic Dermatology, Bangkok, www.euromedicom.com 22 Med-fx Basic Hands-on Dermal Fillers Course, London, www.medfxtraining.co.uk 22 13th Meeting of the European Dermatology Forum, Switzerland, www.edf-meeting.org 23 Wigmore Medical Training Introduction to Skincare Peels and Derma Roller, London, www.wigmoremedical.com 23 Med-fx Basic Hands-on Botulinum Toxin Course, London, www.medfxtraining.co.uk 23 Medics Direct Dermal Fillers Training, Manchester, www.medicsdirect.com 24 Medics Direct Botox Training, Manchester, www.medicsdirect.com 24 Med-fx Chemical Peels Course, London, www.medfxtraining.co.uk 24 Wigmore Medical Training Introduction to Botulinum Toxin Type A, London, www.wigmoremedical.com 26-28 BTEC Professional Certificate: Medical Laser/IPL Therapies, www.lcsacademy.co.uk 26 International Institute of Anti-Ageing (iiaa): Dr Des Fernandes presentation on medical needling, London email: admin@iiaa.eu 28 Dermatology 2010, London, www.mahealthcareevents.co.uk 30 Med-fx Chemical Peels Course, Birmingham, www.medfxtraining.co.uk 30 Foundation Botox and Dermal Fillers Training Course, Manchester, www.thelawrenceaestheticacademy.co.uk 30 Advanced Botox and Dermal Fillers Training Course and Chemical Peel Half Day Training Course, Birmingham, www.thelawrenceaestheticacademy.co.uk 30 Genuine DermarollerTM Medical Device Training, London, www.genuinedermaroller.co.uk 30 Innomed Training Botulinum Toxin in Facial Aesthetics – New Users, Southampton, www.innomedtraining.co.uk 31 Innomed Training Dermal Fillers – New Users, Southampton, www.innomedtraining.co.uk

February 1 CQC Compliance Workshop, www.lcsacademy.co.uk 1 Interventional Cosmetics Symposium, Royal Society of Medicine, London, www.rsm.ac.uk 4 Wigmore Medical Training Sculptra, London, www.wigmoremedical.com 6 Med-fx Basic Hands-on Botulinum Toxin Course, Lancashire, www.medfxtraining.co.uk 6 Medics Direct Dermal Fillers Training, Glasgow, www.medicsdirect.com 7 Medics Direct, Botox Training, Glasgow, www.medicsdirect.com 7 Med-fx Chemical Peels Course Lancashire, www.medfxtraining.co.uk 10 Wigmore Medical Training Introduction to Skincare Peels and Derma Roller, London, www.wigmoremedical.com

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11 Wigmore Medical Training Introduction to Botulinum Toxin Type A, London, www.wigmoremedical.com 12 Wigmore Medical Training Introduction to Fillers, London, www.wigmoremedical.com 13 Med-fx Sculptra Training, London, www.medfxtraining.co.uk 17 Dr Bob Khanna Training Institute, Refresher Course, www.drbobkhanna.com 20 Innomed Training Chemical Peeling Systems – New Users, London, www.innomedtraining.co.uk 20-21 Spa and Resort/Medical Aesthetics Conference and Expo, Los Angeles, www.spaandresortexpo.com 20-21 International Association for Physicians in Aesthetic Medicine (IAPAM) Aesthetic Medicine Symposium, Arizona, www.iapam.com 21 Innomed Training Mesotherapy for Fat, Cellulite and Skin Rejuvenation – New Users, London, www.innomedtraining.co.uk 22 CQC Compliance Workshop, www.lcsacademy.co.uk 23 Laser/IPL Safety Core of Knowledge, www.lcsacademy.co.uk 23 Mapperley Park Core of Knowledge Laser Training, Nottingham, www.mapperleypark.co.uk/training 24 Dr Bob Khanna Training Institute, Chemical Peels, www.drbobkhanna.com 24 Laser / IPL Protection Supervisor Training, www.lcsacademy.co.uk 24 Wigmore Medical Training NeoStrata Peels, London, www.wigmoremedical.com 25 Wigmore Medical Training Advanced Toxin Techniques, London, www.wigmoremedical.com 27 Foundation Botox and Dermal Fillers Training Course, www.thelawrenceaestheticacademy.co.uk 27 Genuine DermarollerTM Medical Device Training, London, www.genuinedermaroller.co.uk 27 Med-fx Sculptra Training, London, www.medfxtraining.co.uk 27 Med-fx Basic Hands-on Botulinum Toxin Course, Glasgow, www.medfxtraining.co.uk 27 Medics Direct Dermal Fillers Training, London, www.medicsdirect.com 28 Medics Direct, Botox Training, London, www.medicsdirect.com 28 Med-fx Basic Hands-on Dermal Fillers Course, Glasgow, www.medfxtraining.co.uk 28 FaceTec+ Training Introduction to Dermal Fillers, venue TBC, www.facetec.info

March 2-3 BTEC Professional Certificate: Medical Laser and IPL, www.lcsacademy.co.uk 5-9 American Academy of Dermatology Annual Meeting, Miami, www.aad.org/meetings/annual/ 6 Med-fx Chemical Peels Course, Glasgow, www.medfxtraining.co.uk 6 Innomed Training Advanced Aesthetics (Botulinum Toxin and Dermal Fillers), London, www.innomedtraining.co.uk 7-8 Professional Beauty London 2010, www.professionalbeauty.co.uk 8-10 Anti-Ageing Medicine World Congress, Monte Carlo, www.euromedicom.com 8 Dr Bob Khanna Training Institute, Beginners Botulinum Toxin, www.drbobkhanna.com 9 Dr Bob Khanna Training Institute, Advanced Botulinum Toxin, www.drbobkhanna.com 10 Dr Bob Khanna Training Institute, Beginners Dermal Filler, www.drbobkhanna.com 10 Wigmore Medical Training Introduction to Skincare Peels and Derma Roller, London, www.wigmoremedical.com 11 Wigmore Medical Training Introduction to Botulinum Toxin Type A, London, www.wigmoremedical.com 12 Wigmore Medical Training Introduction to Fillers, London, www.wigmoremedical.com 12 British Association of Dermatologists and the Royal College of Physicians Medical Dermatology meeting, Royal College of Physicians, London, www.bad.org.uk 12-14 British Society for Dermatological Surgery (BSDS) Annual Surgery Workshop, Dublin, www.bsds.org.uk 13 Dr Bob Khanna Training Institute, Oral Facial, www.drbobkhanna.com 13 Med-fx Sculptra Training, London, www.medfxtraining.co.uk 13 Med-fx Basic Hands-on Botulinum Toxin Course, Newcastle, www.medfxtraining.co.uk 13 Medics Direct Dermal Fillers Training, Belfast, www.medicsdirect.com 14 Medics Direct, Botox Training, Belfast, www.medicsdirect.com

14 Med-fx Basic Hands-on Dermal Fillers Course, Newcastle, www.medfxtraining.co.uk 14 Dr Bob Khanna Training Institute, Advanced Dermal Filler, www.drbobkhanna.com 15-18 BTEC Professional Award: Aesthetic Laser & IPL Therapies, www.lcsacademy.co.uk 17 Wigmore Medical Training NeoStrata Peels, London, www.wigmoremedical.com 18 Mapperley Park Core of Knowledge Laser Training, Nottingham, www.mapperleypark.co.uk/training 19 Mapperley Park Core of Knowledge, Nottingham, www.mapperleypark.co.uk/training 19 Lynton Core of Knowledge (one day), www.lynton.co.uk 19-20 Aesthetic Dentist Conference 2010, NEC Birmingham, www.thedentistryshow.co.uk 19 Dr Bob Khanna Training Institute, Beginner Botulinum Toxin, www.drbobkhanna.com 19 Med-fx Basic Hands-on Dermal Fillers Course, London, www.medfxtraining.co.uk 20 Med-fx Basic Hands-on Botulinum Toxin Course, London, www.medfxtraining.co.uk 20 British Association of Cosmetic Doctors (BACD) Spring Meeting, Royal College of Physicians, London, www.cosmeticdoctors.co.uk 20 Dr Bob Khanna Training Institute, Advanced Botulinum Toxin, www.drbobkhanna.com 20 Innomed Training Chemical Peeling Systems – New Users, London, www.innomedtraining.co.uk 21 Innomed Training Mesotherapy for Fat, Cellulite and Skin Rejuvenation – New Users, London, www.innomedtraining.co.uk 21 International Academy of Cosmetic Dermatology World Congress, Cairo, www.iacdworld.org 21 Dr Bob Khanna Training Institute, Beginners Dermal Filler, www.drbobkhanna.com 22 Care Quality Commission (CQC) Registration and Compliance, www.lcsacademy.co.uk 22-25 Mapperley Park BTEC Principles of laser and light based Hair removal and photorejuvenation, Nottingham, www.mapperleypark.co.uk/training 22-27 American Society for Aesthetic Plastic Surgery (ASAPS) Annual Meeting, Washington DC, www.surgery.org 23 LCS Academy Core of Knowledge, www.lcsacademy.co.uk 26-30 Mapperley Park BTEC Principles of Laser, Light and Associated Aesthetic Therapies, Nottingham, www.mapperleypark.co.uk/training 26-27 British Cosmetic Dermatology Group, Hilton, London Paddington 27 FaceTec+ Training Introduction to Botulinum Toxin Type A, www.facetec.info 27 Foundation Botox and Dermal Fillers Training Course, Manchester, www.thelawrenceaestheticacademy.co.uk 27 Advance Botox and Dermal Filler Training Course, Manchester, www.thelawrenceaestheticacademy.co.uk 27 Med-fx Chemical Peels Course, Newcastle, www.medfxtraining.co.uk 27 Med-fx Basic Hands-on Botulinum Toxin Course, Birmingham, www.medfxtraining.co.uk 28 Med-fx Basic Hands-on Dermal Fillers Course, Birmingham, www.medfxtraining.co.uk 28 FaceTec+ Training Introduction to Dermal Fillers, www.facetec.info 30 British Society for Investigative Dermatology, Annual Meeting, Royal Agricultural College, Cirencester, www.bad.org.uk

aprIl 1 British Society for Investigative Dermatology, Annual Meeting, Royal Agricultural College, Cirencester, www.bad.org.uk 8 Wigmore Medical Training Sculptra, London, www.wigmoremedical.com 10 Innomed Training Botulinum Toxin in Facial Aesthetics – New Users, Southampton, www.innomedtraining.co.uk 11 Innomed Training Dermal Fillers – New Users, Southampton, www.innomedtraining.co.uk 13 Dr Bob Khanna Training Institute, Oral Facial, www.drbobkhanna.com 14 Dr Bob Khanna Training Institute, Advanced Dermal Filler, www.drbobkhanna.com 16-17 Cosmetic News Expo 2010, Business Design Centre, Islington, London, www.cosmeticnewsuk.com • If you have any dates you would like to add to our Dates for the Diary section please email vicky@creativemedialtd.co.uk •

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with confidence Face the future

zalure® is the new choice of tulinum Toxin Type A for sthetic use.

with confidence

ast onset of action (median time to nset 2-3 days)1

ong duration of action (up to 5 months)1

Azzalure® is the new choice of igh level of patient satisfaction (93% after Botulinum Toxin Type A for months, following one treatment session)2 aesthetic use.

• Fast onset of action (median time to onset 2-3 days)1

re® is indicated for the temporary improvement in the appearance of • Long duration of action (up to 5 months)1 ate to severe glabellar lines seen at frown, in adult patients under 65 when the severity of these has an important psychological • High levellines of patient satisfaction (93% after on the patient.

2

New...

6 months, following one treatment session)

... aesthetic choice New...

® Azzalure is indicated for the temporary improvement in the appearance of e® Abbreviated Prescribing Information moderate severe lines seen at frown, adult patients under 65 Effects: Most frequently occurring related reactions are headache and injection site Side tation: Botulinum toxintotype A (glabellar Clostridium botulinum toxin Ainhaemagglutinin years, when the severity of these lines has (powder an important psychological reactions. Generally treatment/injection technique related reactions occur within first week x) 10 Speywood units/0.05ml of reconstituted solution for solution for impact on the patient. following injection and are transient and of mild to moderate severity and reversible. Very n). Indications: Temporary improvement in appearance of moderate to severe r lines seen at frown, in adult patients under 65 years, when severity of these lines Common (≥ 1/10): Headache, Injection site reactions (e.g. erythema, oedema, irritation, mportant psychological impact on the patient. Dosage & Administration: Botulinum rash, pruritus, paraesthesia, pain, discomfort, stinging and bruising). Common (≥ 1/100 to its are different depending on the medicinal products. Speywood units are specific < 1/10): Facial paresis (predominantly describes brow paresis), Asthenopia, Ptosis, Eyelid preparation and are not interchangeable with other botulinum toxins. Reconstitute oedema, Lacrimation increase, Dry eye, Muscle twitching (twitching of muscles around the injection. Intramuscular injections should be performed at right angles to the skin eyes). Uncommon (≥ 1/1,000 to <1/100): Dizziness, Visual disturbances, Vision blurred, sterile 29-30 gauge needle. Recommended dose is 50 Speywood units (0.25 ml of Diplopia, Pruritus, Rash, Hypersensitivity. Rare (≥ 1/10,000 to < 1/1,000): Eye movement tuted solution) divided® Abbreviated equally intoPrescribing 5 injection Information sites: 2 injections into each corrugator disorder, Urticaria. Packaging Quantities & Cost: 1 Vial (125u) £64.00 (RRP). Marketing Azzalure Side Effects: Most occurring reactions headache and injection site toxin the typenasofrontal A (Clostridium botulinum toxin A haemagglutinin Authorisation Number: PLfrequently 06958/0031.

Legalrelated Category: POM.are Full Prescribing Information and one intoPresentation: the procerusBotulinum muscle near angle.

(See summary of reactions. treatment/injection techniqueHouse, related69-71 reactions occur within firstWatford, week complex) Speywood units/0.05ml of reconstituted solution (powder for solution for is Available From:Generally Galderma (UK) Limited, Meridien Clarendon Road, characteristics for full10technique).

Treatment interval should not be more frequent following injection).

Temporary in under appearance of moderate are(0)transient and of mild moderate andDate reversible.

Very Herts. WD17 1DS,injection UK. Tel:and +44 1923 208950 ery three months.

Not Indications: in individuals 18 years of age. to severe +44 (0) 1923severity 208998. of Revision: Fax: to recommended for useimprovement lines seen at frown, in adult patients under 65 years, when severity of these lines Common (≥ 1/10): Headache, Injection site reactions (e.g. erythema, oedema, irritation, ndications: Inglabellar individuals with hypersensitivity to botulinum toxin A or to any of the March 2009.

Copyright © 2009 Galderma (UK) Ltd. has an important psychological impact on the patient. Dosage & Administration: Botulinum rash, pruritus, paraesthesia, pain, discomfort, stinging and bruising). Common (≥ 1/100 to nts. In the presence of infection at depending the proposed myasthenia toxin units are different on theinjection medicinalsites, products.

Speywoodgravis, units are specific < 1/10): Facial paresis (predominantly describes brow paresis), forms Asthenopia, Adverse events should be reported.

Reporting andPtosis, Eyelid Lambert Syndrome or Amyotrophic lateral sclerosis.

Special warnings and to this preparation and are not interchangeable with other botulinum toxins. Reconstitute information oedema, Lacrimation Dry eye, Muscle twitching (twitching of muscles around the can beincrease, found at www.yellowcard.gov.uk.

Adverse events ions for use:prior Usetowith caution in patients with a risk of, or clinical evidence of, injection. Intramuscular injections should be performed at right angles to the skin eyes). Uncommon (≥ also 1/1,000 <1/100): Dizziness, Visual(UK) disturbances, Vision blurred, should betoreported to Galderma Ltd. using a sterile 29-30 gauge needle. is 50 Speywoodat units defective neuro-muscular transmission, inRecommended the presencedose of inflammation the(0.25 ml of Diplopia, Pruritus, Rash, Hypersensitivity. Rare (≥ 1/10,000 to < 1/1,000): Eye movement reconstituted solution) equally into 5 injection sites: 2 injections into each weakness orcorrugator disorder, Urticaria. Packaging Quantities & Cost: 1 Vial (125u) £64.00 (RRP). Marketing ed injection site(s) or when the divided targeted muscle shows excessive Authorisation Number: PL 06958/0031. Legal Category: POM. Full Prescribing Information musclewith and one into the procerus muscle near the nasofrontal angle.muscle (See summary of . Patients treated therapeutic doses may experience exaggerated References is Available From: Galderma (UK) Limited, Meridien House, 69-71 Clarendon Road, Watford, product characteristics for full technique). Treatment interval should not be more frequent ® ss. Not recommended in patients with history of dysphagia, aspiration or with 1. Azzalure Summary of Product Characteristics.

Herts. WD17 1DS, UK. Tel: +44 (0) 1923 208950 Fax: +44 (0) 1923 208998. Date of Revision: than every three months. Not recommended for use in individuals under 18 years of age. ed bleeding time.

Seek immediate medical care if swallowing, speech or respiratory 2.

Ascher B et al.

J Acad Dermatol 2004; 51: March 2009.Am Copyright © 2009 Galderma (UK)223-33.

Ltd. Contraindications: In individuals with hypersensitivity to botulinum toxin A or to any of the ies arise. Facial asymmetry, ptosis, excessive scarring any gravis, excipients.

In the presence of infection dermatochalasis, at the proposed injection sites,and myasthenia ® Adverse events should be reported.

Reporting forms and is a registered trademark of Galderma. ons to facial anatomy, as a result of previous surgical interventions should be taken Eaton Lambert Syndrome or Amyotrophic lateral sclerosis.

Special warningsAzzalure and information can be found at www.yellowcard.gov.uk. Adverse events precautions for use: Use with in patients with a risk of, ordoses clinical evidence of, sideration prior to injection.

Injections at caution more frequent intervals/higher can should also be reported to Galderma (UK) Ltd. marked formation. defective neuro-muscular transmission, in the presenceneurotoxins of inflammation at theof preparation: April 2009 e the risk of antibody Avoid administering different botulinum Date weakness or proposed injection site(s) or when the targeted muscle shows excessive he course of treatment with Azzalure. Contains human albumin, risk of transmission AZZ/11/0409 Patients treated with therapeutic doses may experience exaggerated muscle References ection cannotatrophy. be excluded.

To be used for one single patient treatment only during weakness. Not recommended in patients with history of dysphagia, aspiration or with 1. Azzalure® Summary of Product Characteristics. session. Interactions: Concomitant treatment with aminoglycosides or other agents prolonged bleeding time. Seek immediate medical care if swallowing, speech or respiratory 2. Ascher B et al. J Am Acad Dermatol 2004; 51: 223-33. ng with neuromuscular transmission (e.g. curare-like agents)dermatochalasis, may potentiate effect scarring and any difficulties arise.

Facial asymmetry, ptosis, excessive inum toxin. Pregnancy &facial Lactation: Not be used duringsurgical pregnancy or lactation. alterations to anatomy, asto a result of previous interventions should be taken Azzalure® is a registered trademark of Galderma.

... aesthetic choice

into consideration prior to injection. Injections at more frequent intervals/higher doses can increase the risk of antibody formation. Avoid administering different botulinum neurotoxins during the course of treatment with Azzalure. Contains human albumin, risk of transmission of an infection cannot be excluded. To be used for one single patient treatment only during a single session. Interactions: Concomitant treatment with aminoglycosides or other agents interfering with neuromuscular transmission (e.g. curare-like agents) may potentiate effect of botulinum toxin. Pregnancy & Lactation: Not to be used during pregnancy or lactation.

Date of of Preparation: preparation:December April 20092009 AZZ/11/0409 AZZ/80/1209

Tel: +44 (0) 1923 208950

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