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Prescribing Information can be found on the inside front cover Date of preparation October 2013 1126/BOC/OCT/2013/LD




93% of patients say they ® would have Radiesse again1... 86% feel more attractive2 80% feel more confident2 95% would recommend Radiesse2

1. Moers-Carpi M et al, Physican and Patient Satisfaction After Use of Calcium Hydroxylapatite for Cheek Augmentation. Dermatol Surg 2012, 38: 1217-1222. 2. Tzikas T. A 52 month Summary of Results Using Calcium Hydroxylapatite for Facial Soft Tissue Augmentation. Dermatol Surg 2008, 34, (Supp 1): s9-s15

no wonder you Tel: +44(0) 333 200 4140 Fax: +44(0) 208 236 3526 Email:

Date of preparation: October 2013 RAD079/0913/LD

Bocouture® 50 Abbreviated Prescribing Information Please refer to the Summary of Product Characteristics (SmPC). Presentation 50 LD50 units of Botulinum toxin type A (150 kD), free from complexing proteins as a powder for solution for injection. Indications Temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at frown (glabellar frown lines) in adults under 65 years of age when the severity of these lines has an important psychological impact for the patient. Dosage and administration Unit doses recommended for Bocouture are not interchangeable with those for other preparations of Botulinum toxin. Reconstitute with 0.9% sodium chloride. Intramuscular injection (50 units/1.25 ml). Standard dosing is 20 units; 0.1 ml (4 units): 2 injections in each corrugator muscle and 1x procerus muscle. May be increased to up to 30 units. Not recommended for use in patients over 65 years or under 18 years. Injections near the levator palpebrae superioris and into the cranial portion of the orbicularis oculi should be avoided. Contraindications Hypersensitivity to Botulinum neurotoxin type A or to any of the excipients. Generalised disorders of muscle activity (e.g. myasthenia gravis, Lambert-Eaton syndrome). Presence of infection or inflammation at the proposed injection site. Special warnings and precautions Should not be injected into a blood vessel. Not recommended for patients with a history of dysphagia and aspiration. Adrenaline and other medical aids for treating anaphylaxis should be available. Caution in patients receiving anticoagulant therapy or taking other substances in anticoagulant doses. Caution in patients suffering from amyotrophic lateral sclerosis or other diseases which result in peripheral neuromuscular dysfunction. Too frequent or too high dosing of Botulinum toxin type A may increase the risk of antibodies forming. Should not be used during pregnancy unless clearly necessary. Interactions Concomitant use with aminoglycosides or spectinomycin requires special care. Peripheral muscle relaxants should be used with caution. 4-aminoquinolines may reduce the effect. Undesirable effects Usually observed within the first week after treatment. Localised muscle weakness, blepharoptosis, localised pain, tenderness, itching, swelling and/or haematoma can occur in conjunction with the injection. Temporary vasovagal reactions associated with pre-injection anxiety, such as syncope, circulatory problems, nausea or tinnitus, may occur. Frequency defined as follows: very common (≥ 1/10); common(≥1/100,<1/10);uncommon(≥1/1000,<1/100);rare(≥1/10,000,<1/1000);veryrare(<1/10,000). Infections and infestations; Uncommon: bronchitis, nasopharyngitis, influenza infection. Psychiatric disorders; Uncommon: depression, insomnia Nervous system disorders; Common: headache. Uncommon: facial paresis (brow ptosis), vasovagal syncope, paraesthesia, dizziness. Eye disorders; Uncommon: eyelid oedema, eyelid ptosis, blurred vision, eye disorder, blepharitis,

eye pain. Ear and Labyrinth disorders; Uncommon: tinnitus. Gastrointestinal disorders; Uncommon: nausea, dry mouth. Skin and subcutaneous tissue disorders; Uncommon: pruritus, skin nodule, photosensitivity, dry skin. Musculoskeletal and connective tissue disorders; Common: muscle disorders (elevation of eyebrow), sensation of heaviness; Uncommon: muscle twitching, muscle cramps. GeneraldisordersandadministrationsiteconditionsUncommon:injectionsitereactions(bruising,pruritis), tenderness, Influenza like illness, fatigue (tiredness). General; In rare cases, localised allergic reactions; such as swelling, oedema, erythema, pruritus or rash, have been reported after treating vertical lines between the eyebrows (glabellar frown lines) and other indications. Overdose May result in pronounced neuromuscular paralysis distant from the injection site. Symptoms are not immediately apparent post-injection. Bocouture® may only be used by physicians with suitable qualifications and proven experience in the application of Botulinum toxin. Legal Category: POM. List Price 50 U/vial £72.00 Product Licence Number: PL 29978/0002 Marketing Authorisation Holder: Merz Pharmaceuticals GmbH, Eckenheimer Landstraße 100, 60318 Frankfurt/Main, Germany. Date of revision of text: FEB 2012. Full prescribing information and further information is available from Merz Pharma UK Ltd., 260 Centennial Park, Elstree Hill South, Elstree, Hertfordshire WD6 3SR. Tel: +44 (0) 333 200 4143 Adverse events should be reported. Reporting forms and information can be found at Adverse events should also be reported to Merz Pharma UK Ltd at the address above or by email to or on +44 (0) 333 200 4143. 1. Frevert J. Content in BoNT in Vistabel, Azzalure and Bocouture. Drugs in R&D 2010-10(2), 67-73 2. Prager, W et al. Onset, longevity, and patient satisfaction with incobotulinumtoxinA for the treatment of glabellar frown lines: a single-arm prospective clinical study. Clin. Interventions in Aging 2013; 8: 449-456. 3. Sattler, G et al. Noninferiority of IncobotulinumtoxinA, free from complexing proteins, compared with another botulinum toxin type A in the treatment of glabelllar frown lines. Dermatol Surg 2010; 36: 2146-2154. 4. Prager W, et al. Botulinum toxin type A treatment to the upper face: retrospective analysis of daily practice. Clin. Cosmetic Invest Dermatol 2012; 4: 53-58. 5. Data on File: BOC-DOF-11-001_01 Bocouture® is a registered trademark of Merz Pharma GmbH & Co, KGaA. Date of preparation: October 2013 1126/BOC/OCT/2013/LD

Editorâ&#x20AC;&#x2122;s Letter Welcome to the November edition of Cosmetic News. I am excited to announce that, as of next month, Cosmetic News will be rebranding with a new name, editorial philosophy and design. After listening to feedback from readers and advertisers, our publishers, Synaptiq, have chosen to re-name the journal Aesthetics. As well as clearly signalling where the heart of the journal lies, it will also create more of a synergy between the brand and its associated events; The Aesthetic Awards and The Aesthetics Conference and Exhibition (ACE). Aimed at qualified healthcare professionals working in medical aesthetics as well as clinic managers and ancillary staff, Aesthetics, the premier monthly journal for medical aesthetic professionals, will bring you accessible, relevant and credible editorial content. Encompassing the latest news, views and opinions as well as detailed reports and articles on the most cutting-edge treatments and techniques, alongside CPD accredited educational content and clinical study reviews, the journal aims to provide you with all the information you need to optimise your services and skills and ultimately, build a successful medical aesthetics practice. A must-read for all aesthetic professional clinics, we are looking forward to unveiling the new look Aesthetics journal to you in December 2013.

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Editor’s choice


SkinCeuticals Maximum Strength Refining Night Cream with 1% Pure Retinol

SkinCeuticals Maximum Strength Refining Night Cream with 1% Pure Retinol


Vitamin A is widely acknowledged as one of the cornerstones of any good skincare regime and one of its most effective derivatives used to target skin ageing is retinol.

We round up the latest industry news 12 ON THE SCENE

Out and about in the industry this month 14 NEWS SPECIAL

We report on new rules issued by the Advertising Standards Authority

Products containing pure retinol are considered the ‘gold standard’ for treating skin ageing and after recently being advised to start using a retinol product on my skin I turned to SkinCeuticals. The latest product to be launched by the skincare pioneers is maximum strength refining night cream, Retinol 1.0, containing 1% pure retinol. As I had not used a retinol product before I started using its recommended pre-requisite Retinol 0.5 which contains 0.5% pure retinol to prepare my skin and avoid any unnecessary irritation.


Ros Bown on the challenges of peeling black skin 18 CLINICAL

Mike Murphy on selective photothermolysis in hair and blood vessels 20 CAMBRIDGE MEDICAL AESTHETICS ADVERTORIAL

Advanced injection techniques using UMA JEUNESSE VELVET® 22 ART AND SURGERY

Peter Archer explores the link between art and surgery 25 HAIR REMOVAL

Sujata Jolly on how to tackling vellus hair 28 PEPTIDES

Dr Tiina Orasmae-Meder on the power of peptides 30 SKINCARE INGREDIENTS

Annalouise Kenny on skincare ingredients for different skin conditions


We find out about a new fat dissolving product for intralipotherapy - Aqualyx® 34 TREATMENT SPOTLIGHT

We speak to Dr Martyn King about his clinical experience using 3D-Lipo 36 SKINADE ADVERTORIAL

We find out how your clients can drink their skin healthy with Skinade 38 SYNERON CANDELA ADVERTORIAL

Mastering Body Treatments: The all-new VelaShape III 40 PRODUCT FOCUS

We find out about the latest system from Energist, the Portrait® NeoGen™ Nitrogen Plasma Technology for skin regeneration 42 PRODUCT NEWS

We round up the latest product news IN BUSINESS 44 ONLINE

Both Retinol 1.0 and Retinol 0.5 are part of the portfolio of SkinCeuticals Refining Night Creams containing graduating strengths of retinol and featuring ‘encapsulation technology’ which stabilises the retinol ingredient without enclosing it, to protect potency. In addition, the unique delivery system is based on the skin’s lipid structure to help ensure optimal penetration of the effective ingredients. Retinol is a potent ingredient that converts into an active form (retinoic acid) when applied to the skin, stimulating cell regeneration and collagen production, resulting in younger looking skin, which is firmer and more refined. Due to the acceleration of skin cell renewal, retinol products are often used to prevent and control acne and can be very effective at reducing pigmentation. As the newest addition to the range Retinol 1.0 contains pure retinol at 1%. This high percentage will provide superior skin benefits by stimulating skin surface cell renewal; diminishing the appearance of fine lines and wrinkles from both photo and intrinsic ageing; minimising the appearance of pore size and reducing the appearance of blemishes, often associated with problematic skin. It also contains bisabolol, the principle constituent of chamomile, which is known to have anti-irritant, anti-inflammatory and antibacterial properties. Dr Stefanie Williams commented, “The introduction of SkinCeuticals Retinol 1% bridges the gap between current over-the-counter Retinol products and prescription Vitamin A acid creams, with clinical effects approving prescription strength. This product should be applied in the evening, as tolerated, and combined with a high-grade anti-oxidant serum such as Phloretin CF and broad-spectrum sun protection such as Sheer Mineral Defense SPF50 in the morning, in order to deliver the best anti-ageing benefits to the skin.”

John Castro on what to look for when hiring a web design agency

Works for me!



Eddie Hooker gives his tips for opening a successful clinic



Dr Johanna Ward on retailing skincare 50 BEST PRACTICE

Wendy Lewis on why you should upgrade your offering to service patients better 52 DATES FOR THE DIARY

The latest dates for your diary

Vicky Eldridge Editor | M: 07880 812 582 | Hollie Dunwell Sales Manager | M: 07557 359 257 | Peter Johnson Art Director | 0207 148 0408 | Chiara Mariani Designer | 0207 148 0408 | Craig Christie Administration and Production | 01268 754 897 | DISCLAIMER

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

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

AArevolution aesthetic skincare market... revolutionininthe thenon-surgical non-surgical aesthetic skincare market... is set to create a revolution in the is set to create a revolution in the non-surgical Aesthetic skincare market. Following the of of non-surgical Aesthetic skincare market. Following success the success the award winning 3D-lipo which combines technologies for the the award winning 3D-lipo which combines technologies for the effective treatment of of fat,fat, cellulite andand skin-tightening we are effective treatment cellulite skin-tightening we set are set to launch a phenomenal new multi-functional device for the face. to launch a phenomenal new multi-functional device for the face. Here are just some of the reasons why 3D-skintech will become the Here are just some of the reasons why 3D-skintech will become the brand of choice in 2013 brand of choice in 2013 • Complete treatment portfolio for anti-ageing, •pigmentation Complete treatment and acne portfolio for anti-ageing, pigmentation and acne • 4 technologies ensure a prescriptive & total approach •to4your technologies ensure a prescriptive & total approach clients needs to your clients needs • Used in conjunction with medical peel and •cosmeceutical Used in conjunction skin carewith line medical peel and cosmeceutical skin care line • Unsurpassed results ensures maximum •client Unsurpassed results ensures maximum loyalty clientprofitable loyalty with a multitude of • Highly •services Highly to profitable offer with a multitude of • Provides servicesyou to with offera competitive in youryou area •edge Provides with a competitive • Affordable as package edge in your area price is under £10,000 a product • Affordable aswith package price is starter pack worth £1,000 under £10,000 with a product • Affordable finance packages starter pack worth £1,000 available • Affordable finance packages




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LEDLED ensures both rapid treatment time and excellent Full canopy Fullachieved. canopy LED ensures both rapid treatment and excellent results are Available wavelengths Red (640nm time - 700nm), Blue (425nm - 470nm), YellowAvailable (590nm) and Green (520 - 564nm) results are achieved. wavelengths Red (640nm - 700nm), ensuresBlue effective treatment for anti-ageing, pigmentation, acne and- 564nm) (425nm - 470nm), Yellow (590nm) and Green (520 detoxification. ensures effective treatment for anti-ageing, pigmentation, acne and detoxification.

3D-skintech peels and clinical skincare

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

‘To compliment our core injectable business the 3D-skintech has added an array of new result driven facial services to our clinic’s menu as well as the combination services for ‘Tocurative compliment ourWe core injectablethat business the 3D-skintech has added an array of n our more patients. recognized this device offered the stand alone quality driven infacial services to our clinic’s menu that as well as the combination of eachresult technology a unique machine that will ensure we both deliver the resultsservices but equally can make money from the due its that affordability. As offered a clinician many our more curative patients. We start recognized this device thetoo stand alone qu times inofthe past we have invested huge sums ofthat money in a single has the res each technology in a unique machine will ensure that concept we boththat deliver proven but difficult to profit my opinion system represents the in our too m equally can from. makeInmoney fromthis thetype startof due its affordability. Asfuture a clinician industry.’ Dr Martyn GPhave and Clinical director Skin Clinic times in the King past –we invested huge Cosmedic sums of money in a single concept that proven difficult to profit from. In my opinion this type of system represents the future in industry.’ Dr Martyn King – GP and Clinical director Cosmedic Skin Clinic



VISTABEL® Receives Europe’s First Positive Cosmetic News becomes Aesthetics journal Opinion for Treatment of Moderate to Severe Lateral Crow’s Feet Lines in Adult Patients VISTABEL® has received a Positive Opinion from the Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM) for the temporary improvement in the appearance of moderate to severe lateral canthal lines (crow’s feet lines) seen at maximum smile, either alone or when treated at the same time as glabellar (or frown) lines seen at maximum frown in adult patients. This is an important step for Allergan towards securing national licences in the 27 countries of the European Union as well as Norway and Iceland. This Positive Opinion follows the recent authorisation for a similar indication by the US Food and Drug Administration (FDA). The Positive Opinion is specific to Allergan’s botulinum toxin type A product and is based on Allergan’s successful global Phase III clinical trial programme in Crow’s Feet Lines. “We have a long-term commitment to innovation in neuromodulator research, and this Positive Opinion is testament to this,” said Paul Navarre, President of Allergan EAME. “This is an important milestone for Allergan, extending our commitment to support medical aesthetics practitioners by delivering the scientific evidence, the appropriate country licences to promote the drug and the educational training programs to yield the best possible outcomes for patients.”

A survey carried out by AesthetiCare on a sample of its customers has revealed that Cosmetic News is the most widely read trade publication. 93% of respondents said they read a trade publication on a regular basis with 83% listing Cosmetic News as their chosen title. 49% of respondents said they would trust a trade publication to give them impartial and honest information while 74% of respondents said a decision they had made had been influenced by something they had seen or read. 81% of respondents said that adverts in trade publications helped to create new product awareness. Of the customers surveyed 64% listed their job description as nurse or nurse prescriber.


Bogus injector to be sentenced this month A beautician who lied about her qualifications and left a client with eye injuries after injecting her with botulinum toxin is due to be sentenced this month. Jamie Winter admitted misleading customers for 18 months claiming she had completed Harley Street training in administering the drug but never finished the course. Hull Crown Court heard around a dozen people from Scarborough and Bridlington had been treated by Winter. The case came to light after one client reacted badly to the drug which was unlicensed and available on the internet for £70 and suffered swelling around the eyes. She approached a solicitor seeking compensation and was advised to go to the police. Having launched an investigation Humberside Police interviewed 12 people - two men and 10 women - who had run up bills for treatments ranging from £180 to £360 for a course of injections. Winter was arrested in May 2012 and pleaded guilty to five charges of fraud by false representation between July 2011 and August 2012 at Hull Crown Court. Judge Michael Mettyear told Winter she would be sentenced on November 11.

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

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


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

References: 1. Raspaldo H. J Cosmetic and Laser Therapy, 2008;10:134–142. 2. Fischer TC. Poster presented at EMAA, 1–3 October 2009, Paris. 3. Allergan Data on File (DoF), 2011. 4. Allergan Data on File (DoF) Marketing overview, 2011. Instructions and directions for use of JUvéDeRm® vOLUmA® with Lidocaine are available on request. Lidocaine does not affect the intrinsic performances of JuvéDERM® vOLuMA® and its safety profile, therefore, JuvéDERM® vOLuMA® data is representative of JuvéDERM® vOLuMA® with Lidocaine3

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

Cosmetic News is most widely read trade publication according to AesthetiCare customer survey

Cosmetic News will be re-branding as Aesthetics, the premier monthly journal for medical aesthetic professionals, from December 2013. After listening to feedback from readers and advertisers the magazine’s publishers, Synaptiq, have chosen to re-launch the publication with a new name, look and direction. As well as clearly signalling where the heart of the journal lies, the new name will also create more synergy between the brand and its associated events; The Aesthetic Awards and The Aesthetics Conference and Exhibition (ACE). Aimed at qualified healthcare professionals working in medical aesthetics as well as clinic managers and ancillary staff, Aesthetics, will provide its readers with accessible, relevant and credible editorial content including the latest news, views and opinions as well as CPD accredited educational content and clinic study reviews.

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Reve Medical to distribute Cutera in UK Reve Medical has been given the exclusive rights to distribute Cutera in the UK. Reve Medical is the new aesthetic division of Instinctive UK Limited, created especially to distribute the Cutera aesthetic laser and pulsed light systems. Reve has a dedicated team who will promote the sales and provide clinical education for the Cutera range of products with two new launches planned for 2014. The company will also be holding training courses for Onychomycosis and a master class for vascular treatments.

Aesthetic Source gains recognition in Exuviance International Awards 2013 Aesthetic Source received strong recognition at the recent NeoStrata Company International Distributor Meeting held in Istanbul during EADV 2013. Lorna Bowes, director of the company was presented with the Best International Distributor Award in acknowledgement of significant achievements over the past year in developing the Exuviance brand in the UK. She said, “This is a major award for Aesthetic Source only made possible because of the team’s hard work, enthusiasm and commitment in developing the Exuviance brand in the UK and supporting our customers in bespoke training and marketing programmes. It is very satisfying to work with both the NeoStrata and Exuviance brands with their reputation for developing innovative science-driven skincare solutions and we look forward to further growth in the year ahead. ”Earlier this year Aesthetic Source was presented with an international NeoStrata Award at the AAD meeting in recognition of its launch of the Skin Active and Enlighten skincare ranges.

Injectables experts take centre stage on first day of ACE 2014 nurse, Sharon Bennett who will update delegates on the current situation with regards to the European draft standards on Aesthetic Surgery and Aesthetic Non-Surgical Medical Services and how this will impact the market. Staying on top of what is new in the market is essential if you want to provide patients with the best service and advice. As an internationally esteemed authority on micro-invasive techniques for the rejuvenation of face and body, Munich based dermatologist Dr Sabine Zenker, will be sharing her thoughts and expertise on ‘What is New with Fillers and Other Injectables.” Detailed understanding of facial anatomy is also key when it comes to injectables. Hear from Royal College of Surgeons’ professor of anatomy Prof. Vishy Mahadevan and Mr Humzah on the anatomy secrets every practitioner should know when offering botulinum toxin injections. The day will end with an insight into How to Avoid Complications When Performing Facial Injections by London-based facial surgeon Julian de Silva. In a time when patient safety and satisfaction is being pushed to the forefront how you manage and avoid potentially harmful side effects is one of the most important considerations for anyone administering facial injections. To find out more about The Aesthetic Conference and Exhibition 2014, visit or call 01268 754 897. One day admission to the conference, including lunch and refreshments is just £89 while admission to both days costs £160. If you book before November 30 you can take advantage of our early booking offer and receive a 10% discount. Just use the promotional code HXA38 when booking over the phone. Online booking on will open from midNovember but you can register your interest on the site to be in line for special discounted delegate places when booking opens.

Leading lights from the fields of aesthetic medicine and dermatology will be sharing their knowledge and expertise on injectables as part of an intensive first day agenda at The Aesthetics Conference and Exhibition (ACE). Now in its 6th year, the event (formerly known as Cosmetic News EXPO and Aesthetics Conference) is taking place on March 8th and 9th in London and gives medical aesthetic professionals the opportunity to gain up to 19 CPD points from 46 hours of education spread across the two days. With masterclasses, workshops and the main conference agenda taking place simultaneously, this is an unrivalled opportunity to hear from some of the key opinion leaders driving treatment innovation and best practice in the sector. Injectable treatments are the bread and butter of most aesthetic practices but in the wake of the Keogh review they have been firmly under the spotlight making best practice and advanced skills and training more essential than ever. With this in mind the first day of the scientific programme at ACE will be focused on expanding and enhancing delegates’ knowledge on the latest topics, techniques and treatments shaping the injectables market. Highly respected aesthetic doctor and injector Dr Tracy Mountford and renowned plastic surgeon and facial anatomy trainer Mr Dalvi Humzah will be taking the chair for the first day of the meeting, which will open with a review of the CEN standards. Toxins and fillers and who can inject them have been a controversial focus of CEN. This hot topic will be explored by CEN committee member and aesthetic

Patients prefer Belotero... Clinical studies show a preference for Belotero over Restylane® and Juvéderm® Ultra 31,2 n

Superior evenness1 ®

Comparable cosmetic correction1 ®

Comparable duration2 ®


1. Prager W et al. A Prospective, Split-Face, Randomized, Comparative Study of safety and 12-Month Longevity of Three Formulations of Hyaluronic Acid Dermal Filler for Treatment of Nasolabial Folds. Dermatol Surg 2012, 38: 1143 – 1150. 2. Narins R. S. et al. Improvement in Nasolabial Folds with a Hyaluronic Acid Filler using a Cohesive Polydensified Matrix Technology: Results from an 18-month Open-label Extension Trial. Dermatol Surg. 2010 Nov;36 Suppl 3:1800-8. Restylane is a registered trademark of Galderma S.A. Juvéderm is a registered trademark of Allergan Inc.

Tel: +44(0) 333 200 4140 Fax: +44(0) 208 236 3526 Email:


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Kline reports on industry growth

Growth for CMA

Growing by almost 500% over the last 20 years, non-surgical cosmetic procedures are mirroring consumers’ preferences for minimally-invasive treatments, according to the recently published Professional Aesthetics: U.S. Market Analysis and Opportunities study, by worldwide consulting and research firm Kline & Company. Key factors driving growth include greater awareness of in-office treatments and their benefits, less down time and discomfort, with a whole body of treatments and increased distribution similarly contributing to the market’s overall growth. The injectables market continues to drive overall market growth, with new products such as Belotero Balance from Merz entering the market in 2013, while body contouring and cellulite reduction is the most dynamic addressed skin concern. Injectibles account for just over half of total market sales while body treatment products are growing at close to 20% in 2013 due in part to good alternatives now offered to liposuction. Additionally, the first FDA-approved laser system for cellulite treatments, Cellulaze by Cynosure, was introduced recently. Professional aesthetic devices providing multiple benefits is an increasing trend particularly within the energy and mechanical devices category. This category is also showing the fastest growth due to its technological advances, and consequently more effective and permanent results.

Cambridge Medical Aesthetics has appointed distributors in Sweden, Spain, Czech Republic, Russia and Iran to cope with demand for its products Uma Jeunesse®and Uma Jeunesse Velvet®. The products offer an extremely low rate of injections site reactions and clinical trials have shown superior longevity. With plans for introduction of Uma Jeunesse® range of products into North America later this year, Uma Jeunesse® is becoming a serious player in the world fillers market.

Harley Street pioneers join forces

Top cosmetic surgeons Anthony Erian and Massimiliano Marcellino have announced that they will be joining forces with Dr Roberto Viel at The London Centre of Aesthetic Surgery. LCAS will now provide a more expansive roster of treatments than ever before. Dr Roberto Viel has been practicing as a plastic surgeon on Harley Street since 1990. Dr Roberto Viel is a speaker at international aesthetic congresses as is the co-author of the sold out The Viel’s Beauty Bible. Anthony Erian is an established plastic surgeon with over 29 years experience in the field of aesthetic surgery. Fellow of two Royal Colleges, FRCS (Eng), FRCS (Ed) he is also American Board certified and accredited in Cosmetic Surgery. Massimiliano Marcellino has published over 70 scientific researches and
presentatied at international congresses. He is a member of
the Italian Society of Plastic Reconstructive and Aesthetic
Surgery, Fellow of the Royal Society of Medicine, Fellow of the
International College of Surgeons, and a fellow of the Royal College of Surgeons (FRCS, UK).

UK’S ONLY BREAST IMPLANT MANUFACTURER FIRST TO PLUMP FOR SAFETY INITIATIVE The UK’s only implant manufacturer Nagor, part of GC Aesthetics, has become one of the first founding partners of the National Institute of Aesthetic Research’s Breast Safety Implant Campaign. A joint initiative between the British Association of Aesthetic Plastic Surgeons (BAAPS) and the Healing Foundation, the NIAR is establishing the Breast Safety Implant Campaign as a priority, with breast implant manufacturers worldwide being invited to contribute the equivalent of £1 per implant sold towards funding a research programme aimed at improving all aspects of breast implant safety, treatment and aftercare. Funds donated to the NIAR will support its activites which will include: gaining an improved understanding of the psychosocial factors behind women seeking breast enhancement surgery; providing an independent analysis and comment on data from the Breast Implant Register; promoting clinical research into the safety and efficacy of surgical techniques in breast implant surgery; analysing existing data on breast surgery to provide evidence based advice for surgeons, which may help to define best practice, and scientific research into implant design and technology. According to consultant plastic surgeon and BAAPS President Rajiv Grover, “We are delighted to work with GC Aesthetics as a founding partner in order to fund further scientific research and continuing to put patient safety first.” All research undertaken by the Healing Foundation under the auspices of the NIAR is subject to the charity’s existing, stringent processes of research management. The Healing Foundation is a registered charity and a member of the Association of Medical Research Charities (AMRC).

When it comes to evidence you’re safe with Radiesse…


FDA approved1

1. Sadick N, et al A Multicentre, 47 month Study of Safety & Efficacy of Calcium Hydroxylapatite for Soft-Tissue Augmentation of Nasolabial Folds and Other Areas of the Face. Dermatol Surg 2007; 33 (Supp 2): s112-s127. 2. DoF-1-001_01

most studied safety profile2

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


SAFETY IN BEAUTY CAMPAIGN LAUNCHES IN LONDON The W Hotel in London hosted the star-studded launch of the ‘Safety in Beauty’ campaign, spearheaded by beauty writer, author personal coach Antonia Mariconda.

The British Association of Cosmetic Nurses showed it was going from strength to strength when it held its most well attended and successful annual conference to date. The meeting took place at the Renaissance City Centre Hotel, Manchester and included a full and comprehensive two-day education agenda as well as an exhibition supported by key manufacturers and suppliers from the industry, including Cosmetic News. The meeting also saw a number of significant announcements being made including the accreditation of the BACN’s Career and Competency Framework for Nurses in Aesthetic Medicine by the RCN. This is a landmark achievement for the association and shows its dedication to the future of aesthetic nursing. The document is now being prepared for publication and will be revealed to BACN members via the web site http://www.cosmeticnurses. org before it goes public. The association also announced it had gained a victory over Google. The search engine giant is now to
add ‘Skin Care Clinic’ to it’s Business Page listings so that nurse led clinics will no longer have to add inappropriate Google defaults like ‘Beauty Clinic’ or ‘Beauty Salon’. The BACN also said goodbye to its first president, Liz Bardolph, who took on the role at the inception of the BACN nearly four years ago. She is retiring to create time to continue her Masters post-graduate degree in Medical Law and Ethics. In tribute to her, colleague Lorna Bowes said, “Liz has worked tirelessly behind the scenes since the days developing the original nurse competencies with the Royal College of Nursing For Nurses in aesthetics and was a key player in the development of and delivery of the Greenwich Diploma for aesthetic nurses. She was later to be the Chair of the RCN Forum. In the aftermath of the restructuring of the RCN Forums Liz was one of a small group of leading aesthetic nurses who pursued their dream of an independent body to represent nurses in aesthetics. A dream that culminated in the successful inauguration of the British Association of Cosmetic Nurses.” The 2014 meeting will take place on October 3-4.


The campaign, which aims to promote safe practice in the beauty industry has been backed by a number of celebrities and industry leaders. Safety in Beauty, or #safetyinbeauty, will be used as a hashtag on Twitter and will allow members of the public and professionals alike to share experiences and expose illegal or shoddy work carried out within the beauty industry. It is hoped that this name and shame tactic will discourage bogus or incompetent beauty and cosmetic practitioners from administering treatments. In addition to the campaign, Antonia plans to submit nearly 370 documented examples of poor and often dangerous beauty and cosmetic procedures to a government panel in January 2014 in response to the pressure that has been placed on the industry as a whole. “I am collecting a dossier with hundreds of examples, case studies and documentation of unsafe beauty practices with a view to presenting this to the Department of Health for Sir Bruce Keogh and his panel to consider in the on-going cosmetic interventions review,” explains Antonia, “Ultimately, together with a likeminded group of ethically led, medical, legal and professional individuals, I plan to register the campaign as a charity in the New Year with a view to becoming one of the UK’s only independent charities that will help members of the public who have been victims of malpractice.” Dr Vincent Wong who supports campaign said, “As a doctor, patient safety is my utmost priority. It is a sad truth that there are many unqualified practitioners in this industry who over-exaggerate on their qualifications and experiences are a marketing strategy. Safety in Beauty is a great initiative to draw attention to the general public about safe treatments.” You can find out more about the campaign by searching for #safetyinbeauty on Twitter or visiting Antonia Mariconda’s blog at

SIGMACON LAUNCH, LONDON The Marble Arch Hotel in London was the setting for the unveiling of Sigmacon (UK) Limited’s two latest launches. The company was showcasing its new range of professional only skincare products from PCA Skin. PCA SKIN has been established for over 24 years and is in more than 5,000 medical practices in the United States. Not only is Sigmacon the UK distributor for the range but the company is also the first to supply the products in Europe. Julian McGlynn Sigmacon’s Aesthetic General Manager and Unique Skin Business Director said, “We wanted a business that could offer our existing customers professional skincare products from PCA SKIN, combined with the very popular Professional Dermatological Skin Peels and daily care products from Dermaceutic Laboratoire.” The event also marked the launch of Sigmacon’s new skincare business - Unique Skin - in combination with a dedicated online website store

AESTHETICARE® LAUNCHES SKINSYNERGY™ TRAINING SEMINARS AesthetiCare has launched SKINSYNERGY™ training seminars to enhance delivery of clinically proven, antiageing and problem skin resolution results with its medigrade skincare portfolio. Spread over two days each course starts by looking at the anatomy and physiology of the skin, the skin ageing process and problem skin conditions such as hyperpigmentation, rosacea and spot-prone skin. The rest of day one looks at the regulatory environment we are all working in and the evidence based, medigrade ingredients that are available to us. Day two looks at the AesthetiCare® clinically proven skincare products broken down into the key anti-ageing categories of Protect, Prevent and Rejuvenate and the Resolution of problem skin conditions. The second part of the day gets really hands on as we start building evidence based skincare regimes for different approaches to anti-ageing and problem skin resolution, using the SKINSYNERGY™ clinic materials to demonstrate how cost effective and easy to use these are.

SCULPTRA WORKSHOPS, AMEC Dr Danny Vleggar and Dr Linda Eve join forces to present a Sculptra workshop at the recent. The pair demonstrated different methods of administering the treatment with Dr Vleggar injecting one side of the face with a needle while Dr Eve treated the other side with a cannula.

STYLAGE® Lidocaine is the only patented range of cross-linked hyaluronic acid (IPN-Like technology) dermal fillers which incorporates both an anaesthetic (lidocaine) and an antioxidant (mannitol) for safe, comfortable and effective aesthetic treatments. It can be used for filling and smoothing of wrinkles, natural lip correction, volume restoration, hydration, chin remodelling, tear trough correction, neck, décolleté and hand rejuvenation. STYLAGE® is perfectly suited for use with a cannula. Launched in 2008, STYLAGE® by Laboratoires Vivacy (France) is now one of the world’s fastest growing dermal fillers.

For further information about STYLAGE®, DESIRIAL®, KARTILAGE® Call Medical Aesthetic Group on 02380 676733 or visit

MAGROUP STYLAGE half page (vertical) 95x265mm

Cosmetic News NOV 2013 ISSUE



IT ALL ADS UP We report on new rules issued by the Advertising Standards Authority that will impact the aesthetics industry

Advertising and marketing was one of the key areas highlighted by the Keogh review as needing tighter control and last month saw an important step being made in the right direction when the Advertising Standards Authority (ASA) Committee of Advertising Practice (CAP) and Broadcast Committee of Advertising Practice (BCAP) issued a revised Help Note on Cosmetic Interventions. The note includes important sections on the use of production techniques, ‘before and after’ photographs, endorsements and testimonials, prescription only medicines, Botox® and sales

promotions. The news was welcomed by Treatments You Can Trust which will also be updating its Standards for Injectable Cosmetic Treatments Version 4, April 2013 Standard 8, Advertising and Promotion of Services to reflect the new guidance. Sally Taber commented, “IHAS represented the interests of quality assured clinics registered with Treatments You Can Trust in the evolution of this new guidance, and we support all the advice given in the Help Note, which we believe will benefit TYCT members and the industry at large.”

HIGHLIGHTS The Help Notes interpret The UK Codes on advertising issued by the Advertising Standards Authority (ASA) (The CAP Code). In its monthly newsletter to members the IHAS picked out some of the key policy statements it felt were most relevant to aesthetic clinics. These include: •

• •

Marketing communications must be prepared with a sense of responsibility to consumers and to society. Marketing communications must not materially mislead or be likely to do so. Marketing communications must not mislead consumers by exaggerating the capability or performance of a product. Objective claims must be backed by evidence, if relevant consisting of trials conducted on people. It goes on “Medicinal or medical claims and indications may be made for a medicinal product that is licensed by the MHRA or EMEA, or for a CE-marked medical device. Secondary medicinal claims made for cosmetic products …. must be backed by evidence. These are limited to any preventative action of the product and may not include claims to treat disease”.


The notes also state that marketers offering individual treatments, especially those that are physically invasive, may be asked by the media and the ASA to provide full details together with information about those who supervise and administer them. Marketers should encourage consumers to take independent medical advice before committing themselves to significant treatments, including those that are physically invasive. Another point of note is that: ‘Practitioners must have relevant and recognised qualifications’. The honorific ‘doctor’ is used by many who are not registered and licensed by the General Medical Council. The qualifier ‘MD’ is not recognised in the UK. Neither should be used in a way to mislead, such as ‘Doctor A B Cdefg, MD, Medical Director’ when the foreign-trained person was not registered or licensed by the GMC but running an establishment providing cosmetic interventions. For services including clinics, establishments and the like offering advice on, or treatment in, medical, personal or other health matters the Help Note says “Advertisements are acceptable only if the advertiser can provide suitable credentials, for example, evidence of: relevant professional expertise or qualifications; systems for regular review of their skills and competencies and suitable professional indemnity insurance covering all services provided; accreditation by a professional or regulatory body that has systems for dealing with complaints and

taking disciplinary action and has registration based on minimum standards for training and qualifications”.

Particularly important to some clinics, is the section on non-surgical Practitioners. It says: •

Marketers should hold proof of practitioners’ qualifications from a reputable, independent source before making claims that relate to those qualifications. Marketers should not make claims which misleadingly exaggerate the skills, qualifications or experience of the practitioner of the intervention. Marketers should not misleadingly claim or imply that a practitioner is a medical professional or regulated by a professional body if that is not the case. They should take care not to claim or imply that such practitioners have professional systems of complaint or redress if they do not. Marketers should ensure that they do not misleadingly imply that they operate in a regulated clinical environment, if that is not the case.

Under the heading ‘Cosmetic Interventions (surgical and non-surgical)’ there is a requirement for all objective efficacy claims to be supported by robust evidence….

consisting of trials conducted on people. Take care not to give the impression that a consultation will be with a medical professional if that is not the case. Eschew unrealistic claims. Describe accurately. Only Guarantee facts. The Note has valuable guidance on use of production techniques, ‘before and after’ photographs, responsible advertising, targeting (don’t target the young directly or obliquely), endorsements and testimonials, clinics, sales promotions (“Hurry, offer must end Friday” should not be used), financial products.

TOXINS One area that has come under most scrutiny in the past is the lack of adherence by aesthetic clinics to rules surrounding the advertising of prescription only medicines and in particular, botulinum toxin. As such CAP has created an AdviceOnline article on Botox®, and points to its Blue Guide on the advertising and promotion of medicines and PROMs. It says, “ Botox treatments are increasingly popular, and as a result the ASA has received a number of complaints which relate specifically to the advertising of Botox. But, Botox is a prescription-only medicine, and the rules in the advertising codes (Rules 12.22 of the CAP Code and 11.21.1 of the BCAP Code) reflect the provisions in the Human Medicines Regulations 2012. These prevent prescription-only medicines and medical treatments from being advertised to the public. A website could make limited references to Botox, provided that those references are presented in the context of a balanced and factual overview of all the treatment options which are available.”

With regards to botulinum toxin the Help Note says: •

The Human Medicines Regulations 2012 (“the Regulations”) prohibit the issue of any advertisement wholly or mainly directed to the general public which is likely to lead to the use of a prescription only medicine (POM). Botox is the trade name for Botulinum toxin, produced by bacteria called Clostridium Botulinum. Botox is regulated as a prescription-only medicine which should be injected by a suitably qualified health professional. It may not be advertised to the public: however, it may be advertised to healthcare professionals (see section above on POMs). Materials such as magazine advertisements and flyers distributed to the public must not mention “Botox”, “Dysport”, “botulinum toxin” or any abbreviation of this product. Advertising for cosmetic clinics and beauty salons may promote the services they provide. However, they should do so in a non-specific way without a reference to Botox, for example “a consultation for the treatment of lines and wrinkles.” Hover text, links and any small print at the bottom of a home page should also not refer to Botox or link consumers to a page that refers to Botox.

Our skin changes as we age, and damaging agents such as sunlight, smoking and pollution all leave their mark. The Mene & Moy System of active cosmetics contains naturally occurring compounds that have been skilfully combined and presented in order to pass through the skin barrier to reach the dermis below. Powerful concentrations of Vitamin C, Phytic and Glycolic Acids are combined with soothing and nourishing Chamomile, Vitamins E and A, Shea Butter, Orchid Oils and Bisabolol to create a range of highly effective anti-ageing creams and lotions to suit all skin types, ages and racial groups. These unique formulations are available for home use or by your therapist in conjunction with the Mene & Moy Professional Range of clinical products.

Specialist Solutions for Non-surgical Aesthetic Procedures

The industry is being encouraged to report any advertising that it thinks breaches the ASA rules by visiting Industry-advertisers/Industry-Make-a-complaint.aspx. Useful links:

For further information about these innovative products call Medical Aesthetic Group on 02380 676733 or visit

MAG_MM System - half page Ad (265x95mm) Cosmetic News Nov 2013


Only the brave?

Ros Bown RGN, INP on the challenges of peeling black and Asian skin

Ros Bown (RGN)(INP) is a fully qualified practitioner, and is also an independent prescriber who has worked in theatres for 25 years. Ros has worked as an aesthetic practitioner for over 20 years and has performed over 175,000 procedures, demonstrating her experience in non-surgical cosmetic treatments. Ros is fully qualified to train Botox, Dermal Fillers, Sculptra, Skin Peeling and Radio Frequency Skin Tightening.

In my 20 years as an aesthetic practitioner I have always believed in continual training to gain more experience and obtain new ideas. This has resulted in my practice growing considerably but the one area where my practice has not grown at


all has been in skin peeling. Why? I have tried glycolic peels, TCA peels, combination

Trichloracetic acid (TCA) is created in a

peels, Jessner, ICP, Obagi Blue Peel (great results but the pain, down time and need for a minimum of 12 weeks skin prep has stopped me using). Of all the peels I have used the results have not been great (except Obagi) and whenever I have peeled black skin, Fitzpatrick IV窶天I, I am always wondering if there will be post inflammatory hyperBefore


pigmentation. As I am sure all my colleagues would agree, the skin peel

is a very useful treatment PROVIDED it is treated with the utmost care, especially with Fitzpatrick IV-VI skin types. When treating Fitzpatrick IV-V my experience has

laboratory by combining three chlorine molecules with acetic acid, a relative of vinegar. It provides excellent exfoliation properties while stimulating collagen production to repair the skin. Tretinoic acid (Retin-A) Vitamin A promotes collagen and elastin production, helps to increase water levels within the epidermis, normalizes cell turnover and is a melanogenesis inhibitor.

shown that I can apply a peel to the same client for maybe four times without

Salicylic acid is a beta hydroxy acid (BHA)

any incidence and yet on the fith application there has occasionally been a post

with anti-inflammatory properties and is an

inflammatory hyper- pigmentation. Anyone who has experienced such a reaction

effective anti-acne ingredient working as a

will know that this is one of the most difficult to eradicate, and can take several months. I would also not peel Fitzpatrick VI because of the above risks. When using the Obagi Blue Peel I always follow the guidelines of skin pre-prep with Obagi

keratolytic clearing out dead cells blocking the hair follicle that cause impactions.

Nu Derm for at least 12 weeks, and again would not treat Fitzpatrick VI. So the

Phenol has the ability to trap free radicals,

question is: How can we peel black skin safely? 18 months ago I was introduced

works as a chemical cauterant to exfoliate

to the VI Peel, manufactured by Vitality Institute in the USA. Unlike other peels this

the skin, has preservative properties and in

is a combination peel consisting of TCA, Salicylic, Retinoic and Phenol, all in 15%

low percentages is an effective numbing

concentration. The peel requires no skin prep, is self neutralizing and is suitable for


ALL skin types. This probably sounds too good to be true, but it works, on ALL skin types. VI Peels are formulated using

L-Ascorbic acid (Vitamin C) is a watersoluble antioxidant that provides protection

TCA, Phenol, Salicylic and Retinoic acids in a proprietary formulation with

against UV damage. Vitamin C also

all acids less than 15%. The peels are

stimulates collagen synthesis, reduces

synergistically blended with vitamins

erythema, is a melanogenisis inhibitor, and

and minerals to treat and nourish the

MMPI (matrix metalloproteinase inhibitor)

skin. The phenol acts as a numbing

controlling inflammatory enzymes.

agent ensuring that all VI Peels are painless. 16



Having used the VI peel for melasma and rejuvenation on black skin, I then started to treat acne scarring with superb results and also I am now using the VI Before After Acne Peel on active acne, again with amazing results. As I gained experience I have also used the VI Peel Precision for body peeling, The skin ranges in thickness from approximately 0.5mm on the eyelids to 4mm on the palms of the hands or soles of the feet. The density of the skin, the amount of pores and sebaceous glands affects peel penetration, the ability of the skin to regenerate itself and ability to heal without any complications. In eighteen months I have used these peels on over 100 clients with no hyperpigmentation, no adverse reactions and I have applied to ALL skin types. Benefits for the Physician VI Peels are safe and effective for all Fitzpatrick Skin Types and address all skin concerns, plus they are self neutralizing, the client leaves the clinic with no visible signs. The VI peel may be performed in a series of two to four peels; spaced one month apart to treat acne or acne scarring, stubborn hyper-pigmentation, and for skin rejuvenation. Each treatment can be performed in less than 15 minutes and preconditioning the skin is not necessary. Hundreds of thousands of VI Peels have been performed around the world on all types of skin and on all Fitzpatrick types; to date, not a single lasting complication! Benefits for the Patient Many peels are too active for Fitzpatrick’s iV-VI; limiting Asian, Hispanic, and African American patients’ choices for chemical peels, plus PIH is rare: it can be lifted by a second peel. The treatment is virtually painless

and preparation products are not required. There is minimal peeling time, usually two to three days, and the entire process is complete within a week. A Post Treatment Kit is provided for each patient. Clinical evidence Vitality Institute Medical Products completed an intense clinical study hosted by the esteemed International Research Services, Inc. The evaluation studied the safety and effectiveness of Vitality Institute Medical Products’ VI Peel Facial Peel. Participants were carefully selected based on a variety of skin types and various levels of wrinkles and fine lines. Progress was thoroughly examined by trained professionals utilizing comprehensive visual observations and advanced instrumental analysis. After four weeks of closely-monitored use International Research Services Inc. concluded that VI Peel was determined to be completely safe within intended use. Crow’s feet line improvements were “statistically significant for the spacing parameter, and trendwise (directionally) significant for five additional parameters.” Fine lines and wrinkle improvements were “statistically significant. Overall, the changes were in the direction of smoother fine line texture, i.e., decreases from baseline for Rz, Shadows and NumWr.” Up to 71% of participants reported a significant improvement in “improved fine lines” and “skin suppleness.” Signs of minor irritation decreased quickly after participants used the VI Peel. Participants rapidly showed a reduction in melanin content and increase in collagen content. Just two weeks after VI Peel use, participants showed a haemoglobin increase, suggesting increased blood flow to the treated areas. Conclusion In conclusion, the VI peel has transformed my thoughts on chemical peeling on black skin types. I now consider every client as a possible candidate, in the sure knowledge they will achieve great results with a painless procedure and minimal down time.











VI Peel is available from Rosmetics. SAFE FOR ALL SKIN TYPES Call Clive Shotton Practice Manager Rosmetics 0781 468 7206

Free training available London & Birmingham Tel: 0845 5050601



Mike Murphy on selective photothermolysis in hair and blood vessels a new interpretation of thermal relaxation times

Selective photothermolysis was introduced in 1981 by two American scientists, Anderson and Parrish, following their study with a pulsed dye laser on blood vessels, particularly port wine stains. They theorised that by carefully selecting the most appropriate wavelength a clinician could selectively deliver laser energy into target blood vessels. The light is absorbed by the target’s chromophores – in this case oxyhaemoglobin and deoxyhaemoglobin

within the blood cells. The blood then heats up preferentially and induces damage to the vessel wall thereby destroying the target vessel. An important part of their theory was that the duration of the light pulse had to be less than the ‘thermal relaxation time’ (TRT) of the blood vessel to minimise damage to surrounding tissues. The TRT essentially determines the cooling time of the targets and is dependent on the target’s physical size. As a consequence of this theory

many laser systems were devised which adhered to these principle parameters – the optimum wavelength, energy and pulse duration. However, my colleague and I have recently discovered that this interpretation is incorrect. While the choice of wavelength is essentially determined by the absorption characteristics of the target chromophore the pulse duration of the light energy should not be tied to the TRT of the target, as originally proposed.

The protein breakdown rate is governed by the Arrhenius Damage Integral which determines the amount of tissue damage for a given time and temperature. Once a threshold temperature has been exceeded the breakdown, or denaturation, process can begin. This process will continue for as long as the threshold temperature is exceeded or maintained. The total amount of tissue damage then dictates the clinical outcome – if sufficient damage occurs then that tissue dies and new tissues will grow in its place. The important point here is that the amount of protein denaturation is entirely dependent on the tissue temperature and the time that those temperatures are maintained. When 63.2% of the proteins

have been irreversibly damaged the tissue dies. Hence if a blood vessel or a hair follicle is heated using light, or radio frequency, energy and the correct set of temperature and time is achieved then those targets will be irreversibly destroyed. In many clinical settings this does not occur because either the temperature is not maintained long enough or the temperature achieved is too low. In these situations an insufficient amount of the target tissue is denatured (less than 63.2%) and so the tissue has the capacity to regrow in its original state. This explains why poor results occur so frequently when treating hair or blood vessels (especially those with large diameters which require more damage).

The Science When light energy is absorbed by tissue there are at least two processes occurring: 1. light energy is converted into heat energy which raises the tissue temperature; 2. the proteins within the tissue break down once the temperature exceeds a threshold.

Mike Murphy Mike Murphy is a physicist/ bioengineer who has been involved in medical laser research since 1986 and in the commercial sector since 1989. His original research group developed the scar-free removal of tattoos by Q-switched ruby laser in Canniesburn Hospital, Glasgow. He now runs training courses on IPL systems and aesthetic lasers and their applications.


Are you easily LED?

Undercooked – some proteins remain intact

All of the egg white’s proteins have been denatured. (Note that the yolks have not been denatured–they have different thermal properties compared with the albumen)

I usually explain this process as follows – everyone knows how to fry an egg (I assume!). We can all see the ‘white’ of the egg changing from a transparent appearance to a white appearance. What we are observing is the denaturation of the proteins in the egg white. It is clearly obvious!

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By selecting the correct combination of these parameters...we should always be able to achieve a good clinical outcome. Likewise, we all know that if the cooking temperature is too low then the egg will take forever to cook. Similarly, if we have a high temperature but take the frying pan off the heat too early then some of the egg white will still be transparent – in other words, not all of the proteins will have denatured. As with tissue we need to achieve the correct set of temperatures and times to achieve the best results. So, when targeting skin tissues keep in mind the fried egg analogy – you must ‘cook’ the tissue at a sufficiently high temperature (energy) for a sufficiently long period of time (pulse duration) to ensure complete destruction of the target proteins. In fact, it turns out that the most important parameter in determining the final outcome is the power density (energy per unit area per unit time, measured in watts/cm2). The fact is that the TRT does not matter in the denaturation process - it is merely an indicator of how quickly the target cools – it has nothing to do with the protein denaturation process. You can see a more scientific description of this process in my new report1 in ‘Lasers in Medical Science’.

• Anti - Ageing • Acne (all grades) • Pigmentation • Rosacea • Psoriasis • Accelerated Healing

Before & After Dermalux™ LED Rosacea






AFTER 8 Dermalux treatments in 3 weeks

AFTER 8 Dermalux treatments in 2 weeks

AFTER 9 Dermalux treatments in 3 weeks

Conclusion To achieve good clinical results with lasers or IPL systems it is important to understand the physical processes which are occurring in the tissues. The heating process is relatively simple to grasp and is quite obvious to most patients. However, the physical destruction of the tissue proteins is a more subtle process which is not so immediately obvious. I think this is why the TRT idea stuck around for so long. However, we should now realise that we must always consider the correct parameters when targeting tissues – energy, spot size, wavelength and pulse duration. By selecting the correct combination of these parameters, based on an understanding of the processes, we should always be able to achieve a good clinical outcome. 1 - ‘Thermal relaxation times: an outdated concept in photothermal treatments’, Murphy M.J., Torstensson P.A., Lasers in Medical Science, October 2013.

Aesthetic Technology Limited Park View House, Worrall Street Congleton, Cheshire CW12 1DT t: 0845 689 1789 | e: w: Before and after images courtesy of; Rosacea – Blushers Clinic, Coventry; Psoriasis – Miss Zahida Butt, The Cosmetic Clinic, Kings Lynn; Acne – Dr Steve McGurk – Ilkley


Smooth as Velvet ®

Dr Peeyush Peter Sharma on advanced injection techniques using UMA JEUNESSE VELVET® Uma Jeunesse Velvet® is a newly introduced product which has great potential. It has been specially developed as a bridge between wrinkle fillers and mesotherapy products. Its unique composition is ideal for complex clinical situations where a large area of facial skin has multiple fine wrinkles combined with sagging. Uma Jeunesse Velvet® can also be used for refreshing lips that have lost some volume to give them a youthful look. This is a highly sophisticated product that has been developed as a beauty restorer with built in flexibility and user friendliness. The mission of this product is to restore beauty. Let us look at two of the ways this product can be used to maximally take advantage of its design parameters.

General Injection Tips With Uma Jeunesse Velvet® Uma Jeunesse Velvet® has lower viscosity and small hydrogel particle size but its biocompatibility is the same as that of Uma Jeunesse®. There is 16 mg/ml lightly crosslinked hyaluronic acid as well as 4 mg/ml non-crosslinked hyaluronic acid in each ml of this product. Again this product has the patented property of Adaptation Viscosity® like other products manufactured by Cambridge Medical Aesthetics/Cambridge Biotech. This is only achievable by using the Company’s DXN® Technology. For these reasons, Uma Jeunesse Velvet® should be injected in small quantities, allowing the molecules to uncoil in the tissues to their required size. The Injection technique can be linear threading or serial puncture depending on the situation or a combination of the two. We have used cross hatching technique with great advantage while treating large areas. The 30G needle provided with the product is fine for most applications but one may use the many different cannulas available. We have in particular used the longer 30G cannulas for treatment of complex conditions. We understand that the manufacturers are soon to introduce thin walled needles which will be supplied with all their products. 20

Sagging Skin and Uma Jeunesse Velvet® Sagging skin especially of the cheeks is one of the most complex and difficult to treat conditions. There are many different ways to address this difficult condition starting with operative intervention to the various laser and other similar modalities. Since the availability of Uma Jeunesse Velvet® we have started using this product to treat sagging skin. The results are excellent. Sagging skin is usually accompanied by multiple fine wrinkling of the overlying skin. This fine wrinkling is usually difficult to treat because the wrinkles are usually superficial, innumerable and form part of the entire fascial-aponeurotic degeneration syndrome of this region which cannot be addressed in isolation. In particular the sagging of the cheeks is an area which has traditionally required multiple complex and expensive treatments. That is until the introduction of Uma Jeunesse Velvet® to the market. After careful examination of the patient in general and the lateral malar region, it is possible to treat the area by a modified crosshatching technique. There can be two fans with three or four limbs each. The entry points can be decided upon depending on the extent of the sagging as well as the accompanying fine wrinkling. Use 1ml of Uma Jeunesse Velvet® on each side. Inject small amounts intradermally in a linear threading pattern. Finish by a gentle external massage as well as bi-digital massage on the treated side. Repeat the same procedure on the other side. See the patient in 10 days.

Refreshing Lips With Uma Jeunesse Velvet® Many women experience an early loss of lip volume caused either as a result of lifestyle, illness or genetic predisposition. This may happen at any time after the mid twenties. Equally, many women, and men, see this happening later in life but do not wish to undergo a full lip augmentation. For these patients a light refreshing treatment to mildly augment volume is ideal. This treatment can be tailor-made to patient needs and can be applied seasonally e.g. at the start of the holiday season. In the past we have seen products emerge which are top heavy, come with promises they cannot keep and generally over priced both for the practitioner as well as the patient. I personally feel cheated when most of the fee I might have charged disappears in buying the expensive product. Having tried many of these “lip refreshers”, I became disillusioned. I started using Uma Jeunesse Velvet® and realised for the first time what a difference one can make to seasonally refresh a person’s lips without the terrible side effects or the expense.

stopping at the philtrum, and then the other. Inject only small amounts. Then inject the lower lip. Start at one angle of the mouth and go all the way to the other end. Again inject small amounts. The total injected amount should not exceed 1ml for both lips. Remembering that this is not a full augmentation but a refreshing treatment. This should be followed by a gentle massage. Discharge the patient and see them again in 10 days. Take any supplementary action if needed at that time. Usually the result is a refreshed and fine contour with a happy patient.

The treatment can commence with a nerve block anaesthesia or other depending upon personal preference. I was recently told that due to its unique properties most patients can be treated under topical analgesia. Start with the upper lip. Start injection at one angle of the mouth

Uma Jeunesse Velvet® has the ability to transform one’s practice if used correctly due to its unique features and modest price. It is a sure winner in every respect.


THE ART OF AESTHETICS Peter Archer explores the link between art and surgery

It could be said that cosmetic surgery is where science meets art. In some ways, plastic surgeons have become 21st-century portrait artists or sculptors working with real bodies. Clients arrive with a view of what they want to look like, perhaps seeking rejuvenation in a consumerist spirit of “you’re only young twice”. As surgeons work from photographs, sketches and markings on skin, there is a blurring of the distinction between portraiture and medical procedure. But to achieve perceived beauty, a surgeon has to be more than an accomplished technician. The surgeon has to know the answer to what is beauty? Of course, the concept of “beauty” is problematic and open to subjective judgments. What is considered beautiful may change with time and fashion, and there are also significant cultural differences. However, let’s focus on modern Western perceptions and observations by leading cosmetic surgeons, notably consultant Rajiv Grover, president of the British Association of Aesthetic Plastic Surgeons. The leading Harley Street practitioner recognises that the interaction of art and surgical aesthetics is essential to achieve a natural and pleasing result from cosmetic surgery. According to Mr Grover, pop artist Andy Warhol knew the importance of the central facial triangle, consisting of the two eyes and mouth, as a key feature of the face. “The central facial triangle is the first area to draw the gaze of an observer,” says Mr Grover, who has lectured at the Louvre in Paris, and London’s Royal College of Art and Central Saint Martins. Research conducted at New York’s Metropolitan Museum of Art, when a camera was used to identify where a person’s eyes look when they first see a face, showed people focus initially on the subject’s eyes, then down to the mouth and then back to the eyes, before looking around the outline of the face.“Even very young children look at faces this way, long before they have learnt about facial beauty or perception,” says Mr Grover. Warhol’s striking silk screen prints of Hollywood film stars Marilyn Monroe and Elizabeth Taylor, for example, emphasized the central facial triangle to great effect by creating prominence of the eyes and


lips.“Any feature which could distract from the central facial triangle, such as the nose, was minimised,” says Mr Grover. “This way he emphasised the youth and beauty of his subjects.” In the world of photographic art, the Vogue cover which was voted the most iconic of the 20th century was the January 1950 edition featuring Erwin Blumenfeld’s distillation of the female face down to just an eye and mouth, and yet we can still perceive the image as a face.“This illustrates the powerful impact which the features of the central facial triangle have on perception,” says Mr Grover. “Understanding this allows us to look at beauty in an analytical way. A face where the central facial triangle is emphasised may be perceived as more attractive.Wide bright eyes and proportionate lips, without features that could distract

A face where the central facial triangle is emphasised may be perceived as more attractive attention, such as a large nose, prominent nose-to mouth lines or jowls, mean that you can focus on the key features of the central triangle.” The face of a young Brigitte Bardot illustrates this well. The smooth junction between eyelid and cheek means the eyes are emphasised, as is the mouth. The shape of her mid-face and cheeks also acts as a pedestal to enhance the eyes. “The fact that her central facial triangle is so clear makes her very beautiful,” says Mr Grover. As we age, it can be loss of volume from the face, particularly over the cheeks, which changes angle, so important for youth and beauty. And, according to research by Mr Grover with the Qmed Institute, this occurs about seven

rather than the underlying soft tissues, resulted in surgery which caused pulling and flattening of the cheeks. Tension in the skin distorted facial appearance, including the ears which were often pulled forward. “Surgery has changed a lot in the last two or three decades and appreciation that the soft tissues also require support, rather than just pulling the skin, has led to the so-called ‘deep plane’ lifts where the underlying muscle of the face is pulled in addition to the skin,” says Mr Grover. “The true appreciation that cheek volume is the key to beauty and also to a natural, artistic rejuvenation has only reached prominence in recent years.”

The true appreciation that cheek volume is the key to beauty and also to a natural, artistic rejuvenation has only reached prominence in recent years years before there is evidence of gravity causing facial tissues drop.“Leonardo da Vinci talked about the shape being more important than features and wrinkles as signs of ageing nearly 500 years before its value was appreciated by science,” says Mr Grover. “As the face ages, the loss of midface volume detracts from the eyes and the presence of nose-to-mouth lines distracts from the mouth, as does the development of jowls. The appearance of the central facial triangle therefore seems to reverse.“Modern rejuvenation should address these changes in order to rejuvenate in a natural way and one that respects what is known from the work of the great artists.”

Understanding that the face ages first by volume loss and then by gravity, he concludes, means both these parameters must be addressed. Science has helped us understand the mechanism of ageing and that volume loss is the precursor of gravitational change,” says Mr Grover. “Focusing attention on adding volume to the cheek and mid-face enhances the perception of the central facial triangle, which creates a beautiful and youthful face.” Peter Archer is the Managing Editor of Raconteur Media. An author, specialist writer and editor, he was formerly on the staff of the Press Association national news agency and adviser to the American TV network NBC. CREDIT: First published in Cosmetic Procedures published by Raconteur Media on October 10, 2013 in The Times. To read the full report online visit

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Sujata Jolly on how to tackle vellus hair removal when light-based systems fail Unwanted hair is a major problem for many women and as such hair removal is one of the most popular treatments carried out in aesthetic clinics. There are various solutions to the vast majority of superfluous hair problems but fine, downy hair provides the biggest challenge. Following a course of laser or IPL treatments, clients are often left with vellus hair that cannot be treated effectively by either method. Clinics should look at alternatives to light-based systems so that they can offer a total solution for permanent hair reduction.

CAUSES OF UNWANTED HAIR Excessive hair on the face is a common problem for many people. Around 40% of women will suffer from it at some point. Causes can be: •

Genetic predisposition/ethnicity: people from Asian and Mediterranean backgrounds can be particularly susceptible

Hormonal: excessive hair growth due to hormones (androgen over-production) occurs most commonly with polycystic ovarian syndrome; often occurs at other times of significant hormonal changes such as during pregnancy or menopause

Side effect of medication: unwanted hair growth can be caused by many commonly prescribed medicines such as:

TYPES OF HUMAN HAIR There are three types of human hair. Lanugo hair is the type of hair that is found in new-born babies and is shed three to four months after birth. The two types of unwanted hair found in adults are terminal hair and vellus hair. Terminal hair tends to be coarse hair and has a typical lifecycle of three to 6 months; as a result of body hair shedding, terminal hair does not grow beyond a certain length. Scalp hair is also terminal, however its growth cycle behaves differently. Vellus hair is fine, short, lighter or translucent hair which has very little pigment. It develops during childhood and is found on most areas of the body. This lack of pigment or density of pigment makes removal using light-based methods difficult.

EFFECTS OF UNWANTED HAIR Unwanted facial hair can cause embarrassment and can lead to anxiety and depression. It can make women feel unfeminine, freakish, self-conscious and depressed. It can impact on confidence in professional and social situations. It can be detrimental to self-image and selfesteem, and can be socially isolating and distressing

-chemotherapy – causes excessive growth of vellus hair -glucocorticoids (steroids) – often used to treat allergies and asthma, and in patients who have auto-immune disorders -immunosuppressant drugs for organ transplants patients -Phenytoin – used to treat epilepsy -Diazoxide – used to treat hypoglycaemia or very high blood pressure -Minoxidil – oral version used to treat very high blood pressure -Danazol – used for conditions such as endometriosis -DHEA – anti-ageing supplements

WHY DOES LASER AND IPL FAIL FOR VELLUS HAIR? The problem with vellus hair is the lack of pigment or melanin in the hair. Both laser and IPL are light-based and therefore need a conduit for the light to travel – this is the pigment in the hair. If little or no pigment is present these systems cannot distinguish between the hair and skin. As a result, clients are left disappointed that full clearance of hair has not been achieved. Whilst it is known that blonde, white, grey and red hair cannot be successfully treated with light-based systems, it is also the case that even vellus dark hair is unlikely to respond. For example, a client with Fitzpatrick skin type IV - VI and dark vellus hair will usually find laser and IPL treatments unsuccessful on downy hair; this is because the systems will find it difficult to differentiate hair colour from skin tone. 25


After 14 Days

After 43 Days

WHAT’S THE ALTERNATIVE FOR VELLUS HAIR? When researching a new or complimentary hair removal system, clinics should look for a range that is able to effectively treat and clear fine, downy hair and has been specifically formulated to remove the so-called “peach-fuzz”. Typically, treatments for vellus hair will use a high pH formulation, however it is essential to understand the treatment logical protocol: Step 1: Application of high pH product to break down the protein structure and dissolve the hair deep within the follicle, below skin’s surface Step 2: The product must be removed and then neutralized to ensure that all product residue is removed Step 3: It is essential to restore the skin’s acid mantle to minimise any downtime and initiate the healing process

Step 4: Post-treatment application of hair reduction treatment cream. Client homecare is essential for long term results; this will involve using the same hair reduction treatment cream used by the practitioner. For vellus hair, the correct method of hair removal and specially formulated homecare can lead to long term hair reduction. As treatment progresses, re-growth becomes finer, slower and sparse. Gradually the time interval between treatments will increase with most clients eventually needing just two or three maintenance sessions a year. This type of treatment would enable a clinic to offer a complete hair removal solution to their clientele

Sujata Jolly, founder and medical director of UK-based Clinogen Laboratories, has 35 years experience in the healthcare and aesthetics industries. She is a key opinion leader and she is regularly quoted in both print and broadcast media for her expertise in dermatology. Sujata also plays an active role on the lecture circuit

giving a scientific perspective to her educational talks. Clinogen Laboratories is renowned for being on the cutting edge of R&D and specialises in medical aesthetic treatments using oxygen therapy for treating skin disorders, advanced hair removal, and wound healing and scar reduction.

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THE POWER OF PEPTIDES Introduction A new trend is gaining momentum - biologically active peptides are the focus of chemists, researchers and dermatologists from across the world these days. The peptides in fact are signalling molecules delivering a specific message to a cell and regulating a particular cellular function up or down. The theoretical possibilities are endless - we could “tell” fibroblasts to produce more collagen or “ask” the glabella muscle to contract less. It’s no surprise that there is a peptide boom in the industry. From a chemist’s point of view, the peptides are molecules consisting of one or a few amino acids interconnected by amid bonds. Interestingly, amino acids making the peptides are the same 20 amino acids that are responsible for recording our DNA code. On their own, the chains of amino acids are quite fragile, so they are often stabilised with some fatty acids, such as palmitic, resulting in peptides of palmitoyl group. As a result, a small protein linked to palmitate or acetate penetrate

into the skin and quite easily by-passes the lipid barrier, where it makes a pronounced direct effect on the skin structures, which varies depending on the amino acids combination used for molecule synthesis. Over time, the biotechnologists created and studied over a thousand peptide molecules but only about a hundred of those have proven to be effective and demonstrated an obvious biological effect in tests involving human skin cell cultures. Most of the peptides used for cosmetic purposes are relatively small in size (1 to 9 amino acids) and are water-soluble. They are often able to pass through stratum corneum - once in the derma, the lipid portion is cut by enzymes and peptide begins to act in accordance with its nature. The mechanism of action of the peptide is always about the same: the molecules bind to cell receptors or target proteins, that perceive them as a signal to launch certain changes in the cell. Such interaction is always based on a “lock and key” mechanism.

Meet the new heroes! A variety of peptides can be classified in a number of functional groups based on the mechanism of action and provided effect. SKIN REMODELLING PEPTIDES

Main effect: boosting of collagen and elastin production by fibroblasts This group of peptides is primarily responsible for stimulating synthesis of components of intra-cellular matrix by imitating the natural regulation mechanisms. They are mainly represented by synthetic analogues of molecules that are formed during the natural wound cleansing process before the wound actually starts to heal. The most famous is Matrixyl (Palmitoyl Pentapeptide 4) - one of the most potent stimulators of the synthesis of hyaluronic acid and structural proteins of the skin. STABILISING AND IMMUNOMODULATING PEPTIDES

Main effect: increase of skin’s protective and barrier properties Stabilising peptides generally strengthen the skin, with the changes affecting all layers, from the stratum corneum to the dermal matrix. One of the first peptides, which was used for this purpose, Cu-GHK, showed pronounced wound-healing properties together with vesselstrengthening and a soothing effect. Skinasensyl (Acetyl Tetrapeptide-15) is one of the recent additions to this family and provides a powerful stabilising effect. After using an emulsion with Skinasensyl for 3 days, the response to application of capsaicin decreases by more than 50%. In addition, the peptide has an analgesic effect that makes it ideal for formulations intended for post-injury skin regeneration. Immunomodulating peptides are made of fragments of antibodies and can strengthen a local resistance and immune response of the skin. The most famous of these are Rigin, Bodyfensine and to a certain degree Skinasensyl. REGULATORS OF MELANOGENESIS

Main effect: decreased synthesis of melanin, skin brightening effect These peptides, such as Melitane and Melanostatine, reduce the production of inflammatory mediators, block the activity of alpha-melanocyte stimulating hormone (α-MSG) and also block the receptors for this hormone in the melanocytes, resulting in rapidly decreased melanin synthesis and skin brightening effect. NEUROTRANSMITTING PEPTIDES

Main effect: reduce sensitivity of the skin to external factors Molecules of these peptides are able to influence the neuroceptors by stimulating cell release of encephalin - opioid neurotransmitters with analgesic activity. The skin becomes less sensitive to irritating environmental factors - thermal, mechanical and even chemical. Palmitoyl Proline and Magnesium Palmitoyl Glutamate which belong to this group are even called «happy skin peptides». 28


Main effect: muscle relaxation The most famous of peptides from this group is Argireline (Acetyl Hexapeptide 3,8). As a result of Argireline embedding into a SNARE complex, it loses functionality and does not release the neurotransmitter into the synaptic cleft, thereby the muscle signal does not reach the muscle and it remains in a relaxed state. Leuphasyl couples to enkephalin receptor and “turns down” nerve cell activity by modulating the release of acetylcholine. As opposed to Argireline and Leuphasil that work at the nerve cell level, Syn-Ake works at post-synaptic level directly in the muscle by blocking muscle receptors responsible for triggering the contraction. It can be easily predicted that the most pronounced effect can be achieved when the peptides with different mechanisms of neuromodulation work in synergy with each other. For example, the combination of Acetyl Hexapeptide 8 with Syn-Ake and Leuphasyl when used properly has an effect comparable with the effect of botulinum toxin injection. In order to obtain a global rejuvenation of the skin, making an impact on both, mimic (or dynamic) wrinkles caused by facial expressions and static wrinkles caused by reduction of the skin tissue elasticity, it is recommended to combine neuromodulating peptides with skin remodelling and stabilising peptides. MICROCIRCULATION PEPTIDES

Some peptides are able to remodel the connective part of the vascular wall, which helps to restore tone and vascular integrity. For example, a peptide called Eyeseryl (Acetyl Tetrapeptide-5) is effectively used in eye creams for correction of puffiness and dark circles under the eyes.

Secrets of the trade It is important to remember that peptides are very fragile and certain conditions must be met in order to achieve a desirable result: A peptide should be present in a working concentration. For most of the peptides it varies between 5% and 15% (e.g. 10% for Argireline, 5% for Leuphasil and Syn-Ake). As you can imagine, it’s hard to expect any miracles from 0.001% present in most of the retail moisturisers. The peptide concentrate should always be applied on the prepared skin. The dead cells should be thoroughly removed to ease the

penetration of the peptides into the skin and the surface of the skin should be made more alkaline, so that the peptides are not destroyed on the surface of the skin. Before applying a peptide concentrate it is a good idea to apply some gel containing antioxidants and flavonoids, plus a moisturising product for dry skin. Products containing acids and retinoids should be avoided as they destroy most of the peptides.

Conclusion Overall, the use of biopeptides as active ingredients in the formulations of skin care products is truly revolutionary. Peptidebased products open a new era of physiological cosmetology, with its main purpose of awakening skin’s own recovery and protection mechanism, by a method that is as close as possible to the natural system of cellular metabolism regulation. We can confidently say that peptide-based products not only can slow down the exterior processes of skin ageing, but also make the skin healthier, more protected and

much better looking than the traditional methods of cosmetic care. Moreover, the peptide-based products and professional treatments can significantly improve and facilitate the recovery period after any surgery, machine-based or invasive treatments, due to their amazing healing properties. In fact, the physiological cosmetology continues traditions of natural oriental medicine, jumping to a completely new level of efficiency based on bio-engineering and scientific validation of the results.

About author Dr Tiina Orasmae-Meder is one of the worlds acknowledged specialists in dermatology having more than twenty years experience in the professional beauty industry. Previously she managed a training division for the Swiss luxurious skincare brand CellCosmet, and has led new product development for many professional brands, Thalgo being one of them. Since 2007, she has also been working with one of the largest independent labs, Iris Brand Vigilance, as an expert in cosmetic safety advising the European Parliament. Being a Doctor of Medicine, Tiina has a passion for developing products that deliver results but without the price of increased risks for the client. In late 2009, Tiina launched her own brand Meder Beauty Science (Switzerland), specialising in professional non-invasive treatments for the correction of various aesthetic imperfections. Using the latest advances in peptides research and biotechnologies, the treatments have gained popularity in 22 countries all over the world and offer an effective solution to clients with contra-indications to injective methods and those averse to them. A retail range launch is planned for November 2013. 29


The right ingredients Annalouise Kenny on choosing different skincare ingredients for different skin conditions

Nowadays there are so many different skincare lines available with various ingredients; it becomes hard to decide what will best suit your clinic and your client’s needs. Bring it back to basics ingredients. Knowing your ingredients is knowing your products and how effective the product will be. With the skincare market expanding rapidly and more advanced ingredients coming out all the time it is hard to keep on top of the knowledge. In this article I have broken down a few basic key ingredients for different skin conditions. WHAT IS A COSMECEUTICAL PRODUCT? Carrier ingredients are the base ingredients in which active ingredients are ‘packaged’, a cosmeceutical product is a cosmetic product in which the active ingredient is meant to have a beneficial physiological effect due to an enhanced pharmacological action when compared with an inert cosmetic. However the difference between active and carrier components is often minimal or even nominal; for example, although Vitamin E acetate was originally used as a carrier, it is now known as an anti-oxidant making it active. Every cosmeceutical product is formulated to penetrate the skin and dermal components to different degrees, at several rates and through different pathways. Once it has entered the body, it is transported through normal mechanisms. ACTIVE INGREDIENTS AHAs exfoliate the skin, helping restore a radiant healthy glow. They soften the appearance of fine lines and wrinkles. It appears to improve hydration by enhanced moisture uptake. They dissolve the barrier function then “eat” the corneocytes. Anti-oxidants: Prevent free radical damage. Help to keep the DNA younger and we should consume as well as apply as many as possible. These molecules, together with the power of signalling peptides, help maintain collagen and elastin network in the skin. Vitamin A, C, E. Arbutin: Hydroquinone derivative, lightening agent for pigmentation. Azelaic acid: has demonstrated beneficial therapeutic effects in the treatment of acne and several disorders of hyperpigmentation. It has anti-inflammatory, antibacterial, and antikeratinizing activities. BHA: An exfoliant which is a lot stronger than AHAs, usually less irritating on the skin, as the penetration of the molecule is slower due to its size. Commonly used for problematic/ acne skin. 30

Benzyl peroxide (BPO) Highly antiseptic, target is infection, pustules acne. BPO reduces inflammatory lesions by introducing oxygen into the clogged pore where the anaerobic P. acnes bacteria harbour. BPO also helps reduce oil production, rid the follicle of excess dead skin cells and unclog pores. Enzyme: An enzyme is a protein that speeds up a chemical reaction. They are essential to sustain life because, without them, most chemical reactions in biological cells would occur too slowly. Enzymes accelerate desquamation, leaving skin smoother and more radiant looking. Growth Factors Growth Factors are proteins that regulate cellular growth and the activity of skin cells. As we age the rate at which our skin cells divide and renew slows. By utilising growth factors in skincare we can help reverse this type of deterioration caused by ageing by stimulating the cells to divide and multiply, producing vibrant new cells, as well as increasing the amount of collagen and elastin within the skin. Hydroquinone: Skin lightening agent. Unlicensed in Europe and Asia. Prescription

only. Hydroquinone acts by inhibiting tyrosinase and preventing the conversion of tyrosine to dopa. It is commonly used in the treatment of melasma and postinflammatory hyperpigmentation, the dyschromia of photo-ageing, lentigines, and freckles. It has long been the gold standard for treating hyperpigmentation. Concerns over its safety in recent years have led to its removal from cosmetic products in the EU, Japan, and the United States, but it is still used in Rx products. Kojic Acid: Natural skin lightening agent, derived from mushrooms. Helps to breakdown and dissolve excessive production of melanin in the skin. Other skin lightening agents include licorice, mulberry and bearberry. Kojic acid is a fungal derivative which inactivates tyrosinase. Niacinamide has been reported to improve the appearance and elasticity of ageing skin. Tested in a 4% cosmetic formulation, it showed efficacy relative to placebo in reducing periorbital wrinkles. Peptides: Chains of amino acids that are the building blocks of proteins in the skin. Messengers within the body, they send messages to let the cell know how to function. Peptides have the unique ability to target specific receptors and initiate a specific, intended action, making them effective for all skin problems. Popular peptides at the moment include: ►► Argirelene: Relaxes muscles of facial expression ►► Biopeptide CL: A messenger peptide for collagen renewal, In vitro collagen stimulation by 350%. ►► EYELISS: Improves firmness of skin and increases lymphatic circulation ►► SYN®AKE This peptide has shown in clinical trials its capability of reducing expression lines/wrinkles by inhibiting muscle contraction ►► Cytokines – Polypeptides produced by cells and certain organs to direct local and global cellular activities (i.e. daily repair, wound healing, fighting infection etc) Resorcinol: Often used in combination with Sulphur, resorcinol helps break down rough skin, making it useful for treating blackheads and whiteheads. But like sulphur, resorcinol also has a drying, irritating side and should also be used in moderation. Retinol: Works continually increasing new cell regrowth and rapid exfoliation. Pure vitamin A. Stimulates fibro blast cells.Proven to smooth and reduce wrinkles. Trans-retinol, also known as vitamin A1, is the predominant circulating retinoid in human tissue.

Rucinol, a resorcinol derivative, is the first substance shown to inhibit both tyrosinase and TRP-1 to help with pigmented skin. Salicylic acid Derived from the same substance used in aspirin, salicylic acid unclogs pores, increases cell turnover and neutralizes bacteria, all of which makes this over the counter active a popular and effective acne treatment. Oil-soluble and lipophilic, Salicylic penetrates sebum filled follicles and cleans out clogged pores, resulting in marked improvement in especially acne prone skin.

Others follow. Obagi leads. Others promise. Obagi delivers.

Stem Cells A stem cell is able to self-renew indefinitely â&#x20AC;&#x201C;this property is difficult to prove literally. A stem cell should be able to self-renew without changes in geonomic stability such as malignant transformation. Stem cells promote regeneration of organs and tissues. The anti-ageing effect is believed to occur due to the adiposederived stem cells producing anti-ageing antioxidants, growth factors and cytokines that work on epidermis cells and dermal fibroblasts. Stem cells are either plant derived or human derived stem cells, with plant derived stem cells being used mainly in professional serums, creams and skincare products. With the use of specific stem cells and growth factors applied topically can repair damaged skin by stimulating the cells to build new collagen and elastin; target pigmentation; protect the skin against environmental aggressors, such as UV damage and replenish and regenerate dying cells. Plant derived stem cells have shown to have an anti-wrinkle effect when wrinkle depth measured, protects against UV damage and oxidative stress. Vitamin A is the dominant vitamin of the skin because of its fundamental role in controlling normal activities of cells. Retinyl palmitate is the most useful version of vitamin A to protect skin because it is also photo-protective, whereas other versions are photosensitising. Vitamin A helps pigmentation problems by treating slight discolouration and evening skin tone. Vitamin A can be taken orally as well as applied topically in the form of a retinol cream or other retinoid. Vitamin C: including L-absorbic acid, magnesium ascorbyl phosphate (MAP) and tetrahexyldecyl ascorbate, regenerates vitamin E and other anti-oxidants, acts as an anti-inflammatory. Its most important role is its involvement in the production of the most abundant extracellular protein (i.e. collagen); adding vitamin C to a culture of skin cells (fibroblasts)dramatically increases the synthesis of collagen If the appropriate levels of Vitamin C can be delivered to the skin topically, where it continues to aid in the repair of UV radiation-induced skin damage and prevent oxidative damage caused by free radicals. It can also support wound healing by healing the synthesis of collagen. Vitamin C is effective in the treatment of the appearance of rosacea. Vitamin E is fat soluble and exists in four different forms, four tocopherols and four tocotrienols. Alpha tocopherol exhibits the most potent antioxidant activity of all vitamin E forms. When used in skincare it helps to resurface the skin, promotes new skin cells and boosts the production of collagen.

Proven clinical studies with positive long term results Well tolerated and popular with patients Efficacious in a wide group of patients with all skin types

Vitamin K: Aids in reducing darkened areas under eyes or spider vein reduction.

Annalouise Kenny is MD of Advance. Advance offers, Core of Knowledge, Level 4 Laser and Light based treatment certification, Advanced Skin courses, micro-needling and chemical peel training as well as business development and support to carry out those services.

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INJECTION LOADED We find out about a new fat dissolving product for intralipotherapy - Aqualyx® Fat reduction treatments are increasing in popularity in aesthetic clinics and while devices have corned the market in the UK, injection lipolysis has proven to be a successful alternative elsewhere around the Globe. However now a product has been approved and introduced into the UK marketplace to make this treatment modality more readily available here. Developed for the non-surgical reduction of subcutaneous adipose tissue, Aqualyx® is an injectable, gel-based aqueous solution, which dissolves fat and is biocompatible and biodegradable. The only product available for intralipotherapy with a registered medical CE mark, it is now available to doctors and surgeons in the UK, exclusively via Healthxchange Pharmacy. It works by causing the dissolution of fat cells and the body then expels the released fatty acids naturally. Aqualyx® is a compound solution containing plant cells from the deoxycholate family that has been physically modified creating a slow release sugar-based system by reducing the biological half-life and results in minimal side effects. Developed by renowned aesthetic surgeon Professor Motolese it has been available internationally for intralipotherapy since 2009, with over 2,000,000 patients having undergone the treatment in 49 countries worldwide.


conjunction with the treatment and provides an enhanced patient outcome as well as additional clinic revenue, however doctors are reporting good results without combining the treatment as well. before after Contraindications include pregnancy and lactation, liposdystrophy, pathological conditions and for those under 18 years or over 60 years. Aqualyx® was developed by Professor Pasquale Motolese, Vice President of the Italian Society of Aesthetic Surgery and Medicine. The product was presented at the Aesthetic Medical International Congress in Milan in 2004. The treatment is administered using long flexible and sharp cannulas and can only be performed by a doctor or surgeon. Professor Motolose developed a new injection technique, intralipoterapia, for the treatment and a precise protocol must be followed. Special cannulas, designed for the treatment must be used and should not be substituted and training must be completed before the product will be supplied.


Intralipotherapy using Aqualyx® consists of injecting the solution into localised deposits of adipose tissue in saddle bags, thoracic fold, stomach, upper arms, chin etc. Aqualyx® liquefies the fat cell, destroying it permanently and releasing the lipids that are then eliminated naturally through the lymphatic system. It can also be used to treat pseudo-gynocomastia in men and is an alternative to liposculpture treatments for patients who want a minimally invasive choice.

What is Aqualyx®used for?

Dr Tapan Patel is already using Aqualyx® in the UK. Dr Patel reports: “I have found Aqualyx® to be a very valuable addition to the range of treatments I can offer my clients for the removal of stubborn pockets of fat that are resistant to diet or exercise. It’s a minimally invasive option that patients tolerate well and I am impressed with the results that we’ve seen at the Viva Aesthetic Clinic.”

Who is the treatment suitable for?

Typically, two injection spots are required for each area being treated; patients report good tolerance of the treatment and Lidocaine can be added prior to injection for greater patient comfort. The treatment will be repeated between two and five times depending on the amount of adipose tissue to be reduced. The injections are repeated every three weeks; after each treatment patients can expect some swelling, redness and skin irritation and tenderness in the area treated, which will subside after four to six days. Compression garments should be worn but patients can continue with their normal activities throughout treatment, so there is no downtime for patients who have busy diaries. Lymphatic drainage massage is recommended for patients between treatments and ultrasound is recommended in 32


It is used for intralipotherapy treatment to reduce localised, stubborn fat deposits in areas including the chin, stomach, outer and inner thighs etc.

How quickly will patients see results?

A reduction in fat deposits can be seen after just one treatment, however between two and five sessions are required to see the optimal effect. The speed at which results are seen will vary depending on the stability of the cell membranes; younger patients are more likely to see results after a longer period. It is suitable for patients who do not want the more invasive liposuction or laser lipo treatments, who do not have large amounts of fat to remove and who are over 18 years and under 60 years of age. The treatment is not suitable for pregnant or lactating women or those with a pathological condition.

What are the side effects?

Minimal side effects have been reported globally since its introduction, but patients can expect a little skin irritation, bruising and oedema, which will ease after a few days.

How much should patients be charged for treatment?

Treatment prices are set by the doctor carrying out the treatment and will vary, however, a typical cost for a single treatment starts from £495 References • Rauso R. Non surgical reduction of buffalo hump deformity. Case report and letterature review.Eur J Aesth Med Dermatol 2011;1(1):29-34 • Salti G, Motolese P. Cavitational adipocytolysis with a new micro-gelatinous injectable for subcutaneous adipose tissue volume reduction: ex-vivo histological findings. Eur J Aesth Med Dermatol 2012;2(2):94-97 • Pinto H, Melamed G, Fioravanti L. Intralipotherapy Patient Satisfaction Evaluation Study (IPSES). Eur J Aesth Med Dermatol 2012;2(1):29-34

The most advanced non surgical fat reduction and body shaping system




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

Why i-LipoXcell ?

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

• No side effects

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

Book a demo today

For further enquiries call 0800 0378003 or email UK: +44 (0)1554 755444 • USA: 1-855-438-4547 • South Africa: +27(0)11 079 4242 Australia: 1800 827 817 • Brazil: +55 (11) 4702 4451 • Hong Kong (852) 3965-3175

Made in the UK

chromogenex Leaders in Laser Technology


ANOTHER DIMENSION TO BODY SHAPING We speak to Dr Martyn King about his experience using the 3D-Lipo system and how it has boosted the body shaping business in his clinic

While many clinics run a successful business model based purely on facial rejuvenation, many more are expanding their services to tap into one of the most rapidly expanding areas of aesthetic medicine - body shaping. Introducing body contouring into your practice often involves a significant investment by purchasing capital equipment and for many practitioners finding the right technology at the right cost is a challenge especially with the number of treatments and devices targeting this lucrative sector growing day by day. One system that has been cementing its place as a serious player in this market is 3D-Lipo. By combining three different technologies in one platform, 3D-Lipo offers a powerful new dimension in non-surgical fat removal, treatment of cellulite and skin tightening for both face and body. The system has applications for both cavitation and cryolipolysis to physically destroy the fat cells. Added to this, with the combination of radiofrequency and 3D-Dermology (vacuum skin rolling for targeted cellulite reduction), you are able to combine an effective skin tightening application for both face and body and also target cellulite. Dr Martyn King, medical director of Cosmedic Skin Clinic in Tamworth believes it is its multifaceted approach that offers a key economic advantage to practitioners. He says, “It appealed to us that 3D-Lipo offered a combination of technologies. We tried it out and the cavitation and RF seemed to be a lot better than some other devices we had seen and tried on the market. At the same time cryolipolysis was something we were interested in. There are stand alone machines for this but they work out a lot more expensive and the consumables are a lot more so having it all in one machine was the best option for us. Also if you buy several pieces of equipment it costs more and takes up more space.” Combining all these technologies in one also benefits Dr King’s patients as it allows him to tailor his treatment plans individually. He says, “Sometimes I start off with a bit of cryo and move onto cavitation and other times I use it more for skin tightening using radio-frequency. You have also got dermology, the vacuum part, and that is good for cellulite and post-treatment 34

to give extra lymphatic drainage in the area. You have got a whole combination of things there so you can tailor the treatments. When a patient books in for a course you can look at them and see what combination is going to give them the best result.” Since bringing the system into his clinic, Dr King has increased his body shaping offerings significantly and is seeing positive results. He says, “We have always offered treatments for the body but I have never been that confident in what we had. It was always a bit hit and miss, some people just didn’t seem to respond at all. If people are paying for these treatments and can’t see a difference and you can’t see a difference yourself then you are not going to sell it. With 3D-Lipo when we get clients in week on week we can see a difference and they can see a difference. We generally do courses of eight using a combination of the different technologies at different sessions. We tend to start them off with cryo and you don’t see the results with that for about six weeks so by the time they are getting to the end of their treatment plan they are starting to get the results from the initial cryo too. Because we are seeing results, we are marketing the treatment in the clinic more and our therapists who are selling it on the ground are more confident in promoting it. We are probably doing five times the amount of Before


body treatments we did before already.” The treatment is mainly designed for patients with excess, stubborn areas of fat and is also indicated for cellulite and skin tightening however Dr King has been working with 3D-Lipo on a new programme to treat larger patients by combining it with a new specially developed diet plan for a total approach to weight loss and body contouring. He has just finished a four-month in-clinic trial. He explains, “We are just signing off our four month data. In four months we have had an average weight loss of around 12.5%. We have had one client who has lost 21% of his body weight and his BMI is only slightly above normal now. The diet we put them on involves shakes, soup, a carefully balanced snack and then a proper meal from recipes that we give them. We monitor them in clinic. For the study I have done blood tests, urine tests and biometric monitoring and everything has improved. The programme also involves a weekly treatment with 3D-Lipo, mainly with cavitation, as we are treating bigger people and larger areas. Some of them have also had a bit of cryo in isolated areas where they have needed it.” Dr King will be presenting his findings at the BODY conference this month and will be writing a report on them for our January issue. Before


duction Fat Re ing

Skin Tighten


A Powerful Three Dimensional Alternative to Liposuction

No other system offers this advanced combination of technologies designed to target fat removal, cellulite and skin tightening without the need to exercise

Why choose 3D-lipo? Cavitation Cavitation is a natural phenomenon based on low frequency

• A complete approach to the problem • Prescriptive • Multi-functional • Inch loss • Contouring • Cellulite • Face and Body skin tightening • • No exercise required

ultrasound. The Ultrasound produces a strong wave of pressure to fat cell membranes. A fat cell membrane cannot withstand this pressure and therefore disintegrates into a liquid state. The result is natural, permanent fat loss.

Cryolipolysis Using the unique combination of electro and cryo therapy 20-40% of the fat cells in the treated area die in a natural way and dissolve over the course of several months.

Radio Frequency Skin Tightening Focus Fractional RF is the 3rd generation of RF technology. It utilises three or more pole/electrodes to deliver the RF energy under the skin. This energy is controlled and limited to the treatment area. Key

Complete start up and support package available from under £400 per month

as less energy is required, shorter treatment services and variable depths of penetration.

3D Dermology Combines pulsed variable vacuum and skin rolling for the effective treatment of cellulite.


What the experts say... ‘As a Clinician I need to know that the treatments we offer are safe, effective,



3D-Lipo has delivered this to us’ Dr Mohamed Dewji – GP & Medical Director LasaDerm Ltd (Milton Keynes)

For further information or a demonstration call: 01788 550 440


Inside out

We find out about Skinade, a new UK manufactured skin drink

What we put in our bodies has just as much effect on the skin as what we put on it and as such there is always the need for an internal and external approach to skin health. before after More and more aesthetic clients are looking to add an “inside out approach” to their daily skincare regimes and as such the ‘nutraceutical market’ has been gaining serious momentum. One way you can cash in on this trend and before after complement the results of the treatments you provide is to get your clients to drink Skinade, a uniquely formulated drink which uses advanced technology and high quality ingredients designed specifically to enhance the skin. This patent pending professional grade product delivers active ingredients such as hydrolysed marine collagen and essential micro-nutrients such as Vitamin C, Omega 3, MSM, Vitamin B complex and L-lysine, which work synergistically to create healthier, younger and better looking skin. The liquid formulation also promotes high absorption and bioavailability. Tablets are the traditional supplement solution, but in order to ingest all of the ingredients contained in Skinade, clients would need to take nine large tablets daily. Not only are these difficult to swallow, the body is only able to absorb 30% to 40% of nutrients in the form of a pill. Skinade offers a more palatable, convenient and digestible approach to supplementation. Naturally flavoured with peach and mangosteen, Skinade is a pleasant tasting and convenient addition to your clients’ daily skincare regime. It also contains only 35 calories, which come from the natural sugar of grape juice, so there’s no fear of glycation or the crystallisation of the collagen matrix that can damage the skin. Proven results from drinking Skinade daily include softer and more hydrated skin after four to six days, a more radiant and glowing complexion after ten to fourteen days, and plumper, firmer skin with fewer fine lines and wrinkles following from two to four weeks. Skinade has been designed as an everyday approach to skincare and with daily use results will continue to improve. Stocking Skinade will not only provide clients with the latest, newgeneration approach to skincare, it will also generate significant profits for salons. This profit is two-fold:

First, with only a conservative ten clients using Skinade regularly, an additional bankable profit to clinics of over £2,700 per year is generated. As with all professional products, personal recommendations are vital. That’s why Skinade is happy to provide product to clinic owners and their therapists so that they can experience the impressive results for themselves, at no cost. Secondly, clinic footfall is greatly increased by customers returning to buy their monthly Skinade supply. This gives staff more face time with their customers and provides the perfect opportunity to offer traditional treatments and packages or to disclose any new promotions on offer. 36

THE RIGHT INGREDIENTS Hydrolysed Marine Collagen Skinade uses only type 1 and type 3 hydrolysed marine collagen obtained from fresh water fish, which is low in sodium and removes the risk of contamination from both mercury and PCBs . This is the highest quality source available and is a very expensive ingredient. The hydrolysed marine collagen has a low molecular weight or Dalton number to facilitate high absorption, bioavailability and transport to where it is needed. Each bottle of Skinade contains 7000mg of Hydrolysed Marine Collagen for maximum efficacy and has an 80%-90% absorption rate compared to only 30-40%in tablet form. Vitamin C The vitamin C in Skinade is in the form of calcium ascorbate, which is gentle on the stomach. This is important, as a high dose (450% RDA) is needed to facilitate absorption of the collagen. MSM MSM is a naturally occurring form of organic sulphur found in all living organisms. It plays a key role in protein syntheseis and improves cell membrane elasticity and consequently increases the elasticity of the skin. B Vitamins Riboflavin (vitamin B2), niacin (vitamin B3) and biotin contribute to the maintenance of normal skin health. Vitamin B2 also contributes to the protection of cells from oxidative stress. Folic acid and vitamin B12 play a role in the process of cell division. B-Vits are needed for the metabolism of EFAs and production of anti-imflammatory compounds. B-Vits also promote a healthier, glowing and more radiant complexion Omega 3 and 6 Skinade is formulated with omegas exclusively from organic flax seed oil which provides one of the highest concentrations of Omega 3. This is an essential skin balancing agent that helps moisturise dry skin and balances oily, problem skin. L-lysine L-lysine is an essential amino acid and is key to rebuilding the collagen matrix in the dermis at the cellular level.

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THE SHAPE OF THINGS TO COME Mastering Body Treatments: The all new VelaShape III


orldwide, men and women are becoming increasingly aware of their body image. Body contouring and fat reduction have become buzz words and as demand for these treatments increases, so too do the options available for both invasive and non-invasive treatments. Patients often present with multiple body concerns, ranging from localised stubborn fatty deposits to skin laxity, cellulite, and unwanted ‘figure flaws’ such as saddlebags, muffin tops, bingo wings and bra roll fat. Liposuction has been the most commonly performed invasive solution to unwanted fat and body contouring, however it does not address the other issues patients present with, such as skin laxity, and carries significant cost and downtime to the patient as well as the usual risks accompanying any invasive surgical procedure. For these reasons and more, many patients wish to avoid surgical intervention and instead look to non-invasive body shaping and fat reduction treatments that are more affordable, and offer little or no downtime. VelaShape has already proved itself to be extremely successful at body contouring and treating cellulite, loose skin, and localised fat deposits. With over 35 million treatments world wide and more published studies than any other medical body shaping device globally, safety and efficacy have been proven. It is the only device on the market to combine four modalities (pulsed vacuum, bi-polar radio-frequency, infrared light and mechanical massage) for a total body shaping and contouring solution. The infrared focuses on the dermis providing immediate collagen contraction while stimulating fibroblast activity, with the radio-frequency going deeper and concentrating on the hypodermis through controlled thermal stress. The massage and vacuum offer lymphatic drainage and increased circulation by promoting neocollagenesis by imposing mechanical stress on dermal fibroblasts. This, combined with collagen contraction enriches and strengthens loose connective tissue. All of these combined work to produce significant and measurable improvements in cellulite, body shaping and skin laxity. VelaShape III is the third generation of body contouring device by Syneron Candela offering an increase in energy and refined clinical protocols that achieve consistent, reproducible results in fewer treatment sessions as well as a sleek new design. VelaShape III is CE marked for body contouring and FDA cleared for circumferential reduction of the abdomen and thighs. So what’s new? There’s an increase in radio frequency power of up to 150W, which means the end point is achieved much faster and this in turn reduces treatment time. Due to the higher energy density the tissue heating is improved and therefore fewer treatments are required to achieve an optimal result. There is the option to offer anything from a VelaShape Once treatment (one treatment to give a circumferential reduction) to a three or six treatment protocol, so the flexibility to fit in with the clinic business model and patient schedule is greater. The device itself is 60% smaller than the previous model and has been completely redesigned, allowing the operator to sit or stand during treatment and use the new foot pedal to reduce operator strain. Also featured in the new VelaShape III is a closed loop RF mechanism and inbuilt temperature sensor to allow consistent RF delivery and better


monitoring of tissue. This allows for a more comfortable and precise treatment for each patient. The new state of the art interface is user friendly and allows treatment parameters to be set quickly and easily. With three cover sizes, large, medium and small, you can now treat most body parts optimally and with greater versatility. The new Stacking Mode Clinical Protocol optimizes treatment of localised fat deposits giving a reduction of between 2-4cm in as few as three treatments. VelaShape III demonstrated a 2cm reduction in abdomen and over 1.5cm reduction of thighs , and post-partum patients showed an average measured reduction of 10% in the treated area with a 97% reported patient satisfaction. Already VelaShape III is making waves in the noninvasive body shaping industry, having won the 2013 Anti-Ageing and Beauty Trophy at AMEC in the category of ‘non-invasive body shaping technologies’. VelaShape is the most recognized non-invasive body shaping treatment globally and VelaShape III looks to revolutionize the market further.

Distinctive Technology - Optimal Balance TechnologyTM offers a variety of calibration and cross-linking levels around a fixed HA concentration of 20mg/ml for safety and longevity Long Lasting - 92.1% of participants remained improved at month 6 vs. baseline1 High Patient Satisfaction - Across the range, 92%* of patients would like to have Emervel again2 Proven - Clinical studies demonstrate great efficacy and patient comfort with Emervel1,2,3

Galderma (UK) Ltd, Meridien House, 69-71 Clarendon Road, Watford, Hertfordshire WD17 1DS Galderma Switchboard: 01923 208950 Email: For more information visit

EME/021/1013 Date of prep: October 2013

References 1. Rzany B et al, Dermatol Surg 2012;38: 1153â&#x20AC;&#x201C;1161 2. Cartier et al, J Drugs Dermatol. 2012; 11 (1)(Supp): s17-s26 (*Results taken from a mean value across all treatments performed in study) 3. Farhi D et al, J Drugs Dermatol 2013; 12: E88-E93



We find out about the latest system from Energist, the Portrait® NeoGen™ Nitrogen Plasma Technology for skin regeneration Non-invasive facial rejuvenation treatments are in high demand and nitrogen plasma energy has been heralded as ‘the most important advance’ in this field in recent times. Energist recently unveiled its latest system, the Portrait® NeoGen™. Which utilises this unique technology by delivering controlled pulses of nitrogen plasma energy.

Portrait® NeoGen™ is a completely different approach to restoring and regenerating the skin’s natural architecture. With the added benefit of enabling treatment of the upper and lower eyelids, NeoGen™ promotes the regeneration of new, healthy skin with continual aesthetic improvement. Energist is the only company to use plasma energy for this application with the Portrait® system, representing a dramatic leap forward in the science of skin regeneration. Clinical trials have proven that Portrait® stimulates a natural regenerative process of the skin; recovery time is minimal and there is little or no risk of complications associated with other more aggressive anti-ageing treatments. Plasma energy produces a unique thermal response at and below the skin’s surface. This stimulates significant remodelling of the skin’s architecture, replacing old damaged collagen with significant amounts of new collagen and replacing the damaged elastin tissue. This is key to long-lasting and simultaneous improvements to deep wrinkles, skin laxity, skin texture, acne scars, pore size and surface discoloration. It has been noted that Portrait® provides treatment outcomes similar to those seen with full CO2 resurfacing (considered the ‘gold standard’ amongst industry key opinion leaders), but with significantly reduced downtime. Clinical studies have produced long lasting results with neocollagenesis and reduction in elastosis continuing for


more than one year after treatment. Commenting on the launch, Energist CEO Jonathan Prutton commented, “Portrait® NeoGen™ is the most significant recent development in aesthetic technologies and will undoubtedly become the flagship in our equipment portfolio. Precisely controlled pulses of nitrogen plasma energy deliver unparalleled results as the entire skin architecture is regenerated and benefits from significant tightening, with long-lasting effects”. “Portrait® is ideal for those people who do not want more aggressive treatments but who want the same profound results. Anyone who has lost elasticity or has wrinkles around the eyes and lips can benefit from this treatment as it’s particularly effective in these areas of the face, promoting a more youthful appearance. Most skin types are appropriate for this procedure and this sets Portrait® apart, when compared to laser and other light-based systems”, he said. Portrait® has undergone extensive clinical trials in the US (with over 30,000 treatments performed globally to date) and has achieved endorsement from many major institutions. Eric Bernstein of the Main Line Centre for Laser Surgery, Ardmore, PA said, “With this technology you have the epidermis acting as a natural dressing. There is no better dressing for your skin than your own skin cells, because they produce all the right combinations of growth factors and have the right stimuli to create new skin underneath. To me this is absolutely unique – I have not seen this before with any of the other resurfacing technologies, either CO2 or Erbium”. Jonathan Prutton added, “Our research indicates consistent growth and demand for non-invasive cosmetic treatments and Energist is exceptionally well placed to meet the market needs for technology that delivers outstanding results. We are very excited about the prospects for Portrait® NeoGen™.”


Don’t miss your chance to attend the most prestigious event in the aesthetic calendar. Join us to celebrate our industry’s achievements at this glamorous event held at the luxury Grange Tower Bridge Hotel in the heart of central London.

• • • •







No Sweat

4T Medical to distribute 32G FMS Fine Micro Syringe

Alma Lasers has launched a new treatment to tackle excessive sweating and body odour. Until now there has been no way of selectively targeting and treating both the eccrine glands, located superficially in the skin and the cause of sweating, and the apocrine glands- the ones that cause the odour. SweatX™’s breakthrough dielectric technology selectively deactivates both the eccrine and apocrine sweat glands via focused heating of the relevant skin layer. Clinical studies present dramatic results with no pain, and in only a short twenty-minute treatment. Results are immediate and long lasting after only two to four sessions. Results last over nine months. For clinics Alma SweatX™ offers a targeted treatment for Hyperhidrosis and Osmidrosis with no disposables and a user-friendly interface. Short treatments that are easy to delegate offer a high return on investment for both the patients and the clinic.


Desirial® offers unique new indication for injectable HA Vivacy has launched a new cross-linked hyaluronic acid product to combat vaginal dryness. Desirial® is a revolutionary treatment that involves the injection of a cross-linked HA gel into the dermis of the labium. This helps rehydrate and “puff up” the area to maintain elasticity, firmness, and the proper functioning of female genital tissue. Desirial® is formulated with IPN technology, a patented process that combines Hyaluronic Acid with Mannitol, a natural antioxidant that is found in fruit and vegetables. Hyaluronic Acid behaves like a sponge and can improve water retention capabilities in the vulva-vaginal area. The addition of Mannitol, an antioxidant, protects against the breakdown of the gel from free radical damage and preserves the hydrating effect and longevity of the treatment. It also helps reduce any swelling that may occur from the injections. Desirial® is available in two formulations: Desirial® and Desirial® PLUS. Desirial® is designed for perimenopausal women or of reproductive age suffering from dehydration of the vulva with or without irritation. Desirial® PLUS is for peri-menopausal, menopausal, and women of reproductive age with signs of moderate to severe hypotrophy oratrophy of the vulva labia majora. 42

4T Medical is to be the exclusive UK and Ireland distributor for the 32G FMS Fine Micro Syringe. With its 32G ultra thin wall needle, the high quality fine micro syringe is proving to be a huge hit with aesthetic practitioners around the globe. To further increase patient comfort during elective treatments such as botulinum toxin injections, this 32G fine micro syringe is the ideal device. Ultra thin wall, neat cutting edge and micro polished surface ensures less pain, less haemorrhage and less injection marks.


mesoestetic presents home performance mesoestetic Pharma Group has launched a new home performance product range. The extensive range of cosmeceuticals for home use contains high concentrations of active substances and is produced according to rigorous safety and pharmaceutical control protocols. The home performance range contains 20 hygiene, facial care, sun protection and hair care products, that includes treatment products for all skin types (sensitive, dry, normal, combination, greasy, acne-prone) and for aesthetic disorders such as dark spots, acne and cuperosis.


Adare Aesthetics takes on Varioderm Adare Aesthetics have agreed to distribute Varioderm Hyaluronic Acid Dermal Fillers. Managing Director, Ivan Lawlor commented, “ We are delighted to be involved with Adoderm GmbH and their Varioderm HA Fillers. These fillers are of excellent quality, have significant long lasting results and are very easy to inject. We regard these fillers as one of the best on the market and believe they will be a great success in both the UK and Irish Market.” The Varioderm range includes Lips and Medium, Plus and Subdermal. Results have shown this filler to last up to 18 months due to it being highly cross linked.

Practitioners & their patients feel the difference... “The favourable safety profile has lead to high patient satisfaction and subsequent recommendations from one patient to another, increasing our practice1”

Not palpable2 ®

No Tyndall Effect1 ®

Comfortable on injection2 ®

1. Kuhne, U et al. Five-year retrospective review of safety, injected volumes, and longevity of the hyaluronic acid Belotero Basic for facial treatments in 317 patients. J Drugs Dermatol. 2012 Sep; 11(9):1032-5 2. Data on File: BEL-DOF2_001 Belotero Juvederm Study MRZ 90028_4007

Call Merz Aesthetics Customer Services now to find out more or place orders: Tel: +44(0) 333 200 4140 Fax: +44(0) 208 236 3526 Email: BEL068/0813/LD




John Castro on what to look for when hiring a web design agency

Being in sales and marketing since I can remember, I have always wondered what it is that makes one company choose another service provider over their competitor? When speaking to some clients recently I asked them this question and the answer I got, which surprised me, was “It’s very difficult actually as we are not marketers or even sales people, we are medical professionals. So we find it hard to know what to look for, especially in the website arena” On hearing that, the idea for this article struck me. The intention of this article is to provide you with the five tips you can use when hiring a website design agency for your cosmetic or aesthetic business. When you finish reading you will know what to ask, what to look out for and how to get the best out of your supplier.

TIP 1: Do they give value for money? Any website that is cheap will give you a cheap result; I truly believe that when it comes to web design. However, if an agency is asking you to invest thousands of pounds into your website it is important they communicate the value to your business for spending this amount of money. Do not be blown away by technical jargon. Simply ask them to supply you with a clear value proposition. You spend XYZ, so what is the amount of value you get for that XYZ? Another key thing to point out is to make sure you get some sort of agreement in writing. I have learnt this is imperative. We supply T&C’s to our clients just so all is clear for both parties. Make sure you get something like this so you REALLY do get your value for money. TIP 2: Make sure they understand what you want. When seeking a new website make sure you and the company you want to hire are on the same page. Have them guide you as much as you guide them. I think having them write out some bullet points clearly stating your objectives is a good way to see if they understand what it is you want.

TIP 3: Experience isn’t everything! When looking to hire a website agency sometimes their credentials are irrelevant. Is the company dedicated? Do they sound inspiring or ambitious? Are they eager for your business?


These kinds of characteristics are things to look for. The eager person is the one that understands client attention is priority. Regardless if they have designed one website, the ambition is what you want. There is no time to be laid back in this massive economic change and the regular updates in the web world today. I would always hire eagerness over experience.

TIP 4: Portfolio (extension to TIP 3) Just because a designer has less experience doesn’t mean that he or she can’t build a beautiful site for you. However, if their experience means they haven’t a portfolio then this can be a problem. Ideally you want to see some previous works and previous works in the aesthetic / cosmetic industry would be great. If this were something they cannot supply I would request a design example of what they think you need before any money is exchanged. When I started in this industry I had to do this several times. It shows commitment and dedication to get the work and will relate to my point in TIP 3, eagerness over experience any day.

TIP 5: Are they Mr Yes Sir? Nothing scares me more than a Mr KnowItAll. In the world of web it is important to know your stuff, but what makes web agencies most successful is being able to solve the problems of their clients. So I would suggest you don’t buy in to the agency that says YES to EVERYTHING! This can be a recipe for disaster as when it comes to a point when they cannot give you what they promised, short cuts are made and shorts cuts will only create further problems down the road. A true businessperson will admit what they cannot do and excel at what they can, plus they will seek other resources if needed. This is a good thing. Just because they can’t do it doesn’t mean they won’t. These five tips will help you hire the best agency for your aesthetic and cosmetic business. Use them, take them to your meetings with the agencies and base your questions around these tip’s. Go hire the agency for YOU!

John Castro is the founder and director of Website For Cosmetics, a specialist in Web Marketing to Cosmetic and Aesthetic Healthcare Professionals.

Join us for the 8TH-9TH MARCH 2014 UK’s Largest Aesthetic Meeting THE BUSINESS DESIGN CENTRE, LONDON SPONSORED BY

Continued professional growth and updating of skills is key to the development of any specialty, especially in one so dynamic and ever changing as aesthetic medicine. The Aesthetics Conference offers delegates a premium scientific programme with masterclasses and seminars given by some of the leading lights in aesthetics.


Gain CPD accredited education at exceptional value

Take part in workshops and live demonstrations

Learn from some of the industry’s leading figures

Register your interest NOW for special discounted delegate places when booking opens in mid-November

CALL 01268 754 897 OR VISIT WWW.ACE2014.CO.UK



Eddie Hooker is the managing director of Hamilton Fraser Insurance. Eddie and Hamilton Fraser first started to insure cosmetic practitioners as early as 1996 when they became involved with nurses practising in collagen injections. The company launched the UK’s first ‘aesthetic specific’ medical indemnity insurance policy in 1998 and now insures more than 3,500 individual practitioners and businesses within the sector, growing by over 100 new practitioners every month.

Eddie Hooker from Hamilton Fraser gives his tops tips for opening a successful clinic


hether you are a doctor, nurse or dental practitioner, the unique benefits of entering the cosmetic industry inspire many to try and reap the rewards with their own successful clinic. From learning a range of new, pioneering procedures to devising a unique and prosperous clinic, becoming a cosmetic practitioner can be an extremely rewarding process.

encompasses more than just your cosmetic expertise. It’s important to gauge a clear idea of how much money you have to work with, what services and treatments you’re going to offer and to establish what your financial objectives are. A detailed business plan that looks further than just 12 months ahead can be the difference between a failing start-up and a fledgling one.

With so much to consider when creating your own clinic however, many prospective cosmetic practitioners can feel daunted by the process that lies ahead and subsequently, reluctant to take on such a project.Yet while it’s important to conform to the relevant legal requirements and to adequately create a definitive business plan, the life cycle of a cosmetic practitioner is a lot smoother than you might think when broken down into manageable steps.

Also ensure you dedicate time to researching a clinic/ salon to carry out your procedures in. Look to consider some of the following: 1. Cost of the rental/purchase, utilities and business rates 2. Demand for cosmetic procedures within the area 3. Proximity of potential competitors

To help you gain the coherent knowledge needed to create a successful clinic, we’ve drawn on our 15 years’ worth of expert knowledge to share five key steps towards building a flourishing cosmetic clinic.

1. Find the right training course for you Whether you’re a registered doctor or a mobile nurse practitioner, all forms of cosmetic treatment require appropriate training. While invasive procedures naturally demand a more advanced level of prior expertise than non-invasive ones, the scope of training courses for a variety of different procedures is vast. Irrespective of which procedure you desire to learn, our Registered Training Course scheme can help ensure you receive training from industry leading professionals. You can search through our list of recognised training courses by either treatment type or location. 2. Safeguard yourself and your future business No matter what the size of your start-up or level of experience as a practitioner, seeking comprehensive and flexible protection against allegations of malpractice and negligence is vital.With the cost of medical malpractice claims becoming increasingly expensive, a failure to seek adequate protection can produce potentially devastating financial ramifications for your business. Covering practitioners against any potential damages you may become legally liable to pay arising out of any insured treatments or advice you give to patients, is vital. 3. Create a business plan and locate a clinic From VAT to business entity, developing a successful practice involves building a knowledge that 46

4. Prepare a marketing strategy Attracting new business and competing against your competitors is almost impossible without a tangible and effective marketing plan. Whether you’re advertising in relevant magazines or utilising an online presence, it’s important that you try to maximise your exposure to as many prospects as possible.

In particular, look to focus on building a strong digital presence for your business. Social media channels such as Facebook, Twitter and LinkedIn all offer the opportunity to actively engage with consumers, which can help give your marketing efforts the added edge.

5. Register with a professional body/association Registering with an industry association can help bring a wealth of benefits to your cosmetic practice. Professional bodies such as BCAM, BACD and BACN all provide impartial, independent and valuable advice on relevant treatments. Being registered with an association can also add another layer of credibility to your clinic, setting you apart from your competitors and demonstrating your commitment to upholding industry standards. With the right advice, guidance and appropriate planning, the journey from training course to clinic can be an extremely fulfilling experience. For more information, we’ve created this infographic detailing the ‘Life Cycle of a Cosmetic Practitioner’, that offers a more detailed look at the steps needed to reap the rewards of running a successful clinic.

The lifecycle of a Cosmetic Practitioner

1 2 3 4 5

Ensure you are a member of the GMC, GDC or NMC Find and complete a Recognised Training Course Take out medical Malpractice Insurance

6 7

Prepare a marketing plan


Register with an association, such as BCAM, BACD, BACN, IHAS etc

Take out Salon or Surgery Insurance

9 Create a business plan

Find a clinic to practice in

Update your clinic waiting room literature









4 4 500



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Sales talk

Dr Johanna Ward on retailing skincare in your practice

Dr Johanna Ward BA Hons MBBS DRCOG MRCGP Dip Clin Derm (distinction) Dr Johanna Ward is a GP with a special interest in dermatology, minor surgery and cosmetic medicine. She is passionate about clinical dermatology and raising dermatology standards in the aesthetics industry. Dr Ward is the Medical Director of The Skin Clinic Sevenoaks and its sister clinic The Skin Clinic Brentwood and also works as a clinical fellow in dermatology. She holds the prestigious Diploma in Clinical Dermatology from the University of London. Her area of special interest is the management of acne and acne scarring.

It is estimated that the British public spends over £2billion a year on beauty and anti-ageing products and that women alone spend £140,000 in their lifetime on products that maintain their looks. Skincare and beauty products have the power to make people feel good about themselves and can give an instant confidence boost but more and more discerning consumers are beginning to realise that over the counter, mass produced skincare products just don’t work. Increasingly people are turning to cosmetic clinics for aesthetic procedures that prevent ageing such as botox and fillers and those that are serious about their skin are beginning to understand that there is a whole lot more to anti-ageing skincare than what the high street has to offer. The British public has woken up to the difference between over the counter, mass produced anti-ageing products and those that actually deliver results. They are becoming more educated and savvy about what beauty products work and


want their skincare purchases to be informed and beneficial. There is a general sense of distrust nowadays in the cosmetic giants that for years have convinced us through pseudoscience that our skin will look ‘smoother’, ‘younger’

and ‘softer’ but in reality have never delivered. Despite their alluring packages and dreamy promises, over the counter cosmetics do not affect the inner structure or function of the skin so they just work in a temporary or superficial way. They may create the illusion of less lines or smoother skin but they certainly don’t help reverse the effects of time or have any long-term function. The public has realised that this is all just clever marketing that plays on our vulnerability and insecurity about getting old and that actually high street creams are little more than placebo. Cosmeceuticals however offer consumers a better option for their money. They are a new generation of products that represent a marriage between cosmetics and pharmaceutics and have a known biologic action on the skin. Cosmeceuticals are driven by science and results. They contain active ingredients that

penetrate deeper and have a measurable and quantifiable effect on the skin. Programs like Channel 4’s ‘How Not To Get Old’ have excited a renewed interest in anti-ageing procedures and skincare but with a more discerning and critical audience. People want results these days, not empty promises. The retail potential therefore for aesthetic clinics retailing cosmeceuticals is huge. Men and women alike are exploring the new market of cosmeceuticals and are starting to appreciate that skin care sold by medical clinics might be a far better investment that pricey creams from a department store. Skin care revenue can increase a clinic’s takings by up to 50% if brands and ranges are chosen wisely and sold well. And cosmeceuticals don’t have to be expensive. There are many ranges that are comparable to high street prices but that contain active ingredients that can have beneficial, long term effects on the skin. As doctors and nurses we are in a unique position in that we can stock and sell advanced skincare to our clients. We can sell products that actually reduce wrinkles rather than merely disguising them; products that can help manage common dermatological conditions such as acne and rosacea and products that can help reduce pigmentation and improve skin tone. But with this comes a responsibility and a duty of care. We have to be informed and educated. The world of cosmeceutical ingredients is a minefield for the average anti-ageing shopper and can be extremely confusing. We need to help guide our clients towards good, sensible and effective skincare that rejuvenates their skin and is driven by results. So what should you look for when choosing a brand or range of skincare for your clinic or practice? My advice would be to have a couple of ranges, some at the lower price end and some at the higher price end as each of your clients will have different needs and a different budget. Good active skincare and daily sun protection is where the most powerful antiageing process takes place. Investing in good skincare now will affect how your client’s skin will look in the next 10 to 20 years and beyond. A good cosmeceutical range needs to deliver on a number of levels. Firstly clients look for results. A good brand will have ranges that treat ageing skin, acne prone skin, rosacea/

Cosmeceutical skin care is tipped to become the next rapidly increasing market sector and as consumers take a greater interest in antiageing the shift from retail to clinical is inevitable. sensitive skin, have sun protection, eye creams and pigmentation treatments. Some will also offer an organic range, a men’s range, a pregnancy range and prescription only range for very targeted skin improvements. An antiageing range should ideally offer antioxidants, retinols/retinoic acid, AHA/BHA’s, hyaluronic acid etc to help resurface and stimulate the skin and improve the skin’s complexion. Likewise an effective acne range should offer salicylic acid, glycolics, benzoyl peroxide, aqua based hydrators and topical retinols for maintenance. With these active ingredients clients can and will see a difference. The sun protection industry alone is worth £260million in the UK. In the last 10 years awareness of the importance of daily SPF has grown enormously and this is something that medical skin clinics can tap into. The second most important factor is how the products feel and smell. Scent and texture are extremely important in skin care and should never be underestimated. Countless products sit on our bathroom shelves because we don’t like the smell or texture of them..964 million pounds worth to be exact. And studies have shown that up to three quarters of skin care products purchased are wasted or not used in their entirety. So the range that your clinic sells has to be nice to use and enticing. Results will only be seen if people actually use the products and monogamy to a brand will only occur if it delivers on all levels. From personal experience I have found that ranges that have sample pots for clients to try sell a lot better than ranges that don’t offer samples. People like to know what a cream smells like or feels like before they part with their money and samples are a great way of

encouraging clients to try new products that they might not have otherwise considered. Using active ingredients can however bring its own problems. Clinic staff need to be highly trained and need to spend time with clients explaining how to use the products and what to expect. Retinols for example can cause dryness, irritation and sensitivity, as can AHA and BHAs. If you don’t take the time to educate your clients about how active products work they might think they are having a reaction when in fact it is a normal/expected side effect that will subside with continued use. Another important thing to do is to educate your clients that results with active products are not achieved overnight but over a period of time. Positive impact will happen but it may take weeks rather than days. From a business point of view the best thing about having a robust and popular cosmeceutical range in your clinic is that it provides a second strand of income during quieter times and is an easy source of repeat revenue. If your clinic or practice hasn’t invested in a cosmeceutical range then you are missing out on potential income and a chance to really help your clients in their pursuit of skin health. Cosmeceutical skin care is tipped to become the next rapidly increasing market sector and as consumers take a greater interest in anti-ageing the shift from retail to clinical is inevitable. In the future medical skin clinics may pose a threat to the high street retailer with their mass produced skincare that does little to actually change the science of the skin. Be at the forefront of this change with a great cosmeceutical range and it is likely you will reap the rewards for many years to come. 49


Raising the bar Wendy Lewis on why you should upgrade your offering to service patients better

Wendy Lewis is the president of Wendy Lewis & Co Ltd, and Founder/ Editor in Chief of

Gone are the days when you could just open a clinic offering only BOTOX® treatments without giving any thought to ancillary services. For today’s cosmetic patients, it’s all about the total clinic experience. Surely patients know that they can get their BOTOX® anywhere, so why do they come to your clinic? Hopefully, it is because they are satisfied with the results of their treatment and also because they like the other services and products you have on offer. The evolving range of laser and light treatments and non-surgical services can now effectively address every conceivable aesthetic concern, including wrinkles, brown spots, redness, acne, tattoos, thread veins, unwanted body hair, cellulite and body shaping. Advanced technologies enable laser treatments to be used on all skin types and skin colours. One of the challenges facing aesthetic clinics is what cosmetic conditions to specialise in, and how best to address them. The best way to go about answering these questions is to get to know your patient population. Who are they? Where are they coming from? What is the most prevalent age group you are servicing? Are they mostly women or men too?


Since no clinic can be all things to all people, you have to narrow it down and focus on the most relevant target audience. Another sure fire way to find out where the voids are in your current service offering is to take note of what patients are asking for. For example, if you are finding that patients are inquiring about non-invasive body shaping and you have had to refer them to another doctor or clinic, it may be time to consider keeping them in-house and bringing in a medical device that addresses fat reduction. The risk of every time you refer a patient out is never seeing that patient again, even for treatments you do offer and have been performing for years. In the competitive landscape, the goal is to keep as many patients coming back for more treatments for as long as possible. Map out the conditions you can treat with the current technology and products in the clinic, and consider what is missing. For instance, if you are doing laser hair removal, but not treating browns and reds, it could be

the perfect addition to your menu of services. For a new clinic or one that is strapped for cash for capital equipment, look for multi-functional systems that cast the widest net. Everyone who comes into a cosmetic clinic for hair removal most likely has the odd brown spot or freckle to be removed, and thread veins or redness that could do with some attention. The most economical way to add new services is to build on the systems you already own by investing in an upgrade or new handpiece to expand the uses, or combine several treatments to address multiple patient concerns. Aside from reviewing the treatments your clinic features, the products for sale in the clinic are equally important. A well-designed retail vertical can be a very profitable way to create passive income for a cosmetic doctor; meaning a revenue source that does not require doctor face time. Therefore the doctor can attend a meeting in France, while the clinic is still bringing in money in his absence. It is a compelling concept. Compile a product offering that includes the most popular products of a few brands that are perennial best sellers. For example, a daytime moisturizer with SPF, night cream, eye cream, gentle cleanser, exfoliant, and anti-ageing serum. You do not need a squillion SKUs to build your skin care cente all at once, but you do need a selection that will address most patient’s needs. As you build up a loyal skin care clientele, you can branch out to add more products, such as body and hand creams, treatments, home care devices, post procedure healing, and peel kits. For good measure, you should plan to review your clinic offering at least annually to make sure you are keeping up with what patients want and what they are willing to pay for.

VTCT Level 4 Certification in Laser and Intense Light Treatments As laser and intense light source system advance in technology and applications, serious consideration must be given to the correct selection, installation, training and use of the equipment. At all times the safety of those using lasers/intense light systems and those receiving treatments must be ensured. All of our lectures have years of experience working within the beauty industry and working with advanced treatments, so we have the practical experience to back up the training. The Level 4 VTCT course is an intense course on the use of Laser and light treatments in hair removal and skin rejuvenation. The course will include case studies and carrying out assignments at home and in training.

BOOK NOW or for further information contact us at Advance or Telephone UK: +44 (0) 7885215025 IRE: +353 (0) 1662 9908

The Aesthetic Clinic Menu • Acne extraction • Body shaping • Cellulite reduction • Corrective cosmetics • Deep fillers • Fat grafting • IPL • Laser hair removal • Laser resurfacing • Medical grade skincare • Microdermabrasion • Neurotoxins • Peels • PRP • Sclerotherapy • Skin tightening • Superficial fillers



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