COSMETICNEWSapril2010pageturning

THE uk’S ONLY fREE Of CHARGE mEdICAL AESTHETICS TRAdE SHOW

THE VOICE OF YOUR INDUSTRY www.cosmeticnewsuk.com APRIL 2010

THE SHOW ISSUE EvErything you nEEd to know about THE EvEnt of thE aEsthEtics calEndar

A CLASS Topical retinoids

PASS IT ON How and when to refer

ALSO IN THIS ISSUE

POST-PREGNANCY SPECIAL The growing trend for ‘mummy makeovers’

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The on e stop a e sthetic s s ho p

EDITOR’S LETTER Welcome to the April issue of Cosmetic News. This month sees our inaugural event, the Cosmetic News Expo, taking place in London. The Expo is the first ever free of charge trade show for the aesthetics industry and we are really looking forward to welcoming everyone through the doors of the Business Design Centre on April 16 and 17.

We have received a lot of support from the industry for the event and I would just like to take this opportunity to thank all of our exhibitors and our Platinum Sponsor, Galderma, for their involvement in what I know will be a fantastic two days. I would also like to thank all of our speakers, particularly those who are flying in from across the globe to take part, including Dr Benjamin Ascher, Denise Byrnes and mineral make-up legend Susan Posnick. With speakers of this caliber and a jam-packed CPD accredited educational programme, the event is not to be missed. Our Show Preview on pages 19-27 will tell you everything you need to know about who is speaking, how to get there and how to book your tickets to make sure you don’t miss out. Also make sure you fill out our survey on pages 30-31 to help us put together some industry stats to release at the Expo Press Conference.

Also in this issue, we take a look at the growing trend for mummy makeovers and examine both surgical and non-surgical post pregnancy treatment options (p32-38). We also get some advice from respected American physician and author Dr Peter Pugliese on referrals (p51-52) and look at the role of topical vitamin A in skin health (p40-42).

I hope you enjoy this issue and look forward to seeing you at the Cosmetic News Expo 2010 at the Business Design Centre, London on April 16 and 17.

£200 off all orders placed at Cosmetic News Expo! · · · · · · ·

Book appointments and manage rooms Patient database with clinical notes Billing and stock control Send letters, emails and texts Appointment reminders by text or email Store digital photos Marketing and financial reporting

Call 01274 530505 for your free demo CD or email sara@e-clinic.uk.com

EDITOR’S CHOICE

CONTENTS 6

NEWS We round up the latest people, product and industry news

14 REGULATION We bring you the latest on the Shared Regulation scheme

16 ON THE SCENE Out and about in the industry this month

CACI ULTIMATE Your skin is as specific to you as your thumbprint so it makes sense that the ‘one size fits all’ approach won’t yield the best results. As such CACI has launched the CACI Ultimate, a results-driven anti-ageing facial treatment that can be tailored to each individual. I went to CACI’s flagship clinic, C2 in Hampstead to try it out...

The CACI Ultimate is an hour and a half long treatment that combines

19 COSMETIC NEWS EXPO Find out what will be going on at this month’s event

32 POST-PREGNANCY SPECIAL We look at the growing trend for mummy makeovers

40 VIEW ON: RETINOIDS

four different technologies, so you definitely feel like you are getting a lot for your money. My treatment starts with Orbital Microdermabrasion with LED light therapy. The crystal free method of microdermabrasion uses an abrasive disposable, treatment head tailored to the client’s skin type. LED light therapy stimulates the production of collagen and elastin – the blue light is anti-bacterial, soothing and calming and the red light stimulates collagen production and tissue healing. This combination is extremely beneficial when treating conditions such as blemishes, acne, sun damage, stretch marks and scarring.

Denise Byrnes on the role of topical vitamin A in skin health The second phase of the facial was the Wrinkle Comb phase with LED light

45 COSMETIC DENTISTRY

therapy. The Wrinkle Comb delivers high frequency electrical stimulation with LED light therapy. These two systems have a remarkable synergy to

Dr Michael Norton on the role of dental implants in improving

plump out and soften fine lines, wrinkles and blemishes. This part of the

facial aesthetics

facial was fairly uncomfortable, not unlike a laser treatment, but bearable.

The third stage of the treatment was the CACI Non-Surgical Face-Lift,

51 BEST PRACTICE Dr Peter Pugliese on referrals

microcurrent technology for the face. Microcurrent toning targets all areas of the face, using electrical impulses with unique electro buds filled with Instant Firming Serum to stimulate and re-educate the muscles to help them re-connect and communicate with the brain.

54 BUSINESS FOCUS: INSURANCE

The treatment ended with the Hydratone facial with microcurrent

Eddie Hooker answers the most commonly asked questions

rollers over the CACI gel mask pumped full of rose water, hylauronic

about who to insure in your practice

acid and collagen. The hydrating rejuvenation mask cools and refreshes with intense hydration to calm and balance the skin.

56 TRAINING SPOTLIGHT

Immediately after treatment my skin looked refreshed and felt really soft. Over the next couple of days

Behind the scenes at the Epionce® users meeting with Dr Carl

I noticed a continuous improvement

Thornfeldt

and my skin looked really plumped up. Best of all my friends told me my

56 DATES FOR THE DIARY

skin was looking really good, which is what every girl loves to hear!

Training course, conference and meeting dates

Charlotte Body Publisher 01268 754 897 charlotte@creativemedialtd.co.uk

58

Vicky Eldridge Editor 01268 754 897 M: 07931 924 322 vicky@creativemedialtd.co.uk Emilia Bronze Associate Publisher 01268 754 897 emilia@creativemedialtd.co.uk Peter Johnson, Art Director 01268 754 897 peter.johnson@creativemedialtd.co.uk Charlie Crocker Designer 01268 754 897 design@creativemedialtd.co.uk

register for tickets online at www.cosmeticnewsuk.com

PLATINUM SPONSOR

Hollie-Jane Dunwell Account Manager 01268 754 897 hollie.jane@creativemedialtd.co.uk Shauna Peters Production Assistant 01268 754 897 shauna.peters@creativemedialtd.co.uk

DISCLAIMER The editor and the publishers do not necessarily agree with the views expressed by contributors 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.

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See results of Juvéderm® ULTRA SMILE at our Before and After gallery www.juvedermultra.co.uk If you need more advice ask a qualified and trained healthcare professional. Juvéderm® ULTRA SMILE is a medical injectable device distributed by Allergan Ltd.

0459

Jan 2010 UK/0892/2009

News | Round Up

NEWS IN BRIEF

FDA APPROVAL FOR RESTYLANE® WITH LIDOCAINE

mag INTRODUCES NEw Ha FIllER: RENNOVa®

Restylane® and Restylane® Perlane with lidocaine have been given approval by the US Food and Drug Administration (FDA).

Restylane®-L is approved for implantation into the mid to deep dermis and Perlane-L is approved for implantation into the deep dermis to superficial subcutis, both for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds.

In clinical studies supporting approval, the addition of lidocaine to Restylane® and Perlane substantially reduced pain experienced by patients, while demonstrating adverse event safety profiles similar to those of the original Restylane® and Perlane products.

The safety, tolerability and pain reduction of Restylane®-L and Perlane -L, compared to Restylane® and Perlane, respectively, in the treatment of moderate to severe nasolabial folds (NLF) were evaluated in separate prospective randomised, double-blind, controlled clinical studies involving 120 total patients (60 patients each). Subjects were followed for up to 14 days after injection. In the separate Restylane®-L and Perlane-L studies, subjects were injected with Restylane® -L or Perlane-L in one NLF and Restylane® or Perlane in the other NLF, respectively. Using a validated visual analog scale (VAS) composed of a straight line representing a continuum from no pain to worst pain, subjects evaluated injection site pain for each side of the face.

At the time of injection, 71.7% of patients in the Restylane®-L study and 95% of patients in the Perlane-L study had a within-patient difference in VAS of at least 10mm favoring Restylane®-L and Perlane-L. A within-patient difference in pain of at least 10mm on the VAS was defined as meaningful. For all products in the Restylane® collection, at least 95% of subjects rated the appearance of their NLFs as improved, much improved or very much improved at the end of both studies.

LEADING US DERM REPORTS POSITIVE DATA ON ARTEFILL® Leading US dermatologist Dr Christopher B Zachary has presented 18-month interim results from a prospective, open-label, five-year safety and patient satisfaction study on Artefill® for nasolabial fold (NLF) correction.

The 23-center, prospective, open-label study consists of 1,008 patients who had no recent history of nasolabial fold correction. Patients received an initial treatment with Artefill®, and up to two touch-ups after 30 and 60 days, until full correction was achieved. Potential adverse events and satisfaction data are reported by all patients at 2, 6, 12, 18, 24, 36, 48 and 60 months to assess the presence of or absence of adverse events, patient satisfaction, and any changes in health. Potential subject-reported AEs were followed up on and changes thought to be granulomas were biopsied and confirmed or ruled out by histology. All study patients will complete a final in-office visit at 60-months.

Dr Zachary, who is professor and chair of the Department of Dermatology, University of California, Irvine, commented, “The safety data presented at the Hawaii Dermatology Seminar should give aesthetic physicians some long awaited encouragement to view Artefill on its merits as a safe and long-lasting dermal filler. My own experience with Artefill® as both a clinical investigator in the open-label, long-term safety study, and as a commercial user has been very positive.”Artefill® is the first and only FDA-approved microsphere-enhanced dermal filler for the correction of nasolabial folds. Since Artefill® was approved in 2006, over 20,000 patients have been treated successfully with very high satisfaction rates.

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cosmeticnewsuk.com

medical aesthetic group has introduced Rennova®, an advanced hyaluronic acid filler. manufactured by CROma, austria, who have produced more than 15,000,00 Ha filler syringes in the past 10 years, Rennova® has an excellent safety profile. Rennova® harnesses XPm technology which submits the gel to processes that make the tridimensional molecular structure of the product more even, stabilised and elastic, with new definite molecular ‘bridges’.

These are important characteristics for providing a greater lifting effect, greater duration and greater aesthetic result (up to six to nine months). Rennova® has been trialled for the last three months by Dr Elisabeth Dancey who has been delighted with the performance and ease of use. Dr Dancey is now undertaking a study over the next 12 months. She says “These days we should be looking at volume replacement rather than simply filling lines. Rennova® satisfies the requirement of a good volume filler; longevity, ease of administration, good incorporation into the tissues and good client tolerance.”

FIRST FRaCTIONal laSER FDa ClEaRED FOR STRIaE Palomar medical Technologies’ lux1540™ Fractional non-ablative laser handpiece has received the first clearance by the United States Food and Drug administration (FDa) for the treatment of striae (stretch marks) using a fractional laser. This new clearance will allow aesthetic practitioners to treat the millions of women worldwide who have unwanted stretch marks. Ongoing clinical studies have shown that subjects treated with the lux1540 achieved an average improvement of between 51% and 75% in the appearance of their striae, based upon a blinded review of photographs comparing the pre-treatment appearance of striae versus the results three months post-treatment.

bREakTHROUgH IN FEmalE HaIR lOSS TREaTmENT molecular dermatology research and development innovator HairDX announced the results of a six month pilot study that presents, for the first time, evidence that genetic mechanisms may predict treatment response to Finasteride for postmenopausal female androgenetic alopecia (female hair loss). “while Finasteride therapy in men has proven very effective in treating androgenetic alopecia (male pattern baldness), there have been frustratingly few therapies for the treatment of hair loss in women. Results of our pilot study are very encouraging, as it appears we have found a key piece of the genetic puzzle which identifies women who can benefit from Finasteride therapy in the same way men do. Our findings suggest these women actually have a female corollary to male pattern hair loss (androgenetic alopecia), and that is an important finding,” says Dr. Sharon keene, Chief medical Officer of HairDX. “Once these results are confirmed, it can usher in a new era of treatment for female androgenetic alopecia.”

US CONSUmERS TakE ‘DYSPORT® CHallENgE’ medicis aesthetics, the US distributor of Dysport® has launched a new direct to consumer campaign in the States in a bid to win market share from botox® makers allergan. Potential customers are being asked to sign up on www.dysportusa.com in order to participate in the ‘Dysport® Challenge’, which runs for two months and started at the beginning of march. The promotion is currently only being run in the US where promoting prescription medicines direct to consumer is not illegal. Patients can sign up to the challenge 14 days after their first Dysport® treatment and get a $75 rebate cheque. They will then be invited back three months later to say what they thought of the treatment in order to potentially get another voucher worth $75 off their second treatment. The company hopes that existing botox® users will switch to Dysport® in order to get a discount.

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

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

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

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

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

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

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

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

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

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News | Round Up

NEWS IN BRIEF

BAAPS ANGER AT ENDORSEMENT CLAIMS

COUlD aN IPHONE aPPlICaTION TREaT aCNE?

The British Association of Aesthetic Plastic Surgeons (BAAPS) has issued a statement saying that, despite recent claims by some websites, it does not have any links or endorsements with commercial entities.

Recently, there has been a spate of media articles claiming that commercial enterprises are either ‘approved’ or ‘regulated’ by BAAPS however the association says that it is not a regulatory body and does not and cannot endorse any of these companies.

According to Mr. Nigel Mercer, consultant plastic surgeon and President of the BAAPS, “BAAPS would like to make it clear that we do not approve or endorse any websites or commercial entities that advertise cosmetic surgery or products, and we take these types of claims very seriously. It is an abuse of our good reputation for commercial gain. The BAAPS provides an entirely independent resource for members of the public wishing to find out more about aesthetic plastic surgery, and we always stress patient safety in surgery.”

FAMOUS DERMATOLOGIST DIES AGED 93 Dermatologist Albert M Kligman, whose research led to discoveries including the acne and wrinkle drug Retin-A, has died at the age of 93. Dr Kligman died of a heart ailment at Pennsylvania Hospital in Philadelphia. He is credited as being the first dermatologist to show a link between sun exposure and wrinkles and coined the term ‘photoageing’ to describe skin ageing caused by the sun.

In 1967, he patented Retin-A, a vitamin A derivative known generically as tretinoin, as an acne treatment and received a new patent in 1986 after discovering the drug’s wrinkle-fighting ability.

Kligman’s pioneering work was often overshadowed by his role in an experimental research program at Holmesburg Prison in Philadelphia from 1951 to 1974. Kligman directed and performed hundreds of experiments on prisoners including the testing of mind-altering agents, dioxin and ‘skin-hardeners’ to protect skin from the effects of toxic chemicals. At the time, prison experiments were common and prisoners were paid for participating, however the practice was banned in 1974, amid congressional hearings into medical experimentation.

In 2000, soon after a book on the Holmesburg experiments was published, nearly 300 former prisoners sued Dr Kligman, the University of Pennsylvania, Johnson & Johnson and Dow Chemical, alleging that the experiments caused debilitating health problems. Courts ruled that the statute of limitations had expired.

Dr Kligman never wavered in his defense of the experiments, insisting that the test subjects did not suffer any long-term harm and maintaining that the research should not have been halted because of the scientific advances it might have yielded. Dr Kligman wrote more than 500 research papers and many books during his career, which continued into his later years. Before he died he wrote to Foreward to Advanced Professional Skincare, a new book that we have published an extract from on pages 51-52.

SkINMEDICA® INTRODUCES THE ABLATIVE POST PROCEDURE kIT SkinMedica® has launched the Ablative Post Procedure Kit. The leading skincare range, developed by Dr Richard Fitzpatrick, is currently ranked as one of the top three cosmeceutical lines sold to physicians in the US. Specifically formulated to support skin and optimise results following cosmetic procedures such as laser resurfacing and chemical peels, the Ablative Post Procedure Kit harnesses the unique benefits of NouriCel-MD™, which was discovered through research into wound healing and contains an optimal blend of natural growth factors and other compounds. The kit includes a Sensitive Skin Cleanser, nonpetroleum based Restorative Ointment, TNS Ceramide Treatment Cream and Environmental Defense Sunscreen SPF30+ for optimum skin health during this sensitive time.

The range protects compromised skin and accelerates recovery, helps support skin through the healing process, helps support the barrier function of the skin and reduces the number of acne breakouts typically associated with other post-procedure products.

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Texas dermatologist Dr greg Pearson has launched The acneapp, an iPhone application that claims to use red and blue light to fight blemishes and improve skin health. Users of the application allegedly choose either red light, which is said to have anti-inflammatory properties or blue light to fight bacteria and then hold the iPhone against their skins’ acne-prone areas for two minutes each day. Treatments alternating red and blue light have been shown to eliminate an acne-causing bacteria and reduce skin blemishes up to 76 % of the time however Dr David Pariser, president of the american academy of Dermatologists, said he doubted that this particular application could do the trick as, in order for the treatment to be effective, the skin should be exposed to blue light for about 16 minutes and red light for six to eight minutes per session.

CYNOSURE SUCCESSFUllY SETTlES IN PaTENT lawSUIT agaINST COOlTOUCH Cynosure has announced a settlement of its patent infringement lawsuit against CoolTouch. Cynosure and its largest shareholder, El.En. S.p.a, alleged that CoolTouch’s 1320nm Coollipo™ laser system infringed on El.En.’s US Patent No. 6,206,873 (the 873 patent) licensed to Cynosure, which covers laser technology to remove subcutaneous fat. Under the terms of the settlement, CoolTouch will make payments representing a 9% royalty on sales of Coollipo made prior to the agreement and a portion of Cynosure’s legal expenses. CoolTouch also has agreed to pay a royalty rate of 10% of future net sales for any licensed product sold strictly for lipolysis, and 7.5% of future net sales for any licensed product sold for lipolysis and at least one other aesthetic procedure.

a NEw DImENSION TO DENTISTRY Patients can now gain a fuller experience of their dental care by donning a pair of 3D glasses during treatment. The new lava chairside oral scanner (C.O.S.) from global dental company 3m ESPE, captures highly detailed images of the teeth, replacing traditional putty impression taking which is uncomfortable and less accurate. Following a quick but detailed scan with a wand-sized oral scanner, the patient can view 360 degree images of their teeth on a touch screen monitor next to the dental chair wearing 3D glasses. london based, award-winning dentist, Ilan Preiss, said that patients scanned during his lava COS love to see their teeth in 3D, and are walking away with ‘more beautiful smiles’ as a result of its accuracy.

wEIgHT lOSS SURgERY CaN lEaD TO PSYCHOlOgICal DISTRESS SaYS RESEaRCH People who have gastric band surgery to lose weight are at risk of low self-esteem, relationship problems and being dissatisfied with their body image, according to new research. Researchers from the University of the west of England and Southmead Hospital, bristol, followed 25 patients, aged from 30 to 58 years, and recorded their experience 12 months after receiving a postlaparoscopic gastric banding operation. 64% of the participants had Type 2 diabetes. although the people who took part in the study reported significant health benefits such as improved blood glucose levels and lower cholesterol and blood pressure levels, they also found that living with the gastric band had a strong, negative psychological impact on their daily lives. The majority reported that having a gastric band was as hard as having to diet and that losing the opportunity to eat as a coping strategy left them struggling to deal with distressing life events.

Once again – a sharp innovation Introducing our latest innovation – a Thin Wall Needle developed exclusively for Restylane®.

The new Thin Wall Needle is specially designed to meet your demands for high performance. A thinner needle improves flow rates for Restylane and lowers extrusion force during injection. What's more the ultra sharp bevel means less trauma at the injection site which minimises marking and bruising. The treatment experience is improved and satisfaction is increased for practitioner and patient alike. � Easier treatment � Improved treatment results � Increased patient satisfaction

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News | Round Up

APRIL16th &17th 2010 - THE uk’S onLy fREE Of CHARGE mEdICAL AESTHETICS tRAde SHoW

RAINFOREST TREE BARk COULD HELP kEEP SkIN MOISTURISED An extract from the bark of the rainforest tree Angicobranco can help maintain the water balance in human skin, according to recent research.

The tree (Piptadenia colubrina) is native to the South American rainforest and the study, published in the Journal

of Cosmetic Dermatology, claims that an extract from the plant’s bark can help moisturise the skin.

Scientists from Brazil-based active ingredients company Chemyunion along with researchers from the University of Campinas, and the Sao Paulo State University in Brazil, tested the effect of the extract on genes involved in the formation and functioning of the stratum corneum, along with performing

in vivo tests. According to the study, the extract upregulated the expression of aquaporin-3 (AQP-3) at a concentration of between 10-20 mg/ml, with the highest levels expressed after six hours. The researchers conclude that the extract ‘might be considered as an effective additive to skincare products formulation’.

SCULPTRA COMES OUT ON TOP The results of a study published in the Journal of American Academy of Dermatology showed that treatment with Sculptra® Aesthetic (injectable poly-L-lactic acid) was significantly more effective than a human-derived collagen treatment CosmoPlast® in correcting shallow to deep nasolabial fold (NLF) wrinkle. In addition, this study demonstrated that the effect in correcting the NLF wrinkles with Sculptra® Aesthetic can last for up to 25 months.

A total of 233 patients of ages ranging from 26 to 73 years were randomised to receive injections of either Sculptra® Aesthetic (n=116) or CosmoPlast®(n=117) into the left and right nasolabial folds at three-week intervals for up to a maximum of four treatments and followed for 13 months after the final treatment. Treatment with Sculptra® Aesthetic resulted in significantly (P<0.001) higher scores than CosmoPlast® on the Wrinkle Assessment Scale at week three, and months three, six, nine and 13 during the follow up phase of the study. The Sculptra® Aesthetic patients were followed for an additional 12 months. Sculptra® Aesthetic treatment effects were maintained up to 25 months after the last treatment session, while the human derived collagen was effective up to three months.

The majority of adverse events in both groups were mild or moderate in intensity; these included injection site reactions such as bleeding, tenderness or pain/discomfort, redness, bruising, itching or swelling. During the initial 13 month follow up, product-related application site nodules occurred in 8.6% of patients treated with Sculptra® Aesthetic and 9.4% of those patients receiving CosmoPlast®, papules occurred in 8.6% of patients in the Sculptra® Aesthetic group versus 3.4% of patients treated with CosmoPlast®. In addition, after 25 months papules and nodules were reported in Sculptra Aesthetic treatment group in 1.9% and 0.9% of patients, respectively. Papules and nodules were typically palpable, asymptomatic and non-visible. The majority of nodule and papule events were mild to moderate and most resolved without treatment. Overall, a higher incidence of adverse events was recorded among patients in the collagen group (63.2%) compared with patients treated with Sculptra® Aesthetic (53.4%).

NOUVEAU CONTOUR GETS FRESH Nouveau Contour is offering salons and clinics the opportunity to purchase its freshMinerals ‘Starter Kit’ at a special price of £39.99 so they can familiarise themselves with the versatility of using this new mineral make-up. The starter kit includes: two shades of freshMinerals SPF 20 loose powder foundation; one freshMinerals Bronzing Powder SPF 20; one freshMinerals Finish Powder (acts to gently matt down any shine on the skin and set the foundation); two freshMinerals Shimmering Eyeshadow Dust (that can also be applied wet as an eyeliner); three freshMinerals brushes (face brush, concealer brush and powder brush).

The products are 100% certified Vegan, inorganic and ‘Cruelty Free’.

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cosmeticnewsuk.com

NEWS IN BRIEF TObaCCO PlaNT COUlD PROVIDE aNTI-wRINklE SOlUTIONS a sugar-peptide mix from wild tobacco plants could be an effective anti-ageing ingredient for cosmetics, according to scientists in Italy. The mix of short peptides, amino acids and sugars has antioxidant properties as well as promoting collagen synthesis and stability, and upregulating the expression of a number of genes, the study claims. The effects of the sugar-peptide mix were tested in vitro on cultured human keratinocytes (HaCaT) and mammalian fibroblasts (NIH-3T3).

HURlINgHam ClINIC aND SPa gOES INTO lIqUIDaTION The Hurlingham Clinic and Spa has gone into liquidation. michael Healy of leonard Curtis has been appointed as the liquidator of the london cosmetic clinic and spa business and property and asset consultants Edward Symmons has been instructed to sell the contents via a private treaty sale. Edward Symmons is looking for purchasers for a range of business assets from liposuction and cardiac monitor machines to laser treatment equipment and sundry items such as the luxury treatment couches.

SOlTa mEDICal TO aCqUIRE aESTHERa CORPORaTION Solta medical has entered into a definitive agreement to acquire privately-held aesthera Corporation. Solta will acquire aesthera for $5.25 million in Solta common stock and cash, with potential additional base line milestones of $750,000 for a consideration of $6.0 million. Excluding acquisition and integration related charges, the transaction is expected to be accretive to Solta medical’s earnings within 12 months. aesthera’s light-based treatment systems - the Isolaz™ and Isolaz Pro ™ platforms – are based on proprietary Photopneumatic™ technology and are the only laser or light based devices with FDa marketing clearance for the treatment of inflammatory acne, comedonal acne, pustular acne, and mild-to-moderate inflammatory acne.

FDa ClEaRaNCE FOR EmaTRIX Syneron medical has received expanded clearance from the FDa for the ematrix Sublative Rejuvenation system for the treatment of fine lines and facial wrinkles. according to Syneron medical, the ematrix is the world’s first RF-only technology for fractional ablation, producing a dermal impact with minimal epidermal disruption. The ematrix also offers the industry’s first intelligent feedback system allowing physicians to precisely measure energy and impedance for consistent and reproducible treatment delivery.

INTRODUCINg SPaSHaPE© medixsysteme has introduced Spashape©, a system which combines Scanning Diodes 635mn laser therapy with Second generation of High Focalised Ultrasounds (Dynamic HFU). based on seven years experience in body contouring innovation, the technology is covered by an international patent. Spashape© is a non-invasive treatment designed to target fat cells on the stomach, hips and legs and drain the fluids and the waste immediately after in the lymphatic system. adding the cold laser enhance the results with its proven bio stimulation action. There are also specific programs for men and women, adapting the treatment to the body zone and patient gender and allowing you to tailor treatment to your patients.

Results You Can RelY on “The ultimate in combination laser and light therapy for face, hands and body to optimize results.”

InnovatIve technology Safe, effective treatments with the industry’s most dynamic product portfolio, distinguished by expandable modular platforms that adapt to your changing needs and future breakthroughs.

Before

Before

After

Mini 360 Protocol for the face and neck Photos courtesy: James Chan, MD

After

Before

AFT 570 SR

Photos courtesy: Fernando Stengel, MD

After

Pixel Laser

Photos courtesy: Amber Brown, MD

Multiple technologies can be combined during a single session or repeated frequently and spread out over 60 days.

• When performed in a single treatment session, the Mini Laser360TM program consists of AFT for pigment and vascularity, ST for skin tightening, and Pixel for fractionated skin resurfacing.

• The Traditional Laser360 treatment consists of 4-6 treatment sessions, layering multiple technologies (AFT, ST and Pixel), spaced about 10-15 days apart over a 60-day period.

Pixel ST

Before

AFT

After

Before

AFT 420 Acne

Photos courtesy: Elizabeth VanderVeer, MD

Before AFT 540 VP

After

Photos courtesy: Elizabeth VanderVeer, MD

After

Pixel Laser

Photos courtesy: Bhupendra Patel, MD

Before

After

Tattoo Removal - Photos Courtesy: Fernando

Urdiales, Instituto Médico Miramar, Málaga , Spain

ContaCt us on: tel: 0845 1707788, info@a-b-c-uk.com, www.abclasers.co.uk

Before

After

Traditional Laser360

Photos courtesy: Rick Jackson, MD

WINNER - UK BEST LASER SUPPLIER 2008-2009 As voted by clinics

News | Round Up

CHEAPER INSURANCE FOR BAAPS A new policy backed by one of the most highly-recognised international medical malpractice underwriters and a top global brokerage firm, has been exclusively designed for members of the British Association of Aesthetic Plastic Surgeons, based on their proven track record, low complication rates and comprehensive audits.

The groundbreaking insurance, by Premium Medical Protection is individually tailored to each BAAPS surgeon based on their own claims

Facial injection maniKin

SEE US AT Our extremely realistic injection manikin are an essential aid for any clinic, college or training course • Practice/ Demonstrate needle techniques • Perfect for reassuring delegates & customers STAND 000 • Use on refresher courses • Use along side live models • Hand painted and very realistic in look and feel • Uses include: anti-injectables - Dermal fillers- Electrolysis, laser and many more

experience, and has already resulted in extraordinary savings (in some cases upwards of a third). Traditionally, surgeons pay roughly £40,000 or more yearly to organisations such as the Medical Defence Union or the

SEE US AT

Medical Protection Society, which offer cover to surgeons and doctors in all areas of medicine. Consultant plastic surgeons and BAAPS president Nigel Mercer, “This is fantastic news for our members, who no longer have to

STAND 30

cross-subsidise other surgeons who may be less qualified and who are unscrupulous. We have been concerned for years that fully trained surgeons are paying through our medical malpractice insurance premiums for the mistakes of cosmetic ‘hacks’ who come to this country or enter the market just to make money.” Gary Monaghan, director at PMP added, “At PMP we understand the sense of injustice medical professionals feel when they are

facial injection manikin

unnecessarily paying up to a third of their income for indemnity insurance. The detailed records kept by the BAAPS and their low revision rates make them an ideal low-risk client for us. All medical professionals are not the same and our policy offers all the safety nets of defending, protecting and rewarding

tel: +44 (0) 845 307 61 91 | Fax: +44 (0) 845 307 61 92

email: info@zancomodels.co.uk | Web: www.zancomodels.co.uk

good medical practice.” The individualised PMP policy is based on the BAAPS surgeon’s practice profile and details such as their claims record. Excess is not mandatory and cover continues after retirement, without time limit.

GENERAL & MEDICAL jOINS FORCES WITH REVELATION HEALTHCARE General & Medical has acquired Revelation Healthcare, the Coventry based provider of Healthcare Trust services.

The deal is an important step forward for General & Medical as it significantly expands their customer base and penetration of the Healthcare Trust market.

Revelation has been brought in-house and is handled by General &

“This is an exciting acquisition for General & Medical which

consistently exceeding targeted growth each year. Today, General &

gives us a firm foothold in the Healthcare Trust market”, said the

Medical has become a significant provider of Private Medical Insurance,

company’s md David Wildman. “Revelation Healthcare has built

Cash Plans and Healthcare Trusts, broadening the UK market to

an enviable reputation. Their experience in providing efficient trust

encompass corporate clients, associations and affinity groups. They are

management is an excellent strategic fit with our own product

the preferred provider of the Association of Surgeons of Great Britain and

range, customer base and customer service support.”

Ireland and are regularly advised on advances in Healthcare by their own

A major advantage is that all hospital contract management for

Medical Advisory Panel.for a radiant complexion the natural way.

Medical. This wider customer base and increased negotiating power will deliver improved medical cost containment for both Trusts and the insured business.

General & Medical has continued to evolve at an impressive pace,

MEDIk8® INTRODUCES THE SUPERFACIAL™ PEEL

12

The Medik8® Superfacial™ professional peel harnesses a specially chosen blend of eight active ingredients selected for their potent yet simultaneous gentle mechanisms. As with all Medik8® ‘green cosmecutical’ products the Superfacial™ peel is particularly recommended to treat hypersensitive skin and can be used on the face, neck, décolleté or any other parts of the body requiring treatment. Unlike traditional

The Superfacial™professional peel is effectively able to treat a

chemical peels that induce skin peeling in order to reveal new and

non-acidic form of exfoliation helps to maintain the skins pH balance

unblemished skin, the Superfacial™ Peel contains Papain; a naturally

making it an ideal alternative to more aggressive exfoliation treatments.

derived enzyme that ‘digests’ superficial dead skin cells that lead

The peel stimulates new collagen synthesis and cell proliferation,

to a dull complexion. This enzymatic action ensures that skin is left

improves the skin’s tone and elasticity, helps to alleviate skin dryness and

radiant, with no peeling and minimal erythema and downtime.

decreases facial erythema for a radiant complexion the natural way.

cosmeticnewsuk.com

number of skin conditions including; melasma, acne Grades I-IV, post-inflammatory hyperpigmentation, photoageing, ephelis, fine lines and wrinkles, solar lentigines, enlarged pores, superficial acne scarring, superficial scarring, post-acne hyperpigmentation.

Suitable for all skin types especially sensitive, the Superfacial™ professional peel can be repeated, without limit, every week. The very gentle,

Simple is the new smooth Our new Hyaluronic Acid is available in One, Two, Three easy-to-choose and use formulations for different facial areas, from smoothing fine to deep wrinkles to increasing lip volume.

So now you can refresh the way your patients look quite simply with Succeev® One, Two and Three – the new smooth.

In partnership with Sculptra® it can successfully widen your Medical Aesthetic opportunity.

For more information email gfd-succeev@sanofi-aventis.com or contact your sanofi-aventis Medical Aesthetics Account Manager.

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sanofi-aventis. One Onslow Street, Guildford, Surrey GU1 4YS. Date of preparation: March 2010. GB.HYA.09.12.08

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Regulation | IHAS

WORD ON THE STREET

The industry shows its support for the IHAS on the Shared Regulation Scheme

In February it was announced that the provision of injectable cosmetic treatments, including dermal fillers and botulinum toxin, was to be controlled for the first time with the imminent launch of new rules in the form of a Government backed registration scheme.

This registration, certification and inspection scheme has been developed by the injectable cosmetics industry with the encouragement of Ministers to safeguard patients from treatments carried about by unqualified rogue practitioners. The Independent Healthcare Advisory Services (IHAS), led by Sally Taber, will be running the industry-led shared regulation scheme.

There are currently an estimated 5,000 facilities carrying out an estimated 200,000 treatments a year in the UK. As treatments are elective, until now, providers of injectable cosmetic treatments have fallen outside the scope of watchdogs at the Care Quality Commission (CQC).

The Department of Health has given a one-off contribution of £200,000 to support the development of the IHAS Quality Assurance Mark.

Shared regulators, the General Dental Council (GDC), General Medical Council (GMC) and Nursing and Midwifery Council (NMC) jointly support any appropriate measures to enhance protection of patients and the public which complement their standards and guidance for healthcare professionals.

The IHAS Quality Assurance Scheme will include the registration of organisations where practitioners are providing treatment, as well as registering sole practitioners working in facilities where injectable cosmetic treatments are provided.

The IHAS Quality Assurance Scheme will only register practitioners who are registered adult nurses, doctors or dentists over the next few months. The Scheme will include a dedicated website and will see the launch of an IHAS Quality Assurance Mark logo. The website will list organisations and practitioners that have been accepted for registration and certification, signposting patients to providers who are offering high standard care.

Organisations and practitioners will be able to apply for registration through the website, with self-assessment documents and supporting evidence submissions required. Applications for certification and registration will be reviewed by a team of experts, who will also run inspections by conducting site visits randomly selected, with only 24 hours’ prior notice to providers.

The scheme will be administered by CHKS on behalf of IHAS. All providers will be charged a registration scheme fee, with all funds generated being reinvested into the running of the scheme. The IHAS Quality Assurance Scheme will require practitioners and organisations to seek re-certification every year to ensure standards are maintained.

Industry leaders such as The Harley Medical Group which has 27 clinics, Transform which has 24 clinics and Sk:n. which has 34 clinics, have already indicated their commitment to registering their clinics once the scheme goes live in the next month.

A heavyweight public awareness campaign will be carried out to call on consumers to seek out the IHAS Quality Assurance Mark when undergoing injectable cosmetic treatments. It will also give guidance to consumers on the sort of information, care and standards they should expect when undergoing treatments.

The scheme is being supported by leaders in the industry. Here is what a few of them had to say…

14

cosmeticnewsuk.com

Sally taber, director of the IHAS will be heading up the Shared Regulation scheme

Jason Harries, managing director of CHKS

“CHKS are delighted to have been selected to work with IHAS on this new venture to give the public Janet Kettels, head of confidence that their treatment provider has met the communications at Allergan, necessary standards.” makers of Botox® and Juvederm® “We applaud the IHAS for setting up the Quality Mark which will give consumers extra confidence when seeking injectable treatments.

At Allergan, we have strict processes to control supply of our products to appropriately qualified aesthetic healthcare practitioners (doctors, dentists, registered adult nurses) and to carefully selected pharmacy groups. We are also big supporters of practitioner training which we believe leads to excellence in compliance Dr Mike Comins, and outcomes.”

Chairman of the British Association of Cosmetic Doctors

“As a cosmetic doctor and chairman of the BACD I welcome plans to regulate the industry.

The BACD has launched the first post graduate diploma of cosmetic medicine through the University of Leicester and this along with Shared Regulation will help bring peace of mind to the people having cosmetic treatments and will support ongoing education and James Backhouse, training for doctors.” general manager of Q-Med UK Ltd, the manufacturer of Restylane®

“Q-Med places high priority on patient welfare and clinical excellence by continued investment in clinical trials and aesthetic practitioner training to ensure that Restylane® meets the highest safety standards at all times. Therefore Q-Med welcomes the IHAS shared regulation scheme as it will encourage treatment providers to follow best practice and patient safety will be improved.”

Kevin Lewis, dental director of Dental Protection

“We welcome the launch of the new IHAS shared regulation scheme. Not all dentists are currently involved in dento-facial aesthetics and cosmetics, but we are strongly encouraging those who are to participate in the IHAS Quality Mark scheme, which allows their patients see that they are committed to the same high levels of quality assurance in this aspect of their clinical practice, as in the rest of their professional work.”

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ON THE SCENE

left to The Finishing Touches team fom Jones, right: Gemma Hutchings, Sam Emma Dawn Forshaw, Melanie Clarke, Piggott.

OUT AND ABOUT IN THE INDUSTRY THIS MONTH

r Cosmetic News account manage ie from Ritch hen Step with well Dun Hollie Aesthetic Consulting (UK)

MYFACEMYBODY SHOW ON LOCATION Filming got underway for the TV debut of the MyFaceMyBody Show last month.

Presented by Stephen Handisides, the brains behind consumer information website MyFaceMyBody.com, the 30-minute chat show is dedicated to busting the myths surrounding cosmetic surgery, non-surgical procedures and cosmetic dentistry.

Each episode of the fast-paced and informative programme will give viewers the lowdown on the latest treatments and procedures to hit the UK market, alongside entertaining ‘myth busting’ missions and revealing vox pops. Cosmetic News editor Vicky Eldridge will also be presenting a slot on the latest innovations from the aesthetics industry. The first episode of the show aired on March 23 on InformationTV, Sky Channel 166 and Freesat 404. The episode will be repeated on Thursdays at 3pm and Sundays at 6.30pm as well as being re-shown every Tuesday at 7.30pm with a new episode every month. It will also be available to watch on demand on MyFaceMyBody.com.

owarth Yvonne Butt and Rachel Burkhill-H from JMSR Europe

al Cosmeceuticals’ brand education aging Man and s Cas on Shar r age man director Tracy Parkin

PROFESSIONAL BEAUTY, ExCEL, LONDON INAUGURATION OF Q-MED ACADEMY, PARIS Members of the press and representatives from Q-Med from across Europe came to Paris for the launch of the Q-Med Academy.

Located in the heart of the city, at 49, Rue de Lisbonne, the Academy will become a centre for training and excellence for aesthetic practitioners allowing them to gather knowledge and information on the most advanced and updated techniques and indications within facial aesthetic and body procedures. The international meeting place will allow speakers from all over the world to meet and exchange knowledge as well as playing host to international master classes, state-of-theart meetings, roundtables and expert meetings. For the full report see next month’s Cosmetic News.

16

cosmeticnewsuk.com

took The annual Professional Beauty show The th. mon last l ExCe on’s Lond place at of event was supported by a number stry indu s hetic aest key players from the nal, natio Inter I CAC rs, Lase ABC including on, Cosmeceutcials, Dermapure, Envir Laser Lipo, Finishing Touches, Indiba, JMSR, ms and Syste n ivisio Med n, Lynto Lumenis, SkinBrands.

time for your

surgery insurance check up…

Surgery Insurance ✓ Premises & stock ✓ Public liability ✓ Computer / inspection cover Professional Liability Insurance for Aesthetic Treatments ✓ Botulinum Toxin ✓ Dermal Fillers ✓ Laser and Lights CALL ToDAy to speak to one of our experts and find out how much you could be saving!

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Hamilton Fraser Insurance Kingmaker House, Station Rd, New Barnet, Herts, EN5 1NZ. Hamilton Fraser Insurance is a trading name of HFIS plc. HFIS plc are authorised & regulated by the FSA.

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

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business | Home

with confidence Face the future

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

with confidence

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

ong duration of action (up to 5 months)1

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

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

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

2

New...

6 months, following one treatment session)

... aesthetic choice New...

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

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

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

Treatment interval should not be more frequent following injection).

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

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

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

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

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

Reporting andPtosis, Eyelid Lambert Syndrome or Amyotrophic lateral sclerosis.

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

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

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

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

Ascher B et al.

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

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

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

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

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

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

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

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

... aesthetic choice

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

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

Tel: +44 (0) 1923 208950

Platinum sPonsors of

The first ever Cosmetic News Expo will take place in London this month. Over the next few pages we tell you everything you need

to know about the UK’s first free of charge trade show and educational meeting for the aesthetics industry.

WHAT’S IT ALL ABOUT? On April 16 and 17, Body Media will be opening the doors to the inaugural Cosmetic News Expo. Taking place at the Business Design Centre in Islington, London, the Cosmetic News Expo 2010 gives you the opportunity to network, exchange information with your peers and find out about the latest technologies and products on the market.

Bringing together more aesthetic practitioners under one roof than any other event in the UK, the Cosmetic News Expo is the only free of charge trade show and educational meeting specifically designed for the aesthetics market. The philosophy behind the event comes from Body Media’s extensive experience in running shows for other niche markets.

We believe that education should be available to everyone, no matter what their budget, so we have designed an event that allows you to gather knowledge about the latest treatments and developments at the same time as attending hands on workshops and lectures, for free. Educational workshops will be held throughout the two-day event with industry leading practitioners, manufacturers and suppliers educating you on how to improve your business and get the most out of your clinic by offering the best treatments and products.

Whether you are a cosmetic doctor, aesthetic nurse, dermatologist, plastic surgeon, cosmetic dentist, aesthetician or practice manager there is something for you at the Cosmetic News Expo 2010. The event is designed for industry professionals only and is not open to the public.

Delegates/visitors will be asked to register in advance so they can be given appropriately colored badges to show what their profession is. Workshops and lectures featuring prescription only medicines will only be available to medical practitioners.

DROP-IN BUSINESS CLINIC unique to the cosmetic news Expo, our drop-in business clinic is a fantastic opportunity for you to get expert advice on any aspect of running your business. run by the team from the consulting room™ with help from experts from across the industry, the drop-in clinic will offer you invaluable one-on-one advice for free. whether you want to find out about how to promote your business through marketing or Pr, are confused about insurance or need legal advice, our experts will be on hand to answer your questions. the team will also be providing free website reviews.

For more information or to book an appointment in advance to make sure you don’t miss out contact our events team on 01268 754 897.

cosmeticnewsuk.com

19

Cosmetic News Expo

Luton

Stanstead

No Left Turn

Jury’s Inn Heathrow

ExHIBITORS LIST AALBS ABC Lasers Aestheticare Aesthetic Recruitment ARC Recruitment BACN Bioderm Bio Touch Permanent Make-up Boston Medical Group Ltd Coolsense Cosmetic Courses

HOW TO GET THERE

located outside the congestion charge zone. the

situated in islington, one of london’s most vibrant

venue benefits from on-site car parking, an adjacent

areas, the business design centre is located within

hilton hotel, and has full access for those with

two miles of both the city and the west End, and

disabilities.

is ideally situated for both transport and local

islington offers something for everyone and rivals

entertainment.

the west End for entertainment, shopping, food and

within walking distance of angel tube station and

drink. there are more than 500 bars, restaurants and

only minutes from kings cross and Euston, the bdc is

cafes in the area, as well as local theatres and many

serviced by numerous bus routes and is conveniently

places of interest.

THE ExHIBITION

out live demonstrations and presentations as part

bringing together the industry’s key manufactures

of the workshop programme. Pharmaceutical giant

and suppliers, the cosmetic news Expo is a must visit

galderma, the distributor of new botulinum toxin on

for those new to the industry, who are trying to source

the block, azzalure®, is our Platinum sponsor and more

suppliers, and busy practitioners who want to be able

than 50 other specialist companies from within the

to see all their reps under one roof. our exhibitors

industry will be taking part in the event. our exhibitors

are also dedicated to offering continued education

range from distributors of dermal fillers, botulinum toxins,

and training to professionals working within this

skincare, chemical peels and lasers and iPl to industry

exciting and expanding sector and will be carrying

associations and business solutions companies.

Candela Cel Fusion Cutera (Europe) Consulting Room Cynosure Discus Dental Dermace Dermapure Eden Aesthetics Euromedical Systems Ltd E-Clinic Galderma General Medical Healthxchange Pharmacy Hamilton Fraser

Platinum Sponsor – Galderma (UK) Ltd Stand 50 galderma is a global pharmaceutical company specialising in the research, development and marketing of corrective and aesthetic solutions for dermatology patients and is a leading player in the worldwide dermatology market. created in 1981, galderma is a joint venture between néstle and l’oréal and employs more that 2,400 people. the company has wholly-owned affiliates in thirty-two countries and a worldwide network of exclusive sales agents. committed to the future of dermatology, galderma’s ambition is to be recognised as the most competent and successful innovation-based company focused exclusively on meeting the needs of dermatology patients and physicians.

“Just as the skin is a unique system within the human body, caring for the skin requires specialised knowledge and unique skills. at galderma we are focused exclusively on advancing both the art and science of skincare. by providing physicians around the world with a full range of innovative products and services. by a commitment to researching leading-edge therapies to bring new innovations to market.”

PRODUCT PORTFOLIO galderma’s growing portfolio includes treatment for major skin conditions – acne, rosacea, psoriasis, non-melanoma skin cancer and photodamage and hyperpigmentation disorders.

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IHAS Indiba Laser Care Services Life Style Aesthetics Lynton Lasers Lumenis Macom Compression Garments Medico Beauty Meddbase Med Fx Morning Star Surgical My cells Needle Concept Orascoptic

Pastelli Polaris lasers Q Medical Technologies Sally Durant Sound surgical Solta medical SkinBrands Skin Geeks Skinov 8 Sutton Orthodentist practise Urban Fox Communications Wealden Wellness Trading Wigmore Medical Zanco Models

SPECIFIC PRODUCTS INCLUDE: • Azzalure®: a Botulinum toxin type A for the treatment of glabellar lines • Cetaphil®: a range of cleansing and moisturising products for all skin types. originally formulated for dermatologists, they are gentle on your skin and sensitive to the skin’s needs • Calmurid® cream: containing urea (10%) and lactic acid (5%) for the treatment of skin conditions characterized by dry, rough, scaly skin • differin®: a topical retinoid containing adapalene (0.1%) available as a cream and a gel • etrivex®: a short-contact corticosteroid shampoo for the treatment of scalp psoriasis • Loceryl®: a nail lacquer containing amorolfine (5%) for the treatment of fungal nail infections • Metvix®-Pdt: a topical therapy for pre-cancerous and skin cancer lesions such as actinic keratoses, basal cell carcinomas and Bowen’s disease • Rozex®: metronidazole (0.75%) gel or cream for the treatment of rosacea • Silkis®: a topical treatment for mild to moderately severe plaque psoriasis • tetralysal®: a once-daily oral antibiotic for the treatment of acne • efracea®: 40mg modified release doxycycline for treatment of papulospustular rosacea

CORRECTIVE AND AESTHETIC DERMATOLOGY galderma aims at becoming a worldwide leader in corrective and aesthetic dermatology by providing a full range of products and services to meet the increasing needs of the ageing population, who want to enhance their appearance and improve their quality of life. the evolution of science will lead to a better treatment of age-related diseases and facilitate a stronger emphasis on prevention and corrective treatments, allowing people to age more gracefully. galderma want to be at the leading edge of this evolution.

HIGH TECHNOLOGY • GREATER SAFETY GREATER PURITY • GUARANTEED RESULTS

Renew beauty naturally and safely...

RENNOVA® Fill is a sterile gel, monophasic cross BDDE linked (1,4 - butanediol diglycidyl ether) with a hyaluronic acid, obtained through bacterial bio-fermentation. It is completely viscoelastic, biocompatible, homogeneous, transparent and resorbable. It has results with long-lasting effects. Easier application, greater lifting effect and greater security.

Thanks to its high-tech manufacturing, RENNOVA® offers more visible and longer lasting results.

RENNOVA® was developed and is manufactured by one of the largest pharmaceutical companies in Europe, which has been operating in the pharmaceutical market for more than 30 years, specifically with hyaluronic acid based products for use in ophthalmology, orthopedics and dermatology. It has a history of more than 15 million treatments sold around the world.

Thanks to the new XPM Tech® technology, RENNOVA® is submitted to processes that make the gel’s tridimensional molecular structure even more even, stabilized and elastic, with new definite molecular “bridges”, extremely important characteristics for providing a greater lifting effect, greater duration and greater aesthetic results.

New technology

XPMTech® Xtreme Pure Matrix

0459

Specialist Solutions for Non-surgical Aesthetic Procedures

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

for pigment and vascularity, ST for skin tightening, and Pixel for fractionated skin resurfacing.

• The Traditional Laser360 treatment consists of 4-6 treatment sessions, layering multiple

technologies (AFT, ST and Pixel), spaced about 10-15 days apart over a 60-day period.

Cosmetic News Expo | Exhibitor Profiles

Pixel The Association ofST Advanced Laser Body AFT Sculpture (AALBS) – Stand 77 The Association of Advanced Laser Body Sculpture (AALBS) is dedicated to training and educating physicians from all over the world in the field of aesthetic laser lipolysis. AALBS has not only established treatment regimens but is continually consulting physicians on the best laser lipolysis procedures available to ensure the greatest possible results in the treatment.

able colour corrective treatment that combines cosmetic and skincare technology to promote postprocedure healing, soothe sensitive skin, rejuvenate and camouflage at the same time. Lycogel®’s revoAfter Before lutionary technology combines a breathable Triple AFT 420 Acne Silica Gelcourtesy: BaseElizabeth together withMD LYCO-Complex™, a Photos VanderVeer, carefully balanced set of bio-active agents, that work synergistically to improve the skin.

Before AFT 540 VP

After

Photos courtesy: Elizabeth VanderVeer, MD

Urdiales, Instituto Médico Miramar, Málaga , Spain

BioTouch – Stand 29 Founded in 1984, BioTouch, Inc. is now one of the leading manufacturers and trainers of semi-permanent and permanent make-up, permanent makeup machines, and accessories. BioTouch stresses ongoing research and development by introducing technology in product manufacturing, and inventing new categories of skin care and makeup to ensure the integrity of each state-of-the-art product.

ContaCt us on: tel: 0845 1707788, info@a-b-c-uk.com, www.abclasers.co.uk ABC Lasers – Stand 51A ABC Lasers has been at the forefront of innovative laser and light-based medical technology for more than 15 years and is the UK and Ireland’s sole distributor for Alma Lasers. Its flagship products include the multi-technology/multi-application Harmony platform, as well as the Soprano painless laser hair removal system and the Accent system.

AesthetiCare – Stand 35 AesthetiCare is a division of Ferndale Pharmaceuticals Ltd and distributes products that are specifically designed for skin rejuvenation and repair, daily antiageing use, the resolution of specific skin problems and for use pre and post aesthetic procedures. Its products include the Genuine DermaRoller, Auriderm and LMX4 Lidocaine 4% w/w Cream.

Aesthetic Recruitment – Stand 80 Aesthetic Recruitment offers a new and unique way of ensuring that you have a confident and competent practitioner working for you. The company’s aim is to provide practitioners with the degree of help needed to raise the standard of care to which you and your patients have come to expect, by means of mentoring and ongoing support. Its multidisciplinary team is made-up of practicing aesthetic physicians, ex-clinic owners, and specialised aesthetic trainers and mentors,

ARC Recruitment – Stand 44 Arc Recruitment is a UK wide recruitment consultancy specialising in the introduction of industry professionals within the growing field of aesthetic medicine.

ARC is able to assist market leading cosmetic surgery groups and aesthetic medicine providers in finding new members to join their network of teams, both at corporate and clinical level. Through its experience the company is also able to offer advice and support for new businesses seeking the right people to contribute towards future growth.

BioDerm Ltd – Stand 58B BioDerm Ltd. is the sole distributor for Lycogel® and the Microneedle Therapy System (MTS Roller), for skin needling, in the UK. Lycogel® is the first breath-

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Before

After

Coolsense® – Stand 67 Pixel Laser Coolsense® is a pre-injection device designed Photos courtesy: Bhupendra Patel, MD to prevent pain or unpleasant feeling caused by injection needles and other procedures. The Coolsense® should be stored in freezer cabinet, controlled by a color changed thermometer. It has unlimited repeated use and is currently being used by thouAfter Before Before sands of doctors all around the world. TheAfter product Tattoo Removal - Photos Courtesy: Fernando Traditional Laser360 also has the CE and FDA certificates.

Boston Medical Group Ltd – Stand 53 Boston Medical Group Limited was founded in 2007 to provide a range of aesthetic products to medical practices. The company has successfully launched a number of products into the UK and Irish market including Viscoderm, an oral, topical and intradermal Biorevitalisation treatment system and Dermaroller. Its latest venture is into the dermal fillers market introducing Revanesse and Redexis to the UK and Ireland.

Candela – Stand 62 Since 1970, Candela has led the way in developing innovative new technologies for light-based aesthetic therapies. Today the company offers the most comprehensive and technologically sophisticated aesthetic devices in the industry with more than 300 peer-reviewed papers to its name. Building upon its reputation as the most trusted partner of successful aesthetic practices, Candela delivers innovation expertise and unwavering support to an installed base of more than 13,500 systems in 86 countries worldwide.

Cell Fusion – Stand 25 Cell Fucion C - Nano Cellular therapy provides complete skincare solutions through dermatologists, plastic surgeons, medi-spas and other skincare professionals. The treatment system uses a TDDS (Trans Dermal Delivery System) to increase cellular activity, neutralise free radicals and strengthen the skin’s immune system. The brand is a leader in Asia and America and is the winner of many prestigious awards.

The Consulting Room™ – Stand 69 The Consulting Room™ is the UK’s largest aesthetic website providing clear and unbiased information to the public on a wide range of surgical and non-surgical cosmetic treatments, combined with a directory of UK and Ireland based clinics.The Consulting Room™ also offers professional web design, mystery shopper telephone audits, video marketing and consultancy services to the cosmetic industry.

Photos courtesy: Rick Jackson, MD

WINNER - UK BEST

LASER Cosmetic Courses – Stand 60SUPPLIER 2008-2009 Cosmetic Courses is the leading training As votedacadby clinics emy in medical aesthetics. The learning process of each individual is given total dedication from all of the Cosmetic Course team to provide the highest standard of training and mentorship. The Cosmetic Course trainers are all experts in aesthetics and excel when teaching by using many years of knowledge and experience.

Cutera – Stand 61 Cutera develops, manufactures, markets and sells laser and light based medical devices. Cutera’s key message is directed to physicians specialising in cosmetic procedures with a focus on four categories of aesthetic solutions: hair removal, non-ablative and skin laxity, fractional and ablative resurfacing and vascular. Strengths are defined through safety, clinical excellence, physician/patient education and customer training in more than 40 countries worldwide.

Cynosure – Stand 28A Cynosure is recognised as one of the UK’s leading suppliers of aesthetic lasers with more than 15 years experience. The company has more than 200 installations in NHS hospitals, private clinics and salons. Having a range of excellent lasers is only half the story of the company’s success however.

Cynosure realises the importance of giving customers friendly, prompt and efficient service to ensure that they have the absolute minimal disruption to the client services they offer. All Cynosure systems are backed up by a first-class service, marketing and clinical support, for which the company is renowned.

Dermace – Stand 79 The Dermace Academy is one of the fastest growing cosmetic and medical micropigmentation training organisations in the UK. The company is focussed on providing the highest quality training with the most comprehensive support - at the most competitive prices.

DermaQuest™ Skin Therapy – Stand 57 DermaQuest™ Skin Therapy offers professional skincare products which have been designed to go beyond relaxation and spa treatments. DermaQuest™ products move skin quickly toward visible

improvement through professional treatments and customised home care solutions. Visit DermaQuest™ Skin Therapy on stand 57 to discover what the company can do for your business.

Discuss Dental – Stand 6 Discus Dental develops and markets leading professional dental materials and small equipment in more than 100 countries worldwide. The company is best known for its professional whitening products - Zoom, NiteWhite ACP and BriteSmile.

Additional brands include Splash impression material, Flashlite LED curing light, Fluoridex 5000ppm toothpaste, EndoVac endodontic irrigation system and Insight ultrasonic insert

E Clinic – Stand 64 E-clinic, was developed in 1997 and is now one of the most popular and highly regarded clinic management systems in the country. The company’s clients include the Harley Medical Group, The Private Clinic, Court House Clinics and scores of independent clinics across the country’.

Eden Aesthetics – Stand 83 Eden Aesthetics is a leading UK distributor specialising in high quality, scientifically researched aesthetic equipment and skincare products. Its brands include the well respected DermaGenesis microdermabrasion machines, Agera Rx and Epionce skincare and the Palomar IPL Laser and Light Platform. Recently added to the company’s portfolio is the Colorescience mineral make up range. Visit our stand to find out more.

Euromedical Systems Ltd – Stand 37 Euromedical Systems Limited has been selling medical and surgical products to the NHS and the private medicine sector since 1994. The company supplies surgical disposable products for operating theatres, silicone gel implants for plastic and cosmetic surgery, post-operative support bra’s, post mastectomy bra’s, chemical skin peels (AHA & TCA), hyaluronic acid dermal fillers and mesotherapy products for aesthetic medicine.

The company is the exclusive distributor for Anteis (Jolidermis), Care-Fix, Easy (TCA) Peel, Eurosilicone Implants, Glykopeel, Neova, Skin Tech and many other smaller manufacturers of medical devices.

FACE LTD Untitled-2

Flipside PR – Press Room Flipside PR is a specialised public relations agency working to promote beauty, health and cosmetic surgery and non-surgical treatments, industry leaders and opinion formers. Founded by Lynne Thomas in 2003, the company has an excellent reputation with health and beauty journalists for providing news that is informative, interesting and inspiring. If you are looking for a young and enthusiastic company to promote your brand, Flipside can help your business grow.

time for your

industry with the encouragement of Ministers to safeguard patients from treatments carried about by unqualified rogue practitioners. The scheme will go live in the next few months, and will register doctors, dentists and registered adult nurses. See the workshop programme for details of the regulation workshop.

INDIBA - Stand 23 INDIBA Aesthetics is a pioneering international company in the application of long wave RF technology. INDIBA- Proionic Deep Beauty systems offer unique approaches for a wide range of facial and body treatments with outstanding results.

INDIBA has market presence in UK, Spain, Italy, France, South America, Japan and Singapore.

surgery insurance check up…

General & Medical Healthcare – Stand 43 General & Medical are specialist providers of Private Medical Insurance and Corporate HealthSurgery Insurance care Trusts. For more than 20 years they have ✓ Premises & stock ✓ Public liability ✓ Computer / inspection cover worked with the professions to provide quality LCS Ltd – Stand 82 Professional Liability Insurance for Aesthetic Laser Treatments healthcare with first class service.

The preferred Care Services Ltd specialises in providing ✓ Botulinum Toxin ✓ Dermal Fillers ✓ Laser and Lights provider for the Association of Surgeons for Great assistance to hospitals, clinics and salons with the CALL ToDAy to they speak to one of our experts Britain and Northern Ireland, also retain a and findprocess of registration with the Care Quality Comout how much you could be saving!

Medical Advisory Panel of fully independent surmission under the Care Standards Act 2000. The PLuSpractitioners joIN our PremIer CLub tothem receive a variety geons and medical to advise company also has a training arm, the LCS Acadof benefits and discounts – call now to see what’s on offer and help them evolve. emy Ltd, which is the foremost provider of training and education to the medical cosmetic laser and intense pulsed light (IPL) community. The Academy Quote code: ADCN02 (lines opento Mon-Fri. 9.00 to 5.30) became the first training provider in the industry offer a Master’s Degree in Cosmetic Medicine in association with the University of Greenwich last year.

Hamilton Fraser Insurance Kingmaker House, Station Rd, New Barnet, Herts, EN5 1NZ. Hamilton Fraser Insurance is a trading name of HFIS plc. HFIS plc are authorised & regulated by the FSA. Hamilton Fraser – Stand 40 Hamilton Fraser has P r o pbeen e r t y | providing Te n a n c y D eaesthetic posit Protection | Aesthetic & Cosmetic Professional Liability | business | Home Lynton has been a leading UK manufacturer and supplier and cosmetic professional liability insurance of aesthetic and medical treatment systems since 1994, with products and services widely adopted into private solutions to the aesthetic industry for more than hospitals, cosmetic clinics and aesthetic centres for a 12 years, protecting practitioners against allegaLifestyle Aesthetics – Stand range of treatments from face & body contouring 59 to skin rejuvenation, as well as hair, tattoo and lesion removal. tions of negligence and wrong doing in their Lifestyle Aesthetics (LA) was founded in 2005 by practice of botulinum toxin, dermal fillers and healthcare professionals with many years experiTHERMALIPO II sector and signed other cosmetic treatments. The company works ence in the medical aesthetic The latest radiofrequency system for combined facial and body contouring with all the leading names in the industry, includan exclusive marketing and distribution agreement • Body treatments for lax skin, localised fat & cellulite reduction and improved skinTeoxane. appearance & texture ing high profile practitioners, distributors, manuwith Teosyal’s Swiss manufacturers, The • Facial treatments for lax skin, superficial wrinkles, enlarged pores and improved skin texture as a facturers and training courses to ensure that they company has since established the brand • Safe and easy to use • aesthetic Comfortable treatments understand your insurance requirements. major player in the UK treatment sector.

• Automatic frequency control for consistent tissue The company now alsoheating distributes a range of anti• Bipolar electrodes for safe, controlled application • Ergonomic design and no consumables ageing solutions all based on scientific research backed up by clinical evidence.

Call 0845 310 6300 Re-shape your body

or visit us at: www.hamiltonfraser.co.uk with Lynton’s range of Aesthetic Systems

LIPAWAY

Healthxchange – Stand 78 The Healthxchange Pharmacy supplies aesthetic and pharmacy supplies quickly and accurately at market leading prices leaving you free to concentrate on the core aspects of your business. Supplying only reputable brands from leading manufacturers such as Obagi©, Botox®, Vistabel®, Juvederm Ultra and Macrolane, the Healthxchange has become one of the most trusted and respected suppliers of pharmacy products to medical professionals with an interest in Integrative and aesthetic medicines and treatments.

FACE Ltd - Stand 34 With more than 10 years of aesthetic industry experi1 05/06/2009 14:52:04 ence, FACE Ltd runs the UK’s leading facial aesthetic conference and exhibition (FACE) and publishes Body Language, the UK and Europe’s leading IHAS – Stand 76 medical aesthetic and anti-ageing journal. With The Independent Healthcare Advisory Services the BODY conference, FACE Media division and (IHAS) is running an industry-led shared regulation the aesthetic industry Summer Ball, FACE Ltd is scheme for injectable cosmetic practitioners. This able to offer a wide range of services for the registration, certification and inspection scheme aesthetic practitioner. has been developed by the injectable cosmetics

Selective Subdermal Body Shaping Ultrasound Technology • Volume reduction without surgical intervention • Improved skin appearance and texture • Visible results from just one session • Two sizes of applicator heads • Colour touchscreen control panel • No anaesthesia • No patient down-time • Very fast return on investment • Very low maintenance

Lumenis – Stand 38 Lumenis is the global leader in medical and aesthetic lasers and light-based technology. The MATISSE The leading fractional laser platform for dramatic company is dedicated to improving people’s lives skin rejuvenation and resurfacing • Routine rejuvenation of the facial area with advanced technological solutions for treating • Scars (Acne, surgical, traumatic, burns) • Stretch marks (Striae) their medical and cosmetic conditions. Lumenis • Body rejuvenation Wrinkles and laxity has invested far more• • in research and development Photo-damage (enlarged pores and rough skin texture)in the industry and prothan any other company • Pigmented lesions and dyschromia • Hair Removal (MATISSE HR model) vides unparalleled service and support networks.

www.lynton.co.uk For further information or to book–a Stand demonstration Lynton Lasers 42please call 0845 612 1545 or email info@lynton.co.uk

Lynton is the UK’s leading manufacturer and provider of cosmetic laser solutions and aeslynton-halfCNJAN10.indd 1 17/12/2009and 16:32:29 thetic equipment to the medical, cosmetic beauty industries. Lynton has been manufacturing lasers and intense pulsed light (IPL) systems since 1994 for a wide range of applications

cosmeticnewsuk.com

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Cosmetic News Expo | Exhibitor Profiles including Laser and IPL hair removal, skin rejuvenation, tattoo removal, acne treatments and vascular lesions. Other complementary technologies, including Alexandrite lasers, fractional lasers, microdermabrasion systems and radiofrequency cellulite reduction systems and surgical lasers now complete Lynton’s portfolio of products and services.

Macom Compression Garments - Stand 66 MACOM is the premier UK provider of quality compression garments. Macom products are ideal post surgery, during pregnancy, post delivery, body shaping and for burn treatments.

They provide targeted support, facilitate post operative lymphatic drainage, accelerate the healing process, minimise scarring, and produce the appearance of a slimmer waistline.

The garments are all made of breathable, non-allergenic material, they are seamless and complete with adjustable fastenings ensuring optimal comfort.

Med+DBase - Stand 9 The ground-breaking Med+DBase (www.meddbase.com) online practice management system is perfect for managing all aspects of an aesthetics practice including sophisticated patient communication via SMS and email.

Come and see us at The Cosmetic News Expo to learn more about managing your business via a secure web portal – and take your clinic wherever you want to go!

Med-Fx Med-fx Limited is the UK’s largest one-stop supplier for all your aesthetics and skin rejuvination product needs. Med-fx supplies a wide range of market leading, botulinum toxins, dermal fillers, skin peels, cosmeceuticals, aesthetic lasers and surgery consumables.

Medico Beauty – Stand 43a As the distributor of both Cosmedix and Societe professional skincare and treatment brands, Medico Beauty is dedicated to education in the field of advanced skin health restoration. Founder of Societe and leading US aesthetician Denise Byrnes will be flying in from the States to present as part of the workshop programme.

My Cells – Stand 45 The MyCells autologous platelet preparation kit uses a patient’s own blood, which is separated into its various components and then injected back under the skin. The system recently received marketing

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approval from the US Food and Drug Administration (FDA) and has already proved successful in Europe and Japan.

MyFaceMyBody Group The MyFaceMyBody Group has experience in online sales, marketing strategy, video and TV production, web design, journalism and many years practicing within the cosmetic surgery and medical aesthetics industry. MyFaceMyBody.com is now one of the largest independent resources for consumers in Europe with more than 2,000 pages of treatment education and 200 videos.

producer of microdermabrasion and transdermal therapy equipment.

Sally Durant - Stand 73 In a career spanning 30 years Sally Durant has established a reputation for excellence both in her knowledge and understanding of all issues pertaining to skin health and in the provision of quality education and training within the aesthetic profession. With extensive experience in both the clinical environment and in the formal education arena Sally now acts as a consultant and trainer for a number of high profile aesthetic companies.

skinGeeks Needle Concept – Stand 56 Needle Concept is a new French starting company, which promotes innovative needles known as ‘Magic Needle’. Both the needles and the techniques to use them have been invented by Dr Bernard Hertzog, who is famous in Europe for his innovations. The results are so incredible that this major invention could ‘totally change the technique of fillers Injection within one or two years’. Dr Hertzog will be speaking as part of the Cosmetic News Expo workshop programme.

Orascoptic – Stand 1 Orascoptic is the world’s number one high resolution loupe system, with revolutionary LED light technology, for all medical and dental cosmetic procedures. Orascoptic/Surgical Acuity is renowned for its individual custom made loupes that combine extraordinary resolution with market leading width and depth of field, available in a range of comfortable, fashionable frames.

Pastelli - Stand 27 If you combine 80 years of experience in fashion with the finest fabrics, the style of a perfect cut, innovative fashionable and colourful designs, then you have Pastelli. The company offers a complete range of garments and shoes entirely manufactured by hand in the factory in Campo San Martino, where every single piece is specifically designed for allowing freedom in movement. The quality of the products goes together with the quality of the service. The Pastelli range is successfully distributed in more than 40 different countries.

Polaris Lasers – Stand 51 Polaris Medical is the UK’s leading manufacturer of medical lasers for dermatological applications. The company can offer a range of equipment for hair removal, tattoo removal, thread vein removal and treatment of pigmented lesions. For more than 10 years, Polaris has also been the exclusive distributor for Mattioli Engineering – the world’s leading

skinGeeks - Stand 58a skinGeeks is the purveyor of high quality, professional skincare products. A division of Nutrition Geeks Ltd, they are the distributors and first to offer the Image Skincare cosmeceutical line to the UK

Bringing you the best in

SkinBrands – Stand 24 SkinBrands’ business is founded on the premise of bringing anti-ageing skincare and allied products from around the Globe to the UK and Irish markets, supported by credible science. The company distributes leading skincare brands including SkinCeuticals, SkinMedica and Medik8 as well as the HydraFacial system, Susan Posnick mineral makeup line and RevitaLash™.

mineral make-up with Susan Posnick

Susan Posnick makes beauty simple with a complete line of practical beauty products. Combining unique formulations with innovative, portable packaging Susan Posnick has products to suit women of all ages and lifestyles.

Skinov8 – Stand 28 Skinov8 Aesthetics is a fast growing, innovative brand featuring professional skincare equipment such as radiofrequency, microdermabrasion and the brand new hydrodermabrasion oxygen machine, recommended by dermatology specialists.

The modern brand delivers quality skin aesthetic equipment to highly trained professionals, including doctors and nurses.

Solta – Stand 48 Solta Medical develops innovative products that meet and exceed the needs of the growing aesthetic market. To uphold that mission, Solta Medical is committed to superior innovation, research, development and testing. Both Thermage and Fraxel have unique technologies that renew skin from the inside out, deliver the optimal balance of clinical efficacy and fast recovery and are engineered to fit patients’ lifestyles and physicians’ business needs.

Sound Surgical – Stand 41 The Vaser® Lipo System, from Sound Surgical Technologies, enables a wide range of body contouring

applications from significant fat reduction to precise sculpting. As the industry’s only tissue-selective device designed to emulsify fat cells while conserving other tissues, Vaser® Lipo provides physicians the tool to treat all types of fatty tissue with minimal surgeon effort and fast patient recovery.

Urban Fox Communications – Stand 65 Urban Fox Communications are health and beauty PR specialists, offering affordable solutions which will maintain your market share in these tough times. Philippa Franklin RN and journalist Caroline Reid head a hungry team looking to help grow your business and get you noticed by those that matter.

A complete range of Medical Systems from Lynton Lynton has been a leading UK manufacturer and supplier of light-based aesthetic and medical treatment systems since 1994, with products and services widely adopted into private hospitals, cosmetic clinics and aesthetic centres for a range of treatments from skin rejuvenation to hair and tattoo removal.

LUMINA-Q The flexible dermatological tool-box with Intense Pulsed Light, Laser and Q-Switched Laser technology • Deep & superficial vascular lesions • Permanent hair reduction • Superficial & dermal pigmentation • Photorejuvenation and active acne treatments • Tattoo removal using active Q-Switched laser

Wealden - Stand 85 Wealden are specialists in dental and medical refurbishment fit out.

Through its many years of experience the company fully understands the complex requirements needed to deliver a fully compliant dental or medical surgery. With Wealden Projects involvement, clients can have Wellness HPH March:Layout 1 5/2/10 11:02 Page 1 complete confidence that their surgery will be completed on time, on budget and be fully compliant with all current regulations.

YOULASER CO2 The Fractional ablative CO2 Solution for all types of Skin Resurfacing • Can be used in fractional and fully ablative modes • Wrinkle reduction • Skin rejuvenation treatments • Pigmentation treatments and dyschromia • All types of scarring, including acne scarring Q-PLUS The ultimate Q-Switched laser platform for tattoo and pigment removal • Q-Swiched Nd:YAG (1064/532nm) & Ruby (694nm) • High power specification and active Q-Switching • Unique homogenous, square beam outputs • Treats epidermal and dermal pigmented lesions • ALL treatable tattoo colours can be removed

The lastest revolution in Trans Dermic Roller Technology

Wellness Trading – Stand 54 Wellness Trading Ltd’s professional treatments and home care products are built around the company’s philosophy that beautiful skin begins with healthy skin. Working with Spain’s Bodyesthetic Group, distributor Wellness Trading Ltd offers the full line of Mesoestetic • High which Qualityinclude and Safe Disc roller construction from products daily home care products, professional Medical Grade Steel, more methods, than 3 x the needles of other in-office treatments, anti-ageing anti-cellulite treatments, products. physician grade ampoules for use in mesotherapy and skin rejuve• Swivel for ease oftreatments. application nation and head depigmentation

MATISSE The leading fractional laser platform for dramatic skin rejuvenation and resurfacing • Fractional Erbium:YAG at 1540nm • Long Pulse Alexandrite at 755nm • Face & Body rejuvenation, stretch marks, wrinkles • Scar and photo-damage treatments • Permanent hair reduction (MATISSE HR model)

• Unique 4 step system, massage, needling, cooling, Nano Cell Mask • Amazing results / precision needles • Full professional training - 1 day course • Results - Results - Results

LIGHT SERIES

Wigmore Medical - Stand 34 Wigmore Medical is the longest established aesthetic distribution company in the UK, with more than 30 years of industry experience. The company is based in the hear of London and is always at the forefront of the market. It has a walk-in pharmacy and offers a wide range of aesthetic supplies with free next day delivery or same day delivery within London and prides itself on exceptional customer service.

The latest multifunctional Alexandrite, KTP and Nd:YAG Laser Platforms • Long Pulse Laser Platform System • YAG/Alex for ultimate hair removal on all skin types • YAG/KTP for complete vascular solution • Port Wine Stains, Leg Veins, Rosacea • Pigmented Lesions

www.wellnesstrading.co.uk 0161 976 4614

Zanco Models – Stand 30 Zanco Models is a newly established UK company bringing a different dimension to the world of medical training aids. The company’s highly realistic models are produced using the same methods and high quality materials as used in the film industry, giving our models added realism in look and feel.

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

lynton-halfCNApr10.indd 1

10/03/2010 17:07:34

Cosmetic News Expo | Exhibitor Profiles WORKSHOP PROGRAMME

international speakers.. The event will also be

speakers and

Educational workshops will be running

CPD accredited. The conference auditorium

full programme

throughout the two-day event covering

at the Business Design Centre has the capacity

details. You can

everything from business skills and how to build

for 450 people so make sure you book your

also register for

a successful practice to the latest techniques

place in advance. Keep an eye on our website

tickets online.

and treatments with lectures from both UK and

www.cosmeticnewsuk.com for updates on

SATURDAY APRIL 17

FRIDAY APRIL 16 MAIN AUDITORIUM

10am-12pm BOTULINUM TOxIN

MAIN AUDITORIUM 10am-12pm BODY CONTOURING

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

Body contouring has become big business. We explore the growth of the body

2pm-4pm HOW TO CHANGE A FACE

and most advanced technologies and examine their applications, from hair

We look at how clinics can transform someone’s skin. From the importance of diet and nutrition to skincare and treatments our panel of experts will ponder this question with interaction from the audience. Speakers will include US medical skincare specialist Denise Byrnes, Constance Campion and Professor Syed Haq.

shaping market and examine some of the machines that have been making waves from ultrasound to radiofrequency and laser liploysis. Speakers will include Dr Ravi Jain, Dr Tapan Patel and Dr Ayham Al-Ayoubi.

2pm-4pm LASER WORKSHOP Lasers have so many roles within an aesthetic practice. We look at the different removal and facial rejuvenation to skin tightening and fat removal. Speakers will include Dr Jon Exley and Mr Mark Whiteley.

WORKSHOP ROOM 1 10am-12pm DERMAL FILLERS One of the cornerstones of any aesthetic practice, we take a look at the

1-2 pm REFRESHMENTS - SPONSORED BY AIMA MAIN HALL

WORKSHOP ROOM 1

10am-11am NEW INNOVATIONS Want to find out about the most cutting edge products and technologies?

Then this session is for you. Manufacturers and suppliers will be given 10-15 minute slots to present their latest developments to you and with many new products launching at the Cosmetic News Expo, this is a session you won’t want to miss. Speakers will include Mr Chris Inglefield.

11am-12pm REGULATION UPDATE 2010 will see the introduction of the new Shared Regulation scheme. We look at how this is going to impact the industry and tell you how to make sure you qualify for the quality mark. We will also explore the controversial topics of remote prescribing and laser regulation. With speakers including Sally Taber from the IHAS, Dr Phillip Dobson, Penny Turvey and Mai Bentley.

2pm-3pm WEB WORKSHOP From building a website to the dos and don’ts of online advertising and using social networking media, this in depth workshop will cover everything internet based. Speakers will include Ron Myers from Aesthetic Business Services and ConsultingRoom.com as well as Stephen Handisides from MyFaceMyBody.com

products to new techniques. ‘London Lip Queen’ Dr Rita Rakus will present on treating lips.

2pm-3pm MEDICO LEGAL It is a legal minefield out there so if you want to know how to cope with everything from malpractice claims to bad press then this workshop is for you.

Speakers will include media and libel lawyer Sarah Webb.

WORKSHOP ROOM 2 10am-12pm SKINCARE Nearly every clinic now carries a skincare line, but what are the key things a good cosmeceutical needs and are these products really proven to work?

We explore everything from ingredients to delivery systems and retailing in this workshop.

12-1 pm REFRESHMENTS - SPONSORED BY AIMA MAIN HALL 1pm-3pm MANAGING STAFF Finding the right staff can be a huge challenge so we have brought together some of the aesthetics industry’s recruitment experts to give you advice on how

WORKSHOP ROOM 2

to find and keep the best staff. From motivating your team to recruiting the right

From semi-permanent make-up to minerals and camouflage, we discuss the role of make-up within aesthetics. Includes live demonstrations. Speakers will include Dawn Forshaw from Finishing Touches and mineral make-up legend Susan Posnick.

importance of front of house staff with some revealing secret shopper examples

10am-12pm MAKE-UP AND MEDICAL AESTHETICS

12pm-1pm CLINIC MARKETING Whether you want to know how to stand out from your competitors or are just looking to refresh and improve your marketing, this workshop is for you. With advice from some of the medical aesthetic industriy’s leading marketers, this is a workshop not to be missed. Speakers will include Dr Ravi Jain.

2pm-4pm MEDICAL NEEDLING One of the most talked about treatments in 2009, we bring you everything you need to know about medical needling, from the products to use to treatment protocols. Live demonstrations will also be held to show you how the treatment is performed. Speakers will include Dr Sach Mohen.

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most recent developments in dermal fillers. From some recently launched

cosmeticnewsuk.com

people for the job and carrying out interviews. We will also take a look at the of how a badly run reception can damage your business. Speakers will include John Sellers, Vivienne Smith, Martyn Roe and Ron Myers.

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

CONTACTS For further information regarding exhibition space please contact:

Hollie-Jane Dunwell T: 01268 754 897 E: hollie.jane@creativemedialtd.co.uk For event-related sponsorship opportunities contact:

Emilia Bronze

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

SPEAKER PROFILES Dr Benjamin Ascher Dr Benjamin Ascher is a leading French surgeon specialising in plastic, aesthetic and reconstructive surgery and body contouring.

He is a member of the French Society of Plastic, Aesthetic and Reconstructive Surgery (SOFPRE) and is the scientific director of the International Master Course on Ageing Skin (IMCAS) Congress.

Dr Bob Khanna Dr Bob Khanna is a cosmetic and reconstructive dental surgeon. He was one of the first dentists in the World to venture into facial aesthetic procedures, utilising botulinum toxin and dermal fillers and lectures internationally. He has trained more than 6,500 doctors, dentists and surgeons under the umbrella of The Dr Bob Khanna Institute. He is also founder and president of the International Academy of Advanced Facial Aesthetics (IAAFA) and also clinical lecturer at the Royal College of Surgeons (FGDP Facial Aesthetics Masterclass).

Constance Campion Constance Campion is city analyst who has been working and commenting on the private medical sector and plastic surgery since the 1980s. She is a partner at Plastic Surgery Associates at the Cromwell Hospital, London and is an education programme board member of The Society of Plastic Surgery Skincare Specialists as well as vice president of The American Institute of Medical Aesthetics.

Denise Byrnes Denise Byrnes is co-founder and director of product development of Société Clinical Skincare. She boasts more than 20 years experience as a medical skincare specialist, international speaker and educator. Active within the Society of Plastic Surgery Skincare Specialists (SPSSCS), Byrnes served on its board of directors from 2000-2006 and as its president in 2004-2005. She is also a member of the Society of Cosmetic Chemists as well as the Society of Permanent Cosmetic Professionals.

Professor Syed Haq Professor Syed Haq is a leading authority on cellular signalling, growth, ageing and hypertrophy. He has published more than 60 peer-reviewed articles in several leading international scientific journals and his work has been cited in over 560 peer-reviewed published articles worldwide. He has been the recipient of more than 20 leading national and international awards and scholarships.

Sally Taber Sally Taber is director of the Independent Healthcare Advisory Services. She has worked in the independent sector for more than 20 years and was the director of nursing at the London Bridge Hospital. She worked at the Royal College of Nursing in an advisory capacity for the independent sector for four years and is currently overseeing the government’s Shared Regulation scheme for cosmetic injectables.

Mai Bentley Mai Bentley is a registered nurse and an Independent Nurse Prescriber (NIP) She is one of the directors of Intraderm Ltd and runs aesthetic training courses in London and Leicester. Intraderm are also offering the Independent and Supplementary Prescribing Course for Nurses (V300) in association with De Montfort University. It is currently the only prescribing course with specific aesthetic input.

Dr Philip Dobson Dr Philip Dobson is medical director of LCS Ltd, which specialises in registration with the CQC for the use of lasers, IPL and provision of private doctor services as well as the LCS Academy which provides accredited aesthetic training including a Masters in Cosmetic Medicine.

Ron Myers Ron Myers is a director of The Consulting Room™. In 2002 he set up a specialist consultancy service with business partner Martyn Roe. They have since helped to develop Wigmore Medical’s concept as a specialist aesthetic distributor, launched the FACE conference and worked on numerous business development and website design projects with aesthetic clinics.

Martyn Roe Martyn Roe is a director of The Consulting Room™. Martyn joined Allergan at the beginning of the botulinum toxin boom and, together with business partner Ron Myers, developed a strong team and understanding of the aesthetics industry. In 2002 they both left Allergan to set up ABS, their specialist consultancy service. Since then they have been busy working on a variety of high profile projects.

Mr Chris Inglefield Chris Inglefield has worked as a consultant plastic and reconstructive surgeon since 1998. His areas of specialist interest include breast surgery/reconstruction, eye and facial rejuvenation, labiaplasty and body contouring.

He has written several papers and contributed to many specialist books and journals within the field of plastic and reconstructive surgery and has lectured at national and international meetings.

He is a member of the British Burn Association, the British Microsurgical Society, the British Association of Surgical Oncology and the Royal Society of Medicine Plastic Surgery.

Stephen Handisides A creative sales and marketing expert, Stephen Handisides has in the medical aesthetic industry for the last six years. He is managing director of MyFaceMyBody Ltd, an e-commerce and video production company which helps businesses find creative ways to promote their business through social media, video and website design.

Dr Ravi Jain Dr Ravi Jain runs the Riverbanks Clinic, a busy non-surgical practice based near Harpenden, Hertfordshire and is a leader in the field of nonsurgical body contouring. In 2008 Dr Jain won Best New Clinic and Best Business Development at the Aesthetic Medicine Awards. He will be sharing his tips on how to build and market a successful practice as part of our Clinic Marketing workshop.

Dr Sah Mohan Dr Sach Mohan is the non-surgical clinical lead at Transform, the UK’s largest cosmetic surgery group and was previously the medical director of the Renew Medica Group. He is also chief medical advisor and clinical trainer for AesthetiCare® with Genuine Dermaroller™ Therapy.

Dr Ayham Al-Ayoubi Dr Ayoubi is an international leading surgeon in Smartlipo and Sculptra.

Known as the ‘King of Smartlipo’, for his legendary laser body sculpting, he is the leading Smartlipo MPX trainer surgeon in the UK. Dr Ayoubi uses his own advanced techniques in various aspects of laser surgery many of which have now been adopted by numerous plastic surgeons and cosmetic doctors including scar free breast and neck lifting.

Mr Mark Whiteley Mark Whiteley is a consultant vascular surgeon and director of The Whiteley Clinic and Absolute Aesthetics. Mr Whiteley has won many prizes for his research as well as having more than 60 peer-reviewed publications. He was the first person in the UK to perform the Laser Sweat Ablation operation for axillary hyperhidrosis.

Dr Jon Exley Dr Exley’s interest in lasers began whilst studying physics both at the University of Leeds (UK) and the prestigious Université Joseph Fourier in Grenoble (France). He is now md of Lynton and is on the executive board of the British Medical Laser Association (BMLA).

Dr Rita Rakus Dr Rita Rakus has more than 20 years experience in aesthetic medicine and is a founder and Fellow of The British Association of Cosmetic Doctors (BACD). Known as ‘The London Lip Queen’, Dr Rakus acts as consultant/trainer for Q-Med (Restylane®), Allergan (Juvederm® and Botox®), Thermage, Fraxel and Medicis.

Sarah Webb Sarah Webb is head of media and libel at Russell Jones & Walker and specialises in defamation, media, reputation management, privacy and breach of confidence, professional negligence and commercial litigation. She is also a member of the Civil Justice Committee and Dept of Constitutional Affairs panel on Defamation Costs.

John Sellers John is passionate about the recruitment industry and has extensive experience in helping clients and candidates to find what they are looking for. John is the founding director and owner of the ARC Group. In 2008 he added ARC Aesthetic professionals to his recruitment portfolio specialising in the introduction of industry professionals within the growing field of aesthetic medicine.

cosmeticnewsuk.com

27

the uk’s oNly free of chArge m

The Business design Centre, Islington, London

april 16th & 17th 2010

PLATINUM SPONSOR

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

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

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

www.cosmeticnewsuk.com

medicAl Aesthetics TradE shoW

s iNdUsTry

shoW hiGhliGhTs • More than 50 exhibitors • New products and technologies, giving you the perfect chance to enhance your business • Meet leading distributors and suppliers to the aesthetic industry all under one roof • Free workshops for all delegates: WorKshops iNClUdiNG: • • • • • • • • • • •

Botulinum Toxin New Innovations Regulation Make-up: semi-permanent make-up, minerals and camouflage Skincare How to Change a Face Medical Skin Needling Body Contouring Dermal Fillers Laser and Light Business Management: marketing, managing staff, social media, online marketing and medico legal issues

• Educational seminars with leading UK specialists • International and UK speakers including: Dr Benjamin Ascher, Dr Bob Khanna, Professor Syed Haq, Constance Campion, Mr Mark Whiteley and Dr Sach Mohen • Drop-In Business Clinic where you can receive expert advice on any aspect of running your business • CPD Accreditation

AESTHETICS SURVEY 2010 30

PLATINUM SPONSOR Are you a full time or part time cosmetic practitioner?

What is the biggest misconception patients have about non-surgical treatments?

Full Part

Do you still work in the NHS? Yes No

Do you have your own clinic?

Yes No

If you could pick one treatment that revolutionised your practice in 2009 what would it be?

What age group are the majority of your patients?

Under 20 30-40 50-60 70+

20-30 40-50 60-70

Do you ever use permanent fillers, if so to treat which areas? If not, why?

What percentage of your clients are male?

PRODUCTS AND TREATMENTS What are the three most popular treatments in your clinic for women?

What are the three most popular treatments in your clinic for men?

cosmeticnewsuk.com

What do you think has been the biggest innovation in medical aesthetics in the last five years?

What do you think the biggest trend will be in 2010?

AESTHETICS SURVEY 2010

Do you think non-surgical methods of breast enhancement are safe?

Yes No Unsure

Do you agree with the governments plan to deregulate lasers?

Which laser treatment is the most popular in your clinic?

Hair removal Skin rejuvenation Fractional laser treatments Tattoo removal Fat reduction and body contouring Don’t do laser treatments

What is the top thing patients enquire about?

Botulinum toxin Fillers Hair removal Peels Microdermabrasion Laser lipo Tattoo removal Cellulite treatments Macrolane Weight loss Skin needling/collagen induction therapy Other (please state)

What are the most popular procedures with mums post pregnancy?

Which body contouring procedures do you use?

Radiofrequency Laser lipo

REGULATION

Ultrasound/Vaser Other. Please specify

Yes No Unsure Comments

Do you think the Shared Regulation Scheme will work?

Yes No Unsure Comments

Do you agree with the practice of remote prescribing?

Yes No Unsure Comments

Should sunbeds be banned?

Yes No Don’t know Comments

Additional comments

Do you think mesotherapy works?

Yes No Don’t know

What is the worst contributing factor to ageing in the patients you see?

Smoking Alcohol Sun damage Genes

Please return this form to emilia@creativemedialtd.co.uk no later than 12th April 2010 Many thanks for your co-operation and taking the time for returning the survey.

We look forward to welcoming you to the Cosmetic News Expo 2010. cosmeticnewsuk.com

31

Special Feature | Post-Pregnancy

MUMMY MAKEOVERS

We take a look at the biggest post-pregnancy concerns and give you an overview of the best treatments

Having children is a wonderful thing but for many women the joyful experience of becoming a mum can be blighted by the effect that pregnancy has on their body. Even those who follow a healthy diet and fitness regime to get back in to shape after having children can be left with stretch marks, saggy breasts and excess fat that will just not shift, no matter what they do.

W

ith celebrities seemingly getting back in to their size 0 jeans just weeks after giving birth, women are under more pressure than ever to regain their pre-pregnancy bodies and looks. So it’s no wonder that more and more women are turning to cosmetic surgeons and doctors to give them a helping hand.

“Probably 50% of all the things that we do are post pregnancy changes in the breast and abdomen“, says plastic surgeon Chris Inglefield.

And it is not just the body that pregnancy can take its toll on, melasma, or ‘pregnancy mask’ as it is sometimes called, is believed to occur in

32

cosmeticnewsuk.com

as many as 50% of pregnant women, leaving them with pigmentation on their face that makes them feel even more self-conscious about their looks.

“Pregnancy leads to many changes in a woman’s body, mainly through the interaction of steroid hormones, lactogen and cortisol on the underlying tissues and structures”, says Dr Patrick Treacy, Ailesbury Clinic, Dublin.

“The growing foetus itself causes mechanical change also by stretching skin, muscle and fascia and demanding an increased calorific supply.”

We look at the most common problems encountered by the ‘post-baby’ body type and what you can do to correct them...

THE PROBLEM

MELASMA Melasma is the formation of irregular pigmented patches and is commonly found on the

sun-exposed face in the period

THE

SOLUTION

Chemical peels, prescription and nonprescription skin lightening creams, IPL, fractional lasers, IPL, microdermabrasion, Cosmelan Depigmentation Treatment

“I feel it is important that someone with clinical experience of

during or after pregnancy. It is thought to

pigmented lesions should be involved in the treatment of melasma”, says Dr Treacy.

be caused by increasing levels of both

“There are many reasons for this, melasma can regress and depigment and lesions

oestrogen and progesterone, which stimulate

such as lentigo malignas can appear in the same locations on the face. That said,

melanocytes resulting in increased production

melasma is comparatively easy to diagnose as it tends to occurs in large patches

of the normal tanning protective chemical.

rather than isolated lesions. When there is doubt, I sometimes use a Wood’s UV light to determine the depth of melanin pigmentation in the skin: contrast in epidermal

“Melasma is a condition that can either be

pigmentation is increased while contrast in dermal pigmentation is decreased under

triggered by pregnancy or the contraceptive pill”,

Wood’s lamp illumination compared to ambient visible light. Under Wood’s lamp,

explains Dr Nick Lowe professor of dermatology

excess melanin in the epidermis can be distinguished from that of the dermis.

at UCLA and consultant dermatologist at the Cranley Clinic, London. “It is often worse in

“Dermal melanin is more difficult to remove by methods that do not reach this level.

women that are olive skinned and is usually

Of particular benefit is the Beau Visage dermal melanin analysis system but I am

found on the cheeks, forehead or upper lip.

aware all clinics have not this technology at their disposal. I find this is of particular benefit, especially if I have decided to use a series of IPL laser treatments to help

“One of the interesting things about melasma is

depigmentation. If the pigmentation is dermal then we will require some other method

that it can occur many months or many years

of removal as it will only serve to darken the lesions. Whenever dermal melanin is

after the pregnancy or after the contraceptive

involved I tend to use either the Fraxel or ActiveFx fractionalised CO2 laser. Mandelic

pill and that’s not readily recognised. We believe

acid (Triluma cream) has also been shown to be of benefit in these cases.

that what happens in pregnancy is that it alters the repsonse of the pigment cells, the melanocytes,

“If the melasma is epidermal then topical depigmenting agents, such as hydroquinone (HQ)

to very low levels of ultra violet light and that

are a good starting point. These creams come in either in over-the-counter (OTC)

this triggers them to produce more melanin.

(2%) or prescription (POM) (4%) strength. Hydroquinone is a chemical, which inhibits tyrosinase, one of the enzymes involved in the production of melanin. I

“I see a lot of melasma – it is very common.

also use azelaic acid (20%) as it also decreases the activity of melanocytes.

It is estimated that at least 50% of women get some form of melasma during and

“After pregnancy we can use many topical creams for depigmentation. Isotrex

following pregnancy. The incidence is a bit

(Tretinoin) as 0.025% OTC or 0.05% POM is a retinoic acid that increases skin cell

less in those taking the contraceptive pill but

(keratinocyte) turnover. This treatment is the topical form of Roaccutane and

its certainly up there, probably a third.”

cannot be used during pregnancy. After pregnancy, we can also use facial peels with alpha or beta hydroxyacids or chemical peels with glycolic acid.”

But what makes melasma so different to other forms of skin pigmentation?

Dr Lowe follows a similar treatment protocol, but stresses the importance of sun protection and getting patients to understand that maintenance will be required. He says, “They

“It is the pattern of it that’s different”, says Dr

have got to think of their melasma treatment as a maintenance treatment, so by that I

Lowe. “Other types of pigmentation, such as

mean they have got to use a daily protective cream that contains UVB protection and

solar lentigo, are usually much more defined

very importantly UVA protection as well as antioxidants and some lighteners. Our Super

brown spots. Some drugs can also give facial

Charged SPF15 Day Cream with UVA protection is one of those and I try and get them to

pigmentation, for example Minacine and some

use that every day. If I think they are not willing to use a daily protection cream, more or

of the heart drugs, but its more of a ‘slatey’

less year round with those ingredients, I usually tell them that they are really going to be

grey. It’s the characteristics – the colour and

wasting their time and money having treatment because even low levels of UVA coming

the pattern – that give us the diagnosis.

through window glass like car windows can darken the melasma again. I get them started immediately on that and will then also get them started on a prescription lightening cream.

“You can have superficial melasma or deep

I will use the hydroquinones but they have to be prescription strength (4%). I will also use

melasma and the reason that’s important is it that

our Brightening Radiance Cream as well. They put the brightening cream on the whole

your treatments need to be a little bit different

face at night and then add the prescription lightener to the dark areas on top of that.

depending on the type of melasma. Some people do get spontaneous fading without treatment,

“The next step is active treatments. Melasma has been really difficult to treat in the past, but

but its rather rare to have that. What they often

the most exciting new treatment that we have got is the new Fraxel Dual. Its called the Dual

find is, even if it goes away in the winter months,

because it has got two wavelengths – 1927nm and 1550nm. The wavelength that seems to

it will keep coming back in the slightly sunnier

specifically help melasma is the 1927nm. If I have got somebody with wrinkling, fine lines,

months – that’s quite a common history. The big

sun damage etc I would use both wavelengths but if I am dealing with somebody that has

problem is trying to treat somebody with melasma

got pretty good skin, apart from the melasma, I will use the 1927nm. If we have got a good

who is still taking the pill because that can make

improvement with the Dual and I want to then do maintenance they can come in regularly

the melasma much more resistant to treatment.”

for a further treatment with either microdermabrasion, peels or the laser. I sometimes use IPL, usually at the slightly longer wavelength (590nm and above). There are also some new peels from the States that we have started to use that contain a combination of things like lactic acid, pyruvic acid, kojic acid, azelaic acid. That’s usually for a milder patient or for the maintenance of someone we have done laser treatments on. Some patients also benefit from combining prescription tretinoin/retinoids with the hydraquinone, as a maintenance.

I think the essence is for them to accept that they have got to, in most cases, use some form of maintenance treatment.”

Special Feature | Post-Pregnancy

THE PROBLEM

STRETCH MARKS

THE

SOLUTION

“Stretch marks are caused by rapid

Collagen induction therapy (medical needling), radiofrequency (Accent/ Tripollar), peeling, fractional lasers

stretching of the dermal tissue of “The thing with stretch marks is that, unless the stretch

the abdomen during the distension

marks are localised in the lower abdomen where the

and weight gain of pregnancy”, explains Dr Treacy. “It is thought that nearly 85%

skin will be removed, then you are not going to be able to tackle them

of women will develop some degree of stretch

surgically”, says consultant plastic surgeon Mr Rajiv Grover. “If you have

marks during their pregnancy and these usually

had a baby that has expanded mainly in the upper abdomen and your

appear after prolonged weakening of the dermal

stretch marks are above the navel, those are very difficult to treat, because

tissues about the beginning of the third trimester.

any operation to remove skin does so from the lower abdomen.”

This is also a period of sustained distension. It is felt that dermal weakening occurs during pregnancy

Dr Treacy adds, “Various treatments are proposed for the treatment of

as a result of increased glucocortoid hormones,

stretch marks. In terms of lasers I have used 585nm pulsed dye lasers with

which actually effect the epidermis formation of

some effect but I prefer a combination of dermarolling with radiofrequency.

fibroblasts. The reduced numbers of fibroblasts

I find bipolar and tripolar devices to be of the most benefit. I have used this

consequently result in less collagen and elastin

combination with a Syneron Polaris RF for many years. More recently, I have

being formed and this leaves the dermal tissue

treated abdominal stretch marks with fractionalised CO2 laser resurfacing

supporting structure susceptible to tearing.

with effect. I have been limited by little published data on using this method but we have now treated about 15 cases with lower density settings over

“These skin changes eventually result in reddish or

multiple treatments in order to wound the dermis and try and recreate the

purple lines along the lines of stretching that tend to

collagen and elastin underlying structure, which the skin was deprived off.

gradually fade to a lighter skin colour as a tendency

We tend to tell the patient to expect about 70% benefit over five sessions

towards re-epithelialisation occurs. Over time they

spaced one month apart. In some cases we have almost complete resolution.

“Many patients also ask me if there are any topical creams to help with stretch marks, either during their formation or after they have occurred.

There are no proper control studies but some research suggests a daily application of

Before and after treatment with the Strawberry

a cream containing Gotu Kola extract, vitamin E, and collagen

can diminish but they do not disappear completely

hydrolysates was associated with fewer stretch marks during

and can cause distress in the post natal female.

pregnancy. Other favourites include combinations of cocoa butter,

There is little doubt that stretch marks are also

vitamin E, panthenol, hyaluronic acid, elastin and menthol.”

influenced by hormonal changes in pregnancy as is also associated with the rapid growth of puberty

Professor Lowe explains his preferred treatment options: “Some of the stronger

or weight gain during muscle building etc.”

prescription retinoids can help. The one I tend to use is called Zorac Gel. They will usually apply that twice a week to start with and then wash it off with a

Professor Lowe adds, “We don’t know the true

moisturising wash after 10 minutes”, he says. “The interventional treatments

mechanism of stretch marks we think it’s a hormone

that I find helpful include the Fraxel lasers. Again it depends on the type of

change (probably oestrogen) having an effect

stretch marks. Some are just discoloured and what we do is to essentially

on the collagen and elastin, plus the mechanical

treat those with the milder Fraxel lasers such as the Fraxel Dual. If they are

stretching of the skin. However you can get ladies

much more prominent I will occasionally run over them very lightly with a low

with very small babies who put on a minimal amount

setting Fraxel CO2 laser. If they are purple stretch marks, as some are, then

of weight who have very bad stretch marks and

one of the vascular lasers, for example the yellow dye laser, can be helpful.”

you can get ladies with very large babies and large abdomens who have no stretch marks, so

Dr Michael Prager favors dermal rollering to treat the condition. He combines

there is obviously a genetic component to it too.

the micro-needling technique with SkinMedica’s Tissue Nutrient Solution, with

A certain percentage of stretch marks will improve

human growth factors, which has clinically proven scar healing properties. He

spontaneously after pregnancy, so people shouldn’t

says, “Excellent results to stimulate collagen production are being seen using

rush in and have these stretch marks treated. My

the professional length Medik8 Titanium Dermaroller (2mm). The collagen

advice is to wait at least three or four months or

growth is stimulated by inter-dermal bleeding. This is enhanced when effective

longer because some of them will go away.”

topical products containing growth factors are used alongside the treatment, as the dermaroller also increases absorption. We see the positive effects of increased collagen levels up to a year or longer after the treatment, and with none of the serious down time that is associated with laser or deep peels.”

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cosmeticnewsuk.com

THE PROBLEM

SAGGING SKIN

As the baby grows the skin of the mother’s abdomen stretches which can lead to excess and saggy skin following childbirth.

This problem is compounded by the fact that many women nowadays are having babies later in life when their skin has lost some of the elasticity of its younger years. As the stomach stretches during pregnancy the muscles in the abdominal wall also get stretched and pulled apart, meaning that they lose their tone.

THE

SOLUTION

Abdominoplasty, infra red laser skin tightening (Titan), radiofrequency, Thermage, Velashape

Abdominoplasty or ‘tummy tuck’ is a popular cosmetic surgery procedure used to make the abdomen more firm after pregnancy. The surgery (which can be radical) involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. There are different variations on the technique dependent on which tissues are sagging and if there is associated weight loss or residual fat to be removed.

Mr Grover explains, “Tummy tuck surgery is divided into full tummy tuck or abdominoplasty and mini tummy tuck or mini abdominoplasty. The mini tummy tuck still has a long scar that goes from hip to hip, but you only lift the skin up to the level of the navel and no further. You do not detach the navel and the navel doesn’t have a scar around it. The full abdominoplasty is where you are lifting the fat and skin away from the muscle all the way to the rib cage. In order to get above the umbilicus, you have got to detach it, which means cutting round it. You can then pull the skin of the abdomen down, take off the excess and make a new hole for the navel. If the stomach muscles are stretched and are no longer sitting together in the mid line then, even though you tone your muscles there is still that bulging at the bottom that can give people a little bit of a pot belly. To try and tighten that you put some stitches between the two muscles to bring them back into the mid line again. That you can do with either of these operations.

“I think the most important thing is that people should only do this once the loose skin and their weight has stabilsed after pregnancy. The earliest you should think about doing this is six to nine months after pregnancy, never before, because if the skin is still contracting after its been stretched there may not be as much loose skin as you think.”

Talking about the non-surgical options, Dr Lowe adds, “If you have

Right: Before and after treatment with Accent XL (courtesy of Shadi Danin) Below: The CACI Quantum

got some lax skin on the abdomen following the pregnancy then the other thing that we are very very pleased with is the latest Thermage CPT (Comfort Pulse). It is a totally different machine to the old one. They have changed the characteristics of the hand pieces so the hand pieces vibrate quickly and you don’t get the discomfort that you got with the old Thermage. This means that you can put in more energy and get more effect and that’s very useful. We have now also got larger treatment heads for abdomens for example, which is very relevant after pregnancy.”

Many practitioners also like to use treatments which combine skin tightening with fat reduction. Dr Ayham Al-Ayoubi says, “The best non-surgical treatment for this is Velashape. It’s the only proven, medical solution and the only non-surgical FDA-cleared medical device for the body reshaping market. It’s a body tightening treatment, which uses elos technology to shrink fat cells using a safe level of light energy, with no risk or damage to the skins surface.

“Velashape heats the fatty tissue, while a vacuum and mechanical massage manipulates, tightens and smoothes out the skin so patients can embrace a smoother, tighter version of themselves in a matter of weeks. It’s virtually pain free and some patients have likened it to having a powerful vacuum cleaner pass over the skin. It’s non invasive with no downtime or scarring. It is very important that the woman has stopped breast feeding before she has Velashape or any kind of cosmetic treatment however. No matter how gentle you are, slight discomfort can be caused, which can affect lactation.”

cosmeticnewsuk.com

35

Special Feature | Post-Pregnancy

THE PROBLEM

BREAST ATROPHY/ BREAST SAGGING

THE

SOLUTION

Breast augmentation, breast lift, Macrolane, CACI Quantum “The majority of my breast work is post pregnancy”, says Mr

“This is one of the most

Grover. “I think there are three groups of women coming for

obvious places to see the

breast augmentation. The first is the very young girls who have

difference between a ‘pre’ and ‘post’ body type”, says Dr Treacy. “It is widely

not developed and are maybe 18,19, 20, then there are the young girls who have

accepted that most breasts seem to undergo a

got breasts but want to be bigger and then the third group, which is a very enlarging

‘deflationary’ change in the weeks and months

group in recent years, is the women who have had children, finished their families

after weaning. The reason that this occurs is due

and they want to get back what they had before. This group is often a little bit more

to the fact the ratio of fat tissue to gland tissue in

conservative, so they are not looking for very very big but – they are just looking for

a women’s breast actually changes with the new

increase in size, improvement in shape and lift. Sometimes you can do all three things

requirements of the body. Most women tend to

with an implant, sometimes you need an implant and a lift and if they have sagged, a

regain their normal cup size post natally but many

lift. I think where there has been a big advance in this group is really with the tear drop

do not, especially if they have breast-fed. The

or anatomical implant. These people want to look natural, they are very professional

body has undergone a physiological redistribution

and they don’t want anyone to know they have had breast implants or a ‘boob job’ as

of fat and when the breast gland tissue regresses

they call it – they just want to look like they did before. The tear drop implant does two

there is less fat and the breast may shrink, especially

things: the gentle slope in the upper pole prevents them looking like Posh Spice and the

in the upper poles. Society is hard on mothers

increase projection in the lower pole gives them a little bit more lift for the nipple, so it

and very few magazine pictures display this

really does suit that group of people quite well. They are also often people who have

new physiotype as anything to be proud of.“

looked after themselves quite well, they go to a gym and are slim, and in a slim person the effect of that thin upper pole is particularly valuable, so it doesn’t look stuck on.“ Mr Inglefield adds, “Many women who have lost fullness from breast feeding want to restore some of the volume. They don’t want to be big they just want to get back to what they were pre-pregnancy, which is usually just a cup size fuller or so. Macrolane fits in very well for those women, especially for those with anxiety about having surgery. The fear of the anesthetic itself is probably the biggest motivation to avoid surgery, especially or women with a small child – they don’t want to take the risk.”

Above: The CACI Quantum Right: Before and after treatment with Macrolane at Absolute Aesthetics (courtesy of Mr Mark Whiteley)

THE PROBLEM

ExCESS FAT “The amount of extra weight gained during pregnancy varies among women”, says Dr Treacy. “The National Health Service recommends that the overall weight gain during the nine month period for women who start pregnancy with normal weight should be in the region 10 to 12 kilograms (22–26 lbs.) but as many British females are already over weight, these figures may be downsized. Physicians are aware, insufficient weight gain can compromise the health of the foetus during pregnancy and excessive weight gain can pose

risks to the woman and the baby.

“Women tend to develop layers of subcutaneous fat around their midriff, their buttocks and inner thighs while males seem more prone to develop visceral fat around their organs. One of the more interesting theories to explain why female fat deposits are located where they are was made by a Polish researcher called Boguslaw Pawlowski of the University of Wroclaw. To quote from an issue of Current Anthropology “the fat deposits may help to meet the balance requirements of two-legged walking during pregnancy and lactation”.

36

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Special Feature | Post-Pregnancy

VASER®, liposuction, laser lipolysis, mesotherapy, ultrasound SOLUTION (LipoSonix®/Ultrashape®/ Cellusonic), Acoustic Wave Therapy (AWT), no needle mesotherapy (Acthyderm®/Eporex™),

THE

pregnancy size especially around the tummy” says Mr Inglefield.

“They can get into pretty good shape but they can’t get their abdomen firm or flat. I often combine liposuction on the abdomen with Velashape or Accent for skin tightening to help improve the overall result.”

Speaking about VASER®, Dr Treacy adds, “The makers claims what distinguishes the VASER® procedure from conventional liposuction

There are an umber of options to treat fat that is resistant to diet

is its ability to differentiate targeted fat from other important

and exercise. Liposuction has long been the gold standard

tissues – such as nerves, blood vessels and connective tissue.

procedure for this indication, however in recent years non-

A majority of doctors questioned in a recent survey found that the

surgical procedures such as VASER®, SmartLipo and other laser

system offered benefits over traditional liposuction including fast

lipolysis treatments, such as the Strawberry, have proven popular.

patient recovery, less pain, minimal bruising, reduced need for

Mesotherapy can also be used to address localised pockets of fat.

re-treatments, smooth, predictable results, increased precision,

“A lot of women find it very difficult to get back to their pre

reduced physician fatigue and skin tightening.”

Before and after Acoustic Wave Therapy (Demilec)

THE PROBLEM

VARICOSE VEINS, SPIDER VEINS Pregnancy tends to

Vascular laser and IPL treatments, sclerotherapy, surgery, electrolysis

THE

SOLUTION

worsen spider veins and smaller varicose veins because

circulating hormones associated

“The other thing that occurs in pregnancy, and this is again and oestrogen effect, is an increased number of thread veins and it can occur on the body, on the chest,

on the face and obviously on the legs”, says Dr Lowe. “Again

with pregnancy soften the vein walls and valves.

my advice is to wait for at least three or four months following pregnancy

During pregnancy veins have to carry a greater

because a lot of these will go away. For the ones that persist we can use either

circulating blood volume. Sometimes the enlarged

the ND YAG vascular laser or the yellow pulsed dye laser – I will routinely use

uterus compresses abdominal veins, causing

these on the face and on the body – and on the legs I will treat with injection

further back pressure the leg veins. Changes

sclerotherapy. It depends on the size, it depends on the color and it depends

in body chemistry due to birth control pills can

on the type of thread vein”.

also contribute to spider vein development.

Adds Dr Treacy, “Sclerotherapy is a procedure that is slowly gaining more popularity in the UK and Ireland, especially with the advent of more aesthetic centres. The procedure is used to treat smaller varicose veins with a chemical sclerosing agent or type of foam in order to make these vessels necrose or shrink in size. In this rather simple procedure, veins collapse and fade from view. The procedure may also remedy the bothersome symptoms associated with spider veins, including aching, burning, swelling and night cramps. Spider veins (up to 3mm) respond well to lasers and IPL devices, whereas sclerotherapy or foam sclerotherapy is more appropriate for treating some larger veins.”

Before and after electrolysis treatment for thread veins (courtesy of Sterex)

38

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14:21

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View on | Retinoids

A CLASS Denise Byrnes asks what role does topical vitamin A play in skin health?

Of all the ingredients available for treating ageing skin, vitamin A is one of the most studied and researched, however it is also oftentimes surrounded by confusion as to its exact mechanism of action on the skin. The first laboratory synthesised vitamin A occurred in 1960 and resulted in the all-trans-retinol.

Unfortunately research was discontinued shortly thereafter due its instability.

Since then, research has predominantly focused on a metabolite of vitamin A, all trans-retinoic acid, which is used in the treatment of a variety of dermatological disorders.

Depending on the concentration of topical retinoic acid that is used on the skin, a great deal of repair and reduction in the effects of photodamage, acne and ageing may be experienced. The main drawback with this medication is its side effects, which can include dryness, peeling, erythema and pruritus (itching), ultimately creating a desire to find newer methods of this retinoid ingredient that do not result in these harsh side effects.

This research then lead to the discovery of retinol. Clinical trials have indicated that retinol, like retinoic acid, can induce changes on the epidermis but with decreased irritation and side effects.

FORMS OF VITAMIN A There are two isomers of retinoic acid: all-trans retinoic acid (tretinoin) and 13-cis retinoic acid (isotretinoin).

Tretinoin is the acid form of vitamin A, also known as all-trans retinoic acid, and is commonly used to treat acne vulgaris and keratosis pilaris Isotretinoin (accutane) is an oral medication used for the treatment of severe acne.

It was first developed for use as a chemotherapy medication in the treatment of various cancers, including brain and pancreatic, and is still being used in this capacity because of its ability to kill rapidly dividing cells.

Retinoic acid is better-known as tretinoin or trans-retinoic acid, which is the active ingredient in Retin A. Extensive research has proven its rejuvenating effects on the skin. Tretinoin works on the retinoic cell receptors and triggers them to affect many molecular processes in the skin. These intracellular processes include the synthesis and breakdown of proteins, including collagen and elastin, cell growth and differentiation, sebum production and even telomeres (cells lifespan).

Basically, retinoic acid is responsible for the birthing of healthy, new cells in the epidermis, (also known as normal keratinisation, a process by which epithelial cells lose their moisture and are replaced by horny tissue), cell proliferation and normalised sebum secretion. Because of these attributes it has become a staple in treating a wide variety of skin conditions. Its largest drawback, client compliancy due to the various side effects associated with this medication.

40

cosmeticnewsuk.com

Denise Byrnes is co-founder and director of product development of SociĂŠtĂŠ Clinical Skincare, LLC Atlanta, Georgia.

Denise boasts more than 20 years experience as a medical skincare specialist, permanent make-up artist, owner of a successful medical skincare clinic, international speaker and educator. Her robust career experience encompasses having worked for, and consulted with, well-known companies, including BioMedic, Obagi and CosMedix/Results Rx. Byrnes has studied under top industry experts, including Dr Zein Obagi, Cristina Carlino, Dr Barry Sears, Dr Jean Carruthers, Dr Nicholas Perricone, and Dr Sheldon Pinnell, along with a bevy of others, and regularly takes continuing education courses to further expand her knowledge and keep her abreast of current trends and new innovations. While traveling the world lecturing on various aspects of skin health and innovations within the industry, she continues to research and develop new products for the Societe Clinical Skincare line. Active within the Society of Plastic Surgery Skincare Specialists (SPSSCS) since its inception in 1995, Byrnes served on its board of directors from 20002006 and as its president in 2004-2005. She is also a member of the Society of Cosmetic Chemists as well as the Society of Permanent Cosmetic Professionals.

HOW DO THEY WORK? Retinoic acid works by programming the differentiation (normalised process for cell maturity) of epithelial cells in the skin. It acts by controlling gene transcription and influences cell function by altering patterns of gene expression.

Transcription, or RNA synthesis, is the process of creating an equivalent RNA copy of a sequence of DNA .

Gene expression is the process by which information from a gene is used in the synthesis of a functional gene product. These products are often proteins.

Gene regulation gives the cell control over structure and function, and is the basis for cellular differentiation.

Retinoic acid binds to two receptors: retinoic acid receptors (RARs) and retinoid X receptors (RXRs).

Tretinoin delivers retinoic acid directly to the cells. Since it is an acid, it can cause significant skin irritation and immediately start the exfoliation process, thus leading to its low client compliancy rate. Since its dosage cannot always be controlled, overuse can increase inflammation, and erythemia, resulting in an undesirable proliferation.Tretinoin however is not the only substance capable of activating retinoid receptors. The success of tretinoin in dermatology and skin care prompted researchers to study other retinoids as a potential treatment for problems ranging from wrinkles and acne, to age spots. In fact, a number of related but distinct agents (collectively called retinoids) can do just that.

Retinols are vitamin A derivative retinoids, or lipophilic (fat soluble) molecules, which easily penetrate the epidermis, though its efficiency is dependent upon the delivery system. Retinol products must convert to retinoic acid prior to their delivery. *See the illustration on the metabolism of retinoids below. For this reason, many retinols are cosmeceuticals and do not require a prescription for dispensing, i.e., they are precursor ingredients and not actual retinoic acid. They produce a controlled conversion to retinoic acid in the skin or a direct receptor-independent biologic action. Retinols are whole vitamin A and are used for the topical treatment of photodamage and acne.

VITAMIN A ALSO: • Thickens the dermis • Pulls epidermis cells into line • Increases blood flow to the surface of the skin • Decreases clustering of melanin granules (brown spots) • Produces excellent results in eradicating pre-cancerous lesions • Promotes wound healing • Effectively treats acneic conditions • Has a stimulatory effect on dermis Retinol is the most effective substance for the care of ageing and UV-damaged skin. It accelerates mitosis (process in cell division by which the nucleus divides), increases enzyme activity and normalises keratinisation, which improves and normalises the cell renewal process.

The skin regenerates itself throughout its depth, the epidermis and dermis grow thicker, and the skin becomes more elastic. This ultimately reduces wrinkles and fine lines in number, area, length and width. The skin becomes more elastic, fresh and adequately supplied with moisture.

It also appears clearer and has a healthier color, causing blemishes to become less conspicuous.

As with all retinols, and retinoic acids stability can be a concern. They are highly sensitive to light and heat, which can degrade and break them down very easily. To be sure you are providing the optimum benefit to your clients make sure that the formula you choose is stable.

cosmeticnewsuk.com

41

View on | Retinoids

ADVANCES IN RETINOL FORMULATIONS Formulation advancements include the incorporation of alpha-hydroxy and beta-hydroxy acids into the retinol formula. Since retinols are hydrophobic (fat soluble) and AHAs are hydrophilic (water soluble) the AHAs can diffuse freely through the intracellular phase and increase penetration of the retinol into the epidermis. The addition of the AHAs and BHAs to the formula aid in exfoliation on the skin’s surface and can provide an increased effect when treating conditions like hyperpigmentation, acne and photodamaged skin.

Retinyl plamitate The primary role of retinyl palmitate is to provide a storage form of retinol, thereby serving as a control point. Although topical application of retinyl palmitate may be considered a non-physiological route, there is ample evidence to support the view that the skin possesses the enzymatic machinery necessary to convert retinyl palmitate to retinol. Accordingly, the small amount of retinyl palmitate that actually penetrates the skin would be expected and has been indirectly demonstrated to enter the normal physiological pathways controlling vitamin A homeostasis (the self-regulating process by which a biological or mechanical system maintains stability while adjusting to changing conditions).

Retinyl Palmitate acts as an antioxidant that neutralises harmful elements in our skin, helping to prevent wrinkles, resist infections and keep skin looking youthful. Vitamin A palmitate accounts for about 80 percent of vitamin A found in the skin. Once in the skin, vitamin A palmitate is converted into retinoic acid, which helps to keep skin soft and plump, normalising the skin by acting as a skincell regulator. Clinical results show that vitamin A palmitate helped to significantly increase the skin’s collagen composition, DNA, thickness and elasticity, resulting in healthier and younger looking skin.

Advances in formulations that include retinyl palmitate are better able to store vitamin A in the skin until it is needed and can be converted into retinoic acid and ultimately result in an enhancement in overall skin correction for clients using this type of product.

Retinaldehyde Retinaldehyde is formed by the oxidation of the alcohol group or retinol. The existing research is limited on this form of vitamin A and more studies are needed to assess the full scope of the skin rejuvenation benefits of retinaldehyde. Particularly useful would be those directly comparing retinaldehyde with retinoic acid and/or other retinoids over reasonably long periods of realistic topical application. What we currently know is that it can take up to three times longer for client to see results, and it is unknown if it can be stored in the skin when an excess is present.

THE IMPORTANCE OF USING RETINOLS AS A SKIN PREP CH2

Retinyl palmitate

O

plamitate

Much can be said for the importance of preparing the skin prior to a skin peel, laser modalities, or surgical procedure. Without accelerating cellular proliferation, correcting cellular damage and reinforcing the skin’s ability to heal itself, it could be likened to sending a person with no prior exercise regiment out to run a long marathon – they would be setting themselves

esterase

up for failure. I see this happen time-and-time again in medical practices where not enough emphasis is placed on the importance of proper skin preparation. Much like we would never consider going under the knife CH 2

Retinol (vitamin A)

OH

without taking antibiotics, we should not expose our patients to chemical peeling agents, laser wave lengths and ablation without preparing the skin cells for a speedy recovery, while providing them with the proper antioxidants, anti-inflammatories and amino acids they need to respond well to the treatment they will be experiencing. Incorporating retinols into

alcohol dehydrogenase

the pre-treatment of any patient undergoing a procedure is crucial to a successful outcome, and will ensure the most predictable results without CH

Retinaldehyde

OH

ß-Carotene

complications. And lets face it, is this not what we and our patients desire and expect when they seek out our professional guidance for skin health and rejuvenation?

Without question, retinoids can be your best friend in the treatment of

aldehyde dehydrogenase

a wide variety of skin conditions, and it goes without question that this amazing ingredient can provide the most dramatic and healthy results for all-transRetinoic acid

COOH

your clients.

As with all vitamin A formulations, sun avoidance and proper sun protection is crucial and the key takeaway from this article is that anything, even a good ingredient, can be inflammatory when used in the wrong concentration.

42

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what’s IN A

SMILE Dr Michael Norton on the role of dental implants in improving facial aesthetics

Dr Michael Norton is a graduate of the University Of Wales School Of Dental Medicine. For 10 years Michael served as Honorary Associate Specialist at Charing Cross Hospital, London. Since 1992 he has run a dedicated implant and reconstructive surgery practice in Harley Street, London. He is a registered specialist in oral surgery. In 2007 Michael was awarded the prestigious Fellowship in Dental Surgery of the Royal College of Surgeons, Edinburgh, for his contribution to the field of implant dentistry, and is an examiner for the new Diploma in Implant Dentistry. Michael is a past president and is the scientific adviser of the Association of Dental Implantology (UK) and is a board director and Fellow of the Academy of Osseointegration (AO), being the first from within the UK. He is immediate past editor of the AO’s Academy News and associate editor for the International Journal of Oral & Maxillofacial Implants. He is the joint owner and editor of the journal Dental Implant Summaries and is also a referee for numerous other peer review publications. Michael lectures internationally, and is widely published in the literature. His textbook, Dental Implants - A Guide for the General Practitioner, was the first on the subject by a British clinician and was published by Quintessence in 1995.

Unlike almost any other body part we take our teeth for granted. As you sit

LOOSING ONE’S TEETH RESULTS IN:

reading this article, possibly nibbling on a biscuit or biting into a lunchtime sandwich, you will undoubtedly be executing the task in an unconscious

• Loss of masticatory function

manner. Yet over half the adult population have at least one or more missing

• Cosmetic compromise

teeth and millions suffer the ignominy of having to wear dentures and being

• Loss of lip support

unable to enjoy the pleasure of eating ‘unconsciously’.

• Collapse and thinning of lipstick zone • Appearance of creases and wrinkles

In today’s world, cosmetics is king, the very ethos of this magazine, and again as

• Reduced facial height

you thumb through its pages you can’t fail to appreciate that what drives this as

• Social stigma

well as high street glossy magazines is beautiful women. These women all share

• Loss of self confidence

superlative facial beauty based on recognised parameters of facial symmetry, skin

• Change of personality (Patients describe

tone, eye colour and central to it all the beauty of the smile.

themselves as less happy)

In a publication in the British Dental Journal (Vol. 188 pp. 503-506) a survey of

• Refusal to eat out

patients who had lost some or all of their teeth described their emotions as

• Overall loss of quality of life

ranging from sadness, to depression and remorse.

Cosmetic Dentistry | Implants

Dental implants represent the greatest advance in restorative dentistry in the history of the dental profession. No other body part can be more effectively replaced with such a high predictability of long-term success. The effect on patients is often life altering. This is particularly notable for patients who have had devastating gum disease (Fig 1), or worse oral cancer and lost all their teeth as a result of the consequence of damage to the supporting structures, notably the jaw bone and gums. Such patient’s are left incapacitated, embarrassed and often ashamed through no fault of their own.

Fig 1

sex) a toothless grin doesn’t wash and there is significant prejudice against individuals with missing teeth. Yet for many such individuals the prospect of wearing dentures equates to the prospect of becoming a laughing stock to the masses and a prisoner to plastic.

So what can implants offer? Dental implants can potentially be a third dentition, being permanently fixed structures that can completely restore function, form, aesthetics and self-confidence. Everything from single tooth replacement (Figs 2 and 3) to a full-mouth reconstruction is possible (Figs 4 and 5), even having a full jaw of teeth placed within a day is now routine practice.

So what can dental implants and reconstructive dental surgery offer? In 1981 the first international publication in a peer-review oral surgery journal

Fig 2

Fig 3

Fig 4

Fig 5

published 15-year data on the first osseointegrated dental implant. This implant was based on a serendipitous discovery that when the metal, titanium, is implanted into bone it actual appears to fuse with the bone rendering it one with the host, i.e. it becomes part of the body. This is very different from classic hip and knee implants where the stem of the implant is cemented into the hollow marrow space of the long bones. The unique concept of osseointegration meant that even small medical devices such as dental implants could not only be implanted with a high degree of clinical predictability but they could withstand immense functional forces, typically seen when biting in the premolar and molar regions of the mouth.

Ask any dentist who has mistakenly had their fingers bitten by a patient – not a pleasant occupational hazard!

Over the last two decades there have been problems, and there have been developments. Indeed one of the biggest problems was the ability of the smaller implants, often < 10mm in length to withstand higher

Treatment starts with a full assessment and diagnosis. Implants represent

functional loads, however with significant advances in surface technology

an expensive and time-consuming form of tooth replacement and as

and the use of nano-technology, modern moderately-rough titanium

such they should only be placed in light of a holistic treatment plan,

implants offer success rates higher than 95% even for short implants.

which aims to eradicate disease and restore the patient to functional

This may prove to be of increasing importance because many patients

and cosmetic health. Patients do not come for implants per se but rather

seeking dental implant therapy simply don’t have enough bone in which

tooth replacement and to this end the aim is to provide a tooth or teeth

to place more traditional implants of 13mm to 17mm in length. This is

supported by implants that both the patient and observer perceive to be

due to the fact that not only can the bone be ravaged by disease, but

in harmony with the natural dentition. This means that not only does the

the supporting bone for teeth, the alveolar bone, is a functional matrix

tooth itself have to be the correct shade, shape and orientation but the

whose only purpose is to support the teeth within it. As such when teeth

gum tissue which drapes the tooth has to be a consistent colour, texture

are extracted the jaw undergoes a process of resorption with a net loss

and contour, which is itself determined by the underlying supporting

of bone volume at the site of the extraction. This is the explanation for

bone. This is part of the reason why reconstructive dentistry with implants

why longstanding denture wearers have the classic collapsed face

often includes bone grafting and soft tissue grafting. Implants placed

appearance when they remove their dentures, because this same bone

incorrectly or with a lack of good supporting tissue will yield a most

which supports the teeth also

undesirable

supports the facial tissues not least

outcome as

the lips, chin and cheeks.

in Figure 6 and in these

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cosmeticnewsuk.com

So what’s in a smile? Well it

circumstances

seems everything. Whether it be

the patient may

for eating, socialising, getting a

well have been

job of work or for sexual purposes

better off with

(both attraction and physical

a simple acrylic

actions especially kissing and oral

denture.

Fig 6

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Cosmetic Dentistry | Implants

Fig 7

However understanding

Perhaps the biggest risk lies with the presence of the lingual artery

the principles of implant

behind the anterior mandible as it runs from the floor of the mouth into

dentistry and good

the tongue. There are sadly a few case reports, although thankfully

restorative techniques,

rare, where this artery has been severed during surgery resulting in a

which itself depends

potentially life threatening bleed and haematoma formation in the

on high quality dental

floor of the mouth. Along with the nasal cavity and sinuses all such

technicians, it is possible

vital structures need to be visualised during planning and appropriate

to take a case like that

measures taken to ensure the safe placement of implants. In this

shown in Figure 6 and

respect the use of CT scans has become routine for the planning of

render it aesthetically

implant surgery. Special software is available today which not only

satisfactory as in Figure 7.

allows the visualisation of anatomy in three dimensions, but also allows the interactive placement of implants of an appropriate dimension,

A question often asked, understandably, is whether having implant

inclination and orientation along with the proposed teeth within the

surgery is safe. All surgery carries some risk, and some side-effects of

anatomy (Fig 10).

surgery are unavoidable, e.g. pain, swelling and bruising. Actually implant surgery whilst often causing some degree of swelling and occasional bruising is rarely painful. Typically 85% of patients will report that they did not require any analgesia even 24 hours after surgery.

Infection is always a risk with any oral surgery. The mouth is one of

Fig10

the dirtiest environments in the human body. Even a clean, healthy mouth harbours a very significant microflora including some notoriously pathogenic strains which in the susceptible host might cause periodontal (gum) disease. These pathogenic bacteria as well as those associated with tooth abscess formation and endodontic (root canal) infections are known to cross infect implant sites, resulting in both post-operative infections as well as long-term infections similar to periodontal disease Fig 11: CT schematics

seen around natural teeth. As such the debate continues as to the

of mandibular anatomy

appropriateness of using peri-operative antibiotics at a time when over-

showing nerves, virtual teeth

prescription of antibiotics is causing concern in some quarters.

and virtual implants

Fig 8

Fig 8: The implant has bisected the root apex of the natural tooth, which required a root canal filling

Once planned in this way it is also possible to have a surgical guide fabricated that will then ensure that the implants are then placed in the exact positions

As with any other part of the body, the

dictated by the scan (Figs 11 and 12).

anatomy of the mouth is associated with vital structures. The obvious ones are the adjacent teeth. In some circumstances an incorrectly placed implant might actually damage the root of an adjacent natural tooth (Fig 8) and this may ultimately lead to

Fig11

the need for a root canal treatment or the eventual failure of the tooth.

Fig12

In the posterior mandible (lower jaw) the inferior alveolar nerve courses through its interior before it exits at the position of the premolars to enter the soft tissues, where it provides sensation to the lower lip, chin and overlying skin, (Fig 9). Damage to these nerves by too deep an implant placement will often result in permanent numbness of this whole area, resulting in an inability to sense temperature or touch which can be understandably debilitating as well as embarrassing when it comes to eating and drinking

Fig 12 and 13: The computer-generated guide ensures

as anyone whoâ&#x20AC;&#x2122;s had a dental injection will testify. Even speech can be

accurate placement of implants during surgery

affected.

Fig 9

Today we have the possibility to have in-house dental cone-beam CT scanning equipment. Whilst expensive any serious practice specialising in this kind of surgery really needs one.

With high tech planning such as this, along with the wide variety of new regenerative products to helps us rebuild lost bone and gum, dental

Fig 9: The nerves are traced out in orange

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cosmeticnewsuk.com

implants offer the ultimate reconstruction rebuilding not only the smile but quality of life and patient confidence too.

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Best Practice | Referrals

PASS IT ON

We publish an extract from Dr Peter T. Pugliese’s new book, Advanced Professional Skincare, on how and when to refer patients to a specialist colleague

In everyone’s life their comes a day when you must admit that you do not know everything. This is very hard at first, but, after a while, asking for help becomes both easier and profitable. Referral makes life easier.

It can provide you with a learning experience for each case referred.

It also builds your reputation and provides better care for your client.

Dr Peter Pugliese MD has been engaged in the study of skin physiology for more than 40 years and has made discoveries that have influenced the course of professional skincare around the globe. Dr Pugliese’s research in the field of anti-ageing has given him numerous awards and patents including the Maison Navarre Gold Medal, the highest honor of the National Society of Cosmetic Chemists. In 2003 Dr Pugliese founded the Circadia Skin Care Institute, where he teaches advanced courses for skincare professionals in physiology, histology, biochemistry, cosmetic chemistry and medical aesthetics. He is a member of the Society of Bioengineering and the Skin, the American Academy of Dermatology, the Society of Investigative Dermatology and has given more than 125 presentations at scientific meetings worldwide. He has also contributed to chapters in more than a dozen books and published more than 60 scientific papers. He has authored four books, of which Advanced Professional Skincare (Medical Edition) is the latest.

Every profession has a professional society of some type (a profession is defined as an occupation that requires ‘extensive education in a science of liberal arts’). Skincare is currently a subspecialty of the cosmetic profession. Although it may not be recognised as a profession in its own right, skincare is a field that is pushing forward to reach that level. Its practitioners continue to require more and more education to do their jobs well. While some skincare specialist will be content with basic education, others will strive to reach the top. One way to accomplish this is to associate with other professions that are allied with or related to skincare and to attend their meetings and seek their help.

There are two main professions allied to skincare: medicine and podiatry.

Within medicine, (practitioners from) general medicine, dermatology, plastic and reconstructive surgery and cosmetic surgery may all treat skin conditions so you need to understand he general way to make a referral and understand what conditions to refer to whom.

WHEN TO REFER Cardinal rule for referral: Refer any client who has a condition that you do not feel absolutely confident to treat

REFERRING TO A DERMATOLOGIST The dermatologist is the specialist best trained for recognising and treating

both parties. If you treat every referral as an opportunity or learning, you can get

abnormal skin conditions. Their training is spent studying the diagnosis and

a kind of mini-postgraduate course by making sure you ask the dermatologist to

treatment of both primary diseases of the skin (that is those that arise in

explain their findings and treatment to you. If you ask politely and make it clear

the skin as the first site) and skin manifestation of systemic disorders.

that you want to understand to better know what to refer, then dermatologists

A good working relationship with a dermatologist can be very beneficial for

will be glad to help you. Dermatologists can also learn from you as well.

CONDITIONS APPROPRIATE FOR REFERRAL TO A DERMATOLOGIST LESIONS OF THE FACE • Cystic acne (any number of cysts – even one) • Any pigmented lesions you do not recognise • Rhionphyma • Diffuse seborrheic dermatitis • Any lump or bump • Vascular lesions such as telangiectasia • Severe contact dermatitis • Neurodermatitis

LESIONS OF THE CHEST, BACK AND ARMS You can find the same lesions on the body as those found on the face (except rhionphyma) but here are some more commonly found on the body: • Psoriasis • Impetigo • Tinea versicolor • Herpes zoster (shingles) • Seborrheic keratosis • Any rash that you do not recognise

cosmeticnewsuk.com

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Best Practice | Referrals

REFERRING TO A PLASTIC SURGEON Deciding when you should refer a client to a plastic surgeon is somewhat more difficult than making a referral to the dermatologist. First you should be very familiar with the various designations for plastic surgeons. The term ‘plastic and reconstructive surgeon’ refers to a surgeon who has had special training in reconstructive procedures for both congenital and traumatic defects. The term ‘cosmetic surgeon’ refers to a surgeon who has limited training in a fixed number of procedures, generally those called ‘elective procedures’ – those that are not being done on a life and death basis but that the patient has chosen to have to get a better or more attractive appearance such as breast augmentation.

Entire books have been written on the subject of selecting a physician (surgeon). There is no right way, however as a skincare specialist, you will be expected to know who is the best plastic surgeon in your area. You should remember in your search that not every plastic surgeon is the best at every procedure.

Also, while professional credentials are a good guide, they are in no way a guarantee.

So what do you look for?

•

The surgeon’s major interest must be the welfare of the patient. If this is not the case, forget everything else

•

The surgeon must be considerate, kind, understanding, principled, ethical and of good moral standing – being a good technical surgeon does not necessarily make a good cosmetic surgeon

•

A surgeon must be respected by colleagues and most likely will be a member of a professional medical society

•

Plastic surgeons should not ostentatiously display their wealth, for those who do often the money has become the major reason fro doing surgery

Make an appointment to visit any surgeon to whom you would consider referring clients. Explain the reason you wish to visit, select a time that is convenient for the surgeon and plan to take no more than 30 minutes for your visit.

When you arrive, introduce yourself and explain your reasons for wanting to get to know the surgeon. Don’t discuss credentials at this time but do ask to see photographs of patients treated. If you know anyone who has been treated by the surgeon, discuss the whole procedure from first visit to follow up care with them. The initial visit is very important or your client, so you should know how the surgeon handles patients on their first visit.

Keep in mind that not all plastic and cosmetic surgeons are going to be interested in what is best for your client, but rather what is best for them. The medical profession has a limited number of these physicians, but nevertheless they do exist. If the surgeon recommends multiple procedures on the first visit when your client came in for only one procedure, you should probably view this as a caution sign. While multiple procedures may eventually be desired by the client, such suggestions often have the effect of reducing the client’s self-esteem. Also beware of the surgeon that rushes the patient into surgery. Patients must have time to think about a procedure that will affect the rest of their lives. Once you have established the possibility of a good working relationship with a surgeon you need to know what their credentials are. From the information you receive you will be able to determine the training qualifications of each physician.

COMMON CONDITIONS THAT CAN BE TREATED BY A PLASTIC/COSMETIC SURGEON

SUMMARY

•

In every profession there are different levels of skill. Those

Ageing/sagging facial skin (that can’t be helped with nonsurgical intervention)

•

Unwanted nose shape

•

Dislike or discomfort with breast size

•

Saggy, dropping or baggy eyelids

professionals with a particular skill are called ‘specialists’. When you have a problem with a client, seek help from a specialist, a process called referral. Referral makes life easier. It provides you with a learning experience for each case referred and is thus a true educational resource. Referral also builds your reputation and provides better care for your clients. Know

REFERRING TO OTHER AESTHETIC PRACTITIONERS/AESTHETICIANS You may now an aesthetic practitioner/aesthetician in your area who has a special skill in some procedure. Consider referring clients to them for treatment. As you gain skills in your particular area, you too may want to seek referrals from your peers, after all this is how medical specialties were born. This is a new concept but one that would be a wonderful practice as aesthetic practitioners work towards full professional status.

the limits of your skills and always be ready to learn and refer. Many skin conditions exist that you may not be able to handle, referring them is a sign that you are conscientious.

The referral system forms the backbone of good medicine.

Study the conditions that need referral and the treatments offered by specialists that will help your clients. Careful selection of the physicians or aestheticians to whom you refer is important. Two qualities that are most important are: professional competence and high levels of ethical standards. Check with physicians to whom you refer patients, ask to see results of previous treatments/procedures and establish a professional relationship with them.

Reference: Dr Peter T Pugliese, Advanced Professional Skincare (Medical Edition), Chapter 11: Referral Options – When and How p266-278

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Best Practice | Insurance

QUESTION TIME

Eddie Hooker answers the most common questions on who you should insure in your practice

One of the most common questions that I am asked runs along the lines of “I know that I ought to be insured, but is there anybody else in the business I should be thinking about?” Although common, this question is one of the most difficult to answer in simple terms. The usual response is, “Well, it depends upon your circumstances.” The reasons why anyone else, apart from the owner, should be included in the insurance are numerous, often complex and, for those not dealing with these issues on a regular basis, can be difficult to understand. Nevertheless, whilst warning that if you have any concerns in this connection you should approach your MDO or insurer for clarification, I will attempt to unravel the complexities as best I can.

Q: With regard to the procedures

confidence, etc. – but at the same time would

insured, do I practice or trade solely in

want to set up a limited company (to which

my own name and are the treatment

they contract their services exclusively) to

fees charged to the patient paid to me in

shield their earnings for, say, tax efficiency

person and to no one else?

purposes. Should you decide to follow this

A: If both answers to this two part question

course you must inform your MDO/insurer at the outset: otherwise it is quite possible

Eddie Hooker is managing director of Hamilton

are ‘yes’ then it is likely that the protection/

that your indemnity protection will not

Fraser Insurance. Eddie and Hamilton Fraser

insurance arrangements can properly be in

operate in the event of a claim – particularly

Insurance first started to insure cosmetic

your name alone. However, if in any way you

if the claim is pursued, as is likely, against

practitioners as early as 1996 when they became

are unsure of your answer, I advise strongly

the company. The MPS, for example, are

involved with nurses practicing in collagen

that you to seek advice from your MDO/

specific in their ‘Membership Guidance

injections. Hamilton Fraser launched the UK’s first

insurer. Failure to do so could prove costly at

Notes’ that unless they are specifically

‘aesthetics specific’ medical indemnity policy in

a later date!

informed, any membership granted relates

1998 and now insure more than 2,000 individual

to the individual only.

practitioners and businesses within the sector,

Q: If I do trade in my own name is there,

growing by more than100 new practitioners

for any reason, a limited company, or

Q: Do I trade in the name of a separate

each and every month.

other legal entity behind that name,

legal entity, such as a partnership or

e.g. Cosmetics Ltd T/A Jane Peter’s

limited company, of which I am a partner

Aesthetics?

or shareholder/employee?

A: There are many reasons why an individual A: In these circumstances the contract for

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cosmeticnewsuk.com

should want to practice or trade in their

services is between the patient/customer and

personal name – goodwill, patient/customer

partnership/limited company. Accordingly,

in the event of your alleged mal-practice the aggrieved party is fully entitled in law to sue the partnership/company for compensation; not only under the law governing negligence but also in contract. It is vital, therefore, that you consult your MDO/insurer to ensure that the partnership/company is protected.

Q: Do I offer my services to other organisations - such as beauty clinics, gymnasia or other professionals who do not offer cosmetic or aesthetic procedures?

A: This is an area, which is full of pitfalls unless you are very careful. This does not mean that I caution against this practice. Far from it. It is a practice, which is perfectly reasonable and, of course, holds many business opportunities. In order to gain the correct protection, you need to consider the basis of the relationship between the patient/customer and yourself. Are your

“As a rule of thumb, if the patient/customer is billed in your name and payment made to you directly, then prima facie you are acting as an independent contractor and your existing cover should be adequate”

services being provided by you as an independent outside contractor, or are they being provided as part of the overall services offered by the beauty salon/clinic etc. As a rule of thumb, if the patient/customer is billed in your name and payment made to you directly, then prima facie you are acting as an independent contractor and your existing cover should be adequate. Alternatively, if the bill is presented by the beauty salon/clinic etc. in their name and they get paid (perhaps paying you a fee or commission), it is they who are liable. In the latter event you need to ensure that they also have proper arrangements in place to protect you – otherwise it could get ‘sticky’.

Q: Do I, or my organisation, use independent practioners for specific procedures?

A: Again, if you are billing the patient/client and collecting payment in your name (perhaps paying the practitioners a fee or commission) then your insurance arrangements should be extended to include the treatments. If the practitioner is paid direct then they will need their own insurance. A word of warning though. If your advertising of certain treatments give the impression that it is your business that is offering the treatments, rather than a completely independent contractor, you may still be liable, especially if that contractor is unavailable when a claim is presented to you. I suggest that you always extend your own policy to cover this eventuality.

Q: Do I rent my premises/surgery to cosmetic or aesthetic practitioners for services I do not offer myself?

A: The situation described in this question can arise where a medical practice does not provide cosmetic or aesthetic procedures itself but sees the advantage to its patients of having one that does, in close proximity. In this scenario the owner of the practice does not wish to be involved in the cosmetic/aesthetic business directly but recognises that there will be advantages to be gained by way of attracting new patients if he or she rents out part of his or her premises to a cosmetic or aesthetic practitioner – not to mention the rental income!

Provided the owner or his/her staff does not recommend, overtly advertise, or share staff and services with the cosmetic/aesthetic practice, there should not be any come back

“Most employers know that they are compelled by law to insure their employees for injury suffered by them in the workplace. Most also know that if one of their staff negligently causes injury to a third party, the employer can be legally held responsible for that act – including advice negligently or wrongly given”

nevertheless it might be worthwhile considering ‘contingency cover’ if this is available.

Q: Do I, or the organisation which employs me, employ any one else - including ‘back room’ staff? If so who, and what are their duties?

A: The point of this question is that if staff are employed, particularly nurses and clinical technicians, you must ensure that you, as well as they, are protected against the consequences of them acting in a negligent manner. Most employers know that they are compelled by law to insure their employees for injury suffered by them in the workplace.

Most also know that if one of their staff negligently causes injury to a third party, the employer can be legally held responsible for that act – including advice negligently or wrongly given.

It is essential that you ensure that your MDO/insurer knows that you employ staff, the nature, number and duties of them, and that they are included in the cover provided. Remember that not all injuries suffered by third parties as the result of your, or your staff’s negligence, will be covered by MDO membership or medical mal-practice insurance so alternative arrangements must be made. Most insurers, including my own company, Hamilton Fraser Insurance, can offer Employers Liability and Third Party Insurance on request.

cosmeticnewsuk.com

55

Training Spotlight | Epionce®

MAN OF SCIENCE

Skincare has become an integral part of every medical aesthetics practice but it is not often that you get a chance to meet and learn from the person who created the range that you use in your clinic.

Cosmetic News attended an exclusive Epionce® users meeting and training day in London with the brands creator and leading US dermatologist Dr Carl Thornfeldt do/don’t use certain ingredients in their products.

He goes through all the products in the range and talks about how and when to use them.

“Barrier repair is complex so you have a number of processes that you have to work on to produce the beneficial effect and that’s why we have a number of ingredients”, he says. “There’s actually

For Epionce® stockists, that opportunity came

well as more than 20 scientific publications in the

been some famous dermatologists preaching

last month when its creator, the president, CEO,

area of treatment of skin diseases and conditions.

that your product should have less than 10 active

and chief scientific officer of Episciences, Inc. Dr

He spent more than a decade researching

ingredients otherwise its dangerous. They have

Carl Thornfeldt, flew in from the States to host an

the skin barrier and cutaneous inflammatory

no idea what they are talking about, you can’t

exclusive interactive Epionce® users meeting

condition and developed the Epionce® skincare

do that, you can’t modulate inflammation and

and training day in London. Held at the Radisson

range, based on his research that linked the

alter barrier repair with less than 10 ingredients.

Blu Portman Hotel in Portman Square, the free of

effects of two damaging biological processes

Every ingredient we have in these products has

charge event was organised by Eden Aesthetics,

in the skin: chronic inflammation and disruption

some definite benefit and a specific role – we

the UK distributor of the advanced skincare

of the skin’s natural protective barrier.

don’t have any fluff in this product line.”

accounts as well as those looking to expand

It is the topic of skin barrier damage that Dr

Throughout the morning Dr Thornfeldt stresses

their skincare offering to include the brand.

Thornfeldt begins with after his short introduction.

the importance of the scientific research and

The day was a rare opportunity to receive

He talks about how many products on the

clinical studies behind the products and presents

training from the man who was named as one

market actually damage the skin barrier and

data from various studies they have carried out.

of the top 50 doctors in the US in both 2003 and

cause inflammation. He says, “What differentiates

With their heads filled with knowledge the

2005 by The Sinatra Health Report (and the

Epionce® from any of the other skin products out

delegates break for lunch before the afternoon

only dermatologist on the list) and to improve

there is that we were built from the ground up.

session gets underway. This is focused on practical

and develop product knowledge and learn

We went in with a hypothesis: can we make the

demonstrations of Epionce®’s professional

advanced treatment techniques and protocols.

skin function in its optimum way and if we can

treatments. Two of the Epionce® trainers carry out

can we prevent disease and what we see as skin

treatments on models while Dr Thornfeldt speaks.

After a welcome reception delegates sat down

ageing? So its an entirely different philosophy

The whole event is highly interactive with Dr

to listen to Dr Thornfeldt’s opening lecture. From

to anything out there. The new paradigm is to

Thornfeldt welcoming questions throughout his

the minute he begins to speak it is obvious why

unlock the skin’s natural ability to repair, strengthen

presentations and demonstrations. During the

Dr Thornfeldt has become an internationally

and protect itself with Epionce®. What we

breaks he also makes an effort to talk to everyone

renowned keynote speaker. Clearly passionate

basically discovered was how the body does it

and answer any questions they have. It was clear

about skincare and the brand he has developed,

and all we do is help the body do it its best.”

at the end of the day that the delegates left with

range, and was open to existing Epionce®

the self confessed ‘science geek’ manages

56

a renewed

to make the complex scientific content of his

After talking about the philosophy behind

sense of

presentations easy to understand and engaging.

Epionce® Dr Thorneldt moves on to talk about

passion and

the science of skin ageing. He explains what

excitement

He starts by explaining a little bit about his

happens to skin as it ages and talks about both

about

background and how he came to develop

intrinsic and extrinsic ageing. “80 percent of all skin

applying the

Epionce®. Dr Thornfeldt has been a practicing

ageing is extrinsic so it is controllable”, he says.

knowledge

dermatologist for more than 25 years and is

Living and working in Idaho, Dr Thornfeldt sees

they had

assistant clinical professor of dermatology at the

a lot of sun damage related skin problems and

gained in

University of Oregon Health Sciences Center.

he talks in depth about the effects of the sun

their practices

One of his specialties has been in the field of

on skin ageing as well as the role of chronic

and taking

skin research where he was able to indulge his

inflammation in skin disease and skin ageing.

their use of

passion for all things scientific, a field in which he

In the second part of his presentation Dr Thornfeldt

skincare to

has excelled with 22 US patents to his name as

moves on to talk about ingredients and why they

the next level.

cosmeticnewsuk.com

DATES FOR THE DIARY April 6 Cosme Education Zone Medical Forte Training, Maidenhead, www.cosmeceutcials.co.uk 7 Cosme Education Zone Anti-Ageing Programme, Maidenhead, www.cosmeceutcials.co.uk 8 Cosme Education Zone Advanced Exfoliation Techniques, Maidenhead, www.cosmeceutcials.co.uk 8 Wigmore Medical Training Sculptra, London, www.wigmoremedical.com 10 Innomed Training Botulinum Toxin in Facial Aesthetics – New Users, Southampton, www.innomedtraining.co.uk 10 Cosmetic Courses Advanced Botulinum Toxin and Dermal Filler Training, The National Training Centre, Buckinghamshire, www.cosmeticcourses.co.uk 11 Innomed Training Dermal Fillers – New Users, Southampton, www.innomedtraining.co.uk 11 Advanced Botox and Dermal Fillers, Newcastle, www.medicsdirect.com 12 Skin Peels, Newcastle, www.medicsdirect.com 12-13 Cosme Education Zone Advanced AHA Training, Glasgow, www.cosmeceutcials.co.uk 12-13 Cosme Education Zone CoffeeBerry® Training, Birmingham, www.cosmeceutcials.co.uk 13 Dr Bob Khanna Training Institute, Oral Facial, www.drbobkhanna.com 13 Intermediate Level Obagi Systems and Obagi Blue Peel Workshop, Dublin, www.healthxchange.com/obagi-training 13-14 In Cosmetics, Paris, www.in-cosmetics.com 14 Intermediate Level Obagi Systems and Obagi Blue Peel Workshop, Manchester, www.healthxchange.com/obagi-training 14 Dr Bob Khanna Training Institute, Advanced Dermal Filler, www.drbobkhanna.com 14-15 Cosme Education Zone AHA Training, Birmingham www.cosmeceutcials.co.uk 16 Cosme Education Zone Idebenone Training, Birmingham www.cosmeceutcials.co.uk 16 Dr Brian Franks Facial Aesthetic Training Courses Botulinum Toxin Refresher Course (Vistabel® and Azzalure®), jan@drbrianfranks.com

www.cosmeticnewsuk.com 16-17 Cosmetic News Expo 2010, Business Design Centre, Islington, London, www.cosmeticnewsuk.com 17 Dr Brian Franks Facial Aesthetic Training Courses: Introduction to Botulinum Toxin Type A, Watford, jan@drbrianfranks.com 18 Dr Brian Franks Facial Aesthetic Training Courses: Introduction to Dermal Fillers, Watford, jan@drbrianfranks.com 19 Mapperley Park Core of Knowledge, Nottingham, www.mapperleypark.co.uk/training 19 Dr Bob Khanna Training Institute, Beginners Botulinum Toxin, www.drbobkhanna.com 19 Cosme Education Zone Idebenone Training, Glasgow, www.cosmeceutcials.co.uk 19-20 Cosme Education Zone CoffeeBerry® Training, Maidenhead, www.cosmeceutcials.co.uk 20 Cosme Education Zone Advanced Treatment Techniques, Glasgow, www.cosmeceutcials.co.uk 20 Dr Bob Khanna Training Institute, Advanced Botulinum Toxin, www.drbobkhanna.com 20 One Day Combined Botox and Dermal Filler Course Foundation Level, www.inspiredcosmetictraining.com 20-22 LCS Academy BTEC Professional Certificate: Medical Laser and IPL, www.lcsacademy.co.uk 21 Dr Bob Khanna Training Institute, Beginners Dermal Filler, www.drbobkhanna.com 21 Wigmore Medical Training Introduction to Skincare Peels and Derma Roller, London, www.wigmoremedical.com 21-22 Cosme Education Zone AHA Training, Maidenhead, www.cosmeceutcials.co.uk 22 Wigmore Medical Training Introduction to Botulinum Toxin Type A, London, www.wigmoremedical.com 23 Wigmore Medical Training Introduction to Fillers, London,

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cosmeticnewsuk.com

We round up upcoming events, training courses and meetings

www.wigmoremedical.com 23 Cosme Education Zone Idebenone Training, Maidenhead, www.cosmeceutcials.co.uk 24 Cosmetic Courses Foundation Botulinum Toxin and Dermal Filler Training, The National Training Centre, Buckinghamshire, www.cosmeticcourses.co.uk 24 Foundation Botox and Dermal Filler Training Course, Birmingham, www.thelawrenceaestheticacademy.co.uk 24 Advance Botox and Dermal Filler Training Course, Birmingham, www.thelawrenceaestheticacademy.co.uk 24 Med-fx Sculptra Training, London, www.medfxtraining.co.uk 24 Chemical Peel half day training course, Birmingham, www.thelawrenceaestheticacademy.co.uk 24 Genuine Dermaroller™ Training, Manchester elizabeth@aestheticare.co.uk 24 Innomed Training Chemical Peeling Systems – New Users, London, www.innomedtraining.co.uk 24-25 Foundation Botox and Dermal Fillers, Birmingham, www.medicsdirect.com 24-27 Genuine Dermaroller™ Medical Device Training, Manchester, www.genuinedermaroller.co.uk 25 Innomed Training Mesotherapy for Fat, Cellulite and Skin Rejuvenation – New Users, London, www.innomedtraining.co.uk 25 Advanced Botox and Dermal Fillers, Birmingham, www. medicsdirect.com 26 Skin Peels, Birmingham, www.medicsdirect.com 26-27 Cosme Education Zone CoffeeBerry® Training, Glasgow, www.cosmeceutcials.co.uk 26-30 Mapperley Park Btec Award Laser, Light and Associated Aesthetic Therapies, www.mapperleypark.co.uk/training 26-28 VASER® Training, www.granthamlet.co.uk 27 Wigmore Medical Training NeoStrata Peels, London, www.wigmoremedical.com 29 LCS Academy Core of Knowledge, www.lcsacademy.co.uk

MAy 3 One Day Combined Botox and Dermal Filler Course Foundation Level www.inspiredcosmetictraining.com 4 One Day Combined Botox and Dermal Filler Course Foundation Level www.inspiredcosmetictraining.com 4 LCS Academy Practical Guide to Contraindications for Light Based Therapies, www.lcsacademy.co.uk 5 Mapperley Park Master Class Vascular Therapies, Nottingham www.mapperleypark.co.uk/training 5 Revanesse and Redexis Dermal Fillers Training, Boston Medical Group, www.boston-medical-group.co.uk 6-8 Laser Europe, Tarragona, Spain, www.lasereurope2010.com 7 One Day Combined Botox and Dermal Filler Course Foundation Level, www.inspiredcosmetictraining.com 8 Aesthetox Academy Training Courses, Birmingham, www.aesthetox.co.uk 8 One Day Combined Botox and Dermal Filler Course Foundation Level, www.inspiredcosmetictraining.com 8-9 Foundation Botox and Dermal Fillers, Manchester, www.medicsdirect.com 10 Genuine Dermaroller™ Training, London elizabeth@aestheticare.co.uk 10 LCS Academy Laser / IPL Protection Supervisor Training, www.lcsacademy.co.uk 10 Mapperley Park Core of Knowledge, Nottingham, www.mapperleypark.co.uk/training 10 Cosme Education Zone Omnilux Training, Maidenhead, www.cosmeceutcials.co.uk 10-11 Cosme Education Zone Vitage Training, Glasgow, www.cosmeceutcials.co.uk 11-12 Cosme Education Zone Vitage Training, Maidenhead, www.cosmeceutcials.co.uk 11 Intermediate Level Obagi Systems and Obagi Blue Peel Workshop, Manchester, www.healthxchange.com/obagi-training 12 Introduction to Obagi Products and Systems Workshop With Shannon Lister, London, www.healthxchange.com/obagi-training 12 Wigmore Medical Training NeoStrata Peels, London, www.wigmoremedical.com 13-16 EADV Spring Symposium, Croatia, www.eadvcavtat2010.com 15 Innomed Training Chemical Peeling Systems – New Users, London, www.innomedtraining.co.uk 16 Advanced Botox and Dermal Fillers, Bristol, www.medicsdirect.com

16 Innomed Training Mesotherapy for Fat, Cellulite and Skin Rejuvenation – New Users, London, www.innomedtraining.co.uk 17 Cosme Education Zone Omnilux Training, Birmingham, www.cosmeceutcials.co.uk 17-20 Mapperley Park BTEC Award Laser and Light Based Hair Removal and Photorejuvenation, Nottingham, www.mapperleypark.co.uk/training 18 Intermediate Level Obagi Systems and Obagi Blue Peel Workshop, Glasgow, www.healthxchange.com/obagi-training 18-19 LCS Academy BTEC Professional Certificate: Medical Laser and IPL, www.lcsacademy.co.uk 18-19 Cosme Education Zone Vitage Training, Birmingham, www.cosmeceutcials.co.uk 19 Wigmore Medical Training Introduction to Skincare Peels and Derma Roller, London, www.wigmoremedical.com 20 Wigmore Medical Training Introduction to Botulinum Toxin Type A, London, www.wigmoremedical.com 21 Wigmore Medical Training Introduction to Fillers, London, www.wigmoremedical.com 21 Dr Brian Franks Facial Aesthetics and Facial Aesthetic Training Courses Botulinum Toxin Refresher Course (Vistabel® and Azzalure®), jan@drbrianfranks.com 21-23 The Aesthetics Show, Las Vegas, www.miinews.com/aesthetic/ 22 Dr Brian Franks Facial Aesthetics and Facial Aesthetic Training Courses: Introduction to Botulinum Toxin Type A, Watford, jan@drbrianfranks.com 22-23 Foundation Botox and Dermal Fillers, Glasgow, www.medicsdirect.com 23 Dr Brian Franks Facial Aesthetics and Facial Aesthetic Training Courses: Introduction to Dermal Fillers, Watford, jan@drbrianfranks.com 24 Skin Peels, Manchester, www.medicsdirect.com 24-27 LCS Academy BTEC Professional Award: Aesthetic Laser and IPL Therapies, www.lcsacademy.co.uk 24 Cosme Education Zone Advanced Exfoliation Techniques, Glasgow, www.cosmeceutcials.co.uk 25 Cosme Education Zone Omnilux Training, Glasgow, www.cosmeceutcials.co.uk 26 Mapperley Park Core of Knowledge, London, www.mapperleypark.co.uk/training 26-28 VASER® Training, www.granthamlet.co.uk 27-29 21st European Association of Plastic Surgeons (EURAPS) Meeting, Manchester, www.euraps.org 31 Cosme Education Zone Advanced AHA Training Day 1, Glasgow, www.cosmeceutcials.co.uk

June 1 Introduction to Obagi Products and Systems Workshop With Shannon Lister, Manchester, www.healthxchange.com/obagitraining 1 Cosme Education Zone Advanced AHA Training Day 2, Glasgow, www.cosmeceutcials.co.uk 2 Introduction to Obagi Products and Systems Workshop With Shannon Lister, Birmingham, www.healthxchange.com/obagi-training 5 Aesthetox Academy Training Courses, Birmingham, www.aesthetox.co.uk 5 Boston Medical Group, Introduction to Mesotherapy, www.boston-medical-group.co.uk 5 Innomed Training Botulinum Toxin in Facial Aesthetics – New Users, Southampton, www.innomedtraining.co.uk 5 Advanced Botox and Dermal Fillers, Manchester, www.medicsdirect.com 6 Innomed Training Dermal Fillers – New Users, Southampton, www.innomedtraining.co.uk 7 Dr Bob Khanna Training Institute, Beginners Botulinum Toxin, www.drbobkhanna.com 7 Cosme Education Zone Idebenone Training, Glasgow, www.cosmeceutcials.co.uk 7 Genuine Dermaroller™ Training, London elizabeth@aestheticare.co.uk 7-8 Cosme Education Zone Advanced AHA Training, Birmingham, www.cosmeceutcials.co.uk 8 Cosme Education Zone Advanced Treatment Techniques, Glasgow, www.cosmeceutcials.co.uk 8 Dr Bob Khanna Training Institute, Advanced Botulinum Toxin, www.drbobkhanna.com 9 Cosme Education Zone Idebenone Training, Birmingham, www.cosmeceutcials.co.uk

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

with confidence

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

ong duration of action (up to 5 months)1

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

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

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

2

New...

6 months, following one treatment session)

... aesthetic choice New...

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

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

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

Treatment interval should not be more frequent following injection).

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

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

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

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

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

Reporting andPtosis, Eyelid Lambert Syndrome or Amyotrophic lateral sclerosis.

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

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

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

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

Ascher B et al.

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

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

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

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

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

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

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

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

... aesthetic choice

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

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

Tel: +44 (0) 1923 208950

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